healthwise Health benefits of Preparing for Winter recipe Helpful tips for managing depression social interaction life s what if s

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Health benefits of Preparing for 2 4 6 7 social interaction life s what if s Helpful tips for managing depression Winter recipe healthwise a PERS Health Insurance Program newsletter Winter 2018

Health benefits of social interaction Engaging with others can boost brain function, relieve stress, and improve your emotional well-being. Social stimulation occurs when you interact with others and engage in activities together. It is a protective factor and provides multiple benefits for your mental functioning, physical health, and mood. It s like medicine, but more fun! It s good for your brain Interacting with others boosts brain function, decreases the risk for cognitive decline, Alzheimer s, and dementia. Mental exercise stimulates the brain, which results in improved thinking skills, reasoning skills, and memory. Here are a few ways to stimulate your brain: y Take a cooking class y Learn a new language y Connect with a book club y Get in a good debate with a friend It s good for your body Connecting with supportive friends and family members relieves stress, and as a result, improves your physical health. Doing a physical activity with others provides a double benefit of movement and social connection. In the winter months, some people suffer from Seasonal Affective Disorder due to low exposure to natural light and lower levels of Vitamin D. Getting outside with others can lessen some of those symptoms. Here are a few ways to combine physical activity and social interaction: y Get outside and enjoy nature with a friend y Visit a botanical garden y Participate in a walking group y Take a dance class y Join a gym It can lift your spirits Interacting with others and engaging in activities provides daily structure. It helps you maintain a sense of meaning and purpose, boosts emotional well-being, and can result in a feeling of fulfillment after reaching a goal or contributing to others. Interacting with others helps build relationships and connects you to the community. Here are a few ways to connect socially: y Reminisce with friends y Watch family videos together y Volunteer at a local food bank, religious group or other charity y Play chess Different people have different preferences for social interaction. What s clear are the health benefits of social interaction when you are engaged and stay active. What are your favorite ways to interact with others? Courtesy of Moda Health 2 Healthwise Newsletter

Understanding Osteoporosis Osteoporosis is deterioration of the bone tissue which causes bones to become weak and brittle. Weak bones can break more easily. Although osteoporosis is thought to be a disease afflicting older women, it also affects men and can strike at any age. Osteoporosis is often symptomless when it begins and may not be found until a bone fractures. Sometimes, signs and symptoms do appear. The most common signs and symptoms are: y Back pain y Wrist, hip and spine fractures y Loss of height y Hunched posture Most at risk for osteoporosis are those who: y Are a woman over age 65 or a man over age 70 y Are a woman who experienced early menopause y Have a family history y Have a diet lacking in calcium and vitamin D y Smoke y Have an eating disorder y Consume excessive alcohol y Use certain medications including, but not limited to, prednisone, cortisone, prednisolone and dexamethasone y Are inactive Prevention tips: y If you smoke, quit. y Eat foods that include: Calcium (e.g., dark green vegetables, yogurt and milk) Vitamin D (e.g., eggs, fatty fish and fortified cereal) y Get plenty of bone strengthening exercise (e.g., Tai Chi, walking or yoga); talk with your doctor about safe activities for you. y Test your bone strength. A bone mineral density test is a quick, painless way to measure your bone strength and show if you are at risk for breaking a bone. The test is recommended every two years to monitor your bone strength. If you have osteoporosis, treatment options are available including bisphosphonates medicines that can lower your risk of breaking a bone by 40 to 50 percent. Talk with your doctor to determine what s right for you. Courtesy of Providence Winter 2018 3

Preparing for life s what if s We can t always prevent accidents or emergencies, but we can increase peace of mind in case they occur. Preparing for life s what if s and making decisions about the health care and services you want to receive if you become unable to speak for yourself gives you and your loved ones a little peace of mind. Doing it now and putting it in writing, when you re not in a crisis situation, will help ensure your wishes are carried out. It also helps ensure your family or friends are not unduly burdened. All adults, regardless of their age and health, should do this kind of advance, or life care, planning and decision making. Many older Americans face questions about medical treatment as they age, but are not always capable of making those decisions as they near the end of life. The earlier we do our planning, the better. Advance care planning involves two major choices: y Selecting someone you trust to make your health care decisions in the event you become incapable. y Giving specific instructions about your care in the event of a sudden injury or illness. Preferences for medical care are as unique as individuals themselves and are often based on one s personal values and experiences. These are your decisions to make, and your health care team wants to hear from you firsthand. You ll need to choose someone to be your representative. This person is known as a health care agent or health care proxy. Many people select a close family member, but you are free to pick anyone you think could best represent you. A good health care agent is someone who knows you well and who can act according to your wishes. This person should also be someone with the ability to understand information and make good decisions in stressful situations. Choose one or two people as your alternate agents, in case your primary one is unavailable. Although it isn t always easy, it is important to have conversations with your agent and loved ones about what you value most in life and how you would want to be treated in specific health or medical situations. Then, document your wishes, or care preferences. Putting your plan in writing helps those caring for you to accurately remember your wishes so you get the care that you want. One way you can do this is to complete an Advance Health Care Directive. An advance directive is a legal document that goes into effect only if you are incapacitated and unable to speak for yourself. It helps others know what type of medical care you want. It also allows you to express your values and desires related to end-of-life care. You can change your advance directive anytime, making adjustments as your situation changes, or because of new information or a change in your health. These forms vary from state to state. Forms are available at kp.org/lifecareplan. 4 Healthwise Newsletter

Give copies of your completed and signed advance directive to your chosen health care agent/ representative and alternate. Give your doctor a copy for your medical record. Tell key family members or friends where you keep a copy. For more information: y kp.org/lifecareplan, Life Care Planning y acpdecisions.org, ACP Decisions y theconversationproject.org, The Conversation Project y prepareforyourcare.org, Prepare for Your Care y caringinfo.org, National Hospice and Palliative Care Organization y The American Bar Association also has a list of links for each state that lead to forms you can download, at americanbar.org/ groups/law_aging/resources/ health_care_decision_ making/stateforms.html Courtesy of Kaiser Permanente Winter 2018 5

Helpful tips for managing depression Depression is a mood disorder. It s not caused by personal weakness and is not a character flaw. Depression may result from issues with activity levels in certain parts of the brain. Depression may also result if chemicals in the brain, called neurotransmitters, are out of balance. There are different types of depression. Major depressive disorder is generally one of the more serious kinds of depression, with symptoms ranging from mild to severe. It s normal to experience bouts of sadness, the blues, or feeling down for a few days. But when those feelings persist and significantly interfere with life, a diagnosis of major depression may be appropriate. Depression is an increasingly common disorder characterized by the following: y Depressed mood y Decreased interest or pleasure in activities y Change in weight or appetite y Insomnia or hypersomnia y Psychomotor agitation or retardation y Fatigue or loss of energy y Feelings of worthlessness y Difficulty concentrating y Recurrent thoughts of death Due to their nature, understanding and taking care of depressive symptoms can seem difficult; however, it s important to understand treatment is available and it s possible to feel better. Research indicates that a combination of talk therapy and medication leads to the best outcomes for depression. So what steps can one take when starting to understand signs of depression? Here are some quick tips: y Talk to someone. A trusted friend or family member. This can be the most comfortable place to start for a lot of people. A medical provider. Your health care team cares about you and your whole health. Additionally, your medical provider and care team can help you make a treatment plan that is right for you. Behavioral health provider. Seeking behavioral health services is an important part of the equation. Behavioral health providers can be found in a primary care clinic, a community mental health clinic or private practice. y Discuss with your medical or behavioral health provider whether medication is right for you. Medication may be helpful in managing your mental health but is not indicated for every mental health issue (and may be contraindicated with other medications you are taking). y If you are prescribed medication by your medical or behavioral health provider: Take medication as prescribed. Know that it can take several months for an antidepressant medication to be fully effective. It s important to continue to take the medication for at least six months even if you start to feel better. Follow-up with your provider on a regular basis to discuss how the medication is working. Talk with you provider if you are experiencing side effects. Talk with your provider before discontinuing medication. Courtesy of Providence Health Plans 6 Healthwise Newsletter

Banana Bread Baked Oatmeal 1 ½ cups mashed bananas (from 3 to 4 medium ripe bananas) ¼ cup packed brown sugar 2 large eggs ½ teaspoon salt ¼ teaspoon ground cinnamon teaspoon ground nutmeg ½ teaspoon vanilla extract 1 teaspoon baking powder 1 ½ cups fat-free milk 2 ½ cups old-fashioned rolled oats* ½ cup chopped walnuts Preheat the oven to 375 degrees. Coat an 8-by-8-inch casserole dish with nonstick cooking spray. In a large bowl, combine the bananas, brown sugar, eggs, salt, cinnamon, nutmeg, vanilla, and baking powder. Whisk until smooth. Add the milk and whisk again until smooth. Stir the oats into the banana mixture. Pour the mixture into the prepared casserole dish. Nutrition facts Calories 280 Total fat 4.5 g Carbohydrate 51 g Sodium 330 mg Protein 11 g Fiber 6 g Source: Adapted from Budget Bytes by Beth Moncel. Bake the oatmeal for 45 minutes, or until the top is golden brown and no longer sticky in the center. Divide the oatmeal into 6 portions and refrigerate or freeze in resealable containers until ready to eat. To reheat, microwave until warmed through. *Be sure to use old-fashioned rolled oats rather than quick-cooking oats. Quick cooking lack the texture needed to stand up to the other ingredients in this recipe. Serves 6 RECIPE You asked, we listened If you have your PHIP premium automatically deducted each month either by pension deduct or Electronic Funds Transfer (EFT) please note that your premium will change beginning January 1. For more information regarding your 2019 premiums visit www.pershealth.com. Shingles (herpes zoster). Shingles is a rash that usually appears on one side of the body. It will often blister, can last up to 30 days, and can be very painful. The newest shingles vaccine available, Shingrix, consists of two doses and is used for adults 50 years or older to prevent shingles. One, two-dose series, will be covered under the prescription drug benefit for members 50 years or older. The Centers for Disease Control and Prevention (CDC) prefers use of Shingrix over Zostavax and recommends that adults should receive Shingrix even if they have already received Zostavax. Shingrix can be obtained via the pharmacy. PHIP has been notified that the Long-Term Care policies offered through Unum will receive premium increases effective January 1, 2019. Those who have purchased a Long-Term Care policy through Unum should have received a letter back in September/early October outlining the change. To obtain more information about this pricing increase, please call Unum Customer Service at 800-227-4165. Winter 2018 7

P.O. Box 40187 Portland, OR 97240-0187 PRSRT STD U.S. POSTAGE PAID PORTLAND, OR PERMIT NO. 1039 Contact us PERS Health Insurance Program www.pershealth.com 503-224-7377 800-768-7377 Kaiser Permanente my.kp.org/pers Medicare: 877-221-8221 Non-Medicare and Dental: 503-813-2000 800-813-2000 Moda Health www.modahealth.com/pers Medical (Medicare supplement and non-medicare PPO) 503-243-3880 800-962-1533 PERS Moda Health PPORX (PPO) 503-265-4761 877-299-9061 Pharmacy 503-265-4709 888-786-7509 Delta Dental of Oregon 503-243-4494 800-452-1058 PacificSource Health Plans www.medicare.pacificsource.com Medicare: 541-385-5315 888-863-3637 Non-Medicare: 541-686-1242 800-624-6052 Pharmacy Medicare: 888-863-8637 Pharmacy Non-Medicare: 888-977-9299 Providence Health Plan www.providencehealthplan.com/phip Medicare: 503-574-8000 800-603-2340 Non-Medicare: 503-574-7500 800-878-4445 Pharmacy: 503-574-7400 877-216-3644 43274844 (10/18)