Detecting symptoms of Alzheimer's disease as early as possible can be critical to provide appropriate care and avoid potentially dangerous situations. And family and friends can play a vital role in recognizing and calling attention to these changes in behavior, especially for older adults who live alone.

While celebrating with loved ones this holiday season, Home Instead Senior Care encourages everyone to become more familiar with the symptoms of Alzheimer's, to be more aware so that critical warning signs are not overlooked.

Although many are aware that Alzheimer's disease affects a person's memory, there are several other lesser-known indicators that commonly go unnoticed such as notable changes in mood or personality, difficulty completing familiar tasks, trouble pronouncing words or writing, and increased anxiety.

Lakelyn Hogan, Home Instead Senior Care gerontologist and caregiver advocate, says, "People get wrapped up in the holidays and can miss important signs that a family member needs help - and doesn't even know it." She asks families to be mindful of the following signs that a loved one is struggling:

* Disruption of daily life. Is your loved one easily confused by changes to his or her routine? Are they beginning to forget everyday tasks, such as taking medication, feeding a pet or paying bills?

* Unusual behaviors. Have you noticed they seem unusually agitated or upset? Does it seem like his or her personality has shifted? Do they seem depressed or down?

* Disengaged with family. Is your loved one having a hard time remembering names of familiar family members? Does it look as if his or her mind is going blank during conversations? Are they having trouble keeping up with topics of discussion?

* Impairments in mobility and judgement. Do they seem afraid or unsure when using stairs? Do they hesitate before taking steps or going down ramps? A decline in cognitive ability can also affect the senses, impairing depth perception and hearing.

* Loss of words. Does it seem they are forgetting words for everyday objects, such as toothbrushes, spoons or cups? Are they slow to form sentences or respond to questions?

"It's important that we walk alongside our love ones in the aging process to ensure they are living safe and healthy lives," explains Hogan. "This holiday season, consider the signs that may indicate early-onset or developed Alzheimer's disease and talk to your senior relative or their caregiver about ways to accommodate their symptoms."

For additional tips and resources on spotting the signs of Alzheimer's, go to www.HelpforAlzheimersFamilies.com or, contact your local Home Instead Senior Care office or www.homeinstead.com.

On one hand, school choice recognizes that children are different by nature; they have varying personalities, strengths, and ways of learning. Children's natural differences are one reason we need a variety of schools. While a one-size-fits-all education can't meet the diverse needs of every single child, school choice can allow parents to look for the school best tailored to their child's unique needs.

School choice also recognizes that the learning environment itself can impact a child's success and happiness. Maybe, as an adult, you've felt the difference between a workplace environment that challenges, supports, and stimulates you, and one that drains you and stunts your growth. Kids spend nearly as much time at school as adults spend at a job, and that environment has a profound impact.

Some children are easily inspired by the sheer discovery involved in math, science, and reading. Others find the subjects lackluster on their own and aren't inspired until their life is touched by the example of a fantastic teacher or the uniqueness of a hands-on learning experience.

Every child is different. Moms and dads are experts on their children's needs, interests, and uniqueness - and moms and dads are best qualified to determine the learning environments that will inspire their daughters and sons.

Parents, it's not too soon to think about where your child will thrive in the 2020-2021 school year. If your school works well for your child, share that success with others this National School Choice Week (Jan 26-Feb 1). It might encourage a parent who is struggling to find the right fit for his or her child. If you're interested in switching schools, start researching your options right away at schoolchoiceweek.com.

The more we encourage diverse, innovative learning environments and support families in finding the best fit, the more our children will be inspired to succeed and be happy.

Andrew Campanella is president of National School Choice Week and the author of The School Choice Roadmap: 7 Steps to Finding the Right School for Your Child.

His view is supported by a National Intelligence Estimate, multiple Government Accountability Office (GAO) reports and testimony, and the recently released new Global Health Security Index by the Johns Hopkins Center for Health Security.

After more than a decade of study, Dr. Hatfill and his team have published a comprehensive book, "Three Seconds Until Midnight" which revisits the challenges of the 1918 pandemic and highlights the limitations of the current U.S. public health system while offering some possible solutions. With an introduction written by the famous virus-hunter C.J. Peters, MD, the book also delves into the causes and problems caused by the continuing emergence of new human infectious diseases previously unknown to science.

"The overwhelming majority of Americans assume that the CDC and public health authorities will rapidly detect a new outbreak of a lethal infectious disease and quickly respond with a vaccine, drugs, and other measures to contain the event. In reality, none of this is guaranteed," Dr. Hatfill emphasizes.

The latest Department of Health and Human Services (DHHS) documents show that in a 1918-type pandemic Influenza event, a minimum of 123 to 125 million Americans will not receive any anti-viral drugs or vaccine until after the peak period of infections and deaths. As these individuals watch some of their neighbors, co-workers, or family members become ill and some die around them, all there will be is government advice to frequently wash their hands, cough or sneeze into their sleeve, and if sick, to stay home from work.

In the book, Dr. Hatfill and his team point out how the U.S. has an insufficient public health workforce and lacks the "surge" medical capacity needed for a lethal pandemic situation and that no programs are currently in place to train volunteers on how to safely work in an infectious disease environment.

To decrease hospital overcrowding during a 1918-type pandemic, the DHHS will advise communities to set up Neighborhood Emergency Help Centers to triage which patients can be nursed at home. Yet most adults are uninformed on how to care for ill family members if they contract a contagious and possibly lethal infection, and entire households will become ill, Dr. Hatfill says. Historically, the poor, socially disadvantaged urban communities will have the highest infection, hospitalization, and death rates.

The major problems in pandemic preparedness occur with the local city authorities who are largely unprepared to manage an outbreak of a serious lethal infectious disease on a 1918-type scale. This includes developing methods to manage essential worker absenteeism, pre-planning alternate care sites, gross rapid expansion of mortuary capabilities and teaching non-pharmaceutical interventions to the public.

"There are worse viruses in nature than another 1918-type influenza strain. These viruses are simply waiting for the right conditions to adapt and jump species into man," says Dr. Hatfill. "We are the only large mammal to have ever achieved such a high-density global population level and we have no precedent to indicate if we are nearing a threshold or not." As a consequence, we are all participating in a huge on-going biological experiment."

His book outlines the urgent need for a universal flu vaccine and more effective antiviral drugs. It also describes a disaster train concept for improved military support to disadvantaged communities acting in a disaster response mode, similar to the role played by the Armed Forces after Hurricane Katrina in 2005.

"Three Seconds Until Midnight" is available for purchase online via Amazon or Kindle.

For more information, visit www.threesecondsuntilmidnight.com.

Identifying these so-called "social determinants of health" helps doctors determine the root causes of their patients' medical conditions and is critical to improving whole-person health. The Physicians Foundation found that nearly 90 percent of doctors have patients whose health is affected by these key factors.1

Below are some examples to illustrate how social factors can affect you and your health:

* Loneliness and social isolation. More than a quarter of the U.S. population live alone. Loneliness and social isolation are associated with increased mortality and poor health outcomes. Identifying individuals at risk for these factors allows doctors to recommend prevention and care strategies to improve their patients' health.

* Food insecurity. The U.S. Department of Agriculture defines food insecurity as a lack of consistent access to enough food for a healthy life. According to Feeding America, food insecurity exists in every state in the United States. Seniors face challenges that put them at risk of food insecurity, such as being on a fixed income and having to choose between buying food or medicine, or struggling to obtain food without reliable transportation.

* Transportation Barriers. A lack of transportation affects an individual's health and well-being - from accessing health care services and healthy food options to maintaining social connections. Lack of transportation is the leading cause of patient no-shows for medical appointments, and missed appointments are associated with increased medical care costs and increased emergency room visits.2

But many Medicare Advantage plans, provided by private health insurers such as Humana, offer their members health and wellness benefits, programs and services to help address social determinants, with rides to medical appointments, meal benefits, social interaction and screening for food insecurity.

Humana is working to address social determinants of health through its Bold Goal, by working with Humana care teams, physicians, nonprofit organizations, and business and government leaders to identify, screen and refer members to community resources and long-term support.

The Bold Goal is a population health strategy to help improve the health of the communities we serve by 20 percent by 2020 and beyond.

For more information, visit populationhealth.humana.com.

1 https://physiciansfoundation.org/wp-content/uploads/2018/09/physicians-survey-results-final-2018.pdf

2 http://www.aha.org/transportation  

Y0040_GHHKP2EEN_C

According to Fidelity Investments' 2020 New Year Financial Resolutions Study, 82 percent of respondents said they're in a similar or better financial position than last year. Perhaps surprisingly, most credited their success to their own good habits - saving more (47 percent) and budgeting (29 percent) - rather than their investment gains (18 percent) from a stock market that made one high after another. Less than 25 percent put it down to having been able to work more hours in a strong economy.

And, as the study makes clear, they want to keep the momentum going.

Of the 67 percent considering making a financial resolution, "saving more" and "paying down debt" topped the list, respectively, at 53 percent and 51 percent.

"Living a debt-free life was the biggest motivator for them," said Melissa Ridolfi, Fidelity's vice president of retirement and college products.

Heck, given the choice between the classic New Year's resolution of losing five pounds or socking away $5,000, a resounding 84 percent in the national survey of 3,012 adults opted for savings.

But you want to know some of the biggest and smallest mistakes or setbacks they fessed up to, right? See if you can relate to any of these:

* Dining out too much (36 percent).

* Spending too much on non-essentials like unused apps, streaming media services, and subscription retail boxes (29 percent).

* Taking on debt or adding to existing debt (28 percent).

*Splurging on something they couldn't really afford (28 percent).

* Unexpected medical expenses (24 percent).

* Failing to save as much for retirement as they should (18 percent).

So with all the interest in getting a grip on debt, who seems to be faring the best at it?

Boomers, the study found, with 29 percent crediting being better off financially at year's end to having refinanced, paid off, or reduced debts or loans. Generation X, the next oldest, trailed at 21 percent, followed by 19 percent of millennials, and just 6 percent of Generation Z.

"Boomers are getting the message that the closer they get to retirement, the more essential it becomes to get their debt under control to make the most out of retirement savings," Ridolfi said.

Certainly there's no law that says you have to make a New Year's resolution - financial or otherwise - but even a huge chunk of those surveyed who weren't contemplating explicitly doing so still said they were planning on, say, building up emergency funds. As for what you might call the "traditionalists" out there? Fidelity has some tried-and-true tips that can help ensure your financial vows don't wind up being among the 80 percent of all resolutions that U.S. News says, alas, fail by the second week of February.

The firm also has an impressive, free online "Moments" tool designed to help you plan for lifestyle changes or react to a myriad of curveballs - i.e., the unexpected medical expenses cited as a big setback in the study - that life throws at you. And accessing the Fidelity Retirement Score gives you a quick look at where you stand with your savings.

Oh, and here's one last thing to see if you can relate to: Seventy-eight percent of those surveyed predicted they'd be even better off financially in 2020.

* Are my doctors in network? Use online tools to confirm which doctors and hospitals are in a plan's network. A licensed health insurance agent can also help you see if a specific doctor or hospital is in a plan's network and taking new patients, and can determine what's in network if you're a seasonal resident.

* Are my prescription drugs covered? Although Original Medicare does not cover most prescription drugs, many Medicare Advantage plans include prescription drug coverage, or you can sign up for a Part D Prescription Drug Plan separately. A licensed sales agent can look up the medications you would like covered and help you estimate what the cost of each drug would be on a plan.

* What new, innovative benefits are available? Beyond vision, hearing and dental coverage, if you aim to become healthier, look for fitness program benefits as many Medicare Advantage plans offer a gym membership. If you travel or appreciate technology, virtual doctor visits are helpful when you can't see a doctor right away. Most Medicare Advantage plans now offer transportation to doctor appointments and the gym, when a fitness center membership is offered as a plan benefit.

* What if I'm still working? If you or your spouse have health insurance from an employer, you may be able to delay enrolling in Medicare until the employment or the coverage stops. At that point, you would be entitled to a special enrollment period of up to eight months to sign up for Medicare without incurring any late penalties. Talk with your employer to find out how your coverage works with Medicare.

While the clock is ticking until the Dec. 7 Medicare annual enrollment deadline, remember that you're not alone.

Take advantage of resources including licensed sales agents and websites such as medicare.gov and www.humana.com/medicare. You can also call 1-800-MEDICARE (1-800-633-4227) (or TTY: 1-877-486-2048) 24 hours a day, seven days a week, or call Humana at 1-800-213-5286 (TTY: 711) 8 a.m. to 8 p.m. local time seven days a week.

Y0040_GCHKND9EN_C