Immanuel Lutheran Community

In light of the World Health Organization declaring the coronavirus (COVID-19) a pandemic, Immanuel Lutheran Communities is establishing precautionary measures as of 7p.m. Friday, March 13, 2020.  At this time, access to the community is restricted to essential visitors only. The new visitor restrictions follow guidance from the U.S. Centers for Medicare and Medicaid as well as the Center for Disease Control, which recommends limiting the number of people who enter.

“The health and wellness of the residents and staff of Immanuel Lutheran Communities is our number one priority,” says Jason Cronk, Immanuel Lutheran Communities CEO.  “As we navigate this challenge, we remain focused on providing exceptional care and service for our residents.”

Keeping in touch with family and friends is important during this time and staff will assist residents with communication alternatives such as video chats.

Immanuel Lutheran Communities will continue to follow recommendations from the Centers for Disease Control & Prevention and local and state health departments.

During CES 2020 in Las Vegas in January, more than 4,400 companies debuted some 20,000 tech products, everything from 8K TVs to foldable laptop computers to plant-based pork from the people who brought you the Impossible Burger. (Clearly, the show has grown beyond just focusing on consumer electronics, as it once did.)

Aside from the robotic puppies, Bluetooth-equipped shower heads and robot warrior gaming helmets featured, many of the new products could be useful to people who are around the same age as CES, which debuted in 1967.

In case you’re curious, the Best of the Best award went to the Hydraloop, a home water-purification system that treats outgoing wastewater so it can be used in toilets, washing machines and gardens. The People’s Choice award went to the Razer Kishi, an accessory that turns your iPhone or Android device into a game controller.

Many of the new products could be useful to people who are the same age as CES, which debuted in 1967.

Here are two products that won Best of CES awards and three more that were finalists. (Tech site Engadget has been judging the award program for the past seven years.)

Winners

Withings ScanWatch

Winner, Best Digital Health and Fitness Product

Simple fitness trackers like the old Fitbit Flex are so last decade. Today, smart timepieces like the Apple Watch are all the rage. The French company Withings has carved out something of a niche by designing watches that have a traditional look — think stainless-steel cases, white faces and moving hands — yet boast the latest features to assess health and fitness.

In addition to tracking fitness activities, the company’s new ScanWatch passively tracks the wearer’s heart rate and blood-oxygen levels (a potentially indicator of sleep apnea). Withings says the ScanWatch is “the first hybrid smartwatch to combine medical-grade electrocardiogram and sleep apnea detection.”

The ScanWatch is expected to be available during the second quarter of 2020, pending approval by the Food and Drug Administration (FDA). The price will be $250 for the 38mm size and $299 for the 42mm size.

Olive Smart Ear

Winner, Best Wearable

While over-the-counter hearing aids are still awaiting FDA approval, personal sound amplification products are on the market now. Among the newest is the Olive Smart Ear. Designed to be worn in one ear only, the Smart Ear looks more like a high-end wireless earbud than a hearing aid. In fact, its stark white case may remind you of an Apple AirPod.

The Smart Ear uses Bluetooth to connect with its companion smartphone app. In the app, you can take a simple hearing test designed to fine tune the device’s settings, as well as adjust the volume and deal with feedback, which Engadget’s reviewer says can be a problem. Like high-end hearing aids, the Smart Ear also allows you to receive phone calls without reaching for your phone, and to amplify sound from a television without annoying your loved ones.

The Olive Smart Ear is available now for $299.

Finalists

U by Moen Smart Faucet

Finalist, Best Connected Home Product

“Alexa, turn on the faucet” may not be something you’ve ever wanted to say — after all, how hard is it to turn on your kitchen faucet?— but Moen is betting people will find a use for its U by Moen Smart Faucet. And they actually may, considering the level of control the new faucet offers.

If you’re making yeast bread, for example, you can say, “Alexa, tell Moen to dispense two cups of 110° water.” The faucet will run the water to that temperature, then pause until you wave a hand across the sensor on top. In the faucet’s smartphone app, you can create unlimited presets for containers like dog bowls or baby bottles — any amount from 1 tablespoon to 15 gallons.

Moen says the faucet, which works with Amazon Alexa and Google Assistant, is the only voice-activated faucet to offer voice- and hands-free activation regardless of the position of the manual handle (which is included if you want to turn on the water the old-fashioned way).

The faucet is available now. Prices start at $450 and vary based on style and finish.

Mateo Smart Bathroom Mat

Finalist, Best digital health and fitness product

If you dread looking down at the bathroom scale, you’ll like the Mateo Smart Bathroom Mat. Although it measures your weight when you step on it, it doesn’t display the number for your reading displeasure. In fact, it doesn’t display anything, instead sending the data it collects to its linked smartphone app.

And that data goes far beyond your weight. The mat’s “patent-pending, 7000-dot pressure-mapping system” reads your pressure footprint and calculates a posture score, while its heatmap can suggest the presence of chronic diseases like diabetic neuropathy. Since all this data is stored automatically, it’s easy to track changes over time.

Engadget says Mateo plans to launch a crowdfunding campaign during the next few months and release several versions of the product — topping out at $179 — by the end of the year.

MedExo Robotics ExoBeam

Finalist, Best Accessibility Tech

Unlike the products described above, the MedExo Robotics ExoBeam targets a narrow audience: people with Parkinson’s disease. According to the Parkinson’s Foundation, 60,000 Americans develop this neurodegenerative disorder each year, and nearly a million Americans are living with the disease today.

The ExoBeam is designed to help with freezing of gait, a mobility problem that’s common to people with Parkinson’s disease and can lead to falls. Research has shown that this problem often occurs when someone is starting to walk, turning, entering a narrow space like a doorway or approaching their destination. The ExoBeam device, which attaches to the user’s belt, gives visual, tactile and auditory cues to help the person maintain walking pace and stay focused. As with other smart devices, data goes to an associated smartphone app, so caregivers can view real-time and historical data.

According to Engadget, the ExoBeam will retail for $500 to $700. A release date hasn’t been announced.

A Winning Pitch

While Engadget was judging the Best of CES awards, the CTA Foundation, which is affiliated with show producer Consumer Technology Association (CTA), was already looking for the next tech breakthroughs.

As part of CES 2020, the foundation hosted a business pitch contest, sponsored by AARP Innovation Labs, to (according to a press release) “recognize sports, fitness and related innovations that can provide health solutions to help people stay in the game as they age.”

Eight companies pitched products ranging from a smart bicycle backlight — nearly everything was labeled smart at CES — to an artificial-intelligence yoga coach. The winning product, the Zibrio SmartScale, uses technology developed by NASA to measure and track balance. An associated smartphone app offers coaching in six areas that affect balance, including sleep, exercise and leg strength.

The Zibrio SmartScale costs $249 and will be available this summer.

The author, a nurse, gives an inside scoop on modern medicine


Part of the AGE-FRIENDLY HEALTH CARE SPECIAL REPORT

(Editor’s note: This story is part of a series for The John A. Hartford Foundation.)

Around the time Sana Goldberg began nursing school, her grandfather had a serious, undetermined health problem.

“I remember from the moment of entering the ER to the week later when he was dismissed from the hospital — having such a sense of confusion about what was going on,” Goldberg, a nurse who practices in New Haven, Conn., recalls.

Although Goldberg’s mom was a doctor and Goldberg herself had worked extensively in hospitals and been around this, she’d never before been so intimately connected to the process of dealing with a significant medical issue.

To have a really solid primary care provider is too important to compromise on.

“Because I’m a reader, I went and looked for books, and I couldn’t find much that I felt like was a really good resource,” Goldberg says. “There are a lot of books out there about hospital safety or how to communicate better with your doctor. But they all were sort of paternalistic and didn’t really get at the core of what I was trying to figure out.”

It hit Goldberg that this kind of “how to” information — all compiled into one place — would be profoundly useful for people to have on hand.

“I thought it would be really great if this could be distilled and given to patients because the health care climate is really difficult right now for a lot of people. And so to have better tools to interface with that — I think people are wanting to have that.”

Her book, How to Be a Patient: The Essential Guide to Navigating the World of Modern Medicine, breaks down a wealth of information and expertise into easy-to-understand (and easy-to-find in times of stress) chapters and sections like “How to Choose a Primary Care Provider” and “When You Can’t Get a Diagnosis.”

Chapter 23 goes in-depth on “When You’re Getting Older (Or When It’s Your Parent),” with plentiful guidance on switching to a geriatrician, mental health and loneliness, transportation, end-of-life choices and more.

This is the type of book you keep in a handy place and reference as life happens and issues come up. It’s friendly, approachable, realistic and takes into account the ways modern medicine is not always fair to patients of various genders, sexual orientations, races and ethnicities. Next Avenue asked Goldberg to expand on some of the most intriguing and relevant parts  in her book:

Next Avenue: In the book you discuss ‘unlearning’ things. What are some of the main things you’d like people to unlearn about health care and how it works?

Sana Goldberg: Unlearning the idea that your role as a patient is to be passive and be a recipient of directions and orders. You show up at the doctor, they tell you what to do, you never question somebody in a white coat. This system then becomes really intimidating and you don’t question it, and it becomes OK that a lot goes on that you might not understand.

Knowing that you have agency during medical encounters is really important, and to unlearn this deference to medical providers.

Self-advocacy at the doctor is intimidating for a lot of people. What do you recommend to people who are scared to speak up or ask questions that might seem accusatory or like they’re questioning the doctor’s authority?

What I always tell people first is to acknowledge that the system is imperfect. Even a doctor that you have a lot of trust in is still working within a system that’s imperfect.

So it’s OK to think of yourself as working with them to figure something out rather than directly challenging their authority.

I tell people it really helps to write down your concerns or questions before you go in rather than being on the spot and knowing the clock is ticking. Think about what you want to say and have that in your mind before you go in.

And having an advocate with you can help to bolster your courage in a situation — to feel supported by somebody.

Your book has an entire section about bringing an advocate to the doctor. You suggest always bringing an advocate to appointments and you detail who that person can be and how you can choose them. Some people might be nervous to bring an advocate to appointments, especially if they feel like they should be able to do everything themselves. Why is it so important for people to bring an advocate along?

I get questions about this a lot. [Needing an advocate] is a really strange statement to make and I think it’s pretty foreign, especially for a high-functioning adult or someone thinking about privacy.

My goal is to get people to reframe how they think of their health care and how they interact with their health care. And so to have a consistent person who is up to speed on what’s going on with your health care — the long-term goal is that you have a person who can build a relationship with your providers and be your advocate if something more pressing comes along.

In a hospital setting, it’s really important to have another pair of eyes. In an appointment, the same thing holds because it’s usually such a short time period.

A lot of times, people are nervous because it’s intimidating to be around medical professionals. Or people feel like they’ve been waiting so long to get an answer and [the doctor] is the person who can help, and they’ve got to make the most of this. It can be daunting.

Have another person who can remember a question you might’ve forgotten to ask or who can be there just to receive information that you might not be able to pay attention to because your mind is on other things.

Something we hear from readers is that it’s difficult to communicate with doctors and feel like you have enough face time with them. You touch on this in the book. What’s your advice?

Before you go in, think about the timeline of your symptoms. So rather than saying, ‘This started hurting, I don’t know, sometime last August,’ you’re able to talk about the frequency of the pain, how long it lasts and what you’ve tried to do to remedy it that hasn’t worked. Really thinking dynamically about the problem you’re going in for and having prepared a little elevator pitch of how to talk about it.

The second thing I would say is being comfortable asking questions — and not only just asking questions and getting answers, but being sure that when you’re given an answer, it’s given to you in a way that you can understand.

As medical professionals, we work a lot on health literacy and making sure on our end that we’re not just speaking gibberish over somebody’s head. But patients are really reluctant. There’s this eagerness to please and just say, ‘Yeah, I understand,’ even if you don’t know because it wasn’t communicated very well. So just keeping in mind that it’s OK to say, ‘Can you explain that in another way? I didn’t understand.’

The last thing is feeling comfortable reining the conversation back in if you feel like it is going somewhere that wasn’t the place that you intended or something that you brought up wasn’t prioritized in the way you hoped.

What should you do if a doctor isn’t responding well when you speak up or ask questions?

Firs,t try some of those skills like challenging something or trying to redirect the conversation. But ultimately my stance is that if you don’t feel like you’re heard or you can’t have a productive conversation when you’re trying to communicate with your provider, then it’s probably good — especially if it’s a primary care provider — to find somebody that you can communicate with.

And that’s especially important if you’re older and you have different parties involved in your care and you have to be this conduit of information between them.

To have a really solid primary care provider is too important to compromise on. You can try to advocate and have agency in those interactions and use the tools that are in the book, and then if it doesn’t work, I always think it’s OK to find somebody new.

A call to action based on a new survey of female workers and retirement


There’s bad news and so-so news about the retirement insecurity of American female workers in the new Aegon Retirement Readiness Survey 2019. But the good news is that if employers, the U.S. government, financial advisers and those workers take a few key steps, today’s cloudy retirement prospects for women could become sunnier.

After receiving the survey of 14,400 employees and 1,600 retirees in 15 countries  — from Aegon Center for Longevity and Retirement and nonprofits Transamerica Center for Retirement Studies (TCRS) and Instituto de Longevidaded Mongeral Aegon — I parsed its massive data. Then, I learned more about the findings and advice for working women from the survey’s author, Catherine Collinson, CEO and president of TCRS. (The report’s also called The New Social Contract: Achieving retirement equality for women.) And I asked Cindy Hounsell, president of the nonprofit Women’s Institute for a Secure Retirement for her thoughts. Finally, I had a candid conversation with Holly Lawrence, a 59-year-old freelance writer in Washington, D.C. who has written eloquently for Next Avenue about her financial struggles. She had some piercing opinions about the survey’s results.

Only 23% of the U.S. women surveyed correctly answered three basic financial literacy questions dealing with interest rates, inflation and risk diversification.

“Our overarching goal for the report is to inspire and empower women to take action,” said Collinson. “My sense is that women need a vote of confidence. And small steps can lead to a big impact over time. For many women, taking the first step is the hardest.”

The News About Women and Retirement Insecurity

So, to the news:

First, the bad news. Only 25% of the U.S. women surveyed believe they’re on course to achieve their retirement income needs and just 26% are confident they’ll be able to retire with a comfortable lifestyle. By contrast, 40% of men say they’re on course to achieve their retirement income needs and 48% are confident about their retirement prospects.

“It is alarming,” Collinson said, speaking about the responses of women and the disparities with men.

Two reasons for American women’s retirement insecurity, she noted, are the gender pay gap, making it harder to find spare cash to save for retirement (median income of women surveyed: $40,375; for men, $54,599) and caregiving expenses that cut into retirement savings.

“Almost every woman my age is having to think about how to take care of a parent or a millennial child if he or she can’t get a job,” said Lawrence.

She noted that the retirement insecurities the women expressed in the survey resonate with her.

“I’m definitely on the worried side,” she told me. “I’m underemployed without savings and living below the poverty level. I’ve felt lucky just to make my rent and utilities, with a smidgen in a low-earning savings account.”

And now for the survey’s so-so news: The researchers produce what they call the Aegon Retirement Readiness Index score and it has risen for U.S. women from 5.8 in 2014 to 6.1 in 2019. Collinson calls the 0.3 rise here “a small increase.” Her explanation for it: “When the economy is doing better, people are more likely to be engaging in retirement planning and more optimistic about the long-term.” (The index score rose for women globally, too, from 5.5 in 2014 to 5.8.)

But even a 6.1, Collinson noted, is just a “medium” retirement readiness score. Above 8 is “high.” The score for American men is now 7.1, up from 6.7 in 2014.

What Could Help Women Feel Better About Their Retirement Prospects

What could boost women’s Retirement Readiness Score? A few things, according to Collinson.

More employers could offer retirement savings plans to their part-time workers. The survey found that women in America are nearly twice as likely to work part-time. And part-timers typically aren’t allowed to contribute to 401(k) or similar retirement plans where they work. “Access to workplace savings plans has proven to be an effective way encouraging people to save,” said Collinson.

Hounsell noted that the new federal SECURE Act will encourage employers to let part-timers put money into workplace retirement plans. “That will make a difference,” she said.

Financial advisers and the financial services industry could do more to assist women.  “For many financial advisers, training is deeply rooted in working with men,” said Collinson. “They’re not necessarily understanding or addressing the needs of women and the life course of women in a way that is empowering and can lead to better decision-making.”

Women can try to become what Collinson calls “habitual savers.” Just 50% of women in the survey said they’re habitual savers — always saving for retirement. The percentage was lower for female boomers (45%) and even lower for Gen Xers (39%). About a third of boomer and Gen X women aren’t currently saving for retirement at all.

“Habitual saving is one of the most important things we can do to self-fund a greater portion of our retirement,” Collinson said. She acknowledged, however, that there are times when we can’t save as much as we’d like — or at all — due to pressing financial needs.

Lawrence told me she accumulated some savings years ago, when working in New York City. But that money dwindled due to high rents, her inability to find full-time work and medical emergency expenses.

Lawrence hopes to start saving again, though she detests when financial firms chide people for not putting away enough money for retirement. “I glaze over when they say: ‘You should have been here [with a large amount of savings] by now.’” She added that “the study says it’s imperative women take greater control over their savings and retirement planning, and I certainly agree. But I think that type of sentence packs in some assumptions. If companies make people feel guilt and like they’ve already lost before they get started saving for retirement, they’ll never start.”

What About Social Security?

Hounsell worries that possible cuts in Social Security and Medicare benefits to shore up those programs will only make retirement prospects more frightening for women — and men. “It is clearly a worry,” she said, adding that the foundation for women’s retirement is still Social Security.

She’d like to see Washington make several changes to Social Security: higher benefits for widows; an “anti-poverty” minimum benefit that would not impact the income limits to qualify for Medicaid; bigger benefits starting at age 85 or 90, reflecting Americans’ longer lives and a caregiver earnings credit to offer retirement protection to women (and men) who have spent significant time as family caregivers.

The Power of Financial Literacy

One last finding in the Aegon survey that I think is worth noting. Only 23% of the U.S. women surveyed correctly answered three basic financial literacy questions dealing with interest rates, inflation and risk diversification; 36% of men did (that’s better, but frankly not very impressive).

“We have a tremendous opportunity to increase financial literacy in the United States and around the world,” said Collinson. “How can someone make informed decisions about retirement saving and investing over the long run without an understanding of the most basic concepts?”

Her advice: Take advantage of retirement-saving educational tools and resources offered by your employer, if they exist. Read personal finance websites and publications. Enroll in a personal finance course at a local college.

Lawrence agreed and told me she has made a point of teaching herself about personal finances, watching videos and reading online media. She wants to see other women follow suit. “Even if we don’t have a 401(k) or savings, we need to start educating ourselves about these financial instruments,” Lawrence said. “Education is power.”

History and culture tours can elevate your travels to the next level


Once you’ve seen the Eiffel Tower, well, you’ve seen the Eiffel Tower. But when you learn about the history of how it was built (this architectural marvel was designed as the entrance to the World’s Fair of 1889 commemorating the 100th anniversary of the French Revolution), you get a new world view.

On his website, European guidebook author and public television travel host Rick Steves says,  “Travel changes people. It broadens perspectives and teaches new ways to measure quality of life. Many travelers toss aside their hometown blinders. Their prized souvenirs are the strands of different cultures they decide to knit into their own character. The world is a cultural yarn shop.”

As I get older and hopefully wiser, I notice that I’m not as interested in just ticking sights off my bucket list when I travel. Like a student, I also want to dive into the history, art and culture of a place. After a lifetime of traveling, I’m now able to connect the puzzle pieces of my journeys into a cohesive understanding of the world.

And I’m not alone. Travel companies geared to mature adults have noticed this trend and are offering educational trips in the U.S. and around the world — often with a high level of repeat business.

Choose What’s Right for You

“Our travelers are eternally curious people who want to learn more about the destinations we travel to than most tours offer,” says Karen Ledwin, vice president of program management for Smithsonian Journeys, a nonprofit travel group affiliated with the Smithsonian Museum.

After a lifetime of traveling, I’m now able to connect the puzzle pieces of my journeys into a cohesive understanding of the world.

Smithsonian Journey trips are dynamic and diverse travel experiences led by experts from a variety of fields — academia, the diplomatic corps, scientists and curators, among others, says Ledwin, “and our travelers love not only to hear their insights in lectures, but also to engage with them over meals and during our casual Travelers’ Corners discussions. In addition, we satisfy our lifelong learners through experiential activities from painting classes in the garden of a Tuscan villa to a meeting with Smithsonian scientists at the Smithsonian Tropical Research Institute in Panama.” (Prices are $2,310 and up.)

Another well-known nonprofit travel company, Road Scholar, bills its trips as “university of the world” experiences. Like Smithsonian Journeys, Road Scholar (formerly Elderhostel) offers a slew of educational tours both nationally and internationally.

Its tours are divided into categories such as “Art History and Museums,” “Jewish Studies,” “Literature,” “Philosophy & Religion,” “Science & Technology” and “Theater,” among many others. There are also walking and hiking, multi-sport, national park and water sports adventures; these typically also have educational elements.

Traditional trips are designated from “Easy Going” to “On Your Feet” (some walking is okay) to “Keep the Pace” (walking much of the day) to “Let’s Go!” (a day on the move). Hiking and sports-oriented trips are rated “No Sweat” to “Spirited” and “Challenging.” You can also select a “Choose Your Pace” tour that allows you to customize activities to your level of physical ability ($999 and up).

Judy Lang, 72, and her husband Paul, 74, of Shelton, Conn. have ventured out with Road Scholar several times, visiting Alaska, Iceland, Montana and the Delaware Water Gap.

While they were at Denali National Park in Alaska, Judy says,  “We did a number of day hikes and saw amazing scenery, flora and fauna. The educational talks in the evening shared what life is like in Alaska in the middle of winter when the tourists have gone home, as well as what the local residents did.”

In Iceland, the couple traveled along the southern coast of the country and learned about Iceland’s power sources, geothermal springs and lagoons, Icelandic horses, mosses and trolls. “We re-live these trips every time we tell someone about them!” she says.

Travel With an Insider

The Traveling Professor is a small-group touring company led by Steve Solosky, formerly a professor at the State University of New York. The tours take between 10 and 14 people depending on the destination and have ambitious itineraries. At each stop, groups meet with expert, licensed guides who are native to the area and can go beyond the usual guidebook text.

Based on what he likes when he travels, Solosky looks for guides who can tell visitors about the fascinating history and details of a site or city and who are capable of answering detailed questions. He also likes “traveling with someone having ‘inside information’ on local dining spots, special exhibits and who gets me into the places others can’t,” he says. (The tours cost $1,899 and up.)

Cruising Options

American Cruise Lines offers over 35 river and coastal itineraries in the Northeast, Southeast, Pacific Northwest and along the Mississippi River. It also has themed cruises (Lewis and Clark, Mark Twain, Civil War, etc.) for people with specific historical, literary or other interests. (These trips cost $1,770 and up.)

Viking River Cruises are geared to mature English-speaking adults and focus on European art, history and culture. Each cruise makes one to two port stops a day as the ship winds its way up or down Europe’s most famous rivers like the Rhine, Seine, Danube and Douro. A free sightseeing tour is included at all stops, and special-interest excursions are available for additional fees. Viking also offers tours in the United States. (The cruises cost $2,599 and up.)

Free Walking Tours and Apps

For those looking for more flexibility and budget-style ways of immersing themselves in the culture and history of popular cities and sites, a number of free walking tours such as Freetour.com, Free Tours by Foot and Sandemans New Europe Tours have popped up in recent years. These tour companies don’t charge for the tours but ask that you tip guides commensurate with the value you place on the service you received. Tour guides are typically high-quality, local, freelance guides who work hard to make sure customers are satisfied, which means they’ll be compensated.

If you choose to go it alone, Rick Steves offers downloadable walking tours through his Rick Steves Audio Europe App; the app and tours are all free. Other apps for Apple devices include AnyTour, TravelStorys and VoiceMap Audiotours, which are also free to download but typically charge for individual tours.

You can also go old school and carry a printed guidebook or download e-guidebooks to your smartphone or tablet from major travel leaders like Fodors, Lonely Planet, and DK Eyewitness Travel Guides.

The century-old education philosophy invites people to be active


At a retirement community in Bend, Ore., individuals with cognitive impairment brew craft beers. An educational service agency in Baton Rouge, La., holds parties where family caregivers and their loved ones with Alzheimer’s disease can mingle.

These practices exemplify the application of the Montessori method to people living with dementia. Montessori is an educational philosophy developed for children well over a century ago. Today, research supports use of the method for people with dementia, and experts say it is gaining traction at adult day centers, assisted living residences and skilled nursing residences. The techniques also can be used by family caregivers at home.

Developed by Dr. Maria Montessori, an Italian physician and teacher, the Montessori method emphasizes self-directed, meaningful activities that reflect an individual’s interests and abilities. The overarching philosophy is one of respect, dignity and equality, and the goal is to provide a sense of accomplishment and purpose.

An Example of Patient-Centered Care

The Montessori method for people with dementia is an example of “patient-centered” care, a model that involves patients in decisions about their care and considers their full range of needs.

“For a long time, we’ve been talking about patient-centered care, but what’s new is that we now have evidence that supports the impact of these approaches,” says Sam Fazio, senior director of quality care and psychosocial research at the Alzheimer’s Association. “Research on using the Montessori method in dementia care shows a decrease in use of medication, reduced wandering and agitation and an approach that is very much in line with who individuals are, and have been.”

“People with dementia are not a group — they are individuals, just like us, and our program focuses on that.”

But Fazio notes that an industry-wide transition from standard practices in dementia care to the Montessori method or other person-centered programs isn’t likely anytime soon.

“The conventional model has always existed in a medical framework,” he says. “How do you change an organization’s culture from focusing on completing tasks to engaging with people in a way that’s built around their strengths? Just helping families change their thinking about how to connect with a relative with dementia takes time. Of course, it’s worth the effort.”

Fazio, the lead author of the Alzheimer’s Association’s Dementia Care Practice Recommendations (last updated in 2018), adds that although the association supports practices that support patient-centered care, the agency does not endorse any one program over another.

Brian Pangle, CEO of the Clark Retirement Community in Grand Rapids, Mich., does endorse the Montessori method, which he first learned about during a 2015 event in Washington, D.C., by LeadingAge, a national association for nonprofit aging services providers.

“It really resonated with me and fit with what we’d wanted to do at Clark,” Pangle says. Clark’s two campuses, serving about 60 residents, offer memory care in assisted living and skilled nursing.

Encouraging People to Be Active

Pangle asked Chris Simons, Clark’s director of dementia and life enrichment services, to come up with a year-long implementation plan and program evaluation. Five members of Clark’s life-enrichment staff worked with the Association Montessori Internationale, a global non-governmental organization dedicated to Montessori education, to complete a six-month certification program. In 2017, Clark initiated the Montessori method.

“People with dementia are not a group — they are individuals, just like us, and our program focuses on that,” says Simons. “We have Montessori activity stations with appropriate signage and we also assign roles to people based on their interests.

Some residents maintain the community garden, some set the table for meals and others choose to sweep up afterward. “We asked a pastor’s wife to teach another resident to play piano and we gave a desk and a briefcase to a retired businessman. Families enjoy seeing loved ones once again doing something they used to do all the time,” says Simons.

Programming is as important as medication, says Cameron J. Camp, director of research and development at the Center for Applied Research in Dementia in Solon, Ohio. “When people apply the Montessori principles, it’s not only the right thing to do but provides a better quality of life for everyone — residents, staff and managers. It’s a great business model, too. Aspen Ridge Memory Care in Bend, where residents make beer, has a waiting list.”

Camp has been appointed as principal investigator on numerous projects funded by the National Institutes of Health and served as president of the adult development and aging division of the American Psychological Association.

A Call for Change

Armed with a doctoral degree with training in cognitive psychology and gerontology, early in his career Camp worked with older adults in Kansas, looking at ways to improve their memory. In 1983, he moved to New Orleans, where he worked with individuals with dementia.

“The techniques I was using were worthless, and I realized we needed a different way to help them circumvent their deficits,” he says. That same year, Camp enrolled his son in a Montessori school. “I remember walking in, and the heavens opened and I could feel the angels sing,” he says. “As I learned more about the method, I asked a colleague if this might be the way forward,” for a more effective treatment approach for people with dementia.

“For twenty-five years, I’ve been researching how to use the Montessori method with older adults,” Camp says, “and now people are waking up to the fact that this generation coming into long-term care is different. Baby boomers won’t passively accept what they are told. Plus, younger workers today also don’t want to be told what to do; they want to be empowered.”

Camp’s goal is to change the industry standards by the time he is ready for long-term care. “I’m sixty-seven, so I have about a twenty-year window to get it ready for me,” he says, with a chuckle. Despite the industry’s predominant aversion to change, Camp is optimistic.

“There is hope,” he says. “Providing a good way of life is the best treatment for any human being, and this should be our focus. This isn’t just about dementia. Treating people with respect and dignity is a way of living.”

Experts say it’s worth taking the time to search for the right fit


Change is hard, especially when it comes to health care for you or a loved one. Moving to a new location, switching employer-based health insurance or transitioning to a Medicare Advantage plan can all mean you have to find a new physician.

Finding the right provider can make a huge difference in health and well-being. But many people don’t take the time to do their homework, which experts say can result in missed diagnoses, worse outcomes, unnecessary tests, extra costs or avoidable hospitalizations. Put some time and effort into the search up front, and you (or your loved one) will fare much better over the long term.

“I don’t think the selection of a doctor should be less work than if you’re going to put an addition on your house, says AnnMarie McIlwain, a New Jersey-based patient advocate and CEO of Patient Advocators. “This is your life we’re talking about.”

If you were hiring a contractor, you would get recommendations from friends and neighbors, speak with several prospects and look at samples of prior work, she explains. Taking a similar approach to finding a new physician is the least you should do.

What to Consider When Looking for a Doctor

Suggestions from friends and neighbors are a good place to start your search, according to Dr. Preeti Malani, an internist at the University of Michigan Medical Center. The first step is to make sure the doctor (or nurse practitioner) accepts your health insurance. Your health plan’s website will have a list of participating providers, and you can usually filter by other criteria, such as gender, location, additional training or board certification.

Look at factors like where they went to medical school and their institutional affiliation.

Also, look at factors like where the person went to medical school and their institutional affiliation, since larger medical institutions tend to offer more integrated care, McIlwain says. However, while schooling is important, Malani says it’s not everything — there are great people who train at many different types of hospitals.

For some patients, location is a key consideration. That includes things such as proximity to work or home, accessibility via public transportation or whether a private transportation service, such as  for people with disabilities, will take you there.

Also related to location, some people prefer a satellite clinic in the suburbs or a rural community because it’s less hectic and easier to park than a clinic in the middle of a large city. That might work just fine for healthy people. However, those with more complex medical conditions may fare better at an academic medical center with a larger team of specialists and services; these facilities tend to be located in larger cities.

“Some practices have a pharmacist, a nutritionist or social worker available on the premises. Having someone who works hand in hand with your doctor can help produce better outcomes,” says Malani.

Using Online Rating Sites

After you’ve narrowed down your options, review some of the online rating sites, like YelpVitals or Castle Connolly Top Doctors. But take these rankings with some healthy skepticism, and pay attention to the comments. “Look at who’s writing and what they’re saying,” Malani advises. If comments or ratings are consistent across several sites, it’s probably a more reasonable measure.

A recent University of Michigan National Poll on Healthy Aging found that among adults age 50 to 80, 43% had ever reviewed doctor ratings, 14% had reviewed ratings more than once in the past year and 19% had done so once in the past year.

Among those who looked up ratings more than once in the past year, 67% had chosen a doctor due to good online ratings/reviews and nearly all (96%) thought that the ratings matched their experience after meeting with the doctor.

Among this poll’s group of more frequent users, more than half (57%) reported not choosing a doctor due to poor ratings. The survey found that older adults were typically not offering ratings, but were looking at them. Older adults’ voices aren’t necessarily captured and their needs might be very different than the needs of younger adults, says Malani, who directs the National Poll on Healthy Aging team.

Online rating sites can often clue you in to how efficiently a physician’s office is operated. You can see how long it takes to schedule an appointment, whether appointments tend to run on time or if the doctor is consistently behind schedule. There may be comments about whether the office staff Is friendly and helpful, too. This can be important for anyone needing assistance with forms or other paperwork.

In some parts of the U.S., it can be challenging to even find a doctor who accepts new patients. Over half of physicians surveyed in a 2017 Physicians Foundation report say they have reached a tipping point and plan to make changes to their practices. Many surveyed said they intend to take steps that will likely reduce patient access to their services, which limits physician availability at a time when doctors already are in short supply.

Communication Is Key

It takes time to build a relationship with a new physician, and you need to take charge of managing it, says McIlwain, who matches clients with primary care providers and specialists. When you see a new doctor for the first time, bring a list of key questions and one or two objectives for the visit to help make every second of that interaction count.

“A doctor or nurse with good listening skills who takes enough time to explain and answer questions means better results.”

“You obviously want the (physician) to be maximally responsive, caring and open — not dismissive. Those kinds of qualitative things you can only get at from an introductory appointment,” McIlwain says. Ask yourself if you feel a connection with the doctor and if he or she has spent adequate time getting to know you and your situation. If not, keep looking.

Communication is the most important element of a doctor-patient relationship, Malani says. That may mean the doctor explains something in different ways to help you understand an issue or a timely interaction through an online patient portal or getting your phone call or email returned promptly.

“What’s important is that someone on the care team responds to your concerns,” Malani says. “A doctor or nurse with good listening skills who takes enough time to explain and answer questions means better results.”

You may be comfortable finding a physician on your own. However, there are times when using a patient advocate can help, especially if you move to a new community or need a specific type of specialist.

As a patient advocate, McIlwain acts as the client’s eyes, ears and brain. “You are paying us to go deep with you and to arm you with the information you need to make the best possible choices, and to have the best possible relationships and outcomes,” she says.

McIlwain suggests contacting the Alliance of Professional Health Advocates, a group with a national directory, if you want to work with an expert. Interview several to find a good fit.

As we age, our choice of physician becomes increasingly important. “It’s likely that we will develop some sort of health concerns, whether it’s a chronic health issue or just an acute issue, Malani says. “Keep looking until you’re comfortable with your decision, because you’re probably going to be with this person for a while.”

How one family sought to make everyone happy


One of the biggest challenges for anyone administering an estate is how to distribute what are called its tangible items. Unlike other property which can be easily sold, turned into cash and divided equally, tangible property is unique and often can’t be equally split. Also, its value often can’t be measured by what it could be sold for; a family photo album may have no monetary value, for instance, but great sentimental significance.

So, what should you do if you’ve been given the task to be in charge of divvying up a family member’s estate and it includes assorted tangible items?

The way some families do it is by taking turns selecting which items each will keep, sometimes reversing the order at each round so whoever went first in the initial round won’t get an unfair advantage by going first in all rounds.

The family rejected the often typical system for disbursing tangible items of an estate where family members take turns choosing items.

But let me tell you about a clever way one family dealt with this problem. As an estate planning and probate attorney, I’ve worked with many families over the years. But I’ve never ran into the solution my college friend, Sue, described to me after her mother, Mary Jane, died, and the four children needed to divide things up.

Although Mary Jane’s estate was pretty grand, the method the family used to divvy up the tangible items could be one that other families with much smaller ones could try.

724 Items, Not Counting Linens or Jewelry

After Mary Jane’s death earlier at 93, the executors — Sue and her brother Bruce — created an inventory of the 724 items in her estate that had monetary or sentimental value. (Those are their real first names, but I’m not including their last names to preserve anonymity.) These included furniture, artwork, oriental rugs, cutlery, china, furs, games, a piano and a car.

They didn’t include Mary Jane’s jewelry, books or linens, nor her silver, gold and collectible coins. The four siblings agreed to sell the coins and to deal with the many books, linens and jewelry in a more informal manner after the more significant items had been distributed.

Mary Jane, who the family called “Oma,” and her deceased husband, had received many of the 724 items at their big society wedding in Omaha, Neb., in 1947; purchased others during their long, married life and had inherited others. Many of the inherited items included antiques and boxes from Mary Jane’s mother that had remained in the attic since her mom’s death.

The family rejected the often typical system for disbursing tangible items of an estate where family members take turns choosing items. With over 700 items, this process could take a long time. And, based on their research, they felt that system wouldn’t maximize the value received by the four children and seven grandchildren.

The Family’s Five-Step Process

Instead, their process for dividing up the intangible items followed five steps:

  1. Sue and Bruce circulated the inventory to all four siblings and asked each to indicate which items they were interested in. This resulted in dividing the items into three groups: (a) those in which no one had any interest; (b) those in which only one person had an interest and (c) those in which two or more were interested. The ones where no one had an interest were set aside to be sold or given away. Those who were fortunate to be the only siblings wanting certain items got them.
  2. Then, Sue and Bruce prepared several lists of items in which more than one sibling expressed an interest. Each received a list of those. They were not given information on items in which they weren’t interested; this was one of two ways the system was not transparent.
  3. Each sibling was then provided with 500 virtual poker chips which he or she could use to bid for contested items. However, before the deadline for bidding, the siblings could talk with one another about their intentions. It turned out that many had bid for several similar items — such as family pictures, bookcases and oriental rugs — when they really only wanted one from each category. So, they agreed among themselves who would receive each one without wasting a lot of chips. Such consultation also avoided two people bidding a lot of tokens for a particular item and no one bidding on another similar one.
  4. After the bids were in, Sue and Bruce let everyone know what they had won, without revealing the bids. So, this was not like a silent auction or eBay where bidders can see what others are bidding and readjust their bids up to the deadline. This was the second aspect of the system that was not transparent.
  5. Finally, once all the allocations were determined, Sue and Brian added up the monetary value of all the items and readjusted the estate monetary distributions to ensure that everyone came out at the same place financially. The most valuable items were a 1919 Steinway drawing room grand piano valued at $25,000; a 2005 Toyota Camry valued at $4,500 and several oriental rugs together valued at $13,975. The recipients of these, in effect, had to pay their siblings something for them, with a total of $17,500 trading hands.

This was a time-consuming process, taking about three months. “It’s a good thing I’m retired,” Sue said, “and that I have a tolerance for detail and my siblings’ trust, which has turned out at certain moments to be very important.”

How did it work out?

The siblings felt their system was very fair and the process, unlike what I’ve seen in some other family estates, not only relieved tensions, it brought Mary Jane’s sons and daughters closer together. The adult heirs were also brought closer by spending time together packing items and getting Oma’s condo ready for sale.

Said Martha: “Our parents always encouraged us to treat each other well and not be horrible.”

By Harry S. Margolis

Harry S. Margolis practices estate, special needs and elder law planning in Boston, answers consumer estate planning questions at the AskHarry.info site and is author of Get Your Ducks in a Row: The Baby Boomers Guide to Estate Planning

Despite recent setbacks in clinical drug trials, other studies show promise


The fight against Alzheimer’s disease remains one of medical science’s more demanding challenges. Progress has been slow and often frustrating, as one drug after another has failed to live up to its promise in human clinical trials.

But those failures, along with technological advances in brain-scanning, have helped stimulate new avenues of research — including renewed focus on development of an Alzheimer’s vaccine.

“There are more new tools for early detection and diagnosis that we haven’t had before,” said Rebecca Edelmayer, director of scientific engagement for the Alzheimer’s Association. “Fifteen years ago, we didn’t even have the capability to look into the brain. Now, this is enabling us to better understand the disease process.”

That has been one of biggest hurdles for Alzheimer’s researchers. It’s still not clear how the disease progresses or if its progression can be diagnosed before it has inflicted too much damage to a person’s brain. It’s still unknown whether one of the key hallmarks of Alzheimer’s disease, the buildup of beta amyloid plaque deposits, is a cause or an effect.

Meanwhile, the toll grows more devastating, with close to 5.8 million Americans living with the disease, and the number expected to rise to 14 million in the U.S. by 2050. In addition, the Alzheimer’s Association estimates that 16 million Americans are providing unpaid care to family members or friends with the disease.

More Funding for Different Approaches

Yet, Edelmayer is encouraged that increased funding from the federal government for Alzheimer’s research has led scientists to broaden their focus in multiple new directions, such as looking for ways to stimulate the body’s immune system to stop Alzheimer’s from advancing.

Researchers are working on a mechanism that would provoke human antibodies to clear out destructive protein buildups in the brain.

For almost two decades, most Alzheimer’s research and pharmaceutical company investments have targeted the clumps of beta-amyloid plaque that collect between neurons in the brains of Alzheimer’s patients. But that approach has proven expensive and unfruitful.

Many scientists now believe that the cause and development of Alzheimer’s is considerably more complex, so they have shifted to other targets. Some are focusing on treatments designed to clear out one of the other biomarkers of of the disease: tangles of tau protein that spread throughout the brain.

Other researchers are zeroing in on what’s known as “neuroinflammation,” an age-related, chronic condition tied to overactive immune cells in the brain. One firm working in this area is INmune Bio, of La Jolla, Calif. Its researchers believe that a sustained abnormal immune response isn’t a consequence of degenerating brain neurons, but rather a cause of cognitive decline.

R.J. Tesi, the company’s CEO, thinks Alzheimer’s has more to do with chronic inflammation that comes with aging than with amyloid plaque. “We believe all the focus on amyloid was really unfortunate because it consumed the field for twenty years,” he says.

Instead, he contends that the key is to target the brain’s innate immune system and develop a treatment that “reprograms” cells that are overactivated. “Complex diseases require combination therapies,” Tesi says. “We feel that what we’re doing will be in the mix of everybody’s combination therapy for Alzheimer’s.”

He says a clinical trial is under way and he hopes that by later this year, scientists will be able to measure if INmune Bio’s drug can normalize the immune systems of patients.

Developing a Vaccine

Perhaps nothing excites the public more than the prospect of an Alzheimer’s vaccine, and researchers are working on a mechanism that would provoke human antibodies to clear out destructive protein buildups in the brain.

Several research projects have reported progress on this, although they’re largely in the early stages of testing. One of the more advanced is an effort by United Neuroscience, a biotech company in Dublin, Ireland. It’s spearheaded by lead researcher Chang Yi Wang and her daughter, CEO Mei Mei Hu.

Last year, United Neuroscience disclosed positive results in small human clinical trials. Nearly all of the patients responded, without serious side effects, to a vaccine treatment that reduced the accumulation of beta-amyloid plaque.

More recently, a joint study by scientists at Flinders University in Australia and the University of California, Irvine found that a combination vaccine given to mice generated antibodies that targeted both beta-amyloid plaque and tau protein tangles.

“The first challenge is making antibodies that target the right place on the abnormal proteins,” says Flinders researcher Nikolai Petrovsky. “We also were able to get more antibodies into the brains of the animals. You have to have enough of the right antibody or you’re not going to see much of an effect.”

He says testing the vaccine therapy on human patients is at least a year or two away. Petrovsky estimated that, best-case scenario, an Alzheimer’s vaccine for humans could be available in five to 10 years. But the Alzheimer’s Association was more circumspect about making a prediction, saying only that given the complexity of the disease, it “will likely require a complex treatment/prevention solution.”

Still, another study at the University of New Mexico reported that mice given a vaccine developed antibodies that cleared tau protein tangles in their brains. Those mice also performed better on memory tests than animals that didn’t receive the treatment.

Looking Ahead to Human Clinical Trials

But once again, human clinical trials, which often are demanding and expensive, are likely years away.

“What we see in one animal doesn’t necessarily mean we’ll see it happen in people,” acknowledges study author Nicole Maphis. “It’s a tightrope we walk.”

Maphis also points out that since Alzheimer’s progression is not well understood, it can be difficult to select the most appropriate patients for a trial and know at what point it’s most helpful to study their response to treatment.

“With clinical trials, they (the Food and Drug Administration) want to see results in two or three years,” she says, “but development of Alzheimer’s is such a protracted disease. You may see results in five years, but you also want to look at ten to fifteen years.”

It’s a daunting challenge, Maphis says. “When you go from lab bench to bedside, it can feel like leaping over the Grand Canyon.”

Words celebrating romantic connection can create meaningful memories


I can’t help loving you more than is good for me; I shall feel all the happier when I see you again. I am always conscious of my nearness to you; your presence never leaves me.

Have you ever received a love letter like this? Or written one? In these two sentences, German writer Johann Wolfgang von Goethe (1749-1832) quite effectively captured some of the sentiments found in an ideal love letter — happiness, longing, attachment — in a letter to his muse Charlotte von Stein, a woman he never married.

Romantic expressions in a letter such as Goethe’s have been around for hundreds of years. And like Goethe, many have also penned their feelings to love interests who didn’t stand the test of time. No matter how the relationship turns out, love letters are powerful.

You might remember the feeling of slowly opening an envelope to reveal a letter, perhaps expressing sentiments that might have been hard to say in person, tucked within. And years later, long after those letters have been stored away, the memory of those words can still carry great weight.

Recently we posed these questions on Facebook to Next Avenue readers: Have you kept love letters you’ve received over the years? Why or why not? Do you ever go back and read them? What is your most meaningful love letter?

The many responses were, in a word, heartening. We received comments from men and women about love letters from long ago, or more recently received, which hold great significance for them and can still provoke strong emotions.

“I keep them tucked away to remind myself how much my marriage has evolved. How that young love has grown into such an amazing friendship and love story.”

Some wrote about letters from spouses who have died, including Sandra, who says of letters from her husband of 42 years: “I’ve kept mine and read them from time to time. My husband passed 8 ½ years ago, so they are bittersweet memories.”

Sally has many letters starting from the time her now-husband was away at college. And in honor of their upcoming 50th anniversary, she plans to re-read all of those sweet missives. Another reader, La Bella Luna, tells about the valuable lessons she finds in the love letters from her husband: “I keep them tucked away to remind myself how much my marriage has evolved. How that young love has grown into such an amazing friendship and love story.”

Dave recounted his first meeting with his wife and how it came at a time when he was going to be moving out of the building where they met. She wrote a letter to him, which she passed on to one of his roommates, about how she wished they had met sooner and how she wished him well.

“It touched my heart that someone would be so thoughtful and straightforward, not expecting ever to see me again,” Dave wrote, adding that she walked into the room as he was reading her note. The happy ending: they went on a date, were engaged after three months, and wed after six. They have been married for 45 years.

Letters from Former Loves

Apart from letters saved by those who stayed together, many readers have letters which serve as souvenirs, for better or worse, of past relationships.

“I have letters from my first love — who is not my husband,” one wrote. “Will read one day when the time is right.”

Another has a letter that she wrote but never delivered to a man who is no longer a part of her life. She is still considering whether or not she will finally mail that envelope.

Reader Kerry wrote from a different perspective: “I am very sad that I burned all of the love letters from my young husband when he left me stranded with a 3-year-old and pregnant with our son. I had his duffle bag full of love letters from him… I could not bear to read them, but I wish I would have saved them for my daughter.”

Tied in Ribbons and Boxes

Many readers told us of letters tied together (“I’m so sad that my girls won’t have love letters to tie with a ribbon to revisit,” writes Pepper) and of boxes tucked away, filled with letters that may never be read again, but how knowing they’re there is gratifying. (I’ll admit to having a similar box that has been opened a few times over the years.)

It was a box of letters from the 1990s that she found in her basement which prompted Michelle Janning, a professor of sociology at Whitman College in Walla Walla, Wash., to take a deep dive into the meaning of love letters (paper versions and the more contemporary emails and texts) for her book Love Letters: Saving Romance in the Digital Age.

“One day in 2012, I started looking through my box and my husband walked in and asked what I was doing,” she says. “When I told him, he was interested and said, ‘I wonder if we are the last generation of letter writers.’”

Janning set out to research that very topic, surveying people from the ages of “18 to 80ish” to find out the significance of love letters in their lives.

“It became clear to me that the difference between the use of digital vs. paper communication varied by age and gender,” says Janning. “What I was interested in was the curatorial process of what people kept, what they shared and how they stored what I call ‘romantic communication.’”

A Letter Held in Your Hand

Love letters can be written on elegant paper or on a scrap from a school notebook; it doesn’t matter to some, as long as the tactile nature of the communication can be felt. As Janning says, the meaning of why a “real” love letter matters might have deeper meaning.

“If you prefer paper, what do you really prefer? Is it something that feels more personal? And is it something you can more easily protect, in a box, than a digital message stored in a mysterious virtual closet that Silicon Valley can access?” she says with a laugh. “A tangible letter can be stored ,and for some, that feels sacred.”

Before you assume that millennials are fine with keeping their romantic communications in that virtual closet, Janning will tell you otherwise.

“In my research, I was surprised to find that young people do cherish handwritten letters. They consider them to be precious, rare and valuable,” she says. “In a sense, they have nostalgia for something they’ve never experienced.”

Janning also found that women were more likely to talk about saving love letters in a special box (a box they were more prone to hide, by the way) while men tend to save fewer letters, but are more likely to keep them in an easily accessible place and look at them more often.

She also discovered that people were equally as likely to keep love letters as they were to destroy them. For some, the highly charged nature of the content provoked them to get rid of letters to prevent unexpected discovery by their children one day. (Sometimes destruction can lead to regret. One Next Avenue reader reported she had kept a batch of love letters for 35 years, and then finally gotten rid of them, adding: “Alas.”)

Janning says that love letters provide a window to the past, and if reflected upon, can reveal how life has changed and how the recipient of the letter has grown.

“Some people look at letters as a reminder of what not to be, while others see their true selves in the words of those letters,” she says.

More Love Letters

If it’s been a while since you’ve written a love letter, the More Love Letters website might have the opportunity you are looking for. Its letters are intended to lift up those who may be going through a challenging time by offering caring words of support and love from strangers.

In 2011, Hannah Brencher, author of Come Matter Here and If You Find This Letter, founded More Love Letters and since that time, more than 250,000 love letters have been sent, in all 50 states, and to more than 70 countries worldwide.

“The topic unlocks something in people – they do beautiful things with these letters, and they can really help change someone’s life.”

Each month, Brencher, who lives in Atlanta, and her team field letter requests from people who are hoping that words of love and encouragement from others will help their own loved ones.

“We’ve had requests for letters for children as young as 12, going through chemotherapy, to a recent request for a 58-year old woman, living with MS, who is experiencing loneliness in the assisted living facility where she now lives,” says Brencher.

The month’s stories, always fewer than ten, are posted on the site. Writers can select a person to write to; letters for each “bundle,” as they are called, are then sent directly to the nominating family member or friend. These bundles are far from small; many contain more than 400 letters. There is no charge to receive letters, and to send one is merely the price of a stamp.

“Then there can be a moment between these two people where they can read these words of love together,” says Brencher, adding that many capture the experience and send photos to the More Love Letters team. “They read them together and cry. Sometimes, they go through them in one sitting, other times they parse them out over time.”

Brencher, who wrote all the letters when her company started, says that it’s surprisingly easy to write letters to strangers. “The topic unlocks something in people — they do beautiful things with these letters, and they can really help change someone’s life.”

Not only are the recipients of all ages, but so are the letter writers. “We have many older adults who sign up to write letters, and many millennials who are fascinated by the idea,” she says. Additional information about participating in More Love Letters can be found on the website.

‘An Indescribable Pleasure’

At their core, love letters can be conversations from the past, and sometimes conversations that last for years. Their meaning is specific and intimate to both the writer and recipient, serving as a reminder of what was, and what is.

For instance, John Adams, the second President of the United States, and his wife Abigail Smith Adams were ardent letter writers. Beginning in 1762, when they first began courting, through the end of John Adams’ presidency in 1801, they exchanged more than 1,000 letters.

As Abigail wrote in their later years, “I look back to the early days of our acquaintance and friendship as to the days of love and innocence, and, with an indescribable pleasure.”