Healthier You Summer 2015


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Healthier You shares stories and insight into health-related issues that matter to us all.

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Healthier You Summer 2015 T h e Pa re n ti n g is su e childhood fever: The cold facts  Are you stifling your kids’ play? YOUTH MENTAL ILLNESS A mother’s story protect SCHOOL LUNCHES MADE EASY my son Vaccinate your child  Spotting back-toschool ANXIETY CKNW News reporter – and new parent – Shane Woodford’s plea to parents on behalf of his son, Henrik Parenting 8 ways to help your parents age well – p. 12


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Celebrate Summer at Shannon Oaks! I’ve been enjoying life at Shannon Oaks for 7 years – I wish I had moved in earlier! Call us for your personal tour and stay for a complimentary lunch. Ask about our 3 - 4 day trial stay. You’ll meet Mary and other Residents just like her who are enjoying a healthy lifestyle at Shannon Oaks — a vibrant seniors community in southeast Vancouver. 2526 Waverley Avenue | 604-324-6257 Vancouver Baptist Housing | Enhanced Seniors Living | Since 1964


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The parenting issue Volume 1, Issue 2 Summer coverstory Taking a stand on immunization p. 2015 7 road safety tips Endless, safe fun this summer. By Tobie Patterson p.26 6 CKNW news reporter Shane Woodford writes about how the birth of his son Henrik changed his perspective on parents’ roles in vaccinating their children. By Shane Woodford inside What if no one likes me, mom?�������������� Page 10 How to recognize back-to-school anxiety and what to do about it. By Ritu Guglani cold facts on childhood fever������ Page 22 Here’s what to look for so you can stay calm and help your child feel better. By Dr. Kim Veldhuis Rachel’s Journey��������������������������������������������� Page 16 How do you parent a child with a mental illness when you don’t know how to help? By Cyndi R. Take a chance on play���������������������������� Page 24 Are you stifling your child’s imagination by being too protective? By Kate Turcotte The Daycare Dilemma������������������������������������ Page 20 How to choose the best setting for your child. By Annette Dellinger Share the wealth��������������������������������������� Page 30 Human milk is a valuable resource that’s in short supply. Can you help? By Sidney Harper p.28 Coaching Mom & Dad Help your parents thrive in their senior years by acting on these 8 requirements for a healthy old age. p.12 By Dr. Grace Park School lunches made easy Win the daily battle with these simple and nutritious kid-approved ideas. By Tasleem Juma summer 2015 Healthier You 3


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CEOmessage Fraser Health wishes you better health Thank you for your encouraging feedback on Fraser Health’s first issue of Healthier You magazine. We heard how much you enjoyed reading it and sharing it with your friends and family. I know you will find this issue equally interesting. By Michael Marchbank, President and CEO Fraser Health Healthier You Volume 1, Issue 2 published by: In this issue, we look at ways to improve health through the lens of ‘parenting’ – how parents can influence their children’s health, and vice versa. In our cover story, Shane Woodford, a news reporter with CKNW radio and a new parent, pleads with all parents to take immunizing their kids seriously. Other parents share stories of how they support their kids’ mental and emotional health. You’ll also find quick tips on feeding your children healthy and easy-to-make lunches (School Lunches Made Easy, page 28), picking the right daycare (The Daycare Dilemma, page 20), and learning to cope with childhood fevers (The Cold Facts on Fever, page 22). As a parent myself, I can’t help but reflect on the full circle I’ve traveled. In life and in parenting, we never stop learning and hopefully improving. The same is true in health care. Each day we recommit ourselves to being, and doing, better for our patients, clients and residents. We can achieve our vision of “Better Health. Best in Health care.” by building healthy communities across the region. These are the foundation of good health and a sustainable health system. Through partnerships and collaboration, we can ensure people are able to live longer and healthier, and remain socially connected in their communities for as long as possible. Enjoy our Summer issue and look for the next one this Fall. Our editorial team always welcomes your thoughts and comments, so feel free to send them to Happy reading. PUBLISHED BY FRASER HEALTH & GLACIER MEDIA Copyright ©2015. All rights reserved. Reproduction without permission is prohibited. Fraser Health Editors / Tasleem Juma, Bonnie Irving Content Advisors / Samantha Tong– Population and Public Health Contributors / Stephanie Bale, Annette Dellinger, Helen Edwards, Ritu Guglani, Sidney Harper, Kevin Hill, Nicole Marshall, Kate Nolan, Parachute, Dr. Grace Park, Tobie Patterson, Cyndi R., Kate Turcotte, Dr. Kim Veldhuis, Jane Wark (Fraser Health dietitians), Diane Wild, Shane Woodford Where can you find Healthier You? “In doctors’ offices, walk-in clinics, pharmacies and other community settings, we will be waiting there too – keeping you company, and sharing stories and insight into health-related issues that matter to you.” Glacier Media Group Sales & Marketing Kevin Dergez Director of Special Projects Ellyn Schriber Newsmedia Features Manager BC Creative Director / Eric Pinfold Advertisements in this magazine are coordinated by Glacier Media. Fraser Health does not endorse products or services. Any errors, omissions or opinions found in this magazine should not be attributed to the publisher. The authors, the publisher and the collaborating organizations will not assume any responsibility for commercial loss due to business decisions made based on the information contained in this magazine. Speak with your doctor before acting on any health information contained in this magazine. No part of this publication may be reproduced or transmitted without crediting Fraser Health and Glacier Media. Printed in Canada. Please recycle. 4 Healthier You summer 2015


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coverstory immunization Parents who think their decision not to vaccinate their kids is okay with the rest of us, take note. It’s not. By Shane Woodford Taking a stand on photo: Kevin Hill


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Six months ago, my world changed when I held my son, Henrik, for the first time. Readers who are parents know what I mean. just think it didn’t matter? Well, it does matter. As the disease spiraled through the community, clearly others were being affected. As news coverage of this situation mounted, I began to sense that the laissez-faire attitude society has apparently had to vaccinations was starting to shift. Parents were starting to realize that when some parents don’t immunize their kids, they’re putting not only their own kids at risk, but others’ as well. We live in a so-called ‘information age’ and sometimes we suffer from information overload. In the news business, we aim to get out information based on truth. Let people make their own informed choices. But the web facilitates the spread of crazy ideas that have no merit. What happens to ‘informed choice’ when these fear mongers question vaccine safety, despite all evidence to the contrary, and plant the seeds of doubt in parents worried about their children? There’s nothing to stop them from spreading this nonsense. I find that troubling. Then you have pockets of parents and communities here in BC who don’t immunize their kids for religious reasons. Should that be acceptable? In other cases, basic inattention is the reason shots aren’t up to date. I understand that parents are busy with life and that sometimes their child’s immunizations fall behind. But outbreaks of diseases like measles and whooping cough are occurring more often. I had whooping cough as a child. My earliest memory is of being in an oxygen tent and seeing my parents walk in with balloons to celebrate my second birthday. Whooping cough and measles are diseases we’ve basically had under control for decades. All it takes is for one infectious case to spread and we’re facing an outbreak among people whose vaccinations either never occurred in the first place or are not up to date. As a dad now, I hope these recent outbreaks will motivate other parents who don’t think they need to vaccinate their kids to think twice and protect their children. And mine. Thankfully, most parents do their part to be informed by the evidence and do immunize their kids. In BC around twothirds of children are immunized. The higher that number, the more we boost something called ‘herd immunity’. What’s that? It describes a situation in which a large portion of the population becomes immune to an infection, which in turn helps to protect those who aren’t immune. N ot only did my personal world change, but his birth also changed my world view. Here’s what I mean. Covering a news story as it unfolds is an adrenalineproducing experience for me. Tracking down the facts, following up leads and reporting an ongoing story accurately – all on the tight deadline CKNW News imposes – can be a tough way to earn a living. I love the work and most often I can cover a story with the objectivity the public expects of a news reporter. But now that I have a son, I find objectivity more challenging when I cover certain stories. Take the recent measles outbreak caused by unvaccinated Burnaby students who returned to Vancouver aboard Air China following a trip to Beijing. I’ve covered similar stories in the past and just took it for granted that that there was no right or wrong in such a situation. I assumed it was a parent’s right to vaccinate their child – or not. Now that I’m a dad, I have a different perspective. Now it’s my child who’s out there in the world exposed to others who may not take careful steps to prevent harmful diseases from spreading. This issue of parents and their decision about vaccinating their kids is complicated. Some see it as a right to decide either way based on a religious belief or some ill-informed opinion about vaccine safety. Others just fail to ensure their kids’ vaccinations are up to date. I don’t know what happened in the Burnaby students’ case. But I can’t help but ask, ‘Where is those parents’ accountability to society?’ Surely school protocol requires parents to verify their child’s immunization records before students depart on an overseas field trip? Did these parents report that their children were protected by vaccination? If so, clearly they were not diligent at ensuring all the vaccinations were up to date. Did they consciously choose the no-vaccination route? Or did they summer 2015 Healthier You 7


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The family unit: Catherine, Henrik and Shane. “I hope recent outbreaks will motivate other parents who don’t think they need to vaccinate their kids to think twice and protect their children. And mine.”  – Shane Woodford Herd immunity is a good thing and we need to strive for more. I’ve covered heart-wrenching stories and interviewed parents whose child is battling an awful health issue. Then I learn that their child can’t be immunized due to the medical condition. To know their child is at risk and to not be able to do anything to protect them, outside of relying on society to take measures, requires a good deal of faith in humankind. Increasing the vaccination rate in the rest of the population would increase the level of herd immunity, providing some level of protection for these kids with medical conditions. Canada is so close to making terrible diseases like whooping cough and measles extinct, in comparison with undervaccinated populations in developing countries where, incidentally, parents would clamour for a free vaccine, if it were available. I appreciate the people who work in the Public Health field who are working hard to limit the damage by helping to prevent and fight the spread of these diseases. Henrik has already received his two scheduled rounds of vaccinations, and we’ll always keep his shots up to date. Rest assured, this parent is doing his part and taking the issue of immunization seriously. Count this family in when the ‘herd’ count is done. Shane Woodford is a news reporter with News Talk 980 CKNW in Vancouver. Fraser Health’s point of view Fraser Health believes vaccines are safe and that they protect you from serious diseases. When you are immunized you are protecting yourself, those you care about and others who are vulnerable and cannot immunize for medical reasons. Here are some resources to help you protect yourself and your family: • Find a public health unit to book an appointment: • Get text vaccination reminders for your child: • New app tracks your child’s immunization appointments: •  Popular info and tools: Government of Canada: Immunization & Vaccines • Traveller immunizations: travelling/health-safety/vaccines • Network of British Columbians who support vaccinations: 8 Healthier You summer 2015


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family How to help your child cope While experts say some anxiety about school is normal, parents should take it seriously and ensure it does not progress and create ongoing mental health issues. Here are some suggestions: • Ask your child what’s making them worried. Tell them that it is normal to have concerns. You can also share some of your own general fears to demonstrate this normalcy. • Children feel most comfortable in a private space with your undivided attention. Before bedtime or at the dinner table are also great times for conversation. • Some children like distractions to cut the intensity of their worries, like driving or taking a walk with you. • Do not tell them “Don’t worry!” or “Everything will be fine!” Instead, encourage your child to problem-solve. For example, “What could you do if the worst happened and your ‘what-if’ came true?” • Focus on the positive. Encourage your child to redirect attention away from the worries. • Reflect on your own behavior. Some parents are anxious about handing over care and responsibility of their child to teachers. Children take cues from their parents. The more confidence and comfort you can model, the more your child will relax. • A week before school starts, begin the school-day routine – waking up, eating, and going to bed at regular times. Explain that everyone in the family needs to practice the new schedule, so he or she doesn’t feel alone with these changes. • Younger children may be nervous about separating so suggest taking a special object to school to remind them of home. • A reassuring note in a child’s lunch can also help ease separation anxiety. • Tell your child’s teacher that they are having some separation anxiety – most teachers know how to handle this. • Most important – praise and reward your child for brave behavior. Ritu Guglani with Helen Edwards, Clinical Coordinator, Fraser Health What if no one likes me, mom? By Ritu Guglani How to recognize back-to-school anxiety and what to do about it L indsay was six years old that September when her parents noticed she was behaving differently than usual. Her mom, Marilyn, remembers how mystified she and her husband were by their daughter’s new-found tendency to throw tantrums, to complain of assorted aches and pains and to try to avoid going to school. “We noticed that our child, who loves school, has good friends, is bright, loves to read, and is very creative, started having these emotional outbursts. The tiniest thing would send her into a meltdown,” says Marilyn. Not only was it the see-saw of emotions 10 Healthier You summer 2015 that was upsetting, but Lindsay’s behavior was also distinctly odd, says her mom. She was making it clear she didn’t want to go to school. “It was next to impossible to get her out of bed in the morning. We make sure that our kids get between 10 and 11 hours of sleep each night, but she was difficult to get up even if she went to bed early.” Marilyn and her husband were also worried about Lindsay’s physical complaints. “That month of September she had a whole lot of tummy pain, or she would be complaining about leg pain or headaches,” Marilyn observed. All of these concerns merited a visit to their family doctor. Their family doctor in Port Coquitlam ran some tests, which revealed that Lindsay had no physical illnesses. By October, all of her symptoms had vanished. Both busy working parents, Marilyn and her husband were much relieved – until Lindsay’s symptoms reappeared the following September.


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They started to suspect that the real source of illness for Lindsay was anxiety about going back to school. Each time Lindsay complained about not wanting to go to school, Marilyn took the time to hold that moment for Lindsay. As a result, Marilyn uncovered some of her daughter’s fears. They turned out to be fears of the unknown – Who’s my teacher going to be? Who’s going to be in my class? What if I don’t know anyone? Turns out that just like many of us, kids can become victims of the ‘what-if ’ questions in life and will need help to cope with them. Sharing the learnings From first discovering these signs of anxiety in Lindsay three years ago, to building her daughter’s coping skills, Marilyn has come a long way. Now, she wants to share her experience to help other parents detect and manage the back-to-school anxiety that occurs in one in seven children in British Columbia. Times of transition provoke anxiety and worry in everyone. Experts say children going back to school or new kids coming into elementary school are no exception. Some common worries include: Who will be my new teacher?; What if my new teacher is mean?; Will I understand the new schoolwork?; What if something bad happens to mom or dad while I am at school?; What if I don’t make any friends? Lindsay’s fears reflected similar concerns. So her parents spent time reassuring her that she was not alone and that they would work through the situation together. “That really helped her,” Marilyn says. Ensuring they maintained their familiar daily routine and highlighted something for Lindsay to look forward to at the end of each day also helped Lindsay manage her anxiety. “We always have dinner together, read a book together, and then the kids go to bed,” says Marilyn. “Even though to her, everything else in her life was changing at the moment, our daily routines weren’t changing. That and the added incentive that we would do a favourite activity when she got home from school gave her something she could look forward to and focus on.” Marilyn and her husband were not alone on their journey. They also engaged Lindsay’s teacher and the school counsellor to let them know that Lindsay was experiencing anxiety, so they could be supportive of her. “We believe in learning from others’ experience, and so in addition to connecting with professionals, we also reached out to other parents whom we respect to get their ideas on what to do,” says Marilyn. One of those parents was Lina Thompson of Chilliwack, who shared a technique that worked in her situation. “A trick that I have used in my own home is role playing scenarios that cause anxious thoughts, such as what happens if the bus is late or no one is there to pick me up? Role playing is so wonderful for skill building and allowing children to see their own strengths in problem solving,” says Lina. Helen Edwards, a clinical coordinator of mental health services with Fraser Health, says that although it’s normal for children to have worries about going back to school, it is crucial that they don’t miss school. “If they stay at home, they may miss valuable opportunities to practice social skills, chances to succeed in class or make friends with their classmates,” she says. “Most important, they don’t get a chance to test their own fears and gain confirmation that their fears were unrealistic.” “ We’re making lives better. Attentive visits, delicious meals and light housekeeping. Taking Care Medication management and support with life’s essentials. Enriched Care Vital Care Daily, live-in nursing and end-of-life caring. Call today for a FREE Caring Consult. 604.553.3330


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Mom & Dad By Dr. Grace Park Coaching Help your parents thrive in their senior years by acting on these 8 requirements for a healthy old age The role reversal that occurs between parents and their children as mom and dad move further into their senior years is almost a rite of passage for each. And it can be a difficult time for both. S eniors who skip meals, who isolate themselves and who are sedentary run a risk of becoming frail – thin, weak and slowmoving – as they age. The more frail they become, the more prone they will be to falls, illnesses and trips to the hospital, leading to further deterioration and the need for more care to remain in their home. But frailty is not inevitable, and adult children or grandchildren have a role to play in helping their parents avoid the hazards that increasing frailty can pose. The earlier the start, the better the outcome. Help guide your parents to an old age marked by vitality, strength, energy and well-being. Here are 8 requirements for a healthy old age. 1 Start exercising: The benefits of exercise continue to be trumpeted – how it may prevent and help manage everything from chronic diseases to issues such as arthritis, heart attack, stroke, diabetes, depression, anxiety, high blood pressure, osteoporosis, breast and colon cancer, obesity, back pain, and even dementia. For seniors, losing muscle strength and balance can appear inevitable but improving both through exercise can lead to an improved sense of well-being and the confidence to follow through on other goals. 12 Healthier You summer 2015


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There are many options for classes or programs in our communities geared specifically towards seniors such as yoga, Pilates, aerobics, swimming, strength training. Inquire about your mom or dad’s eligibility for a trained volunteer coach from Self Management BC’s Active Choices program. The coach will help develop an exercise routine and check in by phone to monitor progress and provide motivation, hopefully until the program becomes a way of life. Many seniors still feel uncomfortable about exercising in public. Fortunately, there are many safe, simple exercises that can be done at home by almost anybody, at any age. Home-based exercises can improve strength, balance and mental health. Simple activities such as gardening and walking can supplement an exercise program to increase muscle strength and balance. Adding strength training with light weights can improve upper body strength and prevent osteoporosis. Exercises can even be done in a chair. A great online resource is an exercise program specially designed for older adults that can be done in the comfort and privacy of their home: Get moneysmart early How much will your parents, or you, need to retire comfortably? Coming up with a figure can be a frustrating process. Financial planners tell us that the rule of thumb is to aim for a nest egg that will yield about 70% or more of working income (this is true only if the mortgage has been paid off and there is no other outstanding debt). To complicate matters, life expectancy has increased and our money has to go further. Realistically, a one-size-fits-all retirement plan is impractical. Unexpected expenses can push seniors from living comfortably in their retirement years to near destitution. We often neglect to plan for the possibility, even the inevitability, of deteriorating health and what that entails. A hospitalization for a senior can quickly become life-changing. To help a senior continue their recovery at home, the publicly funded health care system can provide short-term no-cost home health care support – nursing care, grooming, bathing, toileting and feeding. However, ongoing home health care support in the public system is fee-based and dependent on income. Private companies also provide this kind of support. Medical equipment can be borrowed from the Red Cross’s HELP program, but only in the short-term. Simple renovations (hand-rails in the bathroom) and regular private housekeeping services can increase costs to a senior by a couple of hundred dollars a month. Add to that prescription costs, hearing aids (to help with socialization) and/or major renovations to make the home senior-friendly (for example a walk-in tub or ramps to accommodate a walker or wheelchair) and you could be looking at several thousand dollars. Most of these costs will need to be borne by the individual, although the federal government recently proposed a tax credit to help seniors make their homes more accessible. Seniors want to remain in their homes as long as they can. If that is no longer possible, access to a subsidized nursing home may be an option for those with the most complex conditions who require access to round-the-clock nursing care. If that criterion is met, eligibility is based on income and, once admitted, the costs of living in a residential care facility are very similar to the costs of living independently at home. Private pay facilities are another option and generally cost more. Insurance programs can help defray some of these costs – long-term-care insurance and critical illness insurance, for example. But they are not options for seniors already in their ‘golden’ years. summer 2015 2 Eat a balanced diet: Poor nutrition equals poor health, sooner or later. Tea and toast is not an acceptable meal. A healthy meal for seniors should consist of half a plate of brightly-colored fruits or vegetables (frozen are fine; they’re more economical and easy to buy in bulk), a quarter plate of low-fat proteins such as meat, fish, tofu or legumes (peas, beans, lentils among others), and a quarter plate of whole grains such as brown rice or bread. Try to reduce salt intake by substituting herbs, and use either canola or olive oil. Up the intake of calcium and vitamin D with skim milk and yogurt, canned fish with soft bones such as salmon, fortified cereals, juices, and green leafy vegetables. The Healthy Eating for Seniors Handbook from the BC Ministry of Health provides nutritional information and healthy recipes. Call HealthLink BC at 8-1-1 for a copy or download one at A dietitian is also available at this number. If cooking is too much of a challenge, stock the freezer with microwavable single-serving meals, or buy freshly prepared meals. Some supermarkets and other companies will deliver groceries if trips to the store are a burden. Better at Home (, a service of the United Way that operates through volunteers in local community organizations, can help coordinate delivery of groceries and meals. 3 Keep your brain working: We’ve all heard anecdotes about people working well into old age who seem to retain all their wits, while other retirees fade both mentally and physically. Research is pointing to a connection between intellectual stimulation and good health. What type of stimulation will depend on their interests. Encourage them to develop new interests or delve more deeply into old ones by signing up for courses through the universities and colleges. Many offer special courses for inquiring seniors at low cost. What about learning Italian, French or Chinese? Or developing the crossword or Sudoku habit, joining a bridge group at a seniors’ centre or a book club at a community library or with like-minded acquaintances? Anything to keep the mind alert and engaged. 4 Seek a spiritual connection: The term ‘spiritual’ is broad and could include something as restorative as a long walk in a peaceful forest or a quiet beach at sunset. Something that inspires awe at the majesty of this earth. Or they might try something more traditional such as revisiting formal religion, meditating, reading spiritual works, practicing gratitude, even exploring the Healthier You 13


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RETIREMENT. LIVING! spiritual side of yoga. The idea is to connect with something that may take them outside themselves. We don’t have to take care of anything here. Except each other. Sunridge Gardens is a community for seniors who want to stay active, live independently, and have fun with their friends and families every day. You’ll like living here! CALL US TODAY TO BOOK A TOUR 5 Maintain links with the world: Social connection is an important determinant of health and longevity. And for many seniors, social isolation is a problem as their families get caught up in their own busy lives and friends move away, or die. Keeping connected could be as simple as rekindling old friendships over lunch, dinner or just a coffee. Any activities that encourage participation with a group are ideal to ensure this important requirement for health is met. Sitting home in front of the TV or computer all day and evening is a recipe for disaster. One of the best tools to keep connected, albeit remotely, is the internet. An easy-to-use iPad could be an important investment in your parents’ longevity if you include instructions about how – and why – to connect via Facebook, Skype, or FaceTime and to the wider world via almost limitless news and information networks. Don’t let any reluctance – “I’m not good with technology” – put you off introducing them to this window on the world far beyond their front door. 604 510-5091 22301 Fraser Highway, Murrayville Talk To your docTor abouT your bone healTh. book a bone densiTy exam. MSP eligible. 6 Find a ‘job’: The thrill of retirement can wane quickly once the initial freedom wears off. Many seniors will retain the need to feel useful, without the commitment a regular job requires. Volunteering can fill the gap. Many non-profit organizations in the fields of health care, education and societal improvement need help, and healthy seniors can play an important role in addressing some of society’s most important needs. The Go Volunteer website ( is just one source of opportunities as is the seniors’ resource centre in your community. 7 Have a best friend: The family is, of course, the biggest source of emotional attachment, and many seniors struggle with the absence of close ties once the family unit disperses. Grandchildren can bring joy to a senior’s life and creating opportunities for grandparents and grandchildren to meet regularly for ‘play dates’ can enrich the lives of both. Close friends are another source of emotional connectivity and efforts to cultivate new friendships and maintain old ones – despite the effort that may be required – are worth it. It’s also important to interact with strangers and develop new relationships with those with common interests, a local walking club for example. In the absence of family and friends, don’t underestimate the power of a pet dog or cat to breathe life into a senior’s world. 8 Get out of the house: Seniors who may no longer drive need to access alternative forms of transportation in their community to avoid becoming housebound. Transit passes and schedules, HandyDart schedules for those who can’t use regular transit, and pre-paid taxi vouchers will be welcome additions to your senior’s household. Dr. Grace Park is a family physician in White Rock and Fraser Health Regional Medical Director, Home Health Low bone mass can make you more susceptible to low trauma fractures, stress fractures and height loss. Medical Director: BRAD HALKIER, MD, FRCPC bone densiTomeTry Suite 100, 3001 Gordon Avenue Coquitlam, B.C.V3C 2K7 604-941-7611


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