Since 1892, Kalispell has been the focal point of northwest Montana. In fact, Kalispell is considered the largest city and commercial center in the Flathead Valley, with a population of around 23,000 people.
Kalispell provides its residents with a host of amenities to ensure a fun, relaxing and productive lifestyle. You’ll find top-quality restaurants for meals, activities and entertainment, easy access to natural parks and landmarks, and much more!
Things to do in Kalispell, Montana
People are drawn to Kalispell for a variety of reasons. The seat of Flathead County in Montana, Kalispell is an ideal town to not only enjoy city life and community, but also to experience nature’s scenic beauty in this charming mountain town. If you are looking for more reasons to choose Kalispell, here are just a few:
Food and Drink
There are a wide variety of restaurants to suit any taste. Downtown Kalispell is home to many places that offer not only home-grown food, but a taste of international cuisine. From the Brooklyn Style Deli, to Ceres Bakery, to Thai Palace, Scottibelli’s Ristorante Italiano and more, you’re sure to find a place that will satisfy your cravings.
Kalispell also offers numerous places to enjoy a drink with friends as well. Explore some of the wineries in and around the city. Restaurants such as the 406 Bar and Grill and Hops Downtown Grill also provide a welcome place to relax and share some good times with friends. For some international flavor, try Brannigan’s Irish Pub. For a trip into the past, the Moose Saloon is for you.
Sightseeing and Entertainment
Kalispell features some of the most picturesque sites for those wanting to explore. The Conrad Mansion Museum was home to Kalispell’s founding father, Charles Conrad, beginning in 1895. It features 13,000 square feet, three floors, and 26 rooms. Our residents enjoy visiting this historic landmark, and here are a few tips for planning a visit there.
For music lovers, the Glacier Symphony and Chorale performs a diverse variety of musical selections from October to July. If you have an eye for art, the Hockady Museum of Art welcomes seniors once a month with free admission on Senior Tour & Tea Day.
Outdoor Pursuits
Nature enthusiasts will be happy to learn that close to Kalispell are some natural sites to behold.
Glacier National Park is one of the most visited sites in the western United States. With a traveling distance of 33 miles between the park and Kalispell, it is a nice way to spend your day. There are over 700 miles of trail for those wanting to take in the natural sights.
Flathead Lake is the largest freshwater lake in the western part of the United States, boasting 200 square miles of water and 185 miles of shoreline. The lake offers numerous activities including fishing, boating, cruises and kayaking. A quick trip from Kalispell (about eight miles) means you won’t have to travel far to enjoy nature.
A popular destination within Flathead Lake is Wild Horse Island, the largest island within the lake. It is a wildlife refuge, housing more than 75 species of birds, especially geese, osprey, herons and eagles. You can explore the island on one of many beautiful hiking trails, taking in forests, prairie meadows and early 20th century homesteads.
Enjoy Active, Comfortable Senior Living in Kalispell
Kalispell, Montana provides all the comforts of city life with the ability to head off into nature at a moment’s notice. Here at Immanuel Living, you can experience all the amazing social and leisure opportunities in Kalispell, plus a variety of on-campus services and activities for an enriching and enjoyable retirement lifestyle. Contact us today to schedule a tour of our beautiful senior living community.
The Oscar-nominated documentary also spotlights palliative and hospice care
Credit: ‘End Game’ | Netflix
In a pivotal scene of the documentary End Game, we listen in as a team of palliative care professionals discusses Mitra, a 45-year-old woman who is dying of cancer. Should they approach her about hospice? The hospital chaplain urges the group not to bring it up. She had spoken to Mitra’s mother, who told the chaplain that to Mitra, hospice means death. Dr. Steven Pantilat, a palliative care specialist, agrees with her assessment, noting: “Healthy people want to talk about how they want to die. Sick people want to live.”
This exchange in End Game (available on Netflix) captures human nature, and the delicate dilemma doctors and patients face at the end of life, under the best circumstances. Filmed in the serene hospital rooms and corridors of the University of California San Francisco Medical Center and the recently-closed Zen Hospice Project, situated in a tastefully-appointed Victorian house, we see firsthand the inner workings of hospice and palliative care.
We also see clearly how important it is to talk about these matters before we might need them.
Considering Palliative and Hospice Care
Though palliative and hospice care can greatly ease suffering, they are not easy to talk about or decide on for many patients. Some of the people in the 40-minute documentary are not ready to check out and seem to feel that accepting hospice care would mean accepting death. Their family members don’t want to let them go either.
Mitra’s husband hopes each new treatment will bring a miraculous recovery. Her mother knows her daughter will never walk again, much less recover from cancer and thinks her daughter is suffering. In one scene early in the movie, which is doubtless replicated in many hospital rooms every day, Pantilat asks Mitra’s husband and mother if they want to continue treating the cancer.
“If she were clear in her thinking and seeing herself in her bed the way she is right now, what decision would she make?” Pantilat asks. The question hovers in the air.
When Mitra’s sister flies in from Switzerland, initially there is jubilation over the reunion and we rejoice vicariously with the family. In the next scene, however, we see the sister collapsing in her mother’s arms in the hallway, weeping. Later, we see Mitra’s mother literally staggering down the hallway under the weight of her sorrow. We witness Mitra’s husband’s heart breaking, and their 8-year-old son playfully massaging his mother’s bald head.
There is joy, sorrow, love. The camera captures it all, but there is no narration. We witness the family’s struggles as they go through them in real time. This is part of the film’s power: It is easy to identify with the subjects. Viewers might feel they are losing their own family member.
The Filmmakers’ Vision: Bring Death Out of the Closet
The 40-minute film, directed by Rob Epstein and Jeffrey Friedman, was nominated for an Oscar in the category of Documentary Shorts.
The filmmakers, who won an Oscar in 1985 forThe Times of Harvey Milk, wanted to raise awareness about how palliative and hospice care can give us the right care at the right time. As Friedman explained, birth and death are universal life passages, and of those, death is the one we have the option of facing consciously.
“Most of us avoid thinking about it until it’s too late. By doing that, we set ourselves up to lose control of our life story when we’re at our most vulnerable,” Friedman says. “Couple that with medical technology so advanced that we can keep nearly everyone ‘alive’ using machines — but without taking the time to talk about what the quality of that life will be. The result is that far too many people are getting care they don’t understand and don’t want.”
“End Game is about choices we make about how we want to live, when we know our time remaining will be brief,” Epstein adds. “One of our goals in End Game was to inspire conversations — not only about facing death, but about how we want to live, right up to the end.”
End-of-Life Care Explained
According to Pantilat, author of Life after the Diagnosis: Expert Advice on Living Well with Serious Illness for Patients and Caregivers, “Palliative care focuses on improving the quality of life for people with serious illness (whatever the prognosis). It alleviates symptoms like pain, shortness of breath, fatigue and nausea. It’s also about having patients communicate preferences and values, so the care team can attend to their psychological, spiritual and emotional support when they are sick.”
In the United States, hospice is a service to provide palliative care to people, largely at home. For hospice, the eligibility criteria include a prognosis of no more than six months of life and patients and loved ones who have agreed the focus will be comfort care. Hospitalization, generally, will be avoided.
“Most of the time, hospice is not a place, but a service, although there are facilities focused only on hospice care (as Zen Hospice Project was). All hospice is palliative care, but not all palliative care is hospice,” Pantilat explains.
Many people have the misconception that once you choose palliative care, you’re not getting any other treatment for your illness. “That’s not true at all,” Pantilat says. You could have palliative care alongside chemotherapy, bone marrow transplant and many other serious illnesses. In fact, palliative care might help you live longer.
“There’s never been a study that showed that people who receive palliative care live less long. And there are studies that show that people who receive [palliative care] for the illness live longer. It’s an unmitigated good.” Pantilat says.
Help for the Family, Too
There’s another important feature of palliative care: It also attends to a dying person’s loved ones. The palliative care team will talk to family members and offer them comfort, options and counsel.
Pantilat notes: “When people ask, ‘When should my family come?’ I always say come now. If they get better and live for another six months or year or two, no harm, no foul. It’s one more visit. But if you try to time it when they’re really sick and on death’s door, they might be too sick to have a meaningful interaction or you might miss the opportunity. Things can happen suddenly.
“We try to have these conversations in advance and understand what’s really important,” Pantilat continues. “If visiting with your sister or seeing your daughter get married is the most important thing to you, now’s the time to do it. Maybe you shouldn’t wait 10 months for a wedding, because you may not make it. Instead, could your daughter move the wedding up to next month?”
And speaking of not waiting, the doctor has a message: “If you or a loved one has a serious illness, you should have palliative care. Don’t take no for an answer. Because it will help you live better and may even help you live longer.”
Deborah Quilter is an ergonomics expert, a certified Feldenkrais practitioner, a yoga therapist and the founder of the Balance Project at the Martha Stewart Center for Living at Mount Sinai Hospital in New York. She is also the author of Repetitive Strain Injury: A Computer User’s Guide and The Repetitive Strain Injury Recovery Book.
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“Every time I read a post, I feel like I’m able to take a single, clear lesson away from it, which is why I think it’s so great.”
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Pier I juts out over the Hudson River on Manhattan’s Upper West Side with — depending on your vantage point — mesmerizing views of the New York City skyline or New Jersey. As the waning sun hovered above the horizon, 16 older women wearing name tags waited for their Thursday dance class to begin. They didn’t seem to mind that the humidity felt like a sticky second shirt or that there was little breeze in the air.
Naomi Goldberg Haas
Sitting in the middle of that circle was Naomi Goldberg Haas, the 57-year-old founder of Dances for a Variable Population (DVP), a program that offers free classes to older adults in the New York City area. Haas asked her assistant, teaching artist Rebecca Teicheira, to explain the rules to the students: Have fun and don’t do anything beyond your limits.
Then she hit the play button on Simon & Garfunkel’s 1966 classic 59thStreet Bridge Song (Feelin’ Groovy) and the students enthusiastically followed Haas through a seated warm-up where they lifted their legs, twisted their torsos and circled and snaked their arms, alternately reaching for the sky and swooping to the ground.
Haas then passed the baton to Teicheira, who seamlessly picked up leading the group. Participants also were invited to invent their own movements and lead the group themselves. Eventually everybody stood, split into two groups and had a Sharks-and-Jets style dance-off where they tried to outdo each other. This group was hardly hampered by self-consciousness; rather, they confidently strutted their stuff to one another and to the diners in a distant café.
In conversations after class, Haas and her students shared seven of the benefits of dancing, no matter what your age:
1. ‘You Recognize the Difference It Makes’
Haas explained her philosophy of teaching dance: “There’s so much we can learn from dancing with each other. Also, by dance-making with each other, we gain an appreciation of our own body and beauty.”
Some students come for the exercise benefits. “Once you pass a certain age, you realize you have to be in a physical program,” Haas observed. “You recognize the difference it makes. On a larger social level, the lack of movement is killing us.”
DVP, which Haas founded in 2008, works with more than 45 senior centers and institutions. Movement Speaks, one of its programs, offers older adults and low-income communities free dance instruction and a public performance of an original work created by class participants.
Credit: Courtesy of Naomi Goldberg Haas
2. ‘Touch Is Life-giving’
While dance has health benefits for the body and mind, Haas emphasized that her goal is to inspire participants to move creatively and feel empowered by that movement.
DVP classes also incorporate some partner work where people might briefly hold hands as they circle around each other on the floor. “Touch with someone else is life-giving,” Haas explained.
At the end of class, the dancers divided themselves into groups of four. Each participant would lead a few times, then pass the torch to the next person, so everyone got a chance to create a movement and follow their partners.
Haas gazed on with affection as one group of students performed. “Beautiful,” she murmured.
3. You Can Rediscover Dance
Students who had previously studied dance might find the class more doable than a class they would find in a traditional studio because DVP’s emphasis is on what you can do, not insisting that people attempt choreography that would be beyond their limits.
Karen Beja, a 59-year-old school psychologist, began dancing with the group about three years ago. “I did a lot of dance as a young adult and I stopped in my late 30s and I miss it,” she explained. “Naomi has given me back movement.”
In addition to keeping her mobile and flexible, Beja said, “It makes me feel joyful.”
Credit: Courtesy of Naomi Goldberg Haas
4. The Ability to Improvise and Memorize for a Better Brain
In many dance traditions, there is no improvisation, but more than one student noted how good the improvisational sections were for their minds. Indeed, science is discovering many benefits of dancing; having to remember the steps and combinations helps maintain mental muscles.
“In traditional dance, there’s not so much improvisation,” said Beja. “That was newer to me. Improv is really good for my brain. It’s fun.”
5. You Get a Chance to Diversify Your Social Circle
Beja also enjoys the diversity in the class. People come from different age groups, races, socio-economic backgrounds and they have different abilities.
“Maybe it’s because it’s not a heady or verbal group,” she said, “but it’s more about movement uniting everyone.” That kind of mixture sometimes doesn’t happen in life, but DVP provides this opportunity.
Another plus of this diversity, according to Beja, is that in the classes, she observes people who are much older than she is. “They are moving however they can at any age,” she said. This can inspire other participants to keep going because the older dancers set a positive example.
6. Making Connections with People and the Environment
A few students found that the class helps them form new friendships. Beja took part in a performance at Grant’s Tomb and noticed how much closer many class participants became as a result. “People were very connected,” she said.
And the outside class environment offers an additional boost. “It’s wonderful to be outdoors,” said Beja. “You feel part of the city.” Naturally occurring props in different venues can also become part of the dance, including barricades which are used as ballet barres, she added.
7. There Are Other Physical Benefits of Dance
Helga Busemann, a 70-plus former social worker who had been in physical therapy for her osteoporosis, felt that the dance class was more beneficial. “I like the enthusiasm,” she said. “In Naomi’s class, I get a full hour — and social support.”
Busemann once worked in a hospital setting and recalled seeing older patients who lived in sixth-floor walk-up apartments. “People came to rehab because they couldn’t handle the stairs — and they couldn’t handle their lives, either,” she said, adding that she realized, “it could be me.”
As many people age, a “fear of falling and fear of breaking arises,” Busemann noted. “When people break their hips, some people come back, and some people don’t. I don’t want to fall. [In the class], Naomi does a lot of balancing.”
For Busemann, exercise and movement are a must. “It’s like brushing your teeth. You have to do it. I need the exercise. I need the extra push of a class,” she said.
Demonstrating Their Skills
Once a year, students show what they’ve learned in class to friends and passers-by during a public performance. This can be a very special experience for the dancers.
Alice Ellerbeck, a 62-year-old psychotherapist, was part of a performance in the iconic Washington Square Park in Greenwich Village. “That was really exciting,” she recalled. Approximately 10 of her friends and family members came to watch.
“Anyone can dance. Everyone should dance,” Ellerbeck said.
Deborah Quilter is an ergonomics expert, a certified Feldenkrais practitioner, a yoga therapist and the founder of the Balance Project at the Martha Stewart Center for Living at Mount Sinai Hospital in New York. She is also the author of Repetitive Strain Injury: A Computer User’s Guide and The Repetitive Strain Injury Recovery Book.
Next Avenue brings you stories that are inspiring and change lives. We know that because we hear it from our readers every single day. One reader says,
“Every time I read a post, I feel like I’m able to take a single, clear lesson away from it, which is why I think it’s so great.”
Your generous donation will help us continue to bring you the information you care about. What story will you help make possible?
Have you considered how to pass on your non-material assets?
When people find out Debby Mycroft helps people write ethical wills, she always gets a predictable response: The Lament.
“They say, ‘Oh, I wish I had a letter from my dad or grandmother or great aunt,’ whoever that person was. I have not come across a single person who has not wanted a letter from that special person,” says Mycroft, founder of Memories Worth Telling.
Unlike legal wills, ethical wills — also known as legacy letters — are not written by lawyers, but by you. They can include life lessons, values, blessings and hopes for the future, apologies to those you fear you may have hurt or gratitude to those you think you have not thanked enough. Traditionally, they were letters written by parents to children, to be read after death.
People who do not have children address them to friends or groups. One of Mycroft’s clients was placed in child protective services when she was quite young because her parents were addicts. “She had a rough upbringing. She intentionally decided not to have children herself. But she wanted to write an ethical will to other foster kids to let them know [they] can survive this,” Mycroft explains.
Why Write an Ethical Will?
Think that your life isn’t important enough to warrant an ethical will? Mycroft disagrees, saying, “You don’t have to be a war hero or a Nobel Peace Prize winner for your story to have value. When people accept awards at the Olympics, they thank the people who had an impact on their life, like Mom or Dad, who was always there to take them to training.”
But there’s an even more important reason you might want to consider a legacy letter. According to Barry K. Baines, author of Ethical Wills: Putting Your Values on Paper, such documents can bring enormous peace of mind.
Baines recalls one dying patient who was bereft because he felt there would be no trace of him when he left. “The first wave would wash away his footprints. That sense of hopelessness and loss was overwhelming,” says Baines. The man rated his suffering at 10 out of 10; after he wrote his ethical will, his suffering reduced to zero.
Don’t wait until you are on your deathbed to do this, Baines warns. As soon as you articulate your values, suddenly you start to live your life more intentionally. Especially if you share it.
“Live your life as you wish to be remembered,” Baines advises. Plus, he adds, legacy letters can help with making amends, addressing regrets and healing relationships.
Ethical Will: Telling Your Own Story
If you don’t feel capable of writing your legacy letter yourself, you can use an online template, take a workshop, read a book about it or work with a professional writer.
But don’t judge your skills harshly. Baines finds that whether people are educated or not or if their letters are simple or complex, they always have a certain elegance because of the truth they contain. “When the families get one, they just glow,” Baines says, adding, “This is a unique gift that only you can give.”
When you write your letter, don’t just say, “My core values are consideration, gratitude, kindness, simplicity,” advises Mycroft. Tell a story about how you’ve lived these values.
In her own legacy letter, Mycroft told her kids about a temp job she had as a teen. She appeared nicely dressed in a skirt, blouse and heels. When she walked in, the employers gave her a funny look and asked, “Why do you think you are here?”
She explained the agency had sent her out for secretarial work. Then her employers handed her a hard hat and steel-toed shoes. “That’s when I look at them quizzically.”
Turns out they were a plastic-bag manufacturer and she was supposed to sort through damaged goods to salvage the ones that could be sold.
“I was so angry that that agency had sent me out on that job. It was hot and humid in Virginia. I was fuming,” Mycroft says. “When I got home, my parents started grilling me. They said, ‘Did you agree on this job?’” And Mycroft confirmed that she did.
They asked what the contract said. Mycroft replied that the contract was pretty clear. Did she sign the contract, her parents wanted to know?
“Yes, but,” she says she told them. “And my parents said, ‘You signed it; you’re committed to it.’”
Mycroft stuck with the job as promised. “That was my first lesson in integrity, perseverance and diligence,” she recalls. She did what she said she would do. As a postscript, she got fantastic jobs from the agency over the rest of the summer. They knew they could count on her.
What Goes Into the Legacy Letter and What Stays Out
Ethical wills are often likened to letters from the heart, so perhaps the best advice is to literally write a love letter.
Love letters don’t recriminate. They don’t judge. They don’t scold. A love letter is there to show how much someone matters to you.
Criticisms and judgments should be left out, advises Mycroft. It’s okay to include regrets and family secrets, even if they hurt. If worded properly, these could bring the family to a place of acceptance and understanding.
She notes, “Sometimes when those things are hidden for so long it causes a lot of resentment — as in] why didn’t they tell me I was adopted? I wish I had known.”
“Definitely avoid manipulation,” Mycroft advises. “Legacy letters are beautiful expressions of love and encouragement, telling other people what is so fantastic about them. I do not think they should be hands reaching up from the grave slapping you or saying, ‘I told you so.’”
Think about how your letter might be received. Baines worked with a woman who had a very hard life. “Every part of her ethical will was blame and guilt-tripping,” he recalls. While some people can turn around a bad experience and use it is an example of what not to do, this woman could not.
“It almost seemed like she was purposely trying to hurt people,” Baines says. But eventually she realized that and gave up, sparing her family the hurt she would cause them.
Get a Second Opinion
Baines believes writers should show their legacy letter to a trusted friend before passing it on, to avoid inadvertent errors. Your reader might say, “You mentioned your two children, but you only write about one and not the other.” That could be extremely hurtful.
Baines also urges people to share the letters while they’re living. It might be painful, but there’s still potentially an opportunity to mend wounds. After you die, there’s no recourse at all.
What About Videos or Selfie Videos?
Some people make videos or selfies of their ethical wills, but keep in mind that technologies can become outmoded.
Mycroft gave both her children the letter and a video of her reading the letter so they not only have her words, but can also hear her voice.
“I’ve heard of people saving voicemails of people who have passed on,” she says. “Can you imagine saving a voicemail and all it says is ‘Susie, are you there? Can you pick up? Hello?’ If you’re willing to save that message just to hear their voice, how much more powerful would it be to hear your voice reading that letter?”
The Time Is Now
The time to write your spiritual legacy is now. Mycroft provides a case in point about her mother, who knew the family lore and lineage.
“I gave her one of these fill-in-the-blank family history books because I wanted to make sure it was preserved,” says Mycroft. “Five years later, when she had passed away and I went to clean out her office, I found the book. It was completely empty.”
Deborah Quilter is an ergonomics expert, a certified Feldenkrais practitioner, a yoga therapist and the founder of the Balance Project at the Martha Stewart Center for Living at Mount Sinai Hospital in New York. She is also the author of Repetitive Strain Injury: A Computer User’s Guide and The Repetitive Strain Injury Recovery Book.
It may take less time than you think and bring you joy
Do you ever wish you knew how to play a musical instrument? If so, you are not alone. Yet a 2012 National Endowment for the Arts survey found that just 12 percent of U.S. adults were playing musical instruments.
This gap between aspiration and actuality occurs despite research showing that making music, as a pro or amateur, is good for the brain and may delay the onset of some of the mental decline of aging. Scans of musicians’ brains have shown that playing an instrument involves greater communication among regions of the brain than with other tasks, which may lead a musician’s brain to create new neural pathways. Those extra pathways may provide musicians with “cognitive reserve” when dementia strikes because their brains “will automatically be more able to cope and find new ways to do tasks,” explains Canadian neuroscientist Aline Moussard.
Carving Out Time for Music
Given this tantalizing research, why haven’t more adults followed through on their desire to play an instrument? Some have said they had no time to spare. However, the time needed may not be as much as one might think, according to 274 adults who told me — as part of my research for a new book, Making Time for Making Music — how they carve out time to make music.
Ranging in age from 25 to 96, most of them play instruments and a quarter play instruments and sing in choral groups. About five percent don’t practice music at home but still enjoy being part of a community ensemble or choir. About a quarter practice only one or two days a week. Of those who do practice, about 15 percent spend 30 minutes or less a week, often finding ways to shoehorn practice into spare moments. Those who practice more may make more progress, but as Liz Sogge, a Baltimore statistician who plays violin in the Johns Hopkins University Concert Orchestra notes, “There is nothing wrong with never playing at the level of a world-class violinist.”
Music lessons are another time-eater, particularly for newcomers or those who haven’t studied music for years. But there are lower-cost group classes and ensembles that try to speed up the learning process. New Horizons International Music Association has more than 200 such ensembles geared to adults age 50 and over that help newcomers make music as quickly as possible, with instruction built into rehearsals. Only half of the adults I surveyed are taking lessons, with half of them doing so weekly, the rest less often.
‘You Feel as if You are Soaring’
A lack of confidence in their musical abilities may hold back some would-be musicmakers, caused by feelings left over from less-than-positive childhood musical experiences. Luckily, it is possible to reboot as an adult by trying a different instrument or type of music, finding beginner-friendly ensembles, joining music support groups, forging more collegial teacher-student relationships and realizing that recitals are optional for adults.
Some adults may also be unaware of the many new opportunities available now. Music schools began expanding their adult programming as boomers started nearing retirement age. Adults currently make up about 25 percent of the enrollment at Baltimore’s Peabody Institute’s Preparatory Division.
“I had no idea there was a way to make beautiful music in a community orchestra the way I’m doing now,” says Dr. Morris Schoeneman. After retiring from a medical career, he took refresher lessons on the violin he hadn’t played in four decades and found a community orchestra to join near his suburban New York hometown. “I wish I had known about this earlier. I could have been doing this while I was working.”
Once adults make the plunge, it’s not neurological research that spurs them to rush through dinner to make it to an ensemble rehearsal. Instead, it’s the joy they find there, as violinist and Washington, D.C., arts fundraiser Maya Weil notes in my book.
“When you are playing with others and it is going well, you feel as if you are soaring. You are suspended in time and hyper alert. You are moving as a unit and there is a feeling of community,” she says.
Amy Nathan is the author of Making Time for Making Music: How to Bring Music Into Your Busy Life which presents music-making experiences and advice from more than 300 avocational musicians, and also from dozens of music educators, researchers, and health-care professionals, who point out that making music is good for your health. She is the author of several other books, for adults, teens and young readers, on topics including women’s history, civil rights, dance and music.
Age-related macular degeneration (AMD) causes deterioration of the macula, the part of the eye that provides sharp, clear, straight-ahead vision. As many as 11 million people in the United States have some form of AMD, and that number is expected to increase to nearly 22 million by 2050, according to the BrightFocus Foundation, a nonprofit that supports research to end AMD, glaucoma and Alzheimer’s disease.
AMD can be passed from generation to generation, according to Dr. Steve Charles, a clinical professor of ophthalmology at the University of Tennessee and founder of the Charles Retina Institute.
“If you are the sweet daughter that brings her 85-year-old (mother) to my office for macular degeneration treatment, you need to get looked at,” Charles says, adding that there are nine genes responsible for the condition.
It’s not uncommon for those with macular degeneration to notice blurring of their central vision early on or to have difficulty reading. Some may see a dark spot or distortions such as straight lines that seem wavy, says Dr. David Boyer, a clinical professor of ophthalmology at the University of Southern California’s Keck School of Medicine in Los Angeles. To give an idea of what it’s like to have AMD, this video made available by the National Eye Institute shows how a grocery trip may appear.
Also, a person with AMD might experience contrast sensitivity, with difficulty distinguishing, for example, dark gray letters on a light gray background. “I have patients who come in who are 20/20 who tell me they can’t drive at night,” Boyer says.
Over time, some people may have difficulty recognizing faces. Eventually, without intervention, those with severe AMD may lose their central vision entirely, although they may still be able to see peripherally.
Possible Preventative Measures
Fortunately, genetics don’t tell the whole story. Environment also plays a role. For example, smoking increases your risk of getting macular degeneration almost sevenfold, while a healthy diet and regular exercise can help reduce this risk, Boyer says.
Eating fruits and green, leafy vegetables that have high levels of antioxidant vitamins — such as kale, spinach, broccoli and squash — may help to reduce the risk for AMD.
Boyer says research has shown that vitamins, such as the “AREDS 2” formulation, which includes vitamin C, vitamin E, zinc oxide, cupic oxide, lutein and zeaxanthin, have been shown to reduce progression by 25 percent and lower visual loss by 20 percent over a five-year period.
Still, Boyer does not initially recommend these supplements for people whose eyes don’t yet show any changes. “We have to be very careful because we don’t know what high doses of any of these (vitamins) over a 30-year period will do,” he says. “However, when patients show changes, then I would recommend the vitamins.”
Different Types of Macular Degeneration
There are two forms of AMD — wet and dry. About 90 percent of those with AMD have the dry form, and it progresses to the wet form in about 10 percent of patients, according to the American Macular Degeneration Foundation.
With dry AMD, lipid deposits called drusen are the hallmark. Drusen, found underneath the eye’s “retinal pigment epithelium,” a pigmented layer of cells next to the retina, can compromise the eye’s ability to metabolize waste products and lead to damage in the eye’s rods and cones. Rods help us see in low-light conditions; cones allow us to see color.
With wet macular degeneration, abnormal blood vessels leak blood and fluid into the macula causing blurred vision or blind spots. It’s possible for patients to have both dry and wet AMD.
“You can start with dry and it converts to wet,” Boyer says, adding that one eye may develop wet AMD while the other remains at the dry stage. “In those situations, the risk of developing wet AMD in the other eye is about 12 percent a year,” he says.
A ‘Miracle’ Treatment for Wet AMD
The most common treatment for wet AMD is anti-VEGF therapy. Charles explains that, “Every time nature wants to grow a blood vessel, it uses a molecule in the eye called VEGF (vascular endothelial growth factors).” Anti-VEGF medications act as a sponge to soak up VEGF in the AMD-affected area of the eye, Charles says.
You could call these medications “miracle drugs,” Charles says, because they have no ocular or systemic side effects. “Not a single patient got an allergic reaction and nobody required higher doses over time,” he says. The medications go by the names of Lucentis and Avastin, both made by Genentech and Eylea, made by Regeneron Pharmaceuticals.
Currently, Lucentis and Eylea are FDA-approved for macular degeneration treatment. Avastin was initially FDA-approved as a cancer agent, but is used by 70 percent of practitioners for treating wet AMD, Charles says. Avastin costs about $50 per injection versus about $1,850 per injection for Eylea and Lucentis. While these well-accepted treatments are covered by Medicare and other insurance, many plans will not allow patients to use anything by Avastin, Boyer notes.
Treatment with these drugs can go on indefinitely. Some of Boyer’s patients are still maintaining their vision after being on the drugs for more than a decade. The sooner patients start on the treatments the better, since 70 percent of patients on these drugs are able to maintain the vision they had when they started, Boyer says.
Audre Slater, 88, who has battled macular degeneration for more than 20 years, is one such patient. She’s been able to maintain the vision in one of her eyes since Boyer started her on anti-VEGF medication. Unfortunately, prior to going to Boyer for treatment, she had already lost vision in her other eye.
For Slater, the effects of the anti-VEGF drugs have been profound for the vision in her working eye. “Since I went to Dr. Boyer with this forever ago, I just get a shot in my eye every two and a half months … and he keeps me seeing perfectly,” she says, adding that she’s still able to read.
Emerging Treatments for Dry AMD
Unfortunately, for dry macular degeneration, there are no such treatments. Many studies have proven unfruitful for the most part, Boyer says.
One treatment that has shown some promise in FDA trials involves injections of a drug called APL-2, made by Apellis Pharmaceuticals, to slow “geographic atrophy.” In this type of dry AMD, cells in the retina waste away and die.
Currently in research trials, APL-2 has shown to reduce the rate of geographic atrophy by 20 percent. But the tradeoff was an 8 percent increase in the wet form of the condition, Charles observes, adding that while this is not a magic bullet, it may make sense to try it together with an anti-VEGF agent.
The use of stem cells is also being looked at for dry AMD. But it is strictly in the experimental stage and Charles stresses the need for caution. Scam stem cell clinics have popped up in places likes Florida and Mexico. Charles says they use the wrong type of cells, obtained through liposuction, that couldn’t possibly help and could even cause blindness.
Treatments continue to evolve. With any form of macular degeneration, those affected should visit a qualified practitioner as soon as possible to learn how they can ultimately best preserve their vision.
Maxine Lipner is a long-time health, medical and business freelance writer, with a specialty in ophthalmology. She is the senior contributing writer at EyeWorld magazine. Her work has also appeared in a variety of other publications, including New York magazine, Women’s Sports and Fitness, Compass Readings (Northwest Airlines magazine) and Nation’s Business.
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Experts agree it’s crucial for early detection of dementia, but some have concerns
A special section in the recently released Alzheimer’s Association’s 2019 Alzheimer’s Disease Facts and Figures report focuses on the role primary care physicians can play in early detection of the disease. The association says all people 65 and older should receive some kind of assessment of their thinking and memory functions and that the primary care setting is the best place to do it. It should be a part of routine exams, said Joanne Pike, the association’s chief program officer.
“We hope the report will encourage seniors and physicians both to be more proactive in discussing cognitive health during the Medicare Annual Wellness Visit and other routine exams,” she said in the press release about the new report.
According to the report’s survey of 1,954 health care consumers age 65 and older, only half have received a cognitive assessment, and even fewer receive routine cognitive assessments.
Experts say early detection of mild cognitive impairment, which can lead to dementia and Alzheimer’s disease, is important in terms of treatment and other factors. But some see problems with assessing all people who are asymptomatic — that is, showing no signs of impairment and not complaining of thinking and memory problems.
The Alzheimer’s Association’s survey of 1,000 primary care physicians found that nine out of 10 sometimes use one or more of these types of tests, along with their own observations, during office visits. If some indication of impairment is found, most of these doctors refer their patients to a specialist, according to the survey.
Concerns About ‘Mini’ Cognitive Assessments
Dr. Terry Quinn, a geriatrician, researcher at the University of Glasgow and editor with the Cochrane Dementia and Cognitive Improvement Group, has written and been involved in articles investigating the accuracy of several brief cognitive assessments. Quinn is concerned about cognitive screening for all asymptomatic people 65 and older, not only because there’s lack of evidence to show the tests are accurate, but because there’s lack of information about the emotional and practical impacts they can have on people when the tests miss problems or falsely find problems.
“For example, we don’t know whether asymptomatic older adults want screening, we don’t know the effects of an erroneous label of cognitive impairment, we don’t know if screening tests predict future cognitive change, we don’t know the health economics of screening, we don’t even know what to do with a positive screening result,” Quinn says. “There are many examples of screening tests that do more harm than good. I am not against cognitive screening per se, but I would, at least, like to see small-scale pilots before we introduce it at scale.”
One of the most commonly used brief cognitive assessments is the Mini-Cog, a three-minute test in which the patient is asked to remember three words, then draw a clock with the hands set to a certain time. After the patient completes the clock, he or she is asked to recall the three words given at the beginning of the test.
A Cochrane review of studies measuring the accuracy of the Mini-Cog to detect dementia stated that the highest-quality study found the Mini-Cog “failed to detect up to 24 percent of individuals who have dementia,” according to Cochrane. In addition, the same study found that “up to 27 percent of individuals may be incorrectly identified as having dementia.”
Most of the primary care physicians surveyed by the Alzheimer’s Association (94 percent) said it’s important to screen all people 65 and older for cognitive impairment, and 82 percent of the consumers surveyed said it’s important to have their thinking and memory functions checked.
However, the report also found a significant minority of consumer respondents who are concerned about assessment and testing. About one-third believe the tests are unreliable, and 24 percent agreed that “the idea of all seniors being tested for thinking or memory problems is insulting,” according to the report. Also, 19 percent believe that since there’s no cure or treatment for thinking or memory problems, “why bother testing for them.”
‘Is Something Better Than Nothing?’
Neurologist Dr. Ronald Petersen, director of the Mayo Clinic Alzheimer’s Disease Research Center in Rochester, Minn., agrees that there are significant problems with brief cognitive tests, like the Mini-Cog, but still believes regular cognitive assessments should begin at age 65.
“I’m a neurologist, so I’m a specialist, and I sometimes cringe at those very, very coarse assessments of a complicated operation — namely cognitive function,” Petersen says. “But on the other hand, is something better than nothing?”
He says there’s plenty of debate about which brief assessments are better than others, “and studies show that ones that are a little more detailed and take a little longer to do, in fact, give you more information about the future outcome.”
But even at the simplest level, Petersen says, some kind of discussion of thinking and memory should happen during an annual physical exam for people 65 and older because early detection is important. So is having a baseline from which to compare future assessments, he adds.
“It could even be, ‘I asked Bill how his memory was and he said it was OK,’ and put that in the medical record. As incomplete as that might be, at least it shows that some attention has been paid to that issue. And I think that’s an important first step,” Petersen says.
The Alzheimer’s Association website lists these advantages to early detection of dementia:
Treatment that can lessen symptoms, such as memory loss and confusion, for a limited time
Opportunities to participate in clinical trials
A chance to prioritize other health issues, such as high blood pressure, smoking and fitness, which can help preserve cognitive function
Receiving emotional and social support as soon as possible
Planning for the future, including finances and care services
Petersen recommends that people 65 and older bring up the topic of cognitive function with their doctors. Not only can it lead to early detection of possible problems, he says, but peace of mind for those patients. He says studies by AARP and other organizations have found that Alzheimer’s disease is what most scares older people when it comes to medical issues.
“They’ve done surveys asking people, ‘What are you most concerned about?’ and you’d think [things like] heart disease or cancer, but it’s Alzheimer’s disease,” Petersen says. “They’re most concerned about losing their cognitive function, interactions with their family, losing their memory and things like that. So, if that’s the case, shouldn’t we at least open the door on this issue rather than waiting until something develops?”
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Every year around this time, many of us get inspired to clean, declutter and throw away stuff that we no longer need. It’s spring cleaning season, and this is a great time of year to donate your unwanted belongings to a charity or local organization. Not only is donating a great way to eliminate clutter in your home, but you also get to give back to your community and help other people. Plus, if you’re downsizing your home or just need more space, donating to charity is a worthwhile option. The Immanuel Foundation is currently taking donations for its Annual Estate Sale on Saturday, May 18th at the Gateway Community Center, 1203 Hwy 2 W, Kalispell. Call 406.752.9243 for more information.
Things to Donate to Charities and Community Organizations
You might be surprised at the number and variety of items many organizations will take if you’re willing to give it away. If you have an item you can’t bear to toss out but no longer need, there is probably an organization out there that would make good use of it. Consider lending a helping hand and making a difference in someone’s life with your old belongings.
Clothing
A popular and much-needed category, clothing items are essential for everyone. Charities such as Goodwill and The Salvation Army are continually accepting donations of clothing for those in need. If you have professional wear that you no longer use, consider Dress for Success for women or Flathead Industries Kalispell Thrift Store for men. Both organizations support job seekers who need professional clothing for interviews. Other examples of clothes to donate include:
Light jackets
Shoes
Boots (especially boots made for rainy spring weather)
Shirts
Pants
Raincoats and umbrellas
Small Appliances
Some organizations will gladly accept appliances you no longer use, such as blenders or microwaves. However, make sure you check the guidelines for donating certain appliances. Some appliances, such as large dishwashers or dryers, will not be accepted by some charities due to safety concerns.
Pet Supplies
Are you an animal lover? Some of your old pet items can be put to good use for other pet owners. Many animal shelters will accept objects like pet beds, towels, litter boxes and water or food bowls. Check your local animal shelter or the American Society for the Prevention of Cruelty to Animals (ASPCA) to see if they’ll accept donations like these.
Outdoor Tools
Don’t forget about decluttering your garage! Have you considered donating your old tools for outdoor maintenance? There are some charities that will accept donations of tools that can be used to spruce up yards, gardens and other outdoor essentials, especially if you have no further use for them. Consider:
Lawn mowers
Hedge cutters
Rakes
Shovels
Garden hoses
Old patio furniture
Miscellaneous Stuff to Donate
Charities all around the country can use your miscellaneous items to bring much-needed joy to people. For example, some hospitals use the power of music to heal patients during recovery, so they may have use of your old CDs. Some other examples include:
Old sports equipment (bikes, helmets, kneepads)
Office supplies (pens, notepads, extra paper)
DVDs and blu-ray discs
Old electronics like radios or TVs (Some charities can recycle them or use the still-working parts to make something new.)
Before you fill your trash with useable items, please take some time to consider whether it would be better to donate them instead. You never know who you’ll be helping to make treasures out of your trash.
Enjoy an Active, Vibrant Lifestyle With Immanuel Living
At Immanuel Living, you’ll find a variety of on-campus services and activities for an enriching, enjoyable senior living experience. We have everything you need to make sure you thrive and enjoy your carefree retirement years. To learn more about independent living with Immanuel Living contact us today, or view our floor plans to start planning for downsizing your home.
Looking for things to do in Kalispell, Montana? Wineries are a great springtime and warm weather activity for seniors to enjoy. Many locations offer walking tours of their facilities, which means that not only do you get some exercise, but you also get to learn more about the wine industry and how your favorite spirits are produced.
If you enjoy a glass of vino from time to time, add visiting a Kalispell winery to your agenda this spring. Especially here in Montana, wineries tend to have their own unique flare, offering delicious selections, fun wine tastings and live entertainment. Keep reading to discover three local wineries near Kalispell for you to explore!
Glacier Sun Winery
Glacier Sun Winery is a popular destination in Kalispell. Founded in 2011, Glacier Sun Winery is becoming well-known for its flavored ciders and wine choices – their Huckleberry Peach wine is a popular selection. This award-winning winery uses Montana-grown fruits to create their rotating selection of fruit wines.
In addition to wine, you can also purchase fresh fruits and vegetables at Glacier Sun Winery because it’s part of the Apple Barrel Country Market, where you can find fresh produce from across the country. Their tasting room is open Wednesday – Saturday year-round, and you can enjoy live music and entertainment on the weekends. During the summer, you can sit on their pleasant patio, taking in the gorgeous views as you sip from your glass.
Tailing Loop Winery
Located just two miles east of downtown Kalispell in the former Glacier Art Gallery, Tailing Loop Winery offers wines produced from reputable and well-established family vineyards located in the Pacific Northwest, including critically-acclaimed vineyards and cellars in the states of Washington & Oregon.
Live musical performances are a staple at Tailing Loop Winery every Friday and Saturday night. Their tasting room is open Wednesday – Sunday. When the weather is warm, additional concerts are held on their patio, or in their event center. Their wine menu features a variety of red and whites from all branches of the wine spectrum for your enjoyment.
Mission Mountain Winery
Did you know that Mission Mountain Winery is the oldest winery in the state of Montana? Located on the West Shore of Flathead Lake, Mission Mountain Winery offers exquisite, internationally award-winning wines and produces approximately 6,500 cases of wine each year. They grow pinot noir and pinot gris grapes along the shores of the lake, as well as small amounts of Riesling, Chardonnay and Gewurztraminer grapes.
The tasting room at Mission Mountain Winery is open from May 1 – October 31 each year, seven days a week. Although reservations are not required, they are available.
Vibrant Senior Living in Kalispell, MT
At Immanuel Living, our residents enjoy a variety of senior living options, the right level of care, and the lifestyle they crave. From walking tours in the Flathead Valley to activities for the entire family to enjoy, there’s always things to do in Kalispell, Montana! Contact us today to learn more about our active senior living community, or to schedule your personal tour.
What is Independent Senior Living?
An independent living community is a great choice for active older adults requiring little to no assistance with Activities of Daily Living (ADLs and IADLs), such as housekeeping, laundry, medication management, hygiene assistance and toileting assistance.
As you start researching options for independent living near you, keep in mind that an independent living retirement community provides a carefree lifestyle, usually offering these benefits and amenities:
An apartment-style residence, generally available in sizes ranging from studio to two bedrooms, equipped with a small kitchen or kitchenette
Communal dining with custom-designed meal packages
Housekeeping and laundry services provided
No yard work or routine household maintenance chores
An activity calendar filled with scheduled social events, activities and exercise classes
Since most amenities and services are included in your rent, you have fewer bills to manage
Enjoy an Active Lifestyle at an Independent Living Community
Activities are planned to encompass a variety of interests. Although participation isn’t required, it is encouraged so everyone has the opportunity to make new friends, stay active and develop new interests and hobbies.
Independent living communities focus on the active lifestyles of today’s older adult; and, they strive to nurture the mental, emotional and physical well-being of their residents. Other benefits and amenities may include:
24-hour security/staff presence
Fitness centers with exercise machines and fitness classes
Swimming pools and whirlpools
Community centers/Clubhouses
Some form of transportation
Tennis, basketball and volleyball courts
Picnic areas with barbeque grills and pavilions
On-site laundry facilities
On-site hair salons
On-site convenience stores
With so many benefits and amenities that may be offered, it’s important to determine which are important to you and then to pick a community that offers those specific benefits and amenities.
Residents in most independent living communities are allowed and encouraged to furnish and decorate their apartments according to their own individual preferences. However, it’s best to check with each community to ensure using your own décor is allowed.
Independent living tends to be less expensive than other housing options that provide more personal care and healthcare related services. The average cost of independent living can range between $1,500 to $3,500 depending on location, amenities, care offered on-site, apartment size and services provided. The cost generally includes housing and maintenance expenses, utilities, amenities and community activities. Meal plans vary among communities and may be included in the cost or may be an add-on item.
To learn more about independent senior living in Kalispell at Immanuel Living, please contact us today.
