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Savvy Senior
Over-the-Counter Drug Safety
Aug 16, 2007, 11:38

Dear Savvy Senior,
Can you tell me about assisted living facilities and how to go about choosing one for my 83-year-old mother?
Need Assistance
Dear Need,
Assisted living facilities have become a popular option for elderly people who are no longer able to live independently but who don’t need nursing home care either. Here’s what you should know.
Assisted Living
Currently, there are more than 1 million residents living in around 36,000 assisted living facilities nationwide. While there’s no standard blueprint for how these facilities are constructed, the services they typically provide are 24-hour staffing, assistance with personal care (bathing, dressing, eating, going to the bathroom), meals, housekeeping, laundry, transportation, social activities and medication management. A growing number of facilities also offer special care units for residents with dementia.  
Finding Good Care
When it comes to choosing an assisted living facility, many people make uninformed and rushed decisions. After you determine your mother’s physical needs and financial resources, here are some steps that can help you find a good assisted living facility and avoid a bad one:
• Make a list: Contact your Area Agency on Aging for a list of assisted living facilities. Get a list of five or six facilities that are preferably close to family and friends who can visit often. The national Eldercare Locator (800-677-1116, or can direct you to your local agency.
• Call your local ombudsman: This is a government official who investigates long-term care facility complaints. Ask whether there have been complaints with the facilities on your list and how to obtain inspection reports, if there are any. To find your local ombudsman, call your area aging agency or see
•  Call the facilities: Once you have a list of facilities and checked them out with the ombudsman, give them a call. Find out if they are licensed by the state, if they provide the kind of services to meet your mother’s needs, what they charge and if they have any vacancies. Then, if you’re still interested, ask them to send you more information including brochures, pricing details, levels of care, resident’s rights, medication policies, discharge criteria and the contract or residential agreement. Once you receive the materials, read them carefully and write down any questions you have so you can remember to ask them when you go in for a visit.
• Tour your top choices: It’s wise to visit at least two or three facilities so you can adequately compare them. If possible, bring your mother along too. While you’re there, notice the cleanness and smell of the facility. Is it homey and inviting? Does the staff seem friendly and knowledgeable? Also be sure to taste the food, and check-out their monthly activity schedule to see what kinds of stimulation they’re providing.
• Evaluate the staff: Ask to meet the administrator. Find out about staff screening and training procedures and what the staff turnover rate is. Also ask how many residents each staff member has to care for (the smaller the number, the better).
• Talk to the residents: Ask how they like living there. Do they like the food, the staff, and the activities?
•Visit unannounced: An unannounced visit on a weekend or in the evening might be very helpful in making your decision.
 Savvy Tips: If you need help finding a good facility, call in a geriatric care manager (see These are professionals who can assess your mother’s needs and recommend some good facilities to meet them. The cost for an initial assessment is around $300 to $600. Another good resource is the Consumer Consortium on Assisted Living ( or 703-533-8121), which offers a consumers video and guide (for a small fee) on choosing a facility. Also see and
Most people pay for assisted living themselves, some with the help of long-term care insurance. Monthly costs can range from $1,750 to $6,000 or more, depending on where you live, the facility you choose and the services provided (the national average is nearly $3,000/month). Shared rooms, if available, cost less. Medicare does not cover assisted living. In some states however, Medicaid programs pay for some services for residents with low incomes, but the majority of facilities accept private pay only.  
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” books.

Dear Savvy Senior,
Is mixing over-the-counter medicine with prescription drugs dangerous? My 70- year-old husband is currently taking six different prescription medications and two over-the-counter drugs. I’m worried he’s taking too much medicine. Any suggestions?
Doped Up
Dear Doped
Most people, when they think about drug interactions or other problems concerning medicine, they think about prescription drugs. But each year, more than 500,000 Americans end up in hospitals because of unintentional over-the-counter (OTC) drug overdoses, or due to OTC remedies interacting with prescription medication. Here’s what you should know.  
OTC Dangers
Just because OTC medications are available without a doctor’s prescription doesn’t mean they’re safe for everyone. OTC medicines (drugs that can help with coughs, colds, aches, pains, fever, allergies, heartburn and many other ailments) are powerful drugs that offer real benefits when used correctly and real risks when misused. Those most vulnerable to these risks are seniors because they typically take more medication (OTC and prescription) than any other age group, and the fact is, the more drugs you take the greater your risk for potential problems.
OTC Safety Tips
With more than 100,000 OTC medicines on the market today you need to be very aware of what you’re taking, and as always talk to your doctor or pharmacist if you have questions or concerns. Here are some tips to help you avoid potential OTC and prescription medication problems:  
• Always read the “Drug Facts” label on the OTC product and follow directions. It tells you what the medicine is for, how and when (and when not) to take the medication, the product’s active and inactive ingredients, possible interactions, side effects, warnings and more.
• Choose OTC products that treat only the symptoms you have.
• Use extra caution when taking more than one OTC drug at a time. Many OTC medicines contain the same active ingredients, which means you may be getting more than the recommended dose without even knowing it. Always compare active ingredients on the label and never take more than one drug with the same active ingredient unless specifically instructed by your doctor.
• Don’t combine prescription medicines and OTC drugs without first talking to your doctor. Combining drugs can cause adverse reactions or one drug can interfere with the other drug’s effectiveness.
• If taking an OTC medicine becomes more than temporary, or if your symptoms don’t go away, talk to your doctor. Most OTC medicines are only intended for short-term use.
• Make a medicine chart (see of all the prescription and OTC medicines, vitamins and herbal supplements you take and share it with your doctor. Also make sure your doctor is aware of your health history, if you are being treated by another doctor for something else, and if you have any allergies or side effects from any particular medicines.
• Don’t use OTC medicines after their expiration date.
New Warning Labels
To help ensure safety and ingredient awareness, the Food and Drug Administration will soon be requiring bolder new warning labels on hundreds of OTC products that contain acetaminophen, aspirin and NSAIDs (non-steroidal anti-inflammatory drugs). Here’s what to look for in the coming months:
• Products containing acetaminophen: (Sold under the brand name Tylenol and in multiple generic versions too. Other products that contain acetaminophen are Excedrin, Dayquil, Nyquil, Alka-Seltzer Plus Cold & Sinus, Sudafed Sinus & Cold and many others.) The new warning labels will alert consumers of the risk of severe liver damage if taken in high doses or when consuming moderate amounts of alcohol. Labels will also warn patients not to take multiple medicines that contain acetaminophen.
• Products containing NSAIDs: (Aspirin; ibuprofen, which is sold as Advil and Motrin and in generic form; naproxen, best known as Aleve also sold generically; and ketoprofen.) New labels will warn of the risk of stomach bleeding in people over age 60, or in those who have stomach ulcers, take blood-thinning drugs or steroids, use other drugs that contain an NSAID or remain on the medications for an extended period.
 Savvy Tips: A great Web resource to check for drug interactions is – click on “Check Interactions.” And for more information on OTC/prescription drug safety, visit and
 Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” books.

Dear Savvy Senior
I recently read an article about the amazing health benefits of eating a high fiber diet. What can you tell me about this, how much fiber does one actually need to get, and which foods offer the best source of fiber?
All-Bran Betty
Dear Betty,
Fiber has always been an important part of a healthy diet, but lately, it’s been getting a lot more attention. Here’s what you should know.
Fabulous Fiber
Fiber does a lot more than just keep us regular. Research shows that it can also help lower your cholesterol, and reduce your risk of heart disease, diabetes, high blood pressure and gastrointestinal problems like constipation, hemorrhoids, diverticulitis and irritable bowel syndrome. Fiber can even help you keep your weight in check by making you feel full. New research, however, indicates that it does not protect against colorectal cancer or polyps.
Found only in plant foods (see for a list of high-fiber foods), fiber is the part of the plant that humans can’t digest. It’s either soluble (which helps you absorb nutrients from food and slows digestion) or insoluble (which helps food pass through the intestines). Most plant foods are a mix of both fibers. Animal products, such as meat, cheese and eggs, don’t contain fiber.
Bulk Up
Unfortunately, most Americans don’t get enough fiber in their diet. Current recommendations call for adults to get anywhere from 21 to 38 grams of fiber each day. Yet the average American eats only about half that amount. Here are some tips that can help you work more fiber into your diet:
·        Follow the pyramid: Use the U.S. Department of Agriculture’s food pyramid (see as your dietary guide. If you eat 2 to 4 servings of fruit, 3 to 5 servings of vegetables, and 6 to 11 servings of cereal and grain foods, as recommended, you should have no trouble getting 25 to 30 grams of fiber a day.
·        Read the labels: Almost all labels on food products will tell you the amount of dietary fiber in each serving. Foods claiming to be “high in” fiber must contain at least 5 grams of fiber per serving; and foods claiming to be a “good source” must have at least 2.5 grams per serving. Also check the labels to avoid foods high in saturated fats and sodium.
·        Eat cereal: Start the day with a whole-grain cereal that contains at least 5 grams of fiber per serving. Or eat oatmeal or other whole-grain hot cereal. If you want to make it a breakfast of champions, top it off with some wheat germ, oat bran, ground flax seed, nuts, raisins, yogurt, bananas or berries, all great sources of fiber.
·        Get whole: Buy 100 percent whole grain breads, cereals, crackers, tortillas, pastas as well as whole grain flour to bake with. Opt for brown rice instead of white rice. And try barley, buckwheat, bulgur, quinoa, wheat berries, and other whole grains.
·        Eat beans: Add more beans to your chili, soups and atop salads and pasta. Choose bean and lentil soups. And try hummus and bean dips instead of cheese or sour cream dips.
·        Stop peeling: Eat the skins of your potatoes, apples, pears and other fruits and vegetables. Also note that whole fruits contain much more fiber than fruit juices.
·        Snack smart: Popcorn, whole-grain pretzels and crackers are all good fiber snacks. Dried fruit, such as apricots and prunes, as well as fresh fruit and raw vegetables also provide a high fiber option.
·        Take a supplement: Fiber supplements are another way to get some additional fiber into your diet, but don’t substitute it for fiber rich foods. (Note: Some fiber supplements can interfere with prescription medications. Check with your doctor.)
Savvy Tips: When adding fiber to your diet, it’s best to do so gradually to allow your digestive system to adjust, and be sure to drink plenty of water too. Water helps your body process the added fiber you eat. Otherwise the extra fiber can make you constipated.
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” books.

Dear Savvy Senior,
What are the risk factors and symptoms of a stroke? My 74-year-old father had a stroke a few months ago and neither he nor mom had a clue what was happening. What can you tell us?
Caretaking Karen
Dear Karen,
Stroke is the third leading cause of death in the United States and the number 1 cause of disability, yet many Americans can’t name a single stroke symptom. Here’s what you should know.
What is a Stroke?
Every year, around 750,000 Americans suffer a stroke (see A stroke happens when a blood vessel that supplies blood to the brain is suddenly blocked by a clot (ischemic stroke), or burst (hemorrhagic stroke) causing brain damage. About 80 percent of strokes are ischemic. But the good news is that most strokes can be prevented by knowing and controlling the risk factors.
Stroke Factors
There are many factors (some you can’t change and some you can) that increase your risk for stroke. They include:
• Age: The risk of stroke doubles each decade after age 55.
·        Gender: Men are more likely to have a stroke, but women are more likely to die of one.
• Race: African Americans and Hispanics have a higher risk than those of other races.
• Family history: If your parents or siblings have ever suffered a stroke, you’re at twice the risk of having one too.
• Previous stroke: If you’ve already had a stroke or a mini-stroke, you have a 25-40 percent chance of having another stroke in the next five years.
• High blood pressure: Left untreated, high blood pressure (140/90 or higher) is a leading cause of stroke. Work with your doctor to keep your blood pressure under control.
• Smoking: If you smoke – quit. Smoking doubles the risk of stroke.
•  High cholesterol: High levels of cholesterol can clog arteries and cause a stroke or heart attack. High cholesterol can usually be controlled with diet, exercise and medication.
•  Diabetes: The risk of stroke doubles in people with diabetes. There are more than 5 million Americans with type 2 diabetes and don’t know it. Get tested!
• Atrial fibrillation: 3 to 5 percent of people over 65 have atrial fibrillation, a heart rhythm disorder that increases stroke risk. Find out from your doctor if you have it.
•  Obesity. Being overweight increases your chance of developing high blood pressure, atherosclerosis and diabetes – all of which increase stroke risk.
• Alcohol: While one or two drinks a day slightly reduces risk of stroke, excessive drinking (more than three drinks a day) increases risk.
If you’re over age 60 or have other risk factors, getting screened for vascular diseases is a smart way to help prevent a stroke. Here are some convenient services you should know about.
• Legs for Life: A public education national screening program that provides free vascular screenings (throughout September) at hundreds of hospitals and clinics across the country but require an appointment. See to find a screening site near you.
• Society for Vascular Surgery: Offers free screenings at around 150 sites nationwide. See or call 800-258-7188.
•  Life Line Screening: A private company that offers screening tests for $45 at 14,000 sites nationwide. Visit or call 800-697-9721.
Stroke Symptoms
Every minute counts when it comes to treating a stroke. Clot-dissolving drugs used to treat ischemic strokes can save lives and greatly reduce disability, if given within three hours after symptoms appear. If you’re having, or see someone else having symptoms of a stroke, call 911 immediately.

 Symptoms include:
•  Sudden numbness, weakness, or paralysis of the face, arm, or leg on one side of the body.
•  Sudden vision problems in one or both eyes, such as dimness, blurring, double vision, or loss of vision.
• Unexplained dizziness, loss of balance or trouble walking.
• Sudden confusion, trouble speaking or understanding.
•  Severe headache with no known cause, possibly accompanied by vomiting.
Savvy Notes: Mini-strokes (temporary blockage of blood flow to the brain) fool a lot of people because the symptoms (similar to a full-blown stroke) go away. But recognizing them and seeking medical help is crucial because mini-strokes are strong predictors of a more serious stroke to come. For more stroke information, visit
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” books.

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