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5 Surprising Signs of an Unhealthy Heart

5 Surprising Signs of an Unhealthy Heart

We’ve all read the signs of a heart attack listed on posters in the hospital waiting room. But what if there were other, earlier signs that could alert you ahead of time that your heart was in trouble?

It turns out there are. Researchers have done a lot of work in recent years looking at the signs and symptoms patients experienced in the months or even years leading up to a heart attack. “The heart, together with the arteries that feed it, is one big muscle, and when it starts to fail the symptoms can show up in many parts of the body,” says cardiologist Jonathan Goldstein of St. Michael’s Medical Center in Newark, New Jersey. Here are five surprising clues that your heart needs checking out. Any of these signs — and particularly two or more together — is reason to call your doctor for a workup, says Goldstein.

1. Neck pain

Feel like you pulled a muscle in the side of your neck? Think again, especially if it doesn’t go away. Post-heart attack, some patients remember noticing that their neck hurt and felt tight, a symptom they attributed at the time to muscle strain. People commonly miss this symptom because they expect the more dramatic acute pain and numbness in the chest, shoulder, and arm. Women in particular are less likely to experience heart pain that way, and more likely to feel twinges of pain and a sensation of tightness running along the shoulder and down the neck, says Margie Latrella, an advanced practice nurse in the Women’s Cardiology Center in New Jersey and coauthor of Take Charge: A Woman’s Guide to a Healthier Heart (Dog Ear, 2009). The pain might also extend down the left side of the body, into the left shoulder and arm.

Why it happens: Nerves from damaged heart tissue send pain signals up and down the spinal cord to junctures with nerves that extend out into the neck and shoulder.

What distinguishes it: The pain feels like it’s radiating out in a line, rather than located in one very specific spot. And it doesn’t go away with ice, heat, or muscle massage.

. Sexual problems

Having trouble achieving or keeping erections is common in men with coronary artery disease, but they may not make the connection. One survey of European men being treated for cardiovascular disease found that two out of three had suffered from erectile dysfunction for months or years before they were diagnosed with heart trouble. Recent studies on the connection between ED and cardiovascular disease have been so convincing that doctors now consider it the standard of care to do a full cardiovascular workup when a man comes in complaining of ED, according to cardiologist Goldstein says. “In recent years there’s been pretty clear evidence that there’s a substantially increased risk of heart attack and death in patients with erectile dysfunction,” Goldstein says.

Why it happens: Just as arteries around the heart can narrow and harden, so can those that supply the penis. And because those arteries are smaller, they tend to show damage much sooner — as much as three to four years before the disease would otherwise be detected.

What distinguishes it: In this case, the cause isn’t going to be immediately distinguishable. If you or your partner has problems getting or maintaining an erection, that’s reason enough to visit your doctor to investigate cardiovascular disease as an underlying cause. “Today, any patient who comes in with ED is considered a cardiovascular patient until proven otherwise,” says Goldstein.

3. Dizziness, faintness, or shortness of breath

More than 40 percent of women in one study published in Circulation: Journal of the American Heart Association, reported having experienced shortness of breath in the days before a heart attack. You might feel like you can’t breathe, or you might feel dizzy or faint, as you would at high altitude. If you can’t catch your breath while walking upstairs, vacuuming, weeding the garden, or doing other activities that previously caused you no trouble, this is a reason to be on the alert.

Why it happens: Not enough blood is getting through the arteries to carry sufficient oxygen to the heart. The heart muscle pain of angina may also make it hurt to draw a deep breath. Coronary artery disease (CAD), in which plaque builds up and blocks the arteries that feed the heart, prevents the heart from getting enough oxygen. The sudden sensation of not being able to take a deep breath is often the first sign of angina, a type of heart muscle pain.

What distinguishes it: If shortness of breath is caused by lung disease, it usually comes on gradually as lung tissue is damaged by smoking or environmental factors. If heart or cardiovascular disease is the cause, the shortness of breath may come on much more suddenly with exertion and will go away when you rest.

4. Indigestion, nausea, or heartburn

Although most of us expect pain from any condition related to the heart to occur in the chest, it may actually occur in the abdomen instead. Some people, particularly women, experience the pain as heartburn or a sensation of over-fullness and choking. A bout of severe indigestion and nausea can be an early sign of heart attack, or myocardial infarction, particularly in women. In one study, women were more than twice as likely as men to experience vomiting, nausea, and indigestion for several months leading up to a heart attack.

Why it happens: Blockages of fatty deposits in an artery can reduce or cut off the blood supply to the heart, causing what feels like tightness, squeezing, or pain — most typically in the chest but sometimes in the abdomen instead. Depending on which part of your heart is affected, it sends pain signals lower into the body. Nausea and light-headedness can also be signs that a heart attack is in progress, so call your doctor right away if the feeling persists.

What distinguishes it: Like all types of angina, the abdominal pain associated with a heart problem is likely to worsen with exertion and get better with rest. Also, you’re likely to experience repeated episodes, rather than one prolonged episode as you would with normal indigestion or food poisoning.

5. Jaw and ear pain

Ongoing jaw pain is one of those mysterious and nagging symptoms that can have several causes but can sometimes be a clue to coronary artery disease (CAD) and impending heart attack. The pain may travel along the jaw all the way to the ear, and it can be hard to determine which it’s coming from, says cardiovascular nurse Margie Latrella. This is a symptom doctors have only recently begun to focus on, because many patients surveyed post-heart attack report that this is one of the only symptoms they noticed in the days and weeks leading up to the attack.

Why it happens: Damaged heart tissue sends pain signals up and down the spinal cord to junctures with nerves that radiate from the cervical vertebrae out along the jaw and up to the ear.

What distinguishes it: Unlike the jaw pain caused by temporomandibular joint disorder (TMJ), tooth pain, or ear infection, the pain doesn’t feel like it’s in one isolated spot but rather like it’s radiating outward in a line. The pain may extend down to the shoulder and arm — particularly on the left side, and treatments such as massage, ice, and heat don’t affect it.

By Melanie Haiken, Caring.com senior editor

15 Things Your Walk Reveals About Your Health

15 Things Your Walk Reveals About Your Health

 By Paula Spencer Scott, Caring.com senior editor

Walk into an exam room and a trained eye can tell a lot about you in seconds: Your stride, gait, pace, and posture while walking can reveal surprising information about your overall health and well-being.

“Many physicians are keenly aware, when they see someone walking down the street, what their diagnosis might be, whether their underlying health is good or bad, and if not good, a number of tip-offs to what might be wrong,” says Charles Blitzer, an orthopedic surgeon in Somersworth, New Hampshire, and a spokesperson for the American Academy of Orthopedic Surgeons.

Find out what the following 15 walking styles may signal about your health.

Walking clue #1: A snail’s pace

May reveal: Shorter life expectancy
Walking speed is a reliable marker for longevity, according to a University of Pittsburgh analysis of nine large studies, reported in a January 2011 issue of The Journal of the American Medical Association. The 36,000 subjects were all over age 65. In fact, predicting survival based on walking speed proved to be as accurate as using age, sex, chronic conditions, smoking, body mass index, hospitalizations, and other common markers. It’s especially accurate for those over age 75.

The average speed was 3 feet per second (about two miles an hour). Those who walked slower than 2 feet per second (1.36 miles per hour) had an increased risk of dying. Those who walked faster than 3.3 feet per second (2.25 miles per hour) or faster survived longer than would be predicted simply by age or gender.

A 2006 report in JAMA found that among adults ages 70 to 79, those who couldn’t walk a quarter mile were less likely to be alive six years later. They were also more likely to suffer illness and disability before death. An earlier study of men ages 71 to 93 found that those who could walk two miles a day had half the risk of heart attack of those who could walk only a quarter mile or less.

Simply walking faster or farther doesn’t make you healthier — in fact, pushing it could make you vulnerable to injury. Rather, each body seems to find a natural walking speed based on its overall condition. If it’s slow, it’s usually because of underlying health issues that are cutting longevity.

Walking clue #2: Not too much arm swing

May reveal: Lower back trouble
“It’s really amazing the way that we’re made,” says physical therapist Steve Bailey, owner of Prompt Physical Therapy in Knoxville, Tennessee. As the left leg comes forward, the spine goes into a right rotation and the right arm moves back. This coordination of the muscles on both sides is what gives support to the lower back, he says.

If someone is walking without much swing to the arm, it’s a red flag that the spine isn’t being supported as well as it could be, because of some kind of limitation in the back’s mobility. Back pain or a vulnerability to damage can follow. “Arm swing is a great indicator of how the back is functioning,” Bailey says.

Walking clue #3: One foot slaps the ground

May reveal: Ruptured disk in back, possible stroke
Sometimes experts don’t have to see you walk — they can hear you coming down the hall. A condition called “foot slap” or “drop foot” is when your foot literally slaps the ground as you walk. “It’s caused by muscle weakness of the anterior tibial muscle or the peroneal muscles,” says podiatrist Jane E. Andersen, who has a practice in Chapel Hill, North Carolina, and is a past president of the American Association for Women Podiatrists.

A healthy stride starts with a heel strike, then the foot slowly lowers to the ground, then it lifts from the toe and slings back to your heel. But with drop foot, muscle control is lost and the foot can’t return slowly to the ground. Instead, it “slaps” the ground.

“This could be a sign of a stroke or other neuromuscular event, or of compression of a nerve,” Andersen says. A ruptured disk in the back is a common cause, since it can compress a nerve that travels down the leg. A rare cause of drop foot is simply crossing your legs, Andersen says, if the common peroneal nerve is disrupted from the pressure.

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Walking clue #4: A confident stride (in a woman)

May reveal: Sexual satisfaction
Your stride and gait don’t always indicate bad things. A study conducted in Belgium and Scotland, reported in the September, 2008, Journal of Sexual Medicine, found that a woman’s walk can reveal her orgasmic ability. Women who have a fluid, energetic stride seem to be more likely to easily and often have vaginal orgasms, researchers said. They compared the gaits of women known to be orgasmic (defined as by penile intercourse, not direct clitoral stimulation) with those who were not.

What’s the connection? The theory is that orgasms contribute to muscles that are neither flaccid nor locked. Result: a freer, easier stride, researchers found, as well as greater sexual confidence and better self-esteem.

Walking clue #5: A short stride

May reveal: Knee or hip degeneration
When the heel hits the ground at the beginning of a stride, the knee should be straight. If it’s not, that can indicate a range-of-motion problem in which something is impairing the ability of the knee joint to move appropriately within the kneecap. “Degenerative changes in the knee sometimes need to be addressed by manual therapy to stretch out the tightness and improve that range of motion,” Bailey says.

A similar cause of a short stride is lacking extension, or good range of motion, in the hip. By taking shorter steps, the walker doesn’t have to extend as far. “Unfortunately, that compensation puts more stress on the back,” Bailey says. “In older people, a big issue in the back is having enough space for the joints and nerves as it is. When you don’t have a lot of hip extension, there’s not a lot of room to play with, and it can cause back pain and neural issues, such as drop foot.”

Walking clue #6: Dropping the pelvis or shoulder to one side

May reveal: A back problem
Muscles called the abductors on the outside of the hips work to keep the pelvis level with each step we take. So while we’re lifting one leg and swinging it forward, and standing on the other, the abductors keep the body even — unless those muscles aren’t working properly, Bailey says.

What happens then is that the body compensates. In a common walking pattern known as the Trelendenberg gait, as the heel strikes the ground on the unaffected side, the pelvis drops on that side to try to reduce the amount of force the muscle has to produce on the other side. Sometimes the compensating is so pronounced that the whole shoulder dips as well.  The ultimate cause of the weak abductors is often a back problem, Bailey says.

Walking clue #7: Bowlegged stride

May reveal: Osteoarthritis
“Think of the classic image of the old, slow, bow-legged cowboy,” says orthopedic surgeon Blitzer. “He probably looks that way because of arthritic knees.” Eighty-five percent of people with osteoarthritis (OA), the wear-and-tear form of the disease associated with aging, have a slightly bowlegged walk, he says. Bowlegs (also called genu varum) happen because the body can’t be supported adequately; the knees literally bow out.

Rickets or genes can also produce a bow-legged walking style, but these causes are more commonly associated with kids than grown-ups, and they can be outgrown or corrected with braces.

Walking clue #8: Knock-kneed appearance

May reveal: Rheumatoid arthritis
Rheumatoid arthritis (RA), the kind that’s an inflammatory disease, produces a knock-kneed walk, where the knees bend in toward one another. “About 85 percent of people with rheumatoid arthritis are knock-kneed,” Blitzer says. In knock-knee (genu valgum, or valgus knee), the lower legs aren’t straight but bend outward. This can create a distinctive, awkward-looking walk where the knees are close together and the ankles are farther apart. Sometimes osteoarthritis can also result in knock-knees, depending which joints are affected.

Walking clue #9: A shortened stride on turns and when maneuvering around things

May reveal: Poor physical condition
Balance is a function of coordination between three systems: vision, the inner ear, and what’s called “proprioception,” which is the joints’ ability to tell you their position. The joints can do this because of receptors in the connective tissue around them. But the quality of the receptors is related to how much motion the joint experiences. “It’s the old use-it-or-lose-it,” Bailey says. “When you’re active, you lay down more receptors in the connective tissue, so your proprioception is better.”

That means you have better balance. And it’s why someone with balance problems is often frail or in poor physical condition. “If you have trouble balancing, you have a shorter stride, and it’s especially noticeable on turns or when you’re maneuvering around objects. You also have trouble going up steps, which requires balancing on one foot for a longer amount of time,” Bailey says. “You do much better on straightaways.”

Blitzer encourages frail patients who need canes and walkers but avoid them because they “don’t want to look old” to set aside their pride and use them. “Better to use adaptive devices and continue to be active than to be sedentary, which is a vicious cycle that makes you more sedentary,” he says.

Balance problems can be also be related to peripheral neuropathy, a kind of nerve damage caused by diabetes, Andersen says. Other common causes include alcohol abuse and vitamin deficiencies.

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Walking clue #10: A flat step without much lift

May reveal: Flat feet, bunions, neuromas
Flat feet are obvious at a glance: There’s almost no visible arch (hence one of the condition’s names, “fallen arches”). But other conditions can also cause a flat walk. When the person takes a step, the foot flattens even as the heel is lifting off the ground, when it would normally be going into an arched position. The heel may also shift slightly to the inside when it comes up, and the toes may flex upward.

These kind of movements are attempts to create better stability where there isn’t any because of a painful bunion (an abnormal enlargement of the bone or tissue around the base of the big toe) or a neuroma (a nerve condition) in the foot. The most common neuroma, called Morton’s neuroma, is extremely painful thickening of the nerve between the third and fourth toes. The stepping pattern changes in order to protect what hurts.

Walking clue #11: Shuffling

May reveal: Parkinson’s disease
Shuffling — bending forward and having difficulty lifting feet off the ground — isn’t an inevitable aspect of aging. It’s a distinct gait that may indicate that someone has Parkinson’s disease. The person’s steps may also be short and hesitant.

“Shuffling is one of the most common manifestations of Parkinson’s, a neuromotor dysfunction in a neuromuscular disease,” says Blitzer. Along with tremors, it can be an early sign of the disease.

People with advanced dementia, such as is caused by Alzheimer’s disease, may also shuffle as a result of cognitive trouble — the brain and musculature don’t communicate well. But by the time this happens, memory loss and problems with thinking skills are far more obvious.

Walking clue #12: Walking on tiptoes, both feet

May reveal: Cerebral palsy or spinal cord trauma
Another distinctive gait owing to an underlying condition is “toe-walking.” The toe reaches the ground before the heel, instead of the other way around. It’s related to overactive muscle tone, caused by stretch receptors that fire incorrectly in the brain. When the toe-walking happens on both sides, it’s almost always because of damage high in the spinal column or brain, such as cerebral palsy or spinal cord trauma.

Note: Sometimes toddlers walk on tiptoe for a while as they’re getting the hang of it, but this doesn’t mean they have a palsy. If you’re concerned, mention it to the child’s doctor, who will assess for other signs of a problem.

Walking clue #13: Walking on tiptoes, one foot

May reveal: Stroke
Doctors assessing toe-walking look for symmetry: Is it happening on both sides or only one? When a person toe-walks only on one side, it’s an indicator of stroke, which usually damages one side of the body. When polio was still a scourge in the U.S., affected people often had one withered extremity and one-sided toe-walking was more common.

Walking clue #14: A bouncing gait

May reveal: Unusually tight calf muscles
One unusual stride is a gait that causes the walker to literally bounce a bit. Specialists can see the heel-off, the first part of a normal step, happen a bit too quickly, because of tight calf muscles. Women are the most vulnerable, because of chronic high heel use, podiatrist Andersen says.

“I’ve seen women in their 60s who have been told to exercise — sometimes for the first time in her life because a doctor is ordering it for a health issue — and she can’t because she can’t comfortably wear a flat shoe,” she says. “The same thing can happen much earlier in life, too, such as with a 25-year-old who’s been wearing stilettos since she was a teenager.”

Walking clue #15: One higher arch and/or a pelvis that dips slightly

May reveal: One leg is shorter than the other
Limb (or leg) length discrepancy simply means that one leg is shorter than the other. Experts can spot this in several different ways. One is by looking at the foot while you take a step, says podiatrist Andersen; one foot will have a higher arch and the other will look flatter. The flatter foot usually corresponds to the longer leg, she says.

Also, because the shorter leg has to go a bit farther to get to the floor, the pelvis may drop down slightly in the stride, adds Bailey. “If you pull up the shirt you can often see changes to the lumbar spine — a horizontal crease along the spine on the side with the longer leg, because the spine is bending in that direction.”

You can be born with limb discrepancy or get it as the result of knee or hip replacements, if limbs don’t line up perfectly after healing. But unless the discrepancy is three-quarters of an inch or more, Blitzer says, studies indicate it probably won’t cause health problems. Shoe inserts usually can make up for a quarter-inch discrepancy; surgery is sometimes recommended for larger differences.

by Caring.com

Myths About How to Act Around Someone Who’s Dying

Myths About How to Act Around Someone Who’s Dying

 Myths About How to Act Around Someone Who’s Dying

People often adhere to a code of conduct about the end of life that’s just not rooted in common sense or reality — especially when it comes to how to talk to someone who’s dying, in their final days or hours. Hospice nurse Maggie Callanan, who has attended more than 2,000 deaths, wrote her book Final Journeys: A Practical Guide for Bringing Care and Comfort at the End of Life in order to take on these myths:

Myth: Don’t cry in front of the dying.
They know you’re sad. Having the courage to bare your emotions gives the dying person permission to be candid about his or her own feelings. Your tears are evidence of your love. And they can also be a relief to the person, telegraphing that you understand what’s happening.

Myth: Keep the children away.
People often steer kids away from death so they’ll remember the person in a good light and not be frightened. But most kids do well with simple explanations of what’s happening; facts are usually less scary than their vivid imaginations. By cordoning off a child from a natural part of life, you also deprive the dying person of a beloved, comforting presence.

Myth: Don’t talk about how you expect your life will change after the dying person has passed away.
It’s not like they’ll feel left out. You can be sure the dying person is thinking about your life after his or her death — people are often deeply concerned about this. It’s reassuring to hear that loved ones will look after one another.

Myth: If you don’t deal with death well, it’s OK to stay away.
Some people excuse themselves from visiting a dying person with phrases like, “I hate hospitals” or “I want to remember X the way she was.” This is saying that your discomfort is more important than the dying person’s final needs.

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“You have a responsibility,” Callanan says. “If someone has played a positive part in your life, that person deserves your attention as his or her life is ending. I’ve seen too many devastated people dying too sadly, waiting for someone who never came.”

By Paula Spencer, Caring.com senior editor

Caring.com was created to help you care for your aging parents, grandparents, and other loved ones. As the leading destination for eldercare resources on the Internet, our mission is to give you the information and services you need to make better decisions, save time, and feel more supported. Caring.com provides the practical information, personal support, expert advice, and easy-to-use tools you need during this challenging time.

Healthy Diet Linked to Longer Life

Healthy Diet Linked to Longer Life

 Healthy Diet Linked to Longer Life

According to research that will be published in the January 2011 edition of the Journal of the American Dietetic Association, seniors between the ages of 70 to 79 who ate a diet rich in high-fat dairy products had the highest risk of death over a ten-year period.

However, seniors the same age who ate a healthy diet–one with high amounts of vegetables, fruit, whole grains, poultry, and fish–lived longer lives.

The researchers analyzed the diets of 2500 American adults and found that during the ten-year period, those who ate a diet rich in high fat dairy products had a 34 percent death rate.  Those who ate a diet fairly high in sweets and desserts had a 32 percent death rate, while only 21 percent of the healthy diet category died during the decade-long study.

The researchers took into account a number of other factors, such as gender, age, race, education, physical activity, smoking, and total caloric intake as part of the study.

To people who already eat a healthy diet and notice the health improvements this type of diet affords, the outcome of this type of research may seem fairly obvious but positive outcomes with this type of research may help to support further research into other health benefits of healthy diet.

Michelle Schoffro Cook, BSc, RNCP, ROHP, DNM, is an international best-selling and seven-time book author and doctor of natural medicine, whose works include: The Life Force Diet, The Ultimate pH Solution, The 4-Week Ultimate Body Detox Plan, The Phytozyme Cure and HealthSmart News. Learn more at www.DrMichelleCook.com.

Questions to Ask After a Heart Attack

Questions to Ask After a Heart Attack

If your parent has recently been hospitalized for a heart attack, the future may seem very uncertain. Now is the time to organize medical care and figure out how to make the transition from hospital to home as smooth as possible. Ask your parent’s doctors and nurses the following:

1. How serious was the heart attack?

Some heart attacks are worse than others. Knowing how badly your parent’s heart was damaged will give you a clearer sense of his prognosis and timeline for recovery. The extent of damage will also determine any complications your parent might have.

2. What complications should we watch for?

If your parent suffered a very mild heart attack, you might not need to worry about complications at all. But if the attack was more severe, your parent could develop complications, such as an arrhythmia, congestive heart failure, or stroke. Ask the doctor about your parent’s risk for these complications and how to recognize them if they develop.

3. How much care will my parent need — and for how long?

If your parent will need more care than you can provide, now is the time to make plans. The doctors and nurses should be able to give you an idea of how badly and how long your parent will be disabled.

4. When can my parent resume normal activities?

How much and what type of activities your parent can do will depend on the condition of his heart. In most cases, heart attack survivors can get back to normal activities within a few months; others may need to take it easy for a longer period of time. Depending on his state’s laws, your parent may be able to start driving within a couple of weeks. The doctor can help you and your parent set a realistic timetable for recovery.

5. What exercises should my parent do?

Physical activity strengthens the heart muscle and is important for overall health. Exercise can help your parent reduce his cholesterol level, lose weight, and lower his blood pressure. But it’s important not to overdo it, especially soon after a heart attack. Ask the doctor if your parent could benefit from a cardiac rehabilitation program, in which an exercise specialist will help him develop a program he can continue on his own.

6. What kinds of dietary restrictions are necessary?

You probably already realize that your parent will need to make changes to his diet, but the thought of implementing those changes may daunt you. The doctors and nurses can help you figure out the best diet for your parent. Ask what foods are good for heart health, what foods he should limit, and how to control portion size. If you need more help, ask for a referral to a nutritionist who specializes in cardiac patients.

7. What medications will my parent need to take — and what are the likely side effects?

The doctor has probably prescribed a bewildering array of different medications for your parent. Make sure you understand each medication and its potential side effects. For each medication, ask: What does it do? How often should my parent take it? Should my parent take this medication with food? Is there anything my parent should not eat or drink with this medication? What side effects might we expect?

8. What doctors should my parent see?

If your parent’s heart attack was fairly mild, he may be able to continue to see only his primary care physician. But if his heart was badly damaged, he’ll probably need to see a cardiologist as well. Ask what doctors he’ll need to visit and whether your insurance will cover those appointments.

9. What’s my parent ’s risk for another heart attack, and what signs should we watch for?

Most heart attack survivors are at a higher risk for a second attack. Ask the doctor how you can tell the difference between angina and a heart attack. Be aware that the second heart attack may not exhibit the same symptoms as the first. With that in mind, ask the doctor for a list of signs to watch for and what to do if you see them, including where you should seek emergency care.

10. What local support and other resources are available?

Your parent’s doctors and nurses are a great source of information about the support network available for cardiac patients and their families. Don’t hesitate to ask them for referrals.

by Lara, selected from Caring.com

Caring.com was created to help you care for your aging parents, grandparents, and other loved ones. As the leading destination for eldercare resources on the Internet, our mission is to give you the information and services you need to make better decisions, save time, and feel more supported. Caring.com provides the practical information, personal support, expert advice, and easy-to-use tools you need during this challenging time.

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