House Becoming Unfriendly?

Why not remodel? Check out this article by Hermann Samano:

"All You Need to Know About Accessibility Remodeling

Inhabiting a home that works efficiently and effectively is an important part of living life to the fullest. For people with physical handicaps, disabilities, seniors, or the elderly, however, there can be challenges that make it hard to get around the house and complete everyday household tasks like cooking, grooming, and housekeeping. A popular remodeling trend is to retrofit a home to accommodate these challenges in order to live independently rather than moving into an institution like a nursing home or assisted living facility.

Accessible remodeling is the combination of home modifications and renovation that can help people who have physical, mental, or other types of specific needs.

Read the full article for a list of things to consider and questions to ask when accessibility needs to be taken into consideration for remodeling. Here’s the link: https://porch.com/advice/all-about-accessibility-remodeling-and-retrofits"

If you like this blog, please comment,

Robert Tell, Author

www.RobertTell.Com

Cognitive Rehab for Dementia?

 Something new? Something different? Something hopeful?

Maybe!!

Check out this recent article about Cognitive Rehabilitation in the New York Times: "Dementia May Never Improve, but Many Patients Still Can Learn "

According to this article, "Cognitive rehabilitation evolved from methods used to help people with brain injuries...The practice brings occupational and other therapists into the homes of dementia patients to learn which everyday activities they’re struggling with and which abilities they want to preserve or improve upon...The therapists show patients how to compensate for memory problems and to practice new techniques."

It's not a cure, but some practitioners claim it can improve daily function and life quality for patients and caregivers. My suggestion: read the article and see if it represents another option.

Robert Tell, Author
www.RobertTell.Com

How Important is Safe Exercise for Older Adults?

 June Brown is a researcher heading up a project to look at the future of senior accommodation and health across the country for a growing senior health site, which is part of the SeniorAdvisor national network of resources for older adults. While doing her research into the future of health for seniors, she noticed that lack of physical exercise is increasingly becoming a problem for many seniors in our nation. She prepared the following piece on the importance of physical exercise as we age.

"Avoid Brain Fog: Keep Minds Sharp with Physical Exercise as You Age

Physical activity helps keep your brain healthy, slowing down the effects of aging. We all know the benefits of exercise on the body including weight control, prevention of cardiovascular diseases and strengthening of muscles. What is also a remarkable benefit on top of these physiological changes are its effects on the brain. The brain, composed of neurons, is where all the actions happen. This is where all neural activity is stored that is responsible for thought processes, cognition, memory, perceptions, and sensations. Keeping it sharp and strong with physical exercise benefits us as we age.

The Effects of Exercise on the Brain 

Biological effects happen when you exercise. As you exert yourself, your heart rate increases to supply more blood and oxygen to your muscles. Your brain also receives a bigger supply of blood, oxygen, and nutrients for good health. The boost in supply assists in renewing brain cells which help in learning. Simple physical exercises improve memory and build neurons & connections. Physical activity triggers the release of several neurotransmitters such as endorphins dopamine, serotonin, GABA and glutamate. Some of these are known for their ability to improve mood and prevent depression. As a result, you often feel much better after physical activity.

Evidence Supporting the Link Between Exercise and Brain Health

A variety of tests and studies has been undertaken to study the effect of exercise on the brain. The University of Canberra studied the effects of structured physical exercise on the brain of adults for four weeks. After a variety of brain tests, researchers found evidence that aerobic exercise improved cognitive abilities such as thinking, learning, and reasoning. Furthermore, muscle training by carrying weights influences the brain’s memory and its executive functions (planning and organization).

The international collaboration between the University of Manchester and Western Sydney University found out that aerobic exercise can enhance memory function as we age. Researchers studied the effects of physical activity on the hippocampus, the area of the brain where memory and other functions such as spatial navigation and behavioral inhibition occur. The final results suggested that while exercise has no effect on the total hippocampus volume, it increased the left side significantly among humans. Brain size shrinks by 5% every 10 years after age 40. Exercise is viewed as a maintenance activity for brain health to slow down its deterioration due to aging.  

Being physically active not only promotes better biological functions but also improves brain health that can slow down the process of aging and prevent neurodegenerative disorders. If that is not reason enough to get cracking on the bike, consider how wonderful it is to age gracefully with your memory and cognitive abilities in good shape."

Time to get off the couch and go for a long walk. 

 Robert Tell, Author
www.RobertTell.Com

Do you exercise safely?

 You hear it all the time. Exercise, exercise, exercise. It's important for cardiac health, balance, strength maintenance, weight maintenance, and a variety of other health goals. And this advice applies to people of all ages, including folks over 60, although seniors who begin an exercise program should do it under a doctor's supervision, start slowly, and gradually increase.

But one thing I haven't seen before is advice regarding the safety of some exercises for older adults. So a recent article on the Silver Sneakers website was of special interest to me, and I think will be worth your time to review.

 Here's the link:   The 7 Worst Exercises for Older Adults

Happy push-ups!

 Robert Tell, Author
www.RobertTell.Com

When to move to a smaller home?

Into the lives of most older adults there comes a time when serious thought must be given to downsizing.

When that time comes, how does one decide where to live, what to keep and what to dump, what to do with the stuff being dumped (especially pricey and/or sentimental items), how to separate emotionally from beloved items accumulated over a lifetime, and how to ease the adjustment.

The other day, I found an excellent article addressing these issues on the Refin website. I sincerely recommend it to anyone contemplating such a transition. Here is the link:

 A Guide to Downsizing for Seniors and Their Loved Ones

Robert Tell, Author
www.RobertTell.Com

When Can You Buy Dementia Diary for Half-Price?

 IN JULY AT THE BIG SMASHWORDS SALE!

Make a note in your calendar. At one minute past midnight Pacific time on July 1, the special Smashwords Summer E-Book Promotion goes live. (That's 2 am Eastern Daylight Savings Time).  After 11:59 pm Pacific time on July 31, the sale ends.

My memoir, "Dementia Diary" is my best selling book at it's regular e-book price of $3.99. Now, ONLY for the month of July, and ONLY at Smashwords you can buy it for ONLY $2, a real 50% discount.  Here's the link: Dementia Diary Sale Page.

Caregivers everywhere give this book high marks for easing the burden of being a caregiver to a loved one with dementia, and for helping to relieve caregiver burnout. For over 15 years, I was my widowed Mom's caregiver as her mind and personality disappeared into the fog of dementia. My book tells the emotional reality of being a caregiver.

P.S. During this sale, my popular Harry Grouch Mystery Novels, my sci-fi, and my kids poetry books will also be available at Smashwords at discounts ranging from 75% to FREE.

Check this out by clicking here: Robert Tell's Smashwords Page.

AGAIN, DISCOUNT PRICES AVAILABLE ONLY DURING THE SMASHWORDS JULY SALE!

Happy Reading!

 Robert Tell, Author
www.RobertTell.Com

Is Your Mom/Dad/Spouse Ill—Or Just Being Difficult? (Encore)

(I've been asked by readers to post the following encore of an article I published here several years ago. I hope you find it to be helpful.)

I'm often asked about examples of challenging behaviors that I noticed in my mother—behaviors that helped me to finally realize she was sinking into dementia. The list below may help you to evaluate what is happening to your loved one.

For Mom, it started slowly with just a few of these behaviors attracting my attention. I just passed them off to normal aging. Gradually, it reached the tipping point where I could no longer ignore what was happening. There was an emergency a day.

I lived 1500 miles North of Mom, trying to run a business. Every day in the middle of some crisis at work came a phone call about some calamity in Florida. Sometimes from Mom, sometimes about Mom.

Up to 30% of my time was being consumed as a long distance caregiver and decision maker—often without the facts I needed to make correct, emotion free, objective decisions. Frequent air travel to check things out became another costly requirement. Here’s some of what I had to deal with:

• NUTRITION: She was not eating well. Things in her refrigerator were scary: ie: partly eaten fruits and cheeses with lots of mold.
• CLEANLINESS: Her house was dirty (she had been a meticulous housekeeper).
• HOUSEHOLD ORGANIZATION: There was clutter everywhere. This was not my mother!
• FIRE SAFETY: She was storing plastic bags in the oven. Then, forgetting, she was turning the oven on.
• REALITY ISSUES: Hallucinations about mice were occurring with increasing frequency.
• HEALTH ISSUES: Many health issues were threatening her well-being. Hospitalizations for pneumonia, arthritis, etc., were becoming more frequent.
• DRUG COMPLIANCE: She was non-compliant with medications with the result that her blood pressure was out of control and other health conditions were not receiving prescribed therapy.
• MEDICAL CARE: She changed doctors (and HMO's) several times each year. Continuity of care suffered and I could not build a useful relationship with her physicians.
• INTERPERSONAL RELATIONSHIPS: She was isolating herself—alienating friends and family with harsh, judgmental personality changes.
• FALLING: She fell in her room, sustained a serious head injury and no one found her for 2 days
• FINANCIAL MANAGEMENT: She was messing up her finances and making other poor judgments.
• HOUSING: She became a housing hopper: In a 2 year period she went from her Florida house to a Florida condo to a furnished condo in Michigan back to her Florida condo to senior apartment to assisted living in Florida back to assisted living in Michigan. She had trouble settling in anywhere.
• DRIVING: Her driving became a daily nightmare with multiple fender benders and traffic violations.

Sound familiar? Are any or all of these things happening to your mom, dad, spouse or significant other? I hope not, but if they are, it may be time to seek a professional geriatric evaluation.

Robert Tell
Author, "Dementia-Diary, A Caregiver's Journal"
http://www.RobertTell.com

Driving and Dementia—When to Stop!

 As you know, one of the most difficult moments in the life of a caregiver dealing with Alzheimer's Disease (or another dementia) in a loved one, is the famous struggle over the car keys.

I went through this in tragi-comic terms as described in my popular book, Dementia Diary, A Caregiver's Journal. 

There is a better way.  Click the blog, "Dementia Today". It lays out a plan that I would have found helpful at the time. I recommend it to you. It lists the following warning signs of dangerous driving:

• Difficulty navigating to familiar places
• Inappropriate lane changing
• Confusing the brake and gas pedals
• Failing to observe traffic signals
• Making slow or poor decisions
• Hitting the curb while driving
• Driving at an inappropriate speed (often too slow)
• Becoming angry or confused while driving

But it goes further and describes various ways for a caregiver to handle the situation. Take a look.

Robert Tell, Author
Great Books—Thriller Books—Mystery Stories

Advice for Caregivers: Dementia Behavior Problems

I recently discovered the Senior Living Blog and its important advice for dealing with dementia behavior. Here are the major topics it covers:

1. Aggressive Speech or Action
2. Confusion About Time or Place
3. Poor Judgment or Cognitive Problems

I experienced all of these issues when caring for my Mom as described with compassion and humor in my popular book, Dementia Diary, A Caregiver's Journal.

If you are dealing with any or all of the above, I recommend clicking on the Senior Living Blog for a helpful discussion of the do's and don'ts of dementia caeegiving.

Robert Tell, Author
www.roberttell.com

Will Self-Driving Cars Enable Seniors to Keep Driving?

This is my latest update on this important question for senior mobility. Auto industry technology is developing at a much faster rate than anyone might have predicted. It gets closer to self-driving capability with every passing month.

So, I no longer drive the Acura TLX that I raved about in 2015 and I deleted my article about it from that time. Although I did enjoy leasing it, it is no longer unique. Car manufacturer after car manufacturer has added amazing technology to many models, with the number increasing all the time. Just as examples, I can think of Subaru, Genesis, Mercedes, etc., etc.

So my new automobile love is the Touring trim of a 2017 Subaru Outback which does everything the TLX did and then some. But there are many new choices today for someone interested in a vehicle with this kind of technology.

The best thing to do is to consult the Insurance Institute for Highway Safety Ratings Page to look up the car and model you are shopping. And watch the news. I truly believe that totally self driving vehicles are coming soon.

Maybe, just maybe, the day will come when the dreaded conversation about the car keys will no longer be necessary.


Robert Tell, Author
www.roberttell.com

Memory Loss - A few Key Things to Remember (a repeat)

 Just a few tips for the alert caregiver to consider when observing memory loss in a loved one. This is a repeat of a 2008 post. It was very popular and it stimulated much activity on this blog:

* Be alert - document signs of memory loss and circumstances

* Notice if the memory loss is affecting activities of daily living such as planning, organizing and making decisions about every day functions.

* If there is a memory decline/loss be sure to be evaluated by physician

* Keep record of all medications including prescriptions, over the counter, herbs, and vitamins

* Understand the difference between delirium and dementia

* Learn to identify and manage stressful situations

These tips were provided by Jean Bandos, MSN, RN, GCNS-BC Research Director at "My Health Care Manager," a national company that helps seniors and their families manage the complexities of older adult life.

Robert Tell, Author
Dementia Diary, A Caregiver's Journal

What is ElderAction?

 I recently discovered ElderAction and think you should know about it. Jim and Caroline James, the founders, are on a mission of great importance for seniors.

Here's what they say on their website:

"We’re Jim & Caroline and we’re based out of Raleigh, NC. About five years ago, we had to return to our hometown to care for our ailing parents. Little did we know how much we’d learn about the modern senior condition.  Since that first year of our return, we’ve been doing our best to fight for senior mental health and support. We hope you’ll join us in this!"

This looks to me like a significant effort on behalf of our elders. At the moment, ElderAction's focus is on identifying useful resources for highlighting the many issues of aging and eldercare. Check it out, but stay tuned for more. I suspect there will be lots of great information and advice coming from this new source.

Robert Tell, Author

DementiaDiary (A Caregiver's Journal)

What is "Love For The Elderly.org?"

This post is about a 16-year-old teenager named Jacob with a big heart and a great idea to help lonely nursing home residents and other seniors. Let him tell you about it: 

"While volunteering at my local nursing home, I saw many seniors experiencing loneliness and isolation. It was heartbreaking. I needed to change this, so I started to write anonymous letters of kindness. They were so well received that I decided to create website and social media platforms to get the word out about my cause.

"Now, three years later, the global nonprofit I created has impacted tens of thousands of seniors and has inspired people from over 50 countries and 6 continents. I expanded its website, Love for the Elderly.org, beyond anonymous letters to include a Senior Buddy pen-pal program, a Social Impact program, and more! Our newest program, SunshineBox, will launch this August to distribute gift boxes. These will be filled with fun things, like smiley face stress balls, neon yellow sunglasses, and similar items to put smiles on the recipients' faces!

"Our goal is to spread love to a group of people who are so deserving and precious in their final stage of life. If you'd like to help us to bring sunshine into their lives, visit youcaring.com/elderly  this August. Make a difference!"

If the next generation of kids has Jacob's compassion, initiative and caring spirit, we can feel good about the future of our Country. Don't you agree?

Robert Tell, Author

DementiaDiary (A Caregiver's Journal)

What is Lou Gehrig's (ALS) Disease?

Last year, a colleague and good friend succumbed to ALS* (AKA Lou Gehrig's Disease) after a long, courageous battle. He wasn't the first person I've known to have this terrible disease, and I often wondered what these people were feeling and thinking when first diagnosed, and during each stage of the downhill progression of the illness.

Recently, I came across a blog that tells the story of the journey with eloquence and compassion. Called Ray's Little Ride, Ray Spooner, a nurse midwife, entitles his story as a "Journey."

After diagnosis, Ray biked more than 3000 miles across the USA in a successful campaign to fund raise for ALS* research. The blog post referred to above was written in the later stages of the disease and, with a nurse's clinical perspective, shares with the reader his innermost thoughts and feelings. 

It is a journey of courage and bravery and I recommend the blog to my readers.

Robert Tell, Author

Dementia Diary, A Caregiver's Journal

*According to the ALS Association, "ALS (Amyotrophic lateral sclerosis) is a neurodegenerative disease. This fatal disease affects the nerve cells (motor neurons) that control a person’s muscles. As the disease causes these motor neurons to deteriorate, the brain loses the ability to start and control voluntary muscle movement. This is why people with ALS often lose the ability to speak. The disease slowly paralyzes its victims eventually taking away the ability to breathe."

What About The Latest News in Alzheimer's Research?

Is Tau really a more likely cause of cognitive decline in Alzheimer's than Amyloid Beta? Possibly, according to a May 20th article in the CAA Forum, and I quote:

"Scientists using a new PET imaging agent found that measures of tau protein in the brain more closely track cognitive decline due to Alzheimer’s disease compared with long-studied measures of amyloid beta. Scanning multiple individuals the researchers at the Washington University School of Medicine showed that the intensity of tau deposits correlated with the severity of cognitive dysfunction."

The Forum is sponsored by the International CAA Association (CAA standing for Cerebral Amyloid Angiopathy), an organization of medical researchers concerned with cognitive malfunction. For the complete article, please click on this title: "Tau is better marker of progression to Alzheimer’s disease than amyloid beta."

One baby step after another, Alzheimer's Disease gives up its secrets and brings us closer to the elusive cure.

Robert Tell, Author

Dementia Diary, A Caregiver's Journal

Something New? "Great Books—Thriller Books—Mystery Stories"

Guess what? I've started another blog. To see it, please click on the following link: Author's Blog.

This new blog is just one part of my beautiful new website which features all 8 of my books, and my poetry.  Click on the main page: Great Books—Thriller Books—Mystery Stories. I think you'll enjoy surfing around on it. The visuals are stunning.

I've also published much more detail there about "Dementia Diary, A Caregiver's Journal." To view these pages, click on one of the following links: 1. The Book, and/or 2. The Letter.

By the way, I will continue to support this, my original blog, "The Caregiver Chronicles," for as long as there continues to be such a high level of interest in it. It has become very popular.

Thank you all for making it so.

Best wishes,
Robert Tell

What's the Future of Nursing in an Aging America?

The changing demgraphics of America's aging population presents many challenges for the nursing profession. I'm indebted to Deyanara Riddix, content coordinator of Nursingschoolhub.com, for the following information. 

"For every senior over the age of 65 in the year 2000, there will be 2 by the year 2030. Today that is 1 out of every 7 people is over 65. By the year 2022, 32 percent of our workforce will be comprised of seniors over 65. The average american will live 19 or more years past their 65th birthday. 

"The 85 and older population is predicted to triple to 14.6 million by 2040. Most of the seniors’ medical needs will become the responsibility of nurses. Currently there are just more than 1.5 million Nursing Assistants, 738 thousand Licensed Practical Nurses, 2.7 million Registered Nurses, and 151 thousand Nursing Practitioners, anesthetists, and midwives with an 11% growth expected by 2022. 

"The average age of nurses is now 50 years old. From 1982 to 2008, the percentage of nurses under the age of 40 dropped from 54 percent to 29.5 percent. Aging America needs more educated nurses who are versed in some of the more technical areas, such as biometrics, robotics, and electronic records."

For a comprehensive infographic illustrating the above data, please see the following website:  Nursing School Hub

Have You Read My Interview on Smashwords?

I'm excited!

A revised interview with me has just been published at Smashwords. It's an in-depth Q&A interview. If you get a chance, click: Interview With Author Robert Tell.

I would welcome your comments on this blog, and your suggestions for additional questions you'd like to see answered in the interview. I promise to answer them.

Best wishes,
Robert Tell

Should the Drug Zofran Be Avoided During Pregnancy?

A provocative question and one for which this writer has no expertise to share with you. However,  Krystal Blake, of the Birth Injury Guide has studied the matter and has prepared the following guest article for today's post. As always with such matters, each person is cautioned to gather all the available facts and to make an informed decision that makes sense to her and her doctor.

Here's the article:

"What are the Potential Side Effects of Zofran? 

Zofran, also known as Ondansetron, is a prescription medication that is 
manufactured by the pharmaceutical company GlaxoSmithKline (GSK). Zofran1 
was originally developed to help mitigate the effects of chemotherapy and 
radiation that cancer patients often suffer from. This drug can effectively block 
the actions of the body that trigger nausea and vomiting. In addition to being 
used to treat nausea in cancer patients, it was also used and prescribed to treat 
nausea in patients post-operatively. 

Since its development, however, Zofran has also been used “off-label” to treat 
women for morning sickness. Typically prescribed during a pregnant woman’s 
first trimester, it has been given to millions of women across the country for 
years. 

What Does “Off-Label” Mean? 

The term off-label drug use2 has several meanings. It may involve prescribing a 
currently available and marketed drug for a symptom or disease that the Federal 
Drug Administration (FDA) has not approved, or it may involve prescribing a 
marketed medication to a patient population, dosage, or dosage form (e.g., 
intravenously, orally, topically, etc.) that does not have FDA approval. 
Zofran has been prescribed off-label to a patient population that the FDA has not 
approved use for as there are not sufficient studies or tests that have been 
conducted in the respective population to show that it is safe for this particular 
use.

How Does Zofran (Ondansetron) Work? 

Zofran, a powerful anti-nausea and vomiting drug, belongs to a class known as 
the 5-hydroxytryptamine receptor 3 antagonists that block the effects of 
serotonin.3 More commonly referred to as 5-HT3 antagonists or setrons, this class 
of drugs acts as receptor antagonists at a subtype of serotonin receptor found in 
the vagus nerve and other areas of the brain. These receptor antagonists are 
extremely effective in treating nausea and vomiting in patients undergoing 
chemotherapy, radiation, or post-operatively to help with the side effects of 
anesthesia.

Drugs used for chemotherapy often create serotonin in the gut which causes 
nausea and vomiting. With the help of these serotonin antagonists, the body is 
able suppress nausea and vomiting by preventing serotonin from activating and 
sensitizing the gut.4 

The FDA and Zofran

Zofran first entered the U.S. market in 1991 and it was FDA approved for the 
uses previously mentioned. In 2011, the FDA administered a warning about the 
drug indicating that there had been links between Zofran use and QT interval 
prolongation, or effects on the electrical activity of the heart.5 Shortly after, there 
were also warnings regarding the increased risk of birth defects developing in 
children whose mothers had taken Zofran during pregnancy. Among the most 
universally known birth defects associated with the drug are cleft lip and cleft 
palate, in addition to heart defects, including Atrial Septal Defect (ASD).6

There have been a number of studies regarding the drug’s potential effect on 
pregnant women, but additional studies are warranted. The CDC has issued a 
warning of the possible connection between Zofran use and birth defects, and 
the FDA has continued to condone prescribing drugs off-label. However, many 
people believe that more studies are needed in order to obtain a clear answer on 
the risks associated with taking the drug during pregnancy.7"

For further information check out their link at: 

http://www.birthinjuryguide.org/birth-injury/causes/medication/zofran/

Footnotes:
1 http://www.drugs.com/zofran.html
2 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3538391/
3 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3470505/

4  Kamm MA (March 2002). "Review article: the complexity of drug development for irritable bowel syndrome". Alimentary Pharmacology & Therapeutics 

5 http://www.fda.gov/Drugs/DrugSafety/ucm310190.htm

6 http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/AboutCongenitalHeartDefects/Atrial-Septal-Defect-ASD_UCM_307021_Article.jsp

7 http://www.birthinjuryguide.org/birth-injury/causes/medication/zofran/zofran-research-shows-birth-defect-links/

Enjoying A Senior Lifestyle

From childhood to your senior years, you'll transition through numerous lifestyles. When it's time to enjoy a senior living lifestyle, you'll be able to apply many of the life lessons you've learned along the way to the adventures that await. Over the years, you may have compiled a mental list of things you want to do now that you have the extra time and new-found freedom. If you've been too busy to give much thought to how you want to enjoy your retirement years, you can get some amazing ideas and inspiration from sources such as Retirement Living Magazine and friends who are already actively enjoying their retirement years.

Local Activities

When your schedule was full with work and family obligations, you might not have had the time to participate in nearby activities and local places of interest. Now that you're retired, do some exploring around your area to discover interesting attractions.

Get reacquainted with your home

Your retirement lifestyle can make leisurely mornings a reality rather than a dream. An afternoon outdoors with a good book and a cold drink is an activity you can enjoy now. There's an abundance of great movies just waiting for you to watch. Invite some friends over for a marathon movie night. Without a work schedule, you don't have to be concerned with getting to bed on time so you can be alert for work the nest day.

Travel

In addition to exploring activities near your home, you may want to travel to distant destinations that you've dreamed of visiting. If you're undecided about where to go, take some time to read about the many travel packages and destinations designed especially for seniors. Look at the variety of travel modes you have available to you. Don't be afraid to step out of your comfort zone by taking a cruise, experiencing RV travel or flying to your destination. If you're uncomfortable traveling alone, you can arrange a trip with a tour group.

There's a lot to look forward to in your retirement years. This is a great time to get reacquainted with old friends and make new friends. Finding a balance between a relaxed lifestyle that includes lazy days and no definite schedule to abide by and the freedom to explore new places and experience new adventures is the key to happy, fulfilling and rewarding retirement years.