Reading some old Christmas letters from my grandad. Glad to make a cameo, where my three year old self is described as a 'handsome charmer who, amazingly for his age, has a sense of humour described as sardonic.' A rude little man, even then!
Growing old is such an inevitable part of life it should be embraced with a light heart and years worth of wisdom and planning. January 01, 2019 15:46
Quite understandably, few look forward to the twilight of their life and all that it brings in its wake — deteriorating health, loss of vigour, restricted mobility, increasing dependence on others, not to mention a sense of foreboding and anxiety. Yet, ageing is an inevitable part of life that one has to learn to cope with willy-nilly.
At 74, I’ve found that old age need not necessarily be a period of physical and mental decline — though some ‘erosion’ is unavoidable — if one prepares oneself for it adequately in advance. First and foremost it’s imperative to prepare to accept old age all brace for all the restrictions or limitations it imposes on one’s mobility or ability to do things that one did when younger.
Equally important is the need to adopt a positive attitude towards life. Darkly regarding old age as the evening of one’s life must be avoided at all costs if one is to weather and overcome the difficulties and irritants that life is bound to throw up. An optimistic frame of mind or a light-hearted approach does help. Indeed, nothing prevents one from looking at the sunny side of life even in one’s sunset years. American statesman Bernard Baruch, who lived to a ripe old age, once remarked, “To me, old age is always fifteen years older than I am!” And, when asked his age, British satirist Jonathan Swift once quipped evasively, “I’m as old as my tongue and a little older than my teeth!” Is there a cleverer way to parry questions about one’s age?
Also vital is the need for the elderly to stay physically and mentally active in order to keep geriatric health problems at bay, especially Parkinson’s disease. Regular physical exercise coupled with the pursuit of a hobby or pastime that keeps one mentally and usefully engaged, is the perfect antidote for the prolonged spells of ennui that plague the elderly. Keeping abreast of current affairs — political, economic and social — also does help to keep boredom away. And the spicier the social gossip or grapevine, the better.
My former British boss, based in Edinburgh and now a spry 84, still pursues his passion for fishing with a like-minded octogenarian friend whenever the weather permits. They jointly maintain a boat fitted with an outboard engine and like nothing better than to go off trout-fishing on their own. Further, he remains extremely keen to know what’s happening in Munnar’s tea plantations, over which he once ably presided as General Manager. More importantly, advancing years haven’t blunted his sense of humour which remains as robust as ever.
In fact, the role of humour and fun in dispelling gloom in old age cannot be overstressed. These indispensables are the spice of life guaranteed to bring cheer and bonhomie, besides keeping one’s mind off life’s grim realities. The elderly should let humour pep up their lives regularly by hobnobbing with those known to be witty and funny. And letting one’s hair down occasionally — the little that remains of it, at any rate — can certainly do no harm so long as one doesn’t overdo things or get carried away by American statesman Benjamin Franklin’s flippant remark that “There are more old drunkards around than old doctors!”
Old age, of course, gives one an opportunity to take stock of one’s life dispassionately and, at leisure, sift through and analyse one’s successes and failures, achievements and shortcomings notched up over the years.
Companionship, of course, is vital for the elderly. No human being is an island and isolating oneself from society, as the aged often tend to do, is not at all advisable. On the other hand, socialising — to howsoever limited an extent — can inject refreshing variety into the drab routine of a senior citizen’s life and give it a much-needed boost. There’s no substitute for staying connected with one’s contemporaries.
Old age, of course, gives one an opportunity to take stock of one’s life dispassionately and, at leisure, sift through and analyse one’s successes and failures, achievements and shortcomings notched up over the years. It’s also the time when the elderly inevitably reach ‘anecdotage’. They turn nostalgic and love to recall “those good old days” when they were young and life was radically different from what it is today. They try to pass on the benefit of their varied experiences to the younger generation though the latter seldom has the time, patience, or inclination to hear them out. In such circumstances penning down one’s experiences is a good way of keeping oneself usefully engaged in old age. One never knows — one’s memoirs may make the bestseller list some day!
True, physical debility will be a stumbling block for many, quite literally. Ageing and stiffening body joints will ‘creak’ in protest and make mobility difficult — something one should learn to take in one’s stride stoically. Some of the more spirited among the elderly resort to the pretence of acting and behaving as if they are not as old as they really are. This game of ‘make-believe’ is indeed known to help in making light of one’s physical infirmities.
Above all, peace of mind, which everyone seeks but few are fortunate to find, is absolutely necessary. It’s the vital and efficacious balm that brings equanimity to one’s life, helping to salve the inevitable discomforts, irritants and problems of ageing. And, of course, it does help to promote overall health besides physical and mental well-being.
The Biblical lifespan of three score and ten years is now a thing of the past. Thanks to dramatic advances in medical science and technology, we can now expect to live well beyond 90 years and perhaps even longer, given reasonably satisfactory health. And this, assuredly, isn’t wishful thinking. Indeed, it is said there are more nonagenarians and centenarians around today than ever before, negating American humourist Josh Billings’ caustic observation, “Three score years and ten are enough. If a man can’t suffer all the misery he wants in that time, he must be numb!”
Admittedly, many hope for longevity without the inherent disadvantages of growing old. However, trying to put off ageing is futile and unrealistic (no matter what such proponents may tell us to the contrary) for it’s an integral and essential part of life that can never be reversed. So we must resign ourselves to growing old (since it’s the only method known so far of living a long time!). And in the process let’s try to make life as fulfilling and meaningful as possible.
How to Sit More Comfortably September 26, 2018 11:18
All this sounds like a lot of trouble, but it comes down to paying attention to your posture. Be mindful of the position of your spine. Remember what Mom used to say..."Sit up straight!"
Stronger Seniors Chair Exercise DVD Videos for Seniors
10 minutes of exercise a day improves memory September 24, 2018 15:50
Just 10 minutes of light physical activity is enough to boost brain connectivity and help the brain to distinguish between similar memories, a new study suggests.
Scientists at the University of California studying brain activity found connectivity between parts of the brain responsible for memory formation and storage increased after a brief interval of light exercise – such as 10 minutes of slow walking, yoga or tai chi.
The findings could provide a simple and effective means of slowing down or staving off memory loss and cognitive decline in people who are elderly or have low levels of physical ability.
The scientists asked 36 healthy volunteers in their early 20s to do 10 minutes of light exercise – at 30% of their peak oxygen intake – before assessing their memory ability. The memory test was then repeated on the same volunteers without exercising.
The same experiment was repeated on 16 of the volunteers who had either undertaken the same kind of exercise or rested, with researchers scanning their brain to monitor activity. In the brains of those who had exercised they discovered enhanced communication between the hippocampus – a region important in memory storage – and the cortical brain regions, which are involved in vivid recollection of memories.
“The memory task really was quite challenging,” said Michael Yassa, a neuroscientist at the University of California, Irvine, and project co-leader. The participants were first shown pictures of objects from everyday life – ranging from broccoli to picnic baskets – and later tested on how well they remembered the images. “We used very tricky similar items to to see if they would remember whether it was this exact picnic basket versus that picnic basket,” he said.
The people who had exercised were better at separating or distinguishing between the different memories, say the scientists writing in the Proceedings of the National Academy of Sciences.
“An evening stroll is sufficient to get some benefit,” said Yassa, adding that the frequency and exact amount of exercise will depend on the person’s age, level of mobility, potential disability and other lifestyle factors.
The scientists also kept track of the participants’ mood changes. “With exercise you do get an enhanced mood. The question is whether that was explaining the effect we got on the behaviour or the effect we got on the brain and it wasn’t,” said Yassa.
Michelle Voss, a neuroscientist at the University of Iowa, described the findings as “intriguing”. “The brain regions involved here are also the regions that are thought to play a big role in the deterioration of memory with ageing. […] It would be really exciting to see this type of experiment in older adults,” she said.
New Book....Love Your Age April 22, 2018 19:40
The Small-Step Solution to a Better, Longer, Happier Life, by Barbara Hannah Grufferman
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Nutrition and Exercise for Seniors November 13, 2017 12:15
Eating healthy is a lifestyle choice shaped by many elements, including our stage of life, situations, preferences, availability of food, culture, traditions, and the personal decisions we make over time. All your food and beverage choices count. MyPlate offers ideas and tips to help you create a healthier eating style that meets your individual needs and improves your health. For a colorful visual of MyPlate and the 5 food groups, download What's MyPlate All About?. There's also a link for Physical Activity.
Take a look at A Brief History of USDA Food Guides to learn more about previous food guidance symbols.
If you want to improve your quality of life, this government site may just be for you!
Stronger Seniors Chair Exercise DVD Videos for Seniors
More on Malnutrition in Seniors October 16, 2017 11:17
Seniors, Malnutrition, Vitamin Deficiencies
Malnutrition is seen in varying degrees in the elderly, along with varying vitamin deficiencies. Malnutrition is due to under nutrition, nutrient deficiencies or imbalances. Most physicians do not see frank malnutrition anymore, such as scurvy; but more milder malnutrition symptoms such as loss of appetite, general malaise or lack of overall interest and wellness.
Common nutrient deficiencies of dietary origin include inadequate intake of vitamin A, B, C, D, E, folic acid and niacin. Malnutrition may also be the result of some socioeconomic risk factors, such as the following:
- Fear of personal safety (which affects their ability to go grocery shopping)
- Financial concerns
- Institutionalization or hospitalizations (that do not ensure adequate nutrition)
- Lack of interest in cooking or eating alone
- Loss of a spouse or family member
Clearly, nutrition plays a vital role in the quality of life in older persons. This is why preventative medicine and focusing on good eating habits is crucial. It is recommended to follow a preventative health maintenance nutritional program, such as the Dietary Guidelines for Americans, from the U.S. Department of Agriculture (USDA) and Department of Health and Human Services (HHS), which describes two eating plans:
- The USDA food patterns.
- The DASH (Dietary Approaches to Stop Hypertension) Eating Plan.
The USDA food patterns suggests that people 50 or older choose healthy foods every day from the following:
Fruits — 1-1/2 to 2-1/2 cups
What is the same as 1/2 cup of cut-up fruit? A 2-inch peach or 1/4 cup of dried fruit
Vegetables — 2 to 3-1/2 cups
What is the same as a cup of cut-up vegetables? Two cups of uncooked leafy vegetable
Grains — 5 to 10 ounces
What is the same as an ounce of grains? A small muffin, a slice of bread, a cup of flaked, ready-to-eat cereal, or ½ cup of cooked rice or pasta
Protein foods — 5 to 7 ounces
What is the same as an ounce of meat, fish, or poultry? One egg, ¼ cup of cooked beans or tofu, ½ ounce of nuts or seeds, or 1 tablespoon of peanut butter
Dairy foods — 3 cups of fat-free or low-fat milk
What is the same as 1 cup of milk? One cup of yogurt or 1-1/2 to 2 ounces of cheese. One cup of cottage cheese is the same as ½ cup of milk.
Oils — 5 to 8 teaspoons
What is the same as oil added during cooking? Foods like olives, nuts, and avocado have a lot of oil in them.
Solid fats and added sugars (SoFAS) — keep the amount of SoFAS small
If you eat too many foods containing SoFAS, you will not have enough calories for the nutritious foods you should be eating.
Ensuring adequate nutrition and proper intake of vitamins and minerals will help keep our aging population feeling more vital and ultimately more healthy, thus using prevention rather than intervention.
Learn more about the U.S. Department of Health and Human Services DASH eating plan to decide whether it’s right for you or a loved one.
Excerpted from Dr. Lindsay Jones-Born
29% of older Americans use four or more supplements each day October 16, 2017 10:52
The study, published in the October issue of the Journal of Nutrition, is based on data gathered by the government’s National Center for Health Statistics. It found that on a daily basis, 70 percent of older Americans use at least one supplement — preparations that include vitamins, minerals, herbs, amino acids, enzymes and other substances. Twenty-nine percent of older Americans use four or more supplements each day.
The researchers found that supplement use tended to increase with age, and that people who took prescription medications were more likely to use supplements as well. Eight percent of older adults take three medications daily and at least one botanical supplement.
That’s potentially worrisome, because some supplements can alter the effects of medications. For example, use of the herbal supplement ginkgo biloba with blood pressure medications could cause a person’s blood pressure to drop too much, and can raise the risk of bleeding for users of prescription blood thinners such as warfarin, according to the University of Maryland Medical Center.
The researchers wrote that health care professionals need to carefully monitor their patients’ supplement use. In a study published in 2010, only a third of patients said their doctors had asked whether they used supplements.
The study was conducted by researchers from the National Institutes of Health and Tufts and Purdue universities.
What is the 'Senior' Flu Shot? October 05, 2017 14:07
Basically, it's a stronger flu shot. Four times stronger to be precise.
This flu vaccine could significantly reduce the risk of hospitalization among especially vulnerable seniors, a large, random clinical trial has found.
Vaccines typically don’t work very well in older people—a problem because the flu can lead to serious respiratory infections in frail patients such as elderly nursing home residents.
“…the rate of hospitalization for any reason, respiratory or otherwise, was significantly lower in the high-dose group…”
While a prior study showed that older individuals could respond better to the high-dose vaccine, it focused on relatively healthy older adults, says lead author Stefan Gravenstein, professor at both the Warren Alpert Medical School and the School of Public Health at Brown University.
It still needed to be established that it would help even the frailest folks, like those who reside in nursing homes.
In this study, a quarter of the sample was over 90. DId the high-dose vaccine also work better than regular-dose vaccine in the population we consider least able to respond. This paper says yes, it can.
The study compared hospitalization rates among more than 38,000 residents of 823 nursing homes in 38 states during the 2013-14 flu season based on Medicare claims data. Just under half the homes, 409 to be exact, administered the high-dose vaccine while the other 414 provided a standard dose.
In the end, the hospitalization rate for respiratory illnesses among high-dose patients was 3.4 percent compared to 3.8 percent among standard-dose patients over the six months after vaccination. Statistical analysis revealed that the relative risk of hospitalization for respiratory illness was 12.7 percent lower for the high-dose group.
Moreover, the rate of hospitalization for any reason, respiratory or otherwise, was significantly lower in the high-dose group as well. For every 69 people given the high-dose vaccine vs. the standard-dose vaccine, one more person stayed out of the hospital during the flu season.
“Respiratory illness as the primary reason for hospitalization accounted for only about a third of the reduction in hospitalization that we measured,” says Gravenstein.
For many patients, the vaccine appeared to help prevent hospitalization for other problems also, including cardiovascular symptoms.
Gravenstein says the finding of a significant reduction in hospitalizations was particularly notable because the predominant flu strain during the 2013-14 season, A/H1N1pdm, was believed to be less virulent in older people who had spent a long lifetime building up immunity to similar strains.
“That there was differential protection in this context both underlines the potential importance of even low-virulence or less transmissible strains to older populations and the fact that vaccines may afford relevant effectiveness among frail older persons even when A/H1N1 predominates,” the authors write.
The study did not find a significant difference in the rate of death. Researchers speculate that while the standard-dose vaccine might not have been strong enough to stave off illness entirely, it may still have been sufficient to prevent deaths in combination with hospital care.
But a significant reduction in hospitalizations can still be a benefit, Gravenstein says, even though the high-dose vaccine is more expensive than the standard-dose vaccine. Especially for older, frail patients, reducing otherwise necessary trips to the hospital can maintain a higher quality of life.
Ultimately, Gravenstein says, the study should provide nursing home leadership with useful information to consider as they plan for future flu seasons.
Turning 65 Soon? September 06, 2017 12:26
If you are, well, congratulations. If you are planning on signing up for Medicare, here are the 'basic' basics to know before enrollment begins October 15th.
Also, you should start browsing Medicare.gov
Where Can You Find the Best Health Care in the US? August 14, 2017 22:44
50 states are graded for healthy living based on
35 measures of cost, accessibility and outcome. The measures included monthly insurance premiums, cost of visiting a medical professional, quality of hospitals, life expectancy and rates of cancer and heart disease.
7 Ways Cherry Juice Benefits You June 28, 2017 14:49
Cherry juice is not only refreshingly delicious, but it provides some solid health benefits, too. With about 120 calories per 1-cup serving, it is rich in nutrients like potassium and iron. Read on for eight reasons to sip and savor.
1. Helps Post-Workout Recovery
Cherry juice may help recovery post-exercise. It is naturally high in potassium, which conducts electrical impulses throughout the body. This mineral also helps maintain blood pressure, hydration, muscle recovery, nerve impulses, digestion, heart rate, and pH balance. Cherries contain about 330 mg of potassium per cup, which is almost 10 percent of how much you need each day.
2. Fights Inflammation and Arthritis Pain
Research shows that the antioxidants in tart cherry juice can reduce pain and inflammation from osteoarthritis. A 2012 study showed that drinking cherry juice twice a day for 21 days reduced the pain felt by people with osteoarthritis. Blood tests also showed that they suffered from significantly less inflammation.
3. Reduces Swelling
When people experience pain from swelling, they often turn to nonsteroidal anti-inflammatory drugs (NSAIDs). However, the effects of these drugs can be harmful, especially when you take them too often or have allergies. A 2004 study found that cherry juice supplements can reduce inflammation and pain-related behavior in animals, showing promise as a treatment for swelling in humans.
4. Boosts Immunity
Like all fruits and vegetables, cherries pack a powerful antioxidant and anti-viral punch. Flavonoids, a type of antioxidant in cherry juice, are made by plants to fight infection. Research shows that these chemicals can have a significant impact on immune system function.
5. Regulates Metabolism and Fights Fat
There is some evidence in animals that tart cherries can help adjust your body’s metabolism and your ability to lose abdominal body fat. One study showed that anthocyanins, a type of flavonoid responsible for cherries’ red color, act against the development of obesity. Another study in rats found that tart cherries can help reduce inflammation and abdominal fat, and lower the risk of metabolic syndrome.
6. Helps You Sleep
The anti-inflammatory properties of cherry juice combined with a dash of sleep-regulating melatonin may help you sleep better, according to a recent study. The results suggest that tart cherry juice has similar effects as insomnia medications like valerian or melatonin on older adults.
7. Blocks Cancer Growth
In a 2003 study, researchers pitted cherry juice against the NSAID sulindac, which is the most common preventive anti-inflammatory treatment for colon tumors. Although an animal study, it is notable that cherry juice — unlike the NSAID — reduced the growth of cancer cells.
Even without its antioxidants and nutrients, cherry juice is deliciously tart and refreshing. Try replacing sodas and sports drinks with something that can really make a difference to your health.
7 Keys to Growing Old in Your Own Home June 26, 2017 11:02
Aging in place requires planning ahead.
Want to live in your home for the rest of your life? Boost your odds by "future-proofing" now. Older adults who are most likely to remain in their homes have successfully arranged their houses and lives in ways that maximize their ability to weather the physical and practical setbacks often associated with getting older -- setbacks that can make living independently more challenging.
Here are seven ingredients you'll want to have in place in order to age in place:
A single-story floor plan
Sure you can get up and down stairs easily now. And sure, many spry octogenarians can do the same. But what if you break a bone and require extended bed rest? What if you become confined to a wheelchair? It's possible to convert a downstairs room to a bedroom, but not so easy to live on one floor if the only shower is on an upper floor.
Think ahead about how you can convert to all-on-one-floor living, should the need arise. You may need to remodel to add a full bath on the ground level, for example, or insert a door to provide privacy in a downstairs room.
The living space also needs to be all on one level. Split-level homes can be problematic because wheelchairs and walkers can't easily navigate from one room to the next.
Basic safety upgrades
One's risk of falling increases with age, often due to medications or certain health conditions. Installing secure grab bars and wall-to-wall carpeting (or bare wood floors, no throw rugs) are smart safety upgrades that will help you avoid broken hips -- one of the most common reasons older adults are forced to leave their homes.
Familiarize yourself with the basics of bathroom safety and other home care safety, and start to slowly make your home safer for future needs.
Don't overlook good lighting. Dark hallways and burned-out bulbs are a common contributor to accidental falls. Did you know an 85-year-old needs about three times as much light as a 15-year-old does to see the same thing?
Sure you can reach tall cupboards, stacked washer-dryers, and back burners easily now. But it's likely that won't always be the case. Even something as simple as a doorknob may be difficult to open if you develop arthritis or other disabilities.
At least one lower countertop, a taller toilet, and a front- (rather than top-) loading washer and dryer raised up from floor level are all examples of slightly modified household items that become easier to use later in life.
Lever-type door handles, paddle faucets, and curbless showers make these devices easy to use even in the event of arthritis or other disabilities affecting mobility.
4. Update doors and doorways.
At any age, you want to be sure you can get from room to room without trouble. Specifically: * Replace doorknobs with levers, which push down easily. * If possible, keep door frames at 36 inches (or more) wide to allow wheelchair access. * Zero threshold doors are easiest to navigate for those in wheelchairs or using walkers. * Install a ramp to at least one entryway into the house, if necessary. A simple wooden ramp is the least expensive option, but add slip-resistant material to prevent accidents.
5. Add accessible outlets and switches.
The most accessible homes have easy-touch light switches about 42 inches off the ground. Ample electrical outlets throughout the house can handle any necessary medical equipment; outlets should be 18 inches from the floor for optimal accessibility.
6. Modify stairways.
To allow for the possibility of a chairlift in the future, stairways should be four feet wide. The steps should be deep enough to accommodate the entire foot, and you’ll want to install treads.
7. Install grab bars and handrails.
One important way to prevent accidents is to install handrails on both sides of stairways. In the bathroom, put in grab bars by the toilet and in the bathtub and shower. A tub transfer seat can be useful, though the best option is to remove the tub altogether and instead make sure the shower is safe to use.
8. Add light.
Because eyesight tends to worsen with age, it’s a good idea to add more and brighter lights in the house, for better visibility.
Familiarize yourself with the principles of universal design, for a home you can live in forever -- bringing together safety, convenience, and style for residents of any age.
Stronger Seniors Chair Exercise DVD Programs
Eating well, staying Active and Mental Exercises Can Reverse Physical Frailty in Seniors June 21, 2017 12:26The important message from our studies is that frailty is not an inevitable part of aging. There is much that older people can do for themselves to avoid becoming frail and disabled, so it is vital that they pay attention to good quality diet and nutrition, engage in physical exercise,
Episcopal Homes of Minnesota May 06, 2017 13:25
Episcopal Homes of Minnesota in Saint Paul! The residents there are using our Balance and Posture program. Apparently, the residents are also doing Chair Yoga with some little ones as part of their intergenerational programming.
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Why is Exercise and Physical Activity Important for Older Adults? May 05, 2017 10:40
If you’ve never exercised, or if you stopped exercising for some reason, you need not resign yourself to a sedentary (unhealthy) life. Programs like Stronger Seniors are designed just for you- to help you start slowly, and build up to a routine you will enjoy and stick with.
Stronger Seniors Chair Exercise Videos
Cancer prevention, sleep and obesity: Studies may show a connection March 28, 2017 12:19
Studies show that getting the right amount of sleep is an important part of maintaining a healthy weight and avoiding obesity, which has been linked to colorectal, breast and kidney cancers.
This is not meant to scare you, just another reason to take care of your body.
Struggling to lose weight? It may not have anything to do with your diet or activity level.
Studies show that getting the right amount of sleep is an important part of maintaining a healthy weight and avoiding obesity. Obesity has been linked to an increased risk for several types of cancer, including colorectal, post-menopausal breast, endometrial, esophageal, kidney and pancreatic.
“How long, how well, how deep we sleep, what time we sleep and what happens during sleep all effect our metabolism,” says Carol Harrison, a senior exercise physiologist.
Sleep and your metabolism
The simple equation for weight loss is to burn more calories or energy than consumed. But anyone who has been on a diet knows that it’s not nearly that simple. Studies show that sleep may be a part of the reason why.
Our internal clocks are called circadian rhythms. The circadian rhythm determines our sleep patterns, our heart rate and blood pressure.
“If our internal timing – in other words, our circadian rhythm – doesn’t match our external timing, then it can have a negative effect on our metabolisms,” Harrison says.
And remember- regular exercise will improve your sleep.
Written by KELLIE BRAMLET BLACKBURN- University of Texas
Geriatricians Can Help Aging Patients Navigate Multiple Ailments February 27, 2017 09:59
Geriatricians are “experts in complexity,” said Dr. Eric Widera, director of the geriatrics medicine fellowship at the University of California, San Francisco.
No one better understands how multiple medical problems interact in older people and affect their quality of life than these specialists on aging. But their role in the health care system remains poorly understood and their expertise underused.
Interviews with geriatricians offer insights useful to older adults and their families:
Basic knowledge. Geriatricians are typically internists or family physicians who have spent an extra year becoming trained in the unique health care needs of older adults.
They’re among the rarest of medical specialties. In 2016, there were 7,293 geriatricians in the U.S. — fewer than two years before, according to the American Geriatrics Society.
Geriatricians can serve as primary care doctors, mostly to people in their 70s, 80s and older who have multiple medical conditions. They also provide consultations and work in interdisciplinary medical teams caring for older patients.
Recognizing that training programs can’t meet expected demand as the population ages, the specialty has launched programs to educate other physicians in the principles of geriatric medicine.
“We’ve been trying to get all clinicians trained in what we call the ‘101 level’ of geriatrics,” said Dr. Rosanne Leipzig, a professor of geriatrics at the Icahn School of Medicine at Mount Sinai in New York City.
Essential competencies. Researchers have spent considerable time over the past several years examining what, exactly, geriatricians do.
A 2014 article by Leipzig and multiple co-authors defined 12 essential competencies, including optimizing older adults’ functioning and well-being; helping seniors and their families clarify their goals for care and shaping care plans accordingly; comprehensive medication management; extensive care coordination; and providing palliative and end-of-life care, among others skills.
Underlying these skills is an expert understanding how older adults’ bodies, minds and lives differ from middle-age adults.
“We take a much broader history that looks at what our patients can and can’t do, how they’re getting along in their environment, how they see their future, their support systems, and their integration in the community,” said Dr. Kathryn Eubank, medical director of the Acute Care for Elders unit at the San Francisco Veterans Affairs Medical Center. “And when a problem arises with a patient, we tend to ask ‘How do we put this in the context of other concerns that might be contributing?’ ”
Geriatric syndromes. Another essential competency is a focus on issues that other primary care doctors often neglect — notably falls, incontinence, muscle weakness, frailty, fatigue, cognitive impairment and delirium. In medicine, these are known as “geriatric syndromes.”
“If you’re losing weight, you’re falling, you can’t climb a flight of stairs, you’re tired all the time, you’re unhappy and you’re on 10 or more medications, go see a geriatrician,” said Dr. John Morley, professor of geriatrics at Saint Louis University.
“Much of what we do is get rid of treatments prescribed by other physicians that aren’t working,” Morley continued.
Recently, he wrote of an 88-year-old patient with metastasized prostate cancer who was on 26 medications. The older man was troubled by profound fatigue, which dissipated after Morley took him off all but one medication. (Most of the drugs had minimal expected benefit for someone at the end of life.) The patient died peacefully eight months later.
Eubank tells of an 80-year-old combative and confused patient whom her team saw in the hospital after one of his legs had been amputated. Although physicians recognized the patient was delirious, they had prescribed medications that worsened that condition, given him insufficient pain relief and overlooked his constipation.
“Medications contributing to the patient’s delirium were stopped. We made his room quieter so he was disturbed less and stopped staff from interrupting his sleep between 10 p.m. and 6 a.m.,” Eubank said. “We worked to get him up out of bed, normalized his life as much as possible and made sure he got a pocket talker [hearing device] so he could hear what was going on.”
Over the next four days, the patient improved every day and was successfully discharged to rehabilitation.
Finding help. A geriatric consultation typically involves two appointments: one to conduct a comprehensive assessment of your physical, psychological, cognitive and social functioning, and another to go over a proposed plan of care.
The American Geriatrics Society has a geriatrician-finder on its website — a useful resource. Also, you can check whether a nearby medical school or academic medical center has a department of geriatrics.
Many doctors claim competency in caring for older adults. Be concerned if they fail to go over your medications carefully, if they don’t ask about geriatric syndromes or if they don’t inquire about the goals you have for your care, advised Dr. Mindy Fain, chief of geriatrics and co-director of the Arizona Center on Aging at the University of Arizona.
Also, don’t hesitate to ask pointed questions: Has this doctor had any additional training in geriatric care? Does she approach the care of older adults differently — if so, how? Are there certain medications she doesn’t use?
“You’ll be able to see in the physician’s mannerisms and response if she takes you seriously,” Leipzig said.
If not, keep looking for one who does.
Judith Graham- Kaiser Health News,
Geriatricians Can Help Aging Patients Navigate Multiple Ailments
Better Health - Diet vs. Exercise - Part 3 February 20, 2017 16:28Seniors enjoying their healthy longevity
Better Health - Diet vs. Exercise January 27, 2017 14:47If you have decided to make make 2017 a more healthful year for you, your lifestyle choices will change. What course will you chart? Diet? Exercise? How much? How little? ??
Exactly What Does Exercise Do To the Brain December 07, 2016 12:08
Effect of exercise on brain health With aging, however, proteins called brain-derived neurotrophic factor levels fall. The decline is considered one reason brain function deteriorates in the elderly. Certain types of exercise, namely, aerobic exercises that get your heart pumping, are thought to counteract these drops and help restore youthful levels to better protect the aging brain and offset dementia.
Mild Exercise May Reduce Arthritis Pain, says study November 03, 2016 21:07
Arthritis is a clear sign of poor bone health that approaches primarily as one starts aging. It mainly affects the joints and people suffering from it complain of joint pain and stiffness.
Other symptoms may include redness, warmth, swelling, and decreased range of motion of the affected joints.
There are medications and physiotherapy to avoid aches and pains related to the condition, but a new study has suggested that mild exercise could help reduce arthritis pain in the elderly.
The study says that, low-impact exercise program helps to decrease pain, improve mobility and enhance quality of life in older adults with arthritis and other muscle and joint conditions.
"Joints will often stiffen if not used and muscles will weaken if not exercised. Our bodies are meant to move, and inactivity leads to weakness and stiffness, and joints with arthritis often worsen with inactivity," said Theodore Fields, Managing Director of Rheumatology Faculty Practice Plan at Hospital for Special Surgery (HSS), US.
Participants performed chair and floor mat exercises using stretch bands and other gentle exercises. Chinese breathing techniques and meditation were also integrated into the program.
"The study results are consistent with the experience of rheumatologists and with prior studies showing that exercise, even of mild degree, helps with pain. Getting people up and moving does appear to help with mood, pain and overall functioning," Fields added.
The study was presented at the American Public Health Association annual meeting.
An Age Old Opinion on Exercise October 21, 2016 16:41
“All parts of the body if used in moderation and exercised in labors to which each is accustomed, become thereby healthy and well developed, and age slowly; but if unused and left idle, they become liable to disease, defective in growth, and age quickly.” – Hippocrates
Stronger Seniors Chair Exercise Program
Best Exercises for Functional Longevity October 21, 2016 15:42
Let’s face it. Quantity without quality is no fun. Quality without quantity is a ripoff. You really need both quality and quantity to get the most out of retirement years. You need functional longevity.
Stronger Seniors Chair Exercise Program
Medicare Can Pay for Wellness Checkups. Get One! October 13, 2016 12:05
If you’ve had Part B for longer than 12 months, you can get a yearly “Wellness” visit to develop or update a personalized plan to prevent disease or disability based on your current health and risk factors. This visit is covered once every 12 months.
Stronger Seniors Chair Exercise Program
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