November 26, 2014

‘Mild’ control of systolic blood pressure in older adults is adequate

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150 is good enough
By David Stauth
A broad review of the use of medications to reduce blood pressure says that “mild” control of systolic pressure is adequate for adults age 65 or older—in the elderly, there’s no clear benefit to more aggressive use of medications to achieve a lower pressure.
Historically, most medical practitioners tried to achieve control of systolic pressure—the higher of the two blood pressure readings—to 140 or less. Recently changed guidelines now say that for adults over 60, keeping the systolic pressure at 150 or less is adequate.
However, researchers also say in the report that more work needs to be done studying blood pressure in older populations, since most of the research, and the medical guidelines based on them, were done using predominately younger adults.
Scientists from the College of Pharmacy at Oregon State University and Oregon Health & Science University published the review in the professional journal Drugs & Aging.
“The goal of a systolic pressure at or below 140 has been around a long time, and there’s still skepticism among some practitioners about accepting a higher blood pressure,” said Leah Goeres, an OSU postdoctoral fellow and lead author on the publication.
“Keeping systolic blood pressure in older adults below 150 is important, it’s what we consider a mild level of control,” Goeres said. “But for older people, that level is also good enough. After an extensive review, there was no significant evidence that more intensive management is necessary.”
Researchers say the issue of how low is low enough is important because blood pressure medications can have unwanted side effects that increase as higher dosages of medications are used. The problem is common—in the U.S, about 70 percent of adults age 65 or older have hypertension and millions of people take medication to control it.
One of the more significant side effects is what’s called “orthostatic hypotension,” a condition in which a person’s blood pressure can suddenly fall when they rise or stand, making them feel light-headed or dizzy and sometimes leading to dangerous falls. More than 30 percent of people over the age of 80 have this problem.
High blood pressure is a serious health concern, but also one of the most treatable with medication, if such things as diet, exercise, weight management or lifestyle change prove inadequate. Hypertension is often called the “silent killer” because it causes few obvious symptoms, but it weakens blood vessels and has been linked to higher levels of heart attacks, kidney disease and especially stroke.
“There’s clearly a value to controlling blood pressure, enough to keep it at 150 or less,” said David Lee, an OSU assistant professor of pharmacy practice. “Keeping blood pressure within acceptable levels will lower death rates. But as people get older, there’s less clear evidence that stringent control of systolic blood pressure is as important.”
The researchers said a goal for the future should be to do more studies specifically with older adult populations and try to identify health situations and conditions that might benefit from different types of management. Such “individualized” treatments, they said, would consider a person’s entire health situation instead of treating them based on findings made with large groups.

Free and low-cost legal services that help seniors in need

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Savvy Senior
By Jim Miller

Dear Savvy Senior,
Where can seniors turn to for free or low-cost legal help? My husband and I need some professional legal assistance but don’t have a lot of money to pay a high priced lawyer. What can you tell us?
—Seniors in Need

Dear Seniors,
There are actually a number of free and low-cost legal resources available today to help seniors, but what’s available to you and your husband will depend on where you live, the type of legal assistance you need and your financial situation. Here are several resources to check into.
Legal Aid: Directed by the Legal Services Corporation, legal aid offers free legal assistance to low-income people of all ages. Each community program will differ slightly in the services they offer and income qualifications. See lsc.gov/find-legal-aid to locate a program in your area.
Pro Bono programs: Usually sponsored by state or local bar associations, these programs help low-income people find volunteer lawyers who are willing to handle their cases for free. You can look for a pro bono program through the American Bar Association at findlegalhelp.org, or through lawhelp.org.
Senior Legal Hotlines: There are a number of states that offer senior legal hotlines, where all seniors over age 60 have access to free legal advice over the telephone. In Vermont, call (800) 889-2047 or visit www.lawlinevt.org.
Senior Legal Services: Coordinated by the Administration on Aging, this service may offer free or low-cost legal advice, legal assistance or access to legal representation to people over the age of 60. Your Area Agency on Aging can tell you what’s available in your community. Call the Eldercare Locator at 800-677-1116 to get your local number.
National Disability Rights Network: This is a nonprofit membership organization that provides legal assistance to people with disabilities through their Protection and Advocacy System and Client Assistance Program. If you or your husband is disabled, visit ndrn.org to find help in your state.
Other Options
If you can’t get help from one of these programs, or find that you aren’t eligible, another option is to contact your state or local bar association, which may be able to refer you to a low-fee lawyer. Or, you may want to consider hiring a lawyer for only part of the legal work and doing other parts yourself. This is known as unbundled legal services.
Many bar associations offer public service-oriented lawyer referral services that will interview clients and help identify the problems a lawyer could help them with. If a lawyer can help with your problem, the service will provide you with a referral to a lawyer. If the problem does not require a lawyer, the service will provide information on other organizations in your community that may be able to help. Most of these lawyer referral services conduct their interviews and make referrals over the phone.
To contact your state or local bar association, go to americanbar.org and type in “state and local bar associations” in the search field to find their state-by-state directory.
And finally, if you are an AARP member, one other discount resource that may be able to help you is AARP’s Legal Services Network from Allstate. This service provides members a free legal consultation (up to 45 minutes) with an attorney along with 20 percent discounts on other legal services you may need. To locate a lawyer near you, call 866-330-0753.

Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

HANDS reaches out to older adults on Christmas

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Observer staff report
The free 10th Annual Holiday Dinner for Seniors will be held on Christmas Day from noon to 3 p.m. at the Elks Lodge at 925 North Ave. in Burlington.
In collaboration with the Burlington School Food Project, CVAA, Temple Sinai and the Elks Lodge, HANDS (Helping and Nurturing Diverse Seniors) will provide both a delivered meal and a sit-down dinner again this year on Christmas Day.
“We’re happy to be combining our efforts with the Elks Lodge again this year so we’ll have the sit-down buffet dinner there,” said HANDS Director Megan Humphrey. “We also know that some people would rather have a meal delivered to their home and we’ll provide that, too,” she said.
Last year, 300 meals and gift bags were delivered or served.
To reserve the free meal delivered to your home (either ham or vegetarian lasagna), call CVAA at 865-0360 by Dec. 18. After Dec. 18 or to reserve free transportation to the Elks Lodge, call Megan Humphrey at 864-7528 or email [email protected]
“We just couldn’t do this without the help of hundreds of people and many organizations,” said Humphrey.

For more information or to donate, visit www.handsvt.org.

Start the holidays in the giving spirit

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Observer staff report

Holiday deals have started popping up all over Williston—and so have opportunities to give to less fortunate neighbors.
◆ Dozens of red collection barrels for Toys for Kids of Vermont are stationed around Williston and Chittenden County. A volunteer program sponsored by the Vermont Marine Corps League, Toys for Kids of Vermont collects new, unwrapped toys during the Christmas season and oversees their distribution to needy children in Vermont. All money collected stays in Vermont and is used to purchase age-appropriate toys to supplement donations, and gift cards for older children. Monetary donations can be sent to Toys for Kids, PO Box 4092, Burlington, VT 05406.
The program is intended to make sure no Vermont child wakes up on Christmas morning without a gift. See the sidebar for a list of donation sites. For more information and a full list of barrel drop off spots, visit toysforkidsvt.com.
◆ Home Instead Senior Care’s Be a Santa to a Senior program partners with local non-profit and community organizations to identify seniors who might not otherwise receive gifts this holiday season. Each senior’s gift requests is written on a Be a Santa to a Senior tree ornament.
“It is heartbreaking to think of the senior members of our community spending the holidays all by themselves, without any gifts or any way to celebrate the season,” said Patrice Thabault, owner of the Home Instead Senior Care office serving Chittenden and surrounding counties. “But all too often, that’s what happens when seniors live alone. It can be a really tough time of year for them.”
Participating retail locations will display Be a Santa to a Senior Christmas trees that feature ornaments with seniors’ first names and their gift requests. Holiday shoppers can pick ornaments from the trees, buy the items listed and return them unwrapped (and with the ornament attached) to the store.
Be a Santa to a Senior trees will be at several locations including Kinney Drugs, Big Lots in Essex, PT360 in Williston and Shelburne, CVAA in Essex, Peoples United in Burlington and more.
◆ ANEW Place provides gifts for homeless adults including bus passes, new clothing, gift cards to local stores or restaurants or monetary donations so that staff can purchase gifts. Contact Valerie Brosseau at 862-9879 or email [email protected]
◆ Champlain College Single  Parents Program allows residents to sponsor a single parent student and her family by providing gifts for mom and the children.  A wish list will be provided. Contact Bernadette Wagner at 860-2724 or email [email protected]
◆ Residents can also “adopt” a child or children through Women Helping Battered Women, providing gifts on a wish list and wrapping paper and ribbon (so mothers can be involved in wrapping gifts for their children). An organization or business can sponsor a full family. Contact Ikey Spear at 658-3131, Ext. 2011.
◆ The Howard Center provides an opportunity for locals to sponsor an adult, children or family and provide gifts such as books, toys, games, warm clothing, food or gift certificates. Monetary donations will be used to buy gifts. Contact Cheryl Couture at 488-6904 or email [email protected]
◆ LUND also collects gifts and practical items—such as diapers, gift cards, shampoo, new towels, books and warm clothes—for women and children. Contact Amy Cronin at 448-3617 or email [email protected]

Energy Co-op of Vermont launches heat pump leasing program

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Observer staff report
The Energy Co-op of Vermont recently announced the launch of Co-op Heat Pumps, a new heat pump leasing program. The Co-op Heat Pump program offers homeowners a super-efficient Fujitsu heat pump for less than $40 a month on a 10-year lease, with an upfront payment of less than $300.
“Our core mission at the Energy Co-op is to help Vermonters make their homes comfortable, healthy and energy-efficient.” said John Quinney, General Manager. “The Co-op Heat Pump lease program does just that by providing immediate cost savings while reducing fossil fuel use by up to 80 percent. It’s a win-win.”
According to Efficiency Vermont, Vermonters who install a heat pump can save between $800 and $1,200 a year.
The Co-op provides a turn-key application and installation service, beginning with a sign-up form on the Co-op Heat Pumps website, www.co-opheatpumps.net. Completing the sign-up form triggers a short survey that makes it easy for potential customers to determine if their home is suitable for a heat pump. Homes with open floor plans that are heated with oil or propane are best suited for the Co-op Heat Pumps program.

New Williston Smaller Footprint group forms

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Improving one’s carbon footprint and becoming more resilient to extreme weather events
Observer staff report
Sustainable Williston’s new Smaller Footprint group offers a way for residents to make big improvements in their individual, family or small business carbon footprint and become more resilient to extreme weather events by working with other community members in a friendly, laid-back environment.
Nobody can make every desirable change at once, so Smaller Footprint is geared to providing information, support, cameraderie and problem-solving to help each member focus on one major new impact at a time while finding strategies that are cash-positive, free or affordable and that handle time limitations and other common obstacles.
Sustainable Williston member Luc Reid will lead Smaller Footprint meetings and provide specific, actionable information about once every two weeks. The first meeting was held Nov. 20.
Smaller Footprint is free, and no preparation or previous steps are required to get started. There’s no need to attend all the meetings to be involved. Reid encouraged anyone working on their carbon footprint or those who have specialized knowledge or experience about alternative energy, resilience or other related topics to come share their ideas.

For more information, contact Reid at [email protected] or 355-0635.

Local shops get ready for Small Business Saturday

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By Stephanie Choate
Observer staff
With many Black Friday deals already underway, business groups and Williston stores are encouraging people to spend some time shopping locally on Small Business Saturday.
“When you shop local and shop small, you’re supporting your friends and neighbors,” said Shawn Souldice, state director of the National Federation of Independent Business’s Vermont Chapter. “You’re supporting your community, keeping most of that money right on Main Street.”
“Falling between Black Friday and Cyber Monday, on November 29, Small Business Saturday can be a fun part of your holiday weekend,” according to a Better Business Bureau press release. “By staying local, you’ll support the small businesses that helped create the identity of your community. This annual event is a great way to show your support for these local shops.”
Residents can also snag deals on Saturday, while avoiding the crush of big stores.
Amanda Cashin of Lenny’s Shoe & Apparel said the store is offering 20 percent off clothing and 10 percent off footwear on Friday and Saturday.
“We’ve been, for 24 years now, family run and family owned,” she said. “We really see the benefits of supporting our local community instead of just going on the Internet to shop, keeping our dollars local within Vermont.”
Local businesses often work to give back to their communities as well. For instance, Lenny’s is hosting a winter coat drive, accepting donations of gently used winter coats for United Way. When you bring in a donation, you get 20 percent off a new adult coat.
Ginger Morton, who owns Bead Crazy in Taft Corners, is offering 25 percent off storewide on Black Friday and Small Business Saturday.
“I have seen huge competition and a huge reduction in sales from the two box stores that have come in and the Internet,” Morton said.
Morton said residents who want to support local people and who want personal service should shop local on Saturday.
“If they don’t, there will be no small businesses,” she said.
The Paper Peddler owner Kathie Cooke is offering special deals on travel totes, Wind and Fire expandable bracelets and Camellia beads.
“(Shopping locally) helps support our local economy; more of our tax dollars stay local,” Cooke wrote in an email to the Observer. “We offer better, more personable service and, as a locally owned and operated business, we respect, value and appreciate all our customers who shop at our store.”
American Express launched Small Business Saturday in 2010. Shoppers got into the local spirit last year, spending $5.7 billion at locally owned shops and restaurants nationwide, according to a survey conducted by the National Federation of Independent Business and American Express. Last year’s spending marked a 3.6 percent increase over 2012’s event. This year, the National Retail Federation forecasts that holiday sales will increase by more than 4 percent.

Marauding insects headed for Williston

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Experts expect the emerald ash borer to arrive in Vermont in the next several years, devastating the state’s ash trees.

Experts expect the emerald ash borer to arrive in Vermont in the next several years, devastating the state’s ash trees.

Emerald ash borer could kill half of street trees
By Greg Elias
Observer correspondent
Aliens are coming to Williston.
Metallic-green beetles will arrive from out of state, perhaps on a truck full of firewood. They will find home in the town’s many ash trees, munching leaves and mating. Females will lay eggs in the bark.
When larvae hatch, the destruction begins. They feed on tissue that carries water and nutrients, killing the tree from the top down. Then the grown beetles chew D-shaped holes through the bark and fly away, renewing the circle of insect life and tree death.
Emerald ash borers originated in Asia, not outer space. But their destructive power over the millions of ash trees that line streets and carpet forests in the U.S. is akin to flying saucers filled with hostile aliens.
The coming infestation will hit Williston hard. Nearly half of street trees are ash, according to a town survey conducted last summer. In some neighborhoods, more than 90 percent are ash.
The emerald ash borer is an invasive species that has no natural predators in this country. It was first discovered in 2002 in Michigan and has since spread to 21 states and Canada. The insect has killed as many as 200 million ash trees in the U.S.
Forestry experts say it is only a matter of when, not if, the insect arrives in Vermont. The state is surrounded: The beetle has been found in New York, New Hampshire, Massachusetts and Quebec.
“We are actively looking but we have not found them yet,” said Danielle Fitzko, manager of the state’s Urban and Community Forestry Program. “We expect them to come to Vermont in the next couple of years.”
The Williston Selectboard learned how the infestation would impact the town during its Nov. 17 meeting. Gary Hawley of the town’s Conservation Commission outlined the scope of potential damage and suggested ways to cope with the problem.
The survey conducted for the Planning and Zoning Department found that of about 1,000 street trees in Williston, 43 percent were ash. Of particular concern is the land around the library, where the six largest ash trees in town grow.
More alarming, some neighborhoods have much heavier concentrations of the tree. For example, the survey found that 99 percent of Wildflower Circle’s 100-plus trees are ash. Harvest Lane is lined with 134 ash trees, 93 percent of its total.
Even Maple Tree Place has 39 ash trees, almost half of the total at the shopping center. By comparison, ash comprises 7-10 percent of all trees in Vermont.
“Williston is a classic example” of why it is a bad idea to plant too many of one type of tree, Fitzko said, noting developers favor ashes because they are normally a hardy species.
“But they have learned their lesson,” she said. Williston in 2008 banned the planting of new ash trees.
Expensive battle looms
Hawley told the Selectboard that there was little the town could do to prevent the infestation. He instead recommended a plan to cope with the damage.
“Because we don’t want to find all of a sudden 50 percent of our street trees are dead. It’ll look terrible, particularly in those neighborhoods where 90 percent of the trees are ash.”
Williston should devise a plan that covers at least 15 years, Hawley said. A committee could be formed to guide planning.
The town could elect to proactively cut down ash trees, but he said it should wait until the insect is evident. A better approach would be to start planting new trees between ash trees in areas with high concentrations of the species.
“If we could develop a plan where we could plant smaller trees earlier and let them grow up before we cut down the ash trees, it would be cheaper,” Hawley said. Pesticides, though expensive, could be used selectively, perhaps to preserve the library’s ash trees.
He also told the Selectboard about efforts to combat the ash borer in other states. Many things have been tried, he said, including wasps that prey on the larvae and clear-cutting forests to create buffer zones. But he said each of those methods has side effects or limited effectiveness.
Cutting down a tenth of the ash trees in Williston could cost the town around $10,000 each year for more than a decade, he said. It could then run well into six figures to replant all those trees.
Hawley suggested the town budget money in the coming fiscal year to pay for planning and possibly begin planting. He said Williston should remove a percentage of the ash trees each year over a decade or more.
Preparing for invasion
The state has enlisted about 150 volunteers to be on the lookout for the emerald ash borer and launched a website that solicits reports from citizens.
Fitzko said the beetle is not easy to spot. Aside from the tough-to-find exit holes and the beetles themselves, which are about a half-inch long, the other telltale signs are woodpeckers massing around a tree or the loss of leaves.
The insect is capable of flying up to a half-mile, but it mainly spreads by either hitching rides on logs or in nursery stock. The federal government has imposed quarantines on affected states.
Vermont has over the past few years used thousands of purple traps to detect the emerald ash borer. Fitzko said the state now has shifted to monitoring “trash trees” that are damaged or in decline, which the insect prefers to inhabit.
So Vermont awaits the insect. The emerald ash borer’s arrival and the subsequent death of many of the state’s estimated 160 million ash trees may be inevitable, but Fitzko said there’s still a chance to minimize the damage
She said there might be a way to slow the infestation long enough for trees to develop a resistance or for researchers to discover a way to eradicate the beetle.
“We haven’t lost hope yet,” she said.
For more information on the emerald ash borer and other invasive pests, or to report a suspected sighting of the beetle, visit vtinvasives.org.