Ticket to Work Puts People Back in the Driver’s Seat

Back to Work

Ticket to Work Puts People Back in the Driver’s Seat

Social Security encourages people to rejoin the workforce when they are able. Ticket to Work is our free and voluntary program that helps people get vocational rehabilitation, training, job referrals, and other employment support services.

This program is for people ages 18 to 64, who are receiving disability benefits, and need support re-entering the workforce or working for the first time. While many disabled individuals are unable to work and may never be able to return to work, we know that some are eager to try working again. Work incentives make it easier to work and still receive health care and cash benefits from Social Security while providing protections if people have to stop working due to a disability.

Social Security works with employment networks to offer beneficiaries access to meaningful employment. Employment networks are organizations and agencies, including state vocational rehabilitation agencies that provide various employment support services. Some services they may help with include résumé writing, interviewing skills, and job leads.

Ticket to Work gives individuals the opportunity to choose from several employment networks. Participants are free to talk with as many employment networks as they want before choosing one. If someone signs an agreement with an employment network, they’ll help the individual develop an employment plan. We’ll review their progress toward achieving the goals of their employment plan every 12 months. If they are making timely progress in their return to work plan, we will not conduct a medical review of their disability during the time they’re in the program.

Many people have successfully completed the Ticket to Work program. Anyone interested in the Ticket to Work program should call the Ticket to Work Helpline toll-free at 1-866-968-7842 (TTY 1-866-833-2967). More information on the program is available online at www.socialsecurity.gov/work.

Remember, Social Security is with everyone through life’s journey, providing resources that can help people reach their work and retirement goals.

Posted on September 25, 2017 by Jim Borland, Acting Deputy Commissioner for Communications

Original Posting: https://blog.socialsecurity.gov/ticket-to-work-puts-people-back-in-the-drivers-seat/

Healthy Aging – a radio show with Debbie Caneen

Healthy Aging – a radio show with Debbie Caneen

Take a few moments to listen to some interesting information on Healthy Aging presented by Debbie Caneen.

“Rock Steady” Video

Episode 10: Rain Cube, and Permeculture with Alberto Jauregui

Episode 11: the CATE Foundation with Tina Patch
Episode 12: Dementia, and Alzheimer’s Medication with Dr. Banko.
Episode 13: Rawsome Living with Shari Leiderman
Episode 14: Advocacy, and Awareness, with Jennifer Toles of Guided Life Care Planning Services.
Jennifer Toles, (CRC, CLPC, CCM), shares her Journey, passion and hope for disability advocacy, and the power of empathetic wellness awareness.

Anger Management

Anger management is a process of learning to recognize signs that you’re becoming angry, and taking action to calm down and deal with the situation in a positive way. Anger management doesn’t try to keep you from feeling anger or holding it in. Anger is a healthy, normal emotion when you know how to express it appropriately. Anger management is about learning how to do this. Although you can learn how to control your frustrations by practicing anger management techniques on your own, the most effective approach is to take an anger management class or to see a mental health counselor.

Why it’s done

Anger management helps you recognize frustrations early and resolve them in a way that helps you express your needs — and keeps you calm and in control. Coping well with anger is a learned behavior, just as behaving badly when you get frustrated is a behavior you have to unlearn. Anger management is a way of systematically recognizing what pushes your buttons and how to respond in ways that work for you instead of against you.

Everyone feels angry and says and does things he or she regrets from time to time. This is normal, and not necessarily a sign you need to seek out anger management help. However, when your anger is damaging your relationships, is making you miserable or is resulting in dangerous or violent behavior, you probably need help.

Some good indicators you need help controlling your anger include:

  • Often feeling like you have to hold in your anger
  • Frequent arguments with your partner, children or co-workers that escalate frustrations
  • Trouble with the law
  • Physical violence, such as hitting your partner or children or starting fights
  • Threats of violence against people or property
  • Out-of-control behavior, such as breaking things or driving recklessly

How you prepare

Preparing to look for anger management help can be challenging, but there are many resources available to help you in your search. Here are some steps you can take to find a counselor specializing in anger management, an anger management program or other resources:

  • Ask your primary care doctor for a referral
  • Ask family and friends to give you recommendations based on their experiences
  • Check with your health insurance company, employee assistance program (EAP) or church
  • Ask state or local agencies for recommendations
  • Search the Internet
  • Check with your district court
  • Search your library for traditional and online resources, such as blogs, support groups or books

When you start working on anger management, identify your particular triggers and the physical and emotional signs that occur as you begin to get angry. Pay attention to these, and write them down:

  • Identify any stressors that commonly trigger or worsen your anger. Examples include frustration with a child or partner, financial stress, or issues with a co-worker.
  • Pay attention to physical signs that your feelings of anger are rising, for example, clenching your fists or your jaw or driving too fast.
  • Take note of emotional signs your anger’s on the rise, such as the feeling you want to yell at someone or that you’re holding in what you really want to say.

What you can expect

Anger management classes or therapy for anger management (also called psychotherapy) can be done one-on-one, with your partner, child or other family members, or in a group setting. You may need to attend a number of classes or counseling sessions over a period of weeks up to a few months.

  • Generally, counseling for anger management focuses on learning specific skills and ways of thinking to cope with anger.
  • If you have any other mental health conditions, such as depression or addiction, you may need to work on these other issues for anger management techniques to be effective.

The aim of counseling and anger management classes is to teach you to:

  • Identify situations that are likely to set you off and respond in nonaggressive ways before you get mad
  • Use specific skills to use in situations likely to trigger your anger,
  • Recognize when you aren’t thinking logically about a situation, and correct your thinking
  • Calm yourself down when you begin to feel upset
  • Express your feelings and needs assertively (but not aggressively) in situations that make you feel angry
  • Focus on problem solving in frustrating situations — instead of using energy to be angry, focus on resolving the situation


Improving your ability to manage anger has a number of benefits. You’ll feel like you have more control when life’s challenges turn up the heat, and more relaxed in challenging situations. Knowing how to express your feelings assertively means you won’t feel frustrated because you feel like you need to “hold in” your anger to avoid offending someone.

Anger management can help you:

  • Argue less. Enjoy better overall communication that results when you talk about your anger rather than letting it build. This will help you avoid saying impulsive and hurtful things that damage relationships with family members, friends and your partner.
  • Maintain better health. The stress caused by ongoing angry feelings can increase your risk for health problems, including headaches, sleep problems, digestive problems, heart problems and high blood pressure.
  • Prevent psychological problems linked to anger, which can include depression, problems at work and troubled relationships.
  • Use your frustration to get things done. Anger expressed inappropriately can make it difficult for you to think clearly, and may result in poor judgment. Learn to use feelings of frustration and anger as motivators to work harder and take positive action.
  • Help avoid addictive escapes. It’s common for people who feel chronically angry to turn to alcohol, drugs or food. Rather than using alcohol, drugs or food to dull anger, you can use anger management techniques to keep your cool and your control.

Taking Care of Yourself


If you have Alzheimer’s disease, it’s important to understand that your life is not over. Living with Alzheimer’s means dealing with some life changes sooner than you had anticipated.

You can live a meaningful and productive life by taking care of your physical and emotional health, by engaging in activities you enjoy and by spending time with family and friends.

Caring for Your Physical Health

Caring for your physical health can improve the quality of your life for years to come.

  • Get regular checkups
  • Take your medication
  • Eat healthy foods
  • Exercise every day
  • Rest when you are tired
  • Drink less alcohol

Coping With Your Feelings

After receiving a diagnosis, you may experience a range of emotions, including:

  • denial about having dementia
  • fear of losing people important to you
  • loneliness because no one seems to understand what you are going through
  • frustration with not making yourself understood
  • loss of the way you used to see yourself
  • depression or anger about the way your life is changing

The feelings you may be experiencing are normal. But it is important to find ways to deal with those feelings. The following suggestions may help you take care of your emotional needs:

  • Write in a journal about your experiences and feelings.
  • Join a support group. To find one in your area, check with your local Alzheimer’s Association office.
  • Talk to your physician, who can determine if there is an appropriate treatment.
  • See a counselor.
  • Talk to a clergy member or other person who can help with your spiritual needs.
  • Share your feelings with your friends and family.
  • Do the activities you enjoy as long as you are able.
  • Participate in our online community. Share experiences and advice with others on our message boards and live chat.

Mild Cognitive Impairment More Common in Older Men Than Older Women

NIH-supported study suggests gender differences in cognition problems

Older men may be at risk of developing mild cognitive impairment (MCI), often a precursor to Alzheimer’s disease, earlier in life than older women, according to a study appearing today in Neurology.

Primarily funded by the National Institute on Aging (NIA), part of the National Institutes of Health, the study raises the question of whether there may be a gender difference in the development and progression of MCI.

Scientists evaluated the cognitive health of 1,969 dementia-free older people and found 16 percent showed signs of MCI, a condition usually marked by memory problems or other cognitive problems greater than those expected for their age. Prevalence was greater among the older participants, and it was consistently higher in men than women across all age ranges.

Ronald C. Petersen, Ph.D., M.D., and his team at the Mayo Clinic, Rochester, Minn., conducted the research, which was also supported by the National Institute of Mental Health (NIMH), also part of the NIH. Additional funding was provided by the Robert H. and Clarice Smith and Abigail van Buren Alzheimer’s Disease Research Program and the Rochester Epidemiology Project, also supported by NIA.

“Because evidence indicates that Alzheimer’s disease may cause changes in the brain one or two decades before the first symptoms appear, there is intense interest in investigating MCI and the earliest stages of cognitive decline,” said NIA Director Richard J. Hodes, M.D. “While more research is needed, these findings indicate that we may want to investigate differences in the way men and women develop MCI, similar to the way stroke and cardiovascular disease risk factors and outcomes vary between the sexes.”

The researchers conducted in-person evaluations of 1,969 randomly selected people from all 70- to 89-year-olds living in Olmsted County, Minn. The group was evenly split between men and women. Each individual received a neurological evaluation and neuropsychological testing. A panel then reviewed those data plus other information, such as health history and occupation/education levels, to reach a diagnosis. Sixteen percent were diagnosed with MCI; these individuals displayed either amnestic MCI, where memory is impaired, or non-amnestic MCI, where different cognitive problems arise, such as with language.

Results of the study indicated that:

  • Overall, MCI was more prevalent in men (19 percent) than in women (14 percent), even after adjusting for several demographic variables and clinical factors, such as hypertension and coronary artery disease.
  • Of the 16 percent affected with MCI, over twice as many people had the amnestic form that usually progresses to Alzheimer’s disease and the prevalence rate was higher in men than in women.
  • MCI prevalence was higher among people with the APOE e4 gene, a known risk factor for late-onset Alzheimer’s, a form of the disease that usually occurs at age 65 or older.
  • A greater number of years spent in school was significantly associated with decreased MCI prevalence, from 30 percent among participants with less than nine years of education to just 11 percent in those with more than 16 years of education.
  • MCI prevalence was higher in participants who never married, as opposed to those currently or previously married.

The researchers noted that estimates of MCI prevalence vary in studies conducted around the world but generally fall into a range of 11 to 20 percent. The Mayo team’s evaluation of participants included detailed in-person assessments that helped to capture the subtle changes in daily function that may mark the onset of MCI, Petersen said. The researchers also noted that the study’s limitations include a relatively low participation rate by Olmstead County residents and the fact that the population is predominantly white. Thus, these findings may not apply to other ethnic groups.

The NIA leads the federal government effort conducting and supporting research on the biomedical, social and behavioral issues of older people. For more information on aging-related research and the NIA, go to www.nia.nih.gov. The NIA provides information on age-related cognitive change and neurodegenerative disease specifically at its Alzheimer’s Disease Education and Referral (ADEAR) Center site at www.nia.nih.gov/Alzheimers. To sign up for e-mail alerts about new findings or publications, please visit either website.

The mission of the NIMH is to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery and cure. For more information, visit www.nimh.nih.gov.

The National Institutes of Health (NIH) — The Nation’s Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

Alzheimer’s Coping With Changes


Alzheimer’s disease will bring significant changes in your day-to-day experiences. Things you once did easily will become increasingly difficult. The following suggestions may help you cope with changes in your daily life and plan for changes that will occur in the future.

Doing difficult tasks

You may find familiar activities such as balancing your checkbook, preparing a meal or doing household chores more difficult. Try the following tips:

  • Do difficult tasks during the times of the day when you normally feel best.
  • Give yourself time to accomplish a task, and don’t let others rush you.
  • Take a break if something is too difficult.
  • Arrange for others to help you with tasks that are too difficult.
Communicating with others

You may begin to experience difficulty understanding what people are saying or finding the right words to express your thoughts. The following tips are important in communicating:

  • Take your time.
  • Ask the person to repeat a statement, speak slowly or write down words if you do not understand.
  • Find a quiet place if there is too much distracting noise.
  • Understand that at some point it may no longer be safe for you to drive. Discuss with your family and physician about how and when you will make decisions about driving.
  • Make plans for other transportation options, such as family members, friends or community services.
  • Contact your local chapter of the Alzheimer’s Association to learn what local transportation services are available.
Dealing with memory changes
  • Post a schedule of the things you do every day, such as meal times, exercise, a medication schedule and bed time.
  • Have someone call to remind you of meal times, appointments or your medication schedule.
  • Keep a book containing important notes, such as phone numbers, people’s names, any thoughts or ideas you want to hold on to, appointments, your address and directions to your home.
  • Post important phone numbers in large print next to the phone.
  • Have someone help you label and store medications in a pill organizer.
  • Mark off days on a calendar to keep track of time.
  • Label photos with the names of those you see most often.
  • Label cupboards and drawers with words or pictures that describe their contents.
  • Have someone help you organize closets and drawers to make it easier to find what you need.
  • Post reminders to turn off appliances and lock doors.
Living alone

Many individuals manage on their own during the earliest stages of Alzheimer’s disease, with support and assistance from others. The following suggestions may help if you live by yourself.

  • Arrange for someone to help you with housekeeping, meals, transportation and other daily chores. To get information about assistance available in your community, talk to your local chapter of the Alzheimer’s Association.
  • Make arrangements for direct deposit of checks, such as your retirement pension or Social Security benefits.
  • Make arrangements for help in paying bills. You can give a trusted individual the legal authority to handle money matters.
  • Plan for home-delivered meals if they are available in your community.
  • Leave a set of house keys with a neighbor you trust.
  • Make arrangements for someone to regularly check your smoke alarm.
  • Have family, friends or a community service program call or visit daily.
    • Keep a list of questions and concerns to discuss with them during your time together.

Keep a list of things for them to check out around the house, such as electrical appliances, mail and food items.

Seven Stages of Alzheimer’s

This information is provided by the Alzheimer’s Organization (alz.org).

Experts have documented common patterns of symptom progression that occur in many individuals with Alzheimer’s disease and developed several methods of “staging” based on these patterns.

Staging systems provide useful frames of reference for understanding how the disease may unfold and for making future plans. But it is important to note that not everyone will experience the same symptoms or progress at the same rate. People with Alzheimer’s die an average of four to six years after diagnosis, but the duration of the disease can vary from three to 20 years.

The framework for this section is a system that outlines key symptoms characterizing seven stages ranging from unimpaired function to very severe cognitive decline. This framework is based on a system developed by Barry Reisberg, M.D., Clinical Director of the New York University School of Medicine’s Silberstein Aging and Dementia Research Center.

Within this framework, we have noted which stages correspond to the widely used concepts of mild, moderate, moderately severe and severe Alzheimer’s disease. We have also noted which stages fall within the more general divisions of early-stage, mid-stage and late-stage categories.

Stage 1: No impairment (normal function)
Unimpaired individuals experience no memory problems and none are evident to a health care professional during a medical interview.
Stage 2: Very mild cognitive decline (may be normal age-related changes or earliest signs of Alzheimer’s disease)
Individuals may feel as if they have memory loss and lapses, especially in forgetting familiar words or names or the location of keys, eyeglasses or other everyday objects. But these problems are not evident during a medical examination or apparent to friends, family or co-workers.
Stage 3: Mild cognitive decline
Early-stage Alzheimer’s can be diagnosed in some, but not all, individuals with these symptoms
Friends, family or co-workers begin to notice deficiencies. Problems with memory or concentration may be measurable in clinical testing or discernible during a detailed medical interview. Common difficulties include:

  • Word- or name-finding problems noticeable to family or close associates
  • Decreased ability to remember names when introduced to new people
  • Performance issues in social or work settings noticeable to family, friends or co-workers
  • Reading a passage and retaining little material
  • Losing or misplacing a valuable object
  • Decline in ability to plan or organize
Stage 4: Moderate cognitive decline
(Mild or early-stage Alzheimer’s disease)
At this stage, a careful medical interview detects clear-cut deficiencies in the following areas:

  • Decreased knowledge of recent occasions or current events
  • Impaired ability to perform challenging mental arithmetic-for example, to count backward from 75 by 7s
  • Decreased capacity to perform complex tasks, such as planning dinner for guests, paying bills and managing finances
  • Reduced memory of personal history
  • The affected individual may seem subdued and withdrawn, especially in socially or mentally challenging situations
Stage 5: Moderately severe cognitive decline
(Moderate or mid-stage Alzheimer’s disease)
Major gaps in memory and deficits in cognitive function emerge. Some assistance with day-to-day activities becomes essential. At this stage, individuals may:

  • Be unable during a medical interview to recall such important details as their current address, their telephone number or the name of the college or high school from which they graduated
  • Become confused about where they are or about the date, day of the week or season
  • Have trouble with less challenging mental arithmetic; for example, counting backward from 40 by 4s or from 20 by 2s
  • Need help choosing proper clothing for the season or the occasion
  • Usually retain substantial knowledge about themselves and know their own name and the names of their spouse or children
  • Usually require no assistance with eating or using the toilet
Stage 6: Severe cognitive decline
(Moderately severe or mid-stage Alzheimer’s disease)
Memory difficulties continue to worsen, significant personality changes may emerge and affected individuals need extensive help with customary daily activities. At this stage, individuals may:

  • Lose most awareness of recent experiences and events as well as of their surroundings
  • Recollect their personal history imperfectly, although they generally recall their own name
  • Occasionally forget the name of their spouse or primary caregiver but generally can distinguish familiar from unfamiliar faces
  • Need help getting dressed properly; without supervision, may make such errors as putting pajamas over daytime clothes or shoes on wrong feet
  • Experience disruption of their normal sleep/waking cycle
  • Need help with handling details of toileting (flushing toilet, wiping and disposing of tissue properly)
  • Have increasing episodes of urinary or fecal incontinence
  • Experience significant personality changes and behavioral symptoms, including suspiciousness and delusions (for example, believing that their caregiver is an impostor); hallucinations (seeing or hearing things that are not really there); or compulsive, repetitive behaviors such as hand-wringing or tissue shredding
  • Tend to wander and become lost
Stage 7: Very severe cognitive decline
(Severe or late-stage Alzheimer’s disease)
This is the final stage of the disease when individuals lose the ability to respond to their environment, the ability to speak and, ultimately, the ability to control movement.

  • Frequently individuals lose their capacity for recognizable speech, although words or phrases may occasionally be uttered
  • Individuals need help with eating and toileting and there is general incontinence of urine
  • Individuals lose the ability to walk without assistance, then the ability to sit without support, the ability to smile, and the ability to hold their head up. Reflexes become abnormal and muscles grow rigid. Swallowing is impaired.