Meals on Wheels might do more than deliver hot food to isolated seniors: New research suggests it can serve as an early warning system for declining health.
The study included Meals on Wheels drivers in Guernsey County in Ohio and San Diego County, who were trained to use a mobile app to alert care coordinators if the drivers had a concern or noticed a change in a senior's condition.
The care coordinators then followed up with seniors to provide support and connect them with health and community services.
Over the 12-month study period, the drivers submitted 429 alerts for 189 clients. The most frequent alerts were for changes in health (56%), self-care or personal safety (12%) and mobility (11%).
Follow-ups on the alerts led to 132 referrals, with most for self-care (33%), health (17%) and care management services (17%), according to the researchers at West Health Institute, Brown University in Rhode Island, and Meals on Wheels America.
The study was published recently in the Journal of the American Geriatrics Society.
West Health and Meals on Wheels America plan to expand the research program to as many as 30 Meals on Wheels sites across the United States, that include about 40,000 seniors.
"By collaborating with Meals on Wheels America, we've developed a safe, cost-effective and scalable program to preemptively identify and address concerns that too often result in deterioration of a senior's medical condition or pose a major safety risk," said Dr. Zia Agha, chief medical officer at West Health Institute.
"We're excited learnings from this research program are now being implemented across the country within Meals on Wheels America's expanded program that will positively impact as many seniors as possible," Agha added in an institute news release.
In a special editor's note, Dr. Michael Malone, section editor in models of geriatric care, quality of improvement and program dissemination with the Journal of the American Geriatrics Society, wrote, "As health care systems struggle to address the social determinants of health, this innovative Meals on Wheels model may provide part of the solution."
Exercise has countless benefits for those of all ages, including a healthier heart, stronger bones and improved flexibility. For seniors, there are additional benefits, like the fact that regular exercise reduces the risk of chronic diseases, lowers the chance of injury and can even improve one’s mood.
falls in seniors are the third-leading cause of chronic disability, Liu-Ambrose and her team are now looking at whether the exercise program can result in reduced medical costs in this high-risk population. This study shows the importance of a home exercise program and how all adults can benefit from increased muscle strength and balance.
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!
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!
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.
Your nutritional needs have changed as you have become older. Your calorie needs decrease as you get older, but you may need more of certain food groups.
Calories: The amount of calories you need is dependent on how active you are physically. The government defines inactive lifestyles as those in which you only achieve daily living activities. If you exercise for a half an hour or more per day you are considered active. Your level of activity will determine whether you need more or fewer calories than what's recommended if you have been unable to maintain a healthy weight.
Men- an inactive older man needs around 2000 calories per day; if you are active shoot for 2400 calories per day.
Women- Consume 1600 calories daily if you are inactive, 2000 calories if you are an active female older adult.
Now here are some key nutrients you should pay attention to.
Protein- Healthy older men should try to consume 56 grams of protein per day from meat, fish, legumes and dairy. If you are an older female, try for 46 grams of protein daily.
Fiber- A variety of whole grains fruits and vegetables should help you get to the 28 G of daily fiber for an older adult male per day women, strive for 22 grams of fiber per day.
Vitamins and minerals- You are micronutrient requirements increase as you get older eat a variety of whole foods each day to help you meet your vitamin and mineral needs. Try to stay away from processed meals.
Aim for 800 units of vitamin D from fish, egg yolks, fortified foods and supplements everyday.
Production of stomach acid decreases as you age or take certain medications. If this is the case, you may be vitamin B12 deficient, possibly causing depression and fatigue. Supplements and fortified foods, i.e. orange juice, milk and yogurt are usually absorb B12 well.. You also need more vitamin B6 as an older adult. The recommendation is 1.7 mg daily if you are a man and 1.5 mg if you are a woman. Chicken, fish, potatoes and fruit will help you meet your vitamin B6 needs.
For a chart that will help you keep track of your nutritional intake, Click here. USDA Nutrition Chart
If eating food from a box- read the box and watch your sodium intake!
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, downloadWhat's MyPlate All About?. There's also a link for Physical Activity.
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)
Institutionalization or hospitalizations (that do not ensure adequate nutrition)
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 theDietary Guidelines for Americans, from the U.S. Department of Agriculture (USDA) and Department of Health and Human Services (HHS), which describestwo eating plans:
The USDA food patterns.
The DASH (Dietary Approaches to Stop Hypertension) Eating Plan.
The USDA food patternssuggests 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.
A new study reveals high use ofdietary supplementsby Americans 60 and older. In addition to their prescription medications, many older people are taking multiple preparations that have not been approved by the Food and Drug Administration.
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.
Multivitaminsand mineral supplements (39 percent) are the most commonly taken preparations, followed by vitamin D (26 percent), omega-3 (22 percent), B and B-complex vitamins (16 percent), calcium-vitamin D combinations (13 percent), vitamin C (11 percent) and calcium-only supplements (9 percent). Nine percent also use various herbal or plant-based supplements.
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 prescriptionblood thinnerssuch 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.
Eating well is important at any age- adequate nutrition is necessary for health, quality of life and vitality. Unfortunately, for a variety of reasons, many seniors are not eating as well as they should, which can lead to poor nutrition or malnutrition, easily being mistaken as a disease or illness.
Our bodies change as we get older, including perceptual, physiological and and general age-related conditions — such as dental or gastrointestinal conditions. These changes all influence the performance of our body as a whole, which in turn, influences our eating, nutritional intake and overall health.
Perceptual changes later in life can also influence our nutrition, such as changes in hearing, smell and taste:
Hearing: Diminished or loss of hearing also affects our nutrition and food experience. The difficulty and frustration from the inability to hold a conversation with our eating partner out at a restaurant or at a social function can limit one’s food experience.
Smell:The loss of smell can also have a huge impact on the types of food one chooses to eat as there is a loss of satisfaction that can lead to poor food choices.
Taste:One of the most common complaints is in regards to the diminished taste in food. As taste buds decrease, so does our taste for salty and sweet — often times making food taste more bitter or sour.
One reason nutritional needs change is due to physiological changes that occur later in life:
Energy:Expenditure generally decreases with advancing age because of a decrease in basal metabolic rate and physical activity, thus decreasing caloric needs.
Function:Our bodies also begin to experience a decrease in kidney function, redistribution of body composition and changes in our nervous system.
Other Aging-Related Changes
Other changes in body function may impact nutritional intake, such as:
Dentition:The makeup of a set of teeth (including how many, their arrangement and their condition). The loss of teeth and/or ill-fitting dentures can lead to avoidance of hard and sticky foods.
Gastrointestinal Changes:Chronic gastritis, constipation, delayed stomach emptying and gas, may lead to avoiding healthy foods, such a fruits and vegetables — the food categories that should be more emphasized rather than eliminated.
These factors alone may contribute to why 3.7 million seniors are malnourished and shed light on the importance of educating caregivers and aging seniors as to specific dietary need options, as well as, catered senior diets and nutritional needs.
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.
Here are ways to put your priorities at the top of your doctor's agenda..
How do you make sure that your preferences and priorities get on the agenda with your health care providers? And how do you make sure they stay on the agenda beyond a single office visit? Find out here... http://www.nextavenue.org/make-care-person-centered/
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 inpotassium, 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. A2012 studyshowed 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 beharmful, especially when you take them too often or have allergies. A2004 studyfound 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.Researchshows that these chemicals can have a significant impact on immune system function.
5. Regulates Metabolism and Fights Fat
Did You Know?
Most cherry tree varieties are chosen for how pretty they are. Many don’t even yield actual cherries!
Cherries are also a good source of vitamins A and C
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 studyshowed that anthocyanins, a type of flavonoid responsible for cherries’ red color, act against the development of obesity.Another studyin 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 arecent 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 a2003 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.
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.
The 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,