Physical Fitness and Our Aging Population

It’s not a secret that we are living longer. Is this a problem? Medical technology certainly has much to do with prolonging life, yet just living longer does not mean you are living a healthier life. For example, simply walk through nearly any senior apartment complex and look at how many folks are sitting watching television all day long – just sitting all day long. Are these seniors healthy? Or, are they aging more slowly than their parents did due to increased medical advances and medications? 

So, how to change this situation? Physical activity is the answer. Now I know that doesn’t surprise most of you, however, the scope of the affect of regular physical activity on developing a “healthy” life style is impressive. Regular exercise can even go so far as to eliminate the need for medical intervention with regard to many of our illnesses that seem to be so prevalent in today’s world. An example would be diabetes. We would agree that many people are overweight. We would also agree that as we age, we tend to put on needless pounds. And, we might also agree that many of those needless pounds are a direct result of a lessening of regular physical activity (not to mention an unhealthy diet).

Granted the life style of the day was not as advanced with respect to exercise as it is today, so the proliferation of “gyms” as we understand them now had not yet begun. Also, “back in the day,” people’s routines lent themselves to more exercise (i.e., cutting their own lawns, shoveling their own driveways in the winter, painting their own houses, etc.). Yet, we know now that regular exercise and better eating habits, or being “fit,” is the way to go if you want to live a healthier life.

That requires some effort on the part of an individual in order to achieve the desired result: live not only longer, but healthier.

Aging is not only the accumulation of genetic reactions in our bodies, but the accumulation of poor habits, in the forms of eating and physical activity. When we let “ourselves go,” we allow these poor habits to take effect on our already aging bodies, speeding the process along. Take for example the number one problem with our elderly – falling. Falling is the result of a person’s inability to maintain balance. This is a result of the person’s psychological fear of actually falling (and the resulting physical damage the person may incur, i.e., broken hip, fractured arm, etc.), and their physical inability to stop themselves from actually falling (which requires muscle strength). Thus, a regular routine of not only aerobic exercise, but also strength training would go a long way in helping to eliminate the incidences of falling, especially in our elder population. For as our muscles gain strength, so does our ability to control our bodies’ movements, thus the increase in the ability to prevent a fall.

Exercise, both aerobic and weight training, is the way to go, for all adults. The programs that include these two forms of exercise will assist in reducing the need for medical intervention, especially as we age. With less required medical intervention, our elder population can remain more independent for longer periods, and, isn’t that what we all fear the most, losing our independence?

 

Sleep Disorders and the Elderly

Many of us think that as we age, we need less sleep in order to function well during our waking hours, possibly due to the perceived lack of activity of older folks as compared to the young who run, jump, and play all day long. There is no general consensus among sleep professionals on this subject. It is clear that kids do seem to require more sleep in order to maintain such an active lifestyle. However, one thing is certain, we all need a solid night’s sleep in order to keep ourselves active at optimal level throughout the day. For many older folks, that is just not happening.

 

Why? Well, as we age, our lifestyles change, which can and does create potential sleep disturbing issues. For example, we take on more responsibilities, which can develop into worrisome thought, which then can lead to sleep interruption. So as we get older there are many “issues” that can develop, thus adding to sleep disorders. However, there are other more specific reasons for these sleep disorders. Sleep apnea is a major cause of sleep disruption. Apneas are basically an absence of airflow for 10 seconds or longer during our sleep period. When multiple sleep apneas occur during a sleep period, restful sleep is clearly interrupted and the solid night’s sleep is lost.

 

There are also sleep related movement disorders, such as restless leg syndrome which is the need to move one’s legs as a result of “uncomfortable” urges. There is also the more prevalent movement disorder, periodic limp movement disorder, where one’s limbs (again, usually the legs) jerk every 20-40 seconds during sleep periods. Both of these sleep related movement disorders can easily be disruptive to sleep.

 

REM behavior disorder is a disruption of our normal dream process. In this disorder, the elder (and often in men beginning at age 60) experiences incomplete REM cycles, or a temporary loss of muscle strength, that can manifest itself in more violent dreams forms. Sometimes this form of sleep disorder can be a precursor to another form of illness, such as dementia or Parkinson’s.

 

The result of these different sleep disorders can be linked to many of the elder’s symptoms: lack of full night’s sleep, waking up often during the night, difficulty falling asleep, and increased confusion. Often, an elder will seem more depressed, have associated memory issues, will begin napping more during the day and/or begin using more over-the-counter sleep medications as the effects of their sleep disorder(s) continue. It is important to recognize these symptoms in order to treat the underlying issues.  See also last weeks Blog on Stress.

 

Some easily addressed thoughts that can be helpful when a good nights sleep is a problem…..

•       Develop a healthier lifestyle (eat better, exercise regularly, etc.)

•       Avoid eating too close to bedtime.

•       Develop a bedtime routine and stick with it.

•        Use the bed for sleep and intimacy, not for watching TV, etc.

•       Don’t use caffeine prior to bedtime.

•       Put your worries to bed before you put yourself to bed.

•       Avoid daytime napping.

•       Keep the bedroom dark, quiet, and cool during sleep periods.

                                                                              Sweet Dreams

Troubles Sleeping ?

 

Many of us think that as we age, we need less sleep in order to function well during our waking hours, possibly due to the perceived lack of activity of older folks as compared to the young who run, jump, and play all day long. There is no general consensus among sleep professionals on this subject. It is clear that kids do seem to require more sleep in order to maintain such an active lifestyle. However, one thing is certain, we all need a solid night’s sleep in order to keep running at optimal speed during the day. For many older folks, that is just not happening.

 

Why? Well, as we age, our lifestyles change, which can and does create potential sleep disturbing issues. For example, we take on more responsibilities, which can develop into worrisome thought, which then can lead to sleep interruption. So as we get older there are many “issues” that can develop, thus adding to sleep disorders. However, there are other more specific reasons for these sleep disorders. Sleep apnea is a major cause of sleep disruption. Apneas are basically an absence of airflow for 10 seconds or longer during our sleep period. When multiple sleep apneas occur during a sleep period, restful sleep is clearly interrupted and the solid night’s sleep is lost.

 

There are also sleep related movement disorders, such as restless leg syndrome which is the need to move one’s legs as a result of “uncomfortable” urges. There is also the more prevalent movement disorder, periodic limp movement disorder, where one’s limbs (again, usually the legs) jerk every 20-40 seconds during sleep periods. Both of these sleep related movement disorders can easily be disruptive to sleep.

 

REM behavior disorder is a disruption of our normal dream process. In this disorder, the elder (and often in men beginning at age 60) experiences incomplete REM cycles, or a temporary paralysis (low muscle tone during REM), that prevents the dream from being enacted, and can often manifest itself in more violent dreams forms. Often, this form of sleep disorder is a precursor to another form of illness, such as dementia or Parkinson’s.

 

The result of these different sleep disorders can be correlated to many of the elder’s symptoms: lack of full night’s sleep, waking up often during the night, difficulty falling asleep, and increased confusion. Often, an elder will seem more depressed, have associated memory issues, will begin napping more during the day and/or begin using more over-the-counter sleep medications as the effects of their sleep disorder(s) continue. It is important to recognize these symptoms in order to treat the underlying disorder.

There are several easy thoughts that are readily at hand:

 

•       Develop a healthier lifestyle (eat better, exercise regularly, etc.)
•       Avoid eating too close to bedtime.
•       Develop a bedtime routine and stick with it.
•      Use the bed for sleep and intimacy, not for watching TV, etc.
•       Don’t use caffeine prior to bedtime.
•       Put your worries to bed before you put yourself to bed.
•       Avoid daytime napping.
•       Keep the bedroom dark, quiet, and cool during sleep periods.

Don’t forget Fluffy is family too

Benjamin Franklin said, “The only things certain in life are death and taxes.”  At a certain level we all understand and accept that our time on this earth is finite.  We also understand that same thing when it comes to those around us.  Yes even the cat.

Loss tends to be felt the most accutely by those that are least likely to be in a position to be able to accept the loss.  Children and widowed seniors.  We’ve all heard about pets that have passed away right after their owners, and we’ve also heard of people refusing to leave their homes because of the cat.

We are all attached to our pets, but sometimes we forget that when someone looses their pet that there is a grieving process that the person/family has to go through.  It’s not just a dog, its a part of someones life that has passed away.  It’s never just a solitary event either, loosing a pet reminds us of those that have gone before,be it a spouse (to a Senior) or a grandparent (to a child).  Respect, comfort and support are the things that we need to give to those that are grieving.  Understanding the depth of the loss is not totally possible since love in not a rational thing, but allowing someone to grieve and helping them work through that grief is our responsibility.

To steal a passage from John McCrae’s poem In flanders Fields, “ Short days ago, We lived, felt dawn, saw sunset glow, Loved and were loved”  Death is the completion of a cycle, but it is not the end of everyting.  It is the beginning of a new stage “To you, from failing hands, we throw The torch: be yours to hold it high.”  A stage filled with warm memories, loving reflection and the reminder that the pain that is left behind will itself pass.

To all of you that have grandparents, parents, pets or anything that you love – please, cherish that love and know that in your heart nothing every truly leaves us until we let it go.

In loving memory of Edwin (the cat) – October 22, 2013.

Aged Like a Fine Wine

When you think of a beautiful vintage wine, along with the wine itself you probably also get images of other things too.  Perhaps an attractive wine glass, a wine cellar, a wine rack and a corkscrew.  Maybe a plastic screw cap and a box are more your style.  Whatever you envision along with the wine, those are supports.  Things that make the wine what it is and the things that go into making the experience what it is.

 

The same can be said for the Seniors that live in our community.  They can be wonderful family, friends and companions.  They are a veritable font of information and stories.  They can be some of the most valuable members of our community.  Sometimes like the glass of wine, they need supports.  Canes, wheelchairs, our elbow to hold on to, Personal Support Workers etc.

 

The artistic flair of a 19th century crystal wine goblet adds to the experience and enjoyment of a beautiful 70 year old French Cabernet Sauvignon.  So why should a Walker detract from the value of a 70 year old lady ?  Is the perception of supports a sign of weakness and of a decrease in the persons worth ?  I can’t image anyone saying yes.

 

The old adage of  ‘don’t judge a book by its cover’ holds true.  Without or Seniors we as a community would loose a tremendous amount.  I know that in my community if you go to most of the volunteer organization and take a look at who is doing the  work you’ll be amazed at the amount of white hair you’ll see.  Why ? partly because they have the time, but mostly because they have the ability.

 

Don’t underestimate Seniors, and don’t assume that a cane is a barrier.

How do we get help ?

I get this question all the time, or at least some variation of it.  Mom has had a fall and needs….. Dad’s apartment isn’t getting cleaned…..How do we get someone to help my parents with their bathing…..etc. etc. etc.

Lets face it, until your parents need help do these things you are not going to go and find out what is available for them in terms of personal care, housekeeping, laundry, companionship or meal preparation.  Why would you ?  Quite simply you wouldn’t.  But once something happens or even once things are slipping to the point where you feel comfortable stepping in, then the questions come out.

First things first, your parents were the ones who raised you and provided for you when you were growing up (for most of us at least), they are the ones you turned to for advise as you were growing up as well as when you were raising your own family.  That in itself makes it very difficult to start a conversation that reverses the roles.  You are now helping them, and they are relying on you.  Talk about awkward !The only thing I can say is to get over it and get on with it.   Your parents need your help but unlike when you were a child, they are very able to participate in the decision making process, and their voices have to be heard and addressed.  You can’t force a solution on them, it doesn’t work that way.  Roles may have been reversed, but the veto power is still out there.

The next big step is get a commitment from your parents to take a honest look at the things that are not being coped with as well as they should be, and to accept the possibility of getting someone to look after those things.  Based on their needs, try to find one organization that will have the same person do the work each week.  A revolving door of workers is hard on Seniors.

Money “Cents”

I talk to Seniors everyday, partly because that’s my job but mostly because I love working with and helping Seniors.  More often than not I learn from their accumulated wisdom and experience.  What never fails to amaze me however is that Money still causes so much anxiety to people in their 80’s and 90’s.

People will call and say that they need help for their Mother, but when it come time to look at the collars and cents of it all, they are not sure if they can afford to have someone come in an provide Homecare for their Mom.  This could be absolutely true and naturally I would never question the veracity of their statement.  But I will ask them to turn the equation a little bit…..

Is this Home the right place for Mom and is it where she wants to be ?

Will Mom be able to stay at home and maintain a quality of life that meets her approval without someone coming in to help ?

Will Mom be moving in with you or some other family member if she can’t stay living on her own ?

What will it cost to accommodate Mom at a family members home (renovations etc.) ?

Is there even anyone who can provide the assistance Mom needs at that home ?

What will it cost to move Mom out of her home ?

What will it cost per month to have Mom living in a Seniors residential setting ?

If we were to provide the minimum amount of service that was needed, how will that cost stack up against those listed above ?

Often time the answers are either blank stares or “I don’t know”.  To these people I give them homework to do – find out the answers for themselves and then call me back.  I could tell them the answers but then I become a salesman and I hate salesmen.

Once people look into and start to understand the costs associated with having a family member move out of their home they can match that up with their family members wishes ( knowing that given a choice most people don’t want to move – it is a traumatic enough situation regardless of money).  This gives you a way to compare your options and to make an informed decision.

Sometimes people come back to have us provide the Homecare and sometimes they don’t.  Either way, I’ve done my job and I’m happy because now they know what the options are, how to evaluate them.  They can come to an honest decision that will be in the best interest of the Senior.

Planning Ahead

For most of us we started learning about money, banks and banking as a child with our first savings account.  Maybe with birthday money or money from the Tooth fairies.  Regardless of how it started, over the years it develops, changes and expands.  Chequing accounts, credit cards, mortgages and retirement savings accounts.  There are a few things however, that many people don’t learn about banks and banking until it is too late.  After so many years of helping the kids with money, the things we eventually need to know are a complete reversal because they usually involve helping our parents and their money.

The learning curve ideally begins before either of your parents passes away or becomes unable to manage their affairs on their own.  While this is a great idea, acting on it is usually not done, but once things start to change with our parents we need to be in a position where we can step up and return the favour by providing the help they need.

Below are a few simple things that can be done ahead of time to make sure that their money is not one of their issues.   Simple to do, but very difficult to get them done with your parent(s) – you’ll understand soon.  Together with your parent(s) you need to make 3 visits at least (in no specific order)

1) Bank.  Everyone knows that you can not take money out of just any account.  You have to have a right to the account, either you are named on the account or you have legal authority to access the account or it becomes yours through proof of inheritance (probate).  Once an account holder passes away, the Power of Attourney is no longer valid so how do you pay the outstanding bills without using your own money while you wait for probate?  The easiest answer is to plan ahead, by having your name added to the account ahead of time.  The understanding of course is that you won’t touch the account till both your parents are either gone or incapacitated.

2) Lawyer.  So no free legal advise on the blog.  Suffice to say that there are a number of things that you and your parent(s) need to ask about including (but not necessarily limited to just these.)

•  DNR order – Do Not Resuscitate
• Power of Attourney (personal care and financial)
• Living Will
• Will

Once the Lawyer has done their part, make sure that you and your parent(s) know where things are so that they can be easily and quickly accessed.  They should also be reviewed from time to time as situations and wishes change.

3) Final Arrangements.  Eventually we all die, and when the inevitable happens certain other things happen too.  Some of those things cost money and some can be handled ahead of time, and even paid for ahead of time. Those that remain to mourn can be eased greatly if the arrangements are prepared in advance.

Just discussing these things with your parent(s) is difficult.  Not only for you but even more so for them, mortality is a very difficult subject to discuss and always stirs up a lot of emotions.  Remembering this and respecting this throughout the process will help pave the way to a positive experience that can bring everyone closer.  If the Bank, the Lawyer, and the final arrangements are already in place, then when the day comes the burden can be lessened, and the mourning made easier.  Until then it is one less burden to carry.

The biggest thing to know is that you have to plan ahead and then to make sure that you know where things are and how to handle them when the time comes.