The Importance of Exercise

It’s already February 3rd, but it’s not too late for New Year’s resolutions! Actually, as the lines for treadmills start to wane and people lose their resolve, now is a great time to start that exercise regimen you have been thinking about for a while. Seniors should pay special attention to this, for more and more, it is becoming clear that things such as senior independence, health, and mobility can be seen as a direct result of exercise.

Recently, in the Boston Globe, in an article titled “For Elders, Fitness Can’t be Beat,” Kay Lazar wrote “Dr. Jonathan Bean, an associate professor at Harvard Medical School and a researcher at Spaulding Rehabilitation Network, is tracking about 350 older adults, including [Dolores] Selenkow, and has found that building core -- also known as abdomen -- strength, and leg speed are vital to keeping elders active and independent.” This research matches that of many other experts on senior health. Many injuries in seniors can be tracked to falls, and these falls can be directly traced to a lack of balance or a lack of muscle mass. Additionally, a lack of mobility reduces independence for self-evident reasons. When somebody cannot walk for longer than five minutes, it becomes infinitely more difficult to socialize and to take care of yourself. Therefore, if you are a senior – or know a senior – who wants to maintain independence, it is essential that you follow Dr. Bean’s advice and build core strength and leg speed.

Lazar continues, in her article, “Another study, the largest and longest-running trial of its kind, found that regular physical activity in older adults measurably reduced mobility problems.” Optimally, you want to exercise for 30 minutes, five times a week. If this is too much at first, that is fine. Experts urge to go at your own pace and try to build up to that number. It is important to rest and not push yourself. Walking is one way to exercise. If you are looking for alternate ways, or you just got bombarded by snow in the Northeast, here are some videos a simple search on youtube.com brings up: https://www.youtube.com/results?search_query=elderly+exercises. Youtube.com is a great resource, as you can tailor exercise videos for things such as balance, core, or cardio. Another resource that may be helpful is your local senior center and ask them to see if they offer fitness classes, walking clubs, or other services. If you need help locating a local center, you can look in the phone book, or you can locate it at the National Institute of Senior Centers web site: http://www.ncoa.org/national-institute-of-senior-centers/. You may also call them at 571-527-3900. Again, there are many resources out there for you. The most important thing to do is to start exercising. The health benefits of exercise are endless, and they will help anyone maintain mobility, strength, and – most importantly – independence. If you have any questions for us, do not hesitate to email or call.

Got D?

At some point in your life, you have probably been bombarded with the “Got Milk?” commercials (remember all those milk mustaches?) that remind us that calcium is vital to a growing body. Vitamin D is just as important, especially for aging adults. Many health care providers prescribe or recommend Vitamin D supplements along with taking calcium. Why? Without the right levels of Vitamin D in your body, calcium can’t do its job.

Vitamin D is linked to better bone health. Better bone health is good. It prevents osteoporosis and falls in the elderly. Good things. Lower levels of Vitamin D may also increase your risk for autoimmune disorders, colon and prostate cancer, and cardiovascular disease, and may be connected with depression and other mental health problems. Bad things.

Not convinced you need Vitamin D? Let’s look at some facts. The National Institutes of Health recommends that “people ages 51 to 70 should consume at least 600 international units (IU) of vitamin D daily. People over age 70 should consume at least 800 IUs daily.” So how can we get enough D? Here are three great ways:

·       Sunlight: Exposure to sunlight is probably the best source for Vitamin D! Living in the North with a longer winter season, or living inside a senior home without much outside activity, you are less exposed to natural healthy sunlight and are at higher risk for Vitamin D deficiency. Speak with your health care provider about how to get a healthy dose of sunlight, plus using sun screen to protect yourself from skin cancer. Just a simple stroll outside can be enough. And when it is nice out, take advantage of the weather! Or listen to John Ruskin: “Sunshine is delicious, rain is refreshing, wind braces us up, snow is exhilarating; there is really no such thing as bad weather, only different kinds of good weather.”

·       Diet: Vitamin D is naturally present in few foods, but good sources are oily fish (salmon, tuna, herring, sardines, anchovies, cod liver oil), eggs, and fortified milk. That’s right – milk has to be fortified with Vitamin D to have enough to make an impact; this includes dairy milk and other products like soy or almond milk. Check the labels to make sure it’s been fortified. A milk mustache on its own won’t always get the job done!

·       Supplements: Vitamins are an easy and inexpensive way to get the Vitamin D you need. Speak with your health care provider about the right type and dosage, and also talk about how to take it so your body can absorb it appropriately. Look out for signs of too much Vitamin D from supplements, like nausea, vomiting and weakness.

Sources:
http://www.parentgiving.com/elder-care/vitamin-d-deficiency-a-common-risk-factor-for-seniors/
http://nihseniorhealth.gov/falls/bonehealth/01.html
http://www.medpagetoday.com/Endocrinology/GeneralEndocrinology/46915 https://www.vitamindcouncil.org/health-conditions/depression/
http://www.nytimes.com/2010/07/27/health/27brod.html?_r=0
http://www.skincancer.org/healthy-lifestyle/vitamin-d/the-d-dilemma

Adapting Bedrooms

In August, we shared ways to adapt your kitchen for a senior or a person with disabilities. This month, we’d like to share some adaptations that can be made for another room in the house – the bedroom! Depending on how big your house is, if it has more than one floor, or what your budget allows, making just some of these changes can give both a loved one and a caregiver some necessary peace of mind. These changes might also apply to other rooms in the house.

·        Labels: Labels are helpful for everyone, no matter what the room. Add labels to dresser drawers, closet storage, etc. to make things easy to find. We also recommend creating “homes” for things, like a basket for remote controllers, or a basket for books, so that there is a “go-to” place to find what you need. You just have to make sure your loved one puts things back!

·        Organizing cords: Ensure that electric cords are labeled and out of the way. You may need to tape them to the wall or floor with duct tape to prevent your loved one from tripping.

·         Moving the bedroom: The bedroom will need to be close to the bathroom or easily accessible. This might mean moving the bed and bedroom storage into your living room, or converting the dining room into a new bedroom. To close off doorways, add a curtain rod above doorways with simple fabric or curtains to create privacy if a door doesn’t already exist. You’ll want to keep doorways wide for equipment, wheelchairs, etc., and sometimes doors can restrict the passageway.

·        Light switches: If you can’t move light switches to a convenient place, think about adding a remote-controlled light switch device. These are affordable options and a convenient way for people to manage the light in their room without having to move. Check the kinds of light switches on lamps and think about whether or not weak or arthritic hands have the ability to turn switches or “clap on” lights.

·        Alarm clocks: Depending on your loved one’s sleep habits, you may need to invest in a louder alarm or even a bed shaker that lightly vibrates the mattress.

·       Specialized furniture: Does your loved one need a special bed or chair? Or maybe they need a bed rail to keep them in bed at night, or support to get out? Check in with your healthcare provider on these needs before you invest in these devices.

Before making any big (or even small) changes to your home, you can contact an Occupational Therapist. These professionals can help you assess your needs and give you advice on adapting your loved one’s sleeping and living arrangements.

Movie Review: Nebraska

Nebraska, directed by Alexander Payne, tells the story of Woody Grant (Bruce Dern) and his family trying to navigate Woody’s dementia. Will Forte co-stars as David, Woody’s son, and the narrative follows them on an ill-fated trip to Lincoln, Nebraska. Woody has recently received a letter from a company that tells him he has won a million dollars, and he needs to travel to Lincoln to collect it. The letter is obviously a scam, and despite the protests of David, other son Ross (Bob Odenkirk), and wife Kate (June Squibb), Woody insists on Nebraska or bust – he wants his money.
 
The movie opens with Woody wandering down a busy street; what is going on? Why does Woody look so confused? Why would he fall for such an obvious scam? Anyone who has cared for someone with dementia or Alzheimer’s will recognize Bruce Dern’s facial expression immediately. Dern’s performance earned him an Academy Award nomination for good reason – he perfectly inhabits the mental and physical state of dementia: his blank stares are haunting, his ramblings often contain very little logic, and his stubbornness is downright frustrating. After Woody is found walking toward Lincoln twice more, and after David and Ross debate the pros and cons of putting him in a retirement home, David decides to indulge his father’s wish to go to Lincoln.

What follows is a movie heavily steeped in themes intensely familiar to the caregiver of dementia. Woody is forgetful, confused easily, and his unpredictable behavior infuriates his son. Yet, the pulse of this storyline is the love and patience David has for his father. He knows their time together is finite, and he enjoys uncovering things about his father he never knew. There is a particularly moving scene that shows David discovering the full impact that the Korean War had on Woody.

Nebraska is an honest film. It illustrates the emotional toll that caregiving can exact on a family. How are they going to afford the retirement home? What is mom going to do when she is left alone? At what point does caregiving distract TOO much from work? Just what the heck are we supposed to be doing? These are difficult questions, and, like real life, Nebraska provides no easy answers – caregiving is difficult and often there are no right answers, just the ones that make the most sense. But the director also gifts us with some moments that remind us of the true joys of family and caregiving. If you are a caregiver, this is a movie worth watching, and you will walk away with a few chuckles, a newfound respect for Will Forte’s acting chops, and a sense that you are not alone.

Alzheimer’s and Down Syndrome

My friend’s son is a person with Down syndrome; he is in his late 30’s, manages the cart team at a grocery store, and lives in a group home. He is happy, self-sufficient, and resilient.  I think about him every time someone brings up his condition and I hope that others see the potential that people with his disorder can bring to both society and themselves.

I came across a statistic the other day – that more than 75% of those with Down syndrome aged 65 and older have Alzheimer’s.  That’s nearly six times the percentage of people in this age group who do not have Down syndrome. They are also more likely to develop early onset Alzheimer’s since they live, on average, 55-60 years.

Diagnosis of Alzheimer’s for people with Down syndrome can be challenging – people may exhibit noticeable behavior changes rather than forgetfulness or memory loss. Alzheimer’s research may have different implications for people with Down syndrome because of the genetic differences of people with and without it. Even medications are processed differently in the body.

It’s estimated that over 400,000 people in the U.S. have Down syndrome – approximately 1 in every 1,000 babies receive a diagnosis. Down syndrome is a chromosomal condition in which people are born with an extra copy of chromosome number 21. That one extra copy causes developmental delays and health issues, such as heart, bone, and muscle problems.

Down syndrome and Alzheimer’s aren’t going away, but we look forward to future research to find some relief in these life-changing conditions.  

Information retrieved from http://www.alz.org/dementia/downloads/topicsheet_downsyndrome.pdf; Accessed September 2014.

Image from: http://www.alz.org/dementia/down-syndrome-alzheimers-symptoms.asp

Adapting Kitchens for the Elderly and People with Disabilities

Most caregivers and seniors can attest to the changes they have to make in their living space as people’s agility declines or disabilities arise. We all want to live independently, but sometimes our home can feel like a liability when it is not set up in a safe manner. Over the next few months, LTS is going to dedicate a number of blog posts to how we can make adjustments to the different rooms in homes or apartments – big or small – and how to make home feel more like home!

Kitchens can be a danger zone for people with vision loss, who are wheelchair bound, or have declining balance and strength. Here are a number of ways you can adapt kitchens for seniors. Maybe Lidia Bastianich or Martha Stewart could show us a few easy recipes in an adapted kitchen? PBS – we hope you are reading this!

Easy, cost-effective ways: Sometimes a few simple and inexpensive adjustments can significantly increase the safety level for both the elderly and caregivers.

·         Labels – Clearly label the cabinet doors or shelves to make things easy to find.

·         Placement – Make sure that commonly used items like drinking glasses, silverware, dishes, or pots are within reach.

·         Microwave – If you have a microwave above the stovetop, consider purchasing a new/used microwave to place on the counter to reduce stretching and having to carry heavy dishes.

·         Cabinet doors and drawers – Always keep these closed to avoid accidents, and paint or tape the edges with a contrasting color in case they are left open.

·         Remove lower cabinets – You may need to remove the cabinet below the sink or in other areas to accommodate wheelchairs or other mobility devices.

·         Lighting under side cabinets – Purchase inexpensive touch lights to illuminate the countertops

·         Trays – Using contrasting colored trays under daily food items or cups can decrease the odds of a spill.

• Unplug stove – If you think the elderly person will not need the stove or oven, consider unplugging it to avoid accidents.

Re-building your kitchen: If you have the funds to adapt your existing kitchen, work with an architect and a long-term services and supports specialist to find the right tools and appliances for your unique needs. Here are some things to consider:

·         Pull down shelves – These are nifty shelves that move upward and downward using a hinge. They allow individuals to pull shelves closer to their points of view while also carrying the weight of the items on the shelves.

·         Countertop height – Depending on the individual, lowering a countertop’s height might make a world of difference for everyday tasks.

·         Side opening oven – Lifting a heavy oven door downward can be uncomfortable, difficult, and dangerous. A side door can eliminate all these hassles.

·         Pullout shelf below oven – Adding a shelf below the oven acts as placeholder for hot items. This way, you don’t have to lift hot items over to another counter.

·         Easy to use faucets– Hot, cold? Which way?! Install a new faucet that has clear red or blue marks to represent hot or cold water, and that has a simple handle with a gripper rather than difficult knobs.

·         Electrical outlets – Install outlets in convenient locations; consider adding contrasting outlet covers for visibility.

Let us know what challenges you’ve faced in the kitchen and how you’ve overcome them. We’ll be happy to update our blog with your tried and tested ideas!

Yes, the elderly date, too.

Just like “young folks,” people in older generations look to connect with others on a social, emotional, and physical level. A quick Google search reveals many online dating sites specific to seniors, and this vast list indicates how prevalent elderly dating is. Here are a few different issues we’ve come across with the elderly and dating.

Parents and dating: The thought of your parent dating might be one of the hardest things to imagine if he or she is dating someone new. It might be especially difficult if it comes after the loss of their significant other. The new couple can most likely relate to one another’s experience with aging, and they may also bond if they have the same physical illness or condition. If there is a large age difference or you have other reservations, you may want to consider these reservations more closely if the person brings positivity to your parent.

Sex and the elderly: In a New York Times op-ed from January 2014, Dr. Ezekiel Emanuel shares the startling trends in Sexually Transmitted Diseases (STDs) among elderly: “The Department of Health and Human Services released a little-noticed report on Medicare a few months ago…The number of Medicare enrollees who took advantage of free STD tests is about the same as the number who received free colonoscopies to screen for colon cancer, amounting to about 5 percent of all those on Medicare.” As he says, this might not be surprising to everyone, as “…retirement communities and assisted living facilities are becoming like college campuses. They cram a lot of similarly aged people together, and when they do, things naturally happen.”

Clinicians need to be aware and open about this trend to prevent problems from arising. According to A Place for Mom, many STDs may be untreated in seniors because they’re hard to detect and they are so unexpected; also, STDs can actually make chronic diseases like diabetes and heart disease worse. As a caregiver, as hard as it may be, it’s possible that you may want to have the “birds and the bees” talk with your elderly parent.

Dementia patients date: People who suffer from memory loss are also capable of finding connections with others. In the critically-acclaimed movie, Away from Her, starring Julie Christie, an aging married couple begins to feel the tensions of the wife suffering from Alzheimer’s. The wife moves into a long-term care facility. After some time, her husband visits and realizes his wife has connected with a mute, wheelchair-bound man who has made her happy. Obviously, this new relationship is difficult for the husband to understand, but as the film progresses, he finally comes to terms it. Away from Her was a beautiful movie and rated number six on Roger Ebert’s best movies of 2007. This movie was directed by Sarah Polley and was an adaptation of Alice Munro’s short story "The Bear Came Over theMountain" in The New Yorker.