Memory Slower? You’re Processing a Lifetime of Information!

Older adults have always joked that it takes them longer to remember things because they must sort through their years of knowledge to find the right answer. They might say something like, “My brain is too full!”

Is this true? Research recently appearing in the journal Topics in Cognitive Science [http://onlinelibrary.wiley.com/doi/10.1111/tops.12078/abstract] described the work of linguistics researchers who are using computers to demonstrate that, indeed, the “full brain” of seniors is the most common cause of slower memory and slower performance on certain memory-related tests.

The study team, headed by Dr. Michael Ramscar of the University of Tübingen in Germany, put computers to the test by loading them with information to simulate the increased knowledge of human seniors. Would computers experience a “senior moment”? According to the researchers, when the computer sorted through a small amount of information, its performance on cognitive tests resembled that of younger humans. But, say the researchers, “When the same computer was exposed to the experiences we might encounter over a lifetime, its performance looked like that of an older adult. Often it was slower, not because processing capacity had declined. Rather, increased ‘experience’ had caused the computer’s database to grow, giving it more data to process—which takes time.”

The researchers say that standard memory tests may not yield an accurate picture of an older adult’s memory health. They explain that older brains not only have more memories to sift through, but also more chances to forget things.

The team also examined a classic memory lapse many seniors worry about: forgetting names. They remind us that the more people we meet in life or read about, the more names we need to sort through and remember. And seniors of today, take heart: The researchers also reported that it is harder now than it was two generations ago to connect faces to names, due to a much greater diversity in names today. They say, “The number of names anyone learns over their lifetime has increased dramatically. This work shows how this makes locating a name in memory far harder than it used to be. Even for computers.”

Of course, not all memory loss is benign. It’s important to know the signs that might indicate a problem. According to the National Institute on Aging, these are some symptoms that indicate that a person should consult their healthcare provider:

  • Asking the same question over and over
  • Becoming lost in places that are familiar
  • Not being able to follow directions
  • Becoming more confused about time, people and places
  • Neglecting personal safety, hygiene and nutrition

These symptoms might indicate the onset of Alzheimer’s disease or other serious memory loss. Or they could result from a fortunately treatable cause such as medication side effects, infections, nutritional deficiencies, depression or alcohol abuse. No matter what the cause, early diagnosis is important.

Meanwhile, seniors who are experiencing normal age-related changes of memory should take these words of Dr. Ramscar to heart: “The brains of older people do not get weak. On the contrary, they simply know more.” Given that age-related stereotypes have been shown to trigger depression and inactivity, this understanding is great ammunition for combating the clichés that slow us down!

Learn More

The National Institute on Aging offers the free booklet, “Understanding Memory Loss: What To Do When You Have Trouble Remembering,” [link to: http://www.nia.nih.gov/alzheimers/publication/understanding-memory-loss/introduction] that explains the difference between mild forgetfulness and more serious memory problems.

Source: AgeWise reporting on study from Tubingen University.

Home Care Helps Seniors Manage Medications

The U.S. Census Bureau recently reported that the percentage of seniors who are living in a nursing home has dropped by 20 percent in the last decade—yet there are more seniors than ever, and the number is growing. Are seniors just healthier these days? The truth is, older adults need as much care as ever, but more of them are receiving it in assisted living communities, adult day centers—and for a growing number, in their own homes.

Most seniors would prefer to receive care in the comfort and familiar surroundings of their own home. Yet many have trouble with the activities of daily living and managing their healthcare, and that includes their medications. According to the Agency for Healthcare Research and Quality, the number of older adults hospitalized due to medication-related problems has doubled over the last decade, and the number is rising as the baby boomers age. For many seniors, the ability to manage their medications may be the deciding factor when they and their families are making the decision between home and an institutional care setting.

Medicines play an important part in senior health. They are beneficial in controlling many of the diseases and conditions that older adults experience, such as arthritis, diabetes, high blood pressure, osteoporosis and heart disease.

But medications, whether prescribed by a doctor or bought over the counter, have potentially toxic side effects that can cause significant problems. For example, it is not at all uncommon for families to suspect dementia or depression in an older adult, when the symptoms are actually caused by undesirable effects from prescription drugs. Medication problems can lead to hospitalization and even death.

Undesirable effects of medications may be caused by:

  • Negative side effects of a drug
  • Interaction between one or more drugs
  • Overdose from taking too much of a single medication
  • Overmedication when two drugs work in a similar way
  • Changes in the way an older person’s body reacts to and processes certain drugs that allow a toxic level to build up.

Overmedication isn’t the only problem: if a senior misses doses, the drug may not be as effective.

Often, medication management problems result from the complexity of juggling a variety of drugs for various conditions. Compound the issue with multiple prescriptions, different times to take them, different ways they should be taken, and it’s easy to see why medication compliance is so complicated. Seniors living with memory problems are even more likely to take an extra dose or skip a dose.

Families worry about their older loved one’s ability to take prescriptions correctly. There are some relatively simple safeguards to take. Family can:

  • Help their loved one make a list of all medications and bring the list (or the medication containers) to their loved one’s doctor for a periodic review of all prescriptions.
  • Check their loved one’s medicine chest for old prescriptions that are no longer needed or have expired.
  • Help their loved one contact the healthcare provider if there are signs of bad side effects, such as a rash, headaches, drowsiness, dizziness or nausea.
  • Encourage their loved one to use a single pharmacy for all prescriptions so the pharmacist can help avoid drug interactions.

But when it comes to the daily monitoring of a medication regimen, families may feel helpless, wondering whether their parent is following the doctor’s recommendations. They worry when they aren’t around, and wonder if the senior is safe taking the medications properly. This is where home care can fill in the gap, providing an extra measure of safety and peace of mind.

Skilled nursing services can be provided in the home, including medication administration. Less costly personal care and companion services may also include certain medication support tasks, depending on state law. Caregivers can:

  • Remind senior clients to take medications on time and in the way they are supposed to be taken
  • Take clients to the pharmacy, or pick up prescriptions
  • Observe and report problems that might suggest side effects
  • Help senior clients learn to use pill organizers, dispensers, automatic reminders or other devices.

Medication management is just one of the many ways that home care workers can help seniors maintain their independence, and help family caregivers go about their daily tasks with confidence, knowing their loved one is safe.

Copyright © AgeWise, 2014

It’s Never Too Late to Start an Exercise Program

Study after study shows that physical activity is the top factor influencing how healthy we will be in later life. While there are no 100 percent guarantees when it comes to good health, we know that exercise helps us maintain physical, emotional and intellectual well-being—factors that work together to protect us from many common diseases and conditions that become more common as we age.

Recently, researchers from the University of Western Australia released results of study that demonstrates this benefit. They studied 12,000 elderly Australian men over the course of 13 years, and found that those who took part in 150 minutes of vigorous physical activity each week added two to three years to their lives—and those years were healthier, more independent years.

Lead author Prof. Osvaldo Almeida said, “Not only were the active people more likely than non-active people to survive, but those who were alive and active when we followed up had reached old age in good shape, without evidence of depression or cognitive or functional problems.”

Is it ever too late to take up exercise? Some of the study participants who had been inactive most of their lives took up exercise during the follow-up period. Reports Prof. Almeida, “Those who started out inactive but became more active as time went by benefited as well. Not as much as the ones who were active at the beginning and the end, but quite a bit more than those who were inactive throughout.”

What if we turn into couch potatoes later on? Prof. Almeida found that the men who were active at the beginning of the study but let their exercise routine lapse over the years all but lost the health benefits of their previous activity. He says, “It’s better to become active than to be active and stop. By engaging in regular physical activity, older people not only survive longer, but they ensure that the chance of them aging successfully—without significant functional impairments—also increases. Not only do they add years to life, but they add quality to their years.”

Source: AgeWise reporting on study from University of Western Australia

Aging with HIV and AIDS: A Growing Social Issue

As the first people with HIV grow old, a new study from St. Michael’s Hospital in Toronto, Ont., questions whether the health care system and other government policies are prepared to meet their complex medical and social needs.

In high-income countries, 30 percent of people living with HIV are 50 or older, and many are living into their 60s and 70s. In San Francisco, more than half the people with HIV are over 50.  Dr. Sean B. Rourke, a neuropsychologist who heads the Neurobehavioural Research Unit at St. Michael’s, says that these numbers are a positive sign, in that they demonstrate that people living with HIV are accessing the medications and healthcare they need to survive into their later years. On the other hand, said Dr. Rourke, “A very significant crisis is looming.”

In a study published in the July issue of the journal Current Opinion in HIV and AIDS, Dr. Rourke noted that aging for people with HIV may be more challenging than for the general population because of HIV-related stigma, loss of friends and social networks, and the detrimental health effects of the virus and medications taken to combat the virus.

Older people with HIV are more likely to experience mental health and neurocognitive impairments than other people of the same age, as well as more social isolation. A study in the United States found that 94 per cent of people with HIV who were over 50 have at least one other chronic illness, with an average of three conditions.

Pension plans and health care facilities are not designed for, or expecting, people to have these issues at younger ages, Dr. Rourke said. Geriatric physicians are not trained for working with HIV, and those trained for HIV are not trained in geriatrics.

As a large number of people with HIV approach retirement age, policy makers need to develop new policies or adapt the existing ones to improve their social and economic outlook. Dr. Rourke said people aging with HIV who are still working may need more time off to take care of themselves or rest breaks during their shifts; reforming retirement benefit programs could allow people with HIV to remain in the workforce as long as possible; retirement homes and long-term facilities need to be more welcoming places for older people living with HIV.

Individuals with HIV continue to live with health consequences that limit their ability to participate in society. This could mean the inability to work or engage in a community. Some people have to remain jobless or in low-paying jobs so they can receive social assistance and government-funded drugs.

Dr. Rourke said a growing body of research is exploring interventions and other coping strategies to minimize the negative impact of aging with HIV, including being proactive and managing treatment appropriately. Eating properly, exercising regularly and taking care of health needs earlier are much more important with a chronic illness like HIV, he said.

Source: St. Michael’s Hospital (http://www.stmichaelshospital.com).

How Do Seniors Choose Among Their Medicare Plan Options?

Seniors appreciate having a wide range of Medicare private plan choices available to them but often feel unqualified to choose among them, a new Kaiser Family Foundation report concludes. Based on discussions with seniors in four cities around the country, the report captures seniors’ experiences and frustrations in making decisions about their Medicare plans.

Seniors cite many factors as influencing their initial choice of a Part D or Medicare Advantage plan, including premiums, benefits, out-of-pocket costs, brand recognition (i.e., AARP) and adequate coverage for their health care needs, including coverage for their specific medications and, for Medicare Advantage plans, access to desired physicians and hospitals.

However, many seniors say the initial process of comparing and choosing plans was not easy due to the large volume of information they receive and their inability to compare plan features to determine which option is best for them. Few used the government’s online comparison tool, and those that did cite several shortcomings. Many relied on advice from sources they trust, including insurance agents, plan representatives, friends, family members, medical professionals and pharmacists.

After they enroll in a plan, many seniors are reluctant to revisit their initial decision and switch plans, even when premiums go up, because of frustration and confusion during their initial selection process and because of fears about disrupting their care or increasing out-of-pocket costs. They lack confidence in their ability to choose a plan that would be appreciatively better for them.

“How are Seniors Choosing and Changing Health Insurance Plans?” was based on focus-group discussions with seniors in Baltimore, Md.; Seattle, Wash.; Memphis, Tenn.; and Tampa, Fla.; and is authored by researchers at the Kaiser Family Foundation and PerryUndem Research and Communication.

The report’s findings were discussed as part of a policy briefing in Washington, D.C.. Watch a video of the archived webcast of the briefing here. [add link to: http://kff.org/medicare/event/may-13-briefing-how-well-are-seniors-making-choices-among-medicares-private-plans-and-does-it-matter]. Click here to read the full report [link to: http://kff.org/medicare/report/how-are-seniors-choosing-and-changing-health-insurance-plans].

Source: The Henry J. Kaiser Family Foundation. Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.

 

Helping Someone Move to a Long-Term Care Facility

Moving to a long term care facility is often difficult for an older adult. But there are many things family members and friends can do to reduce the physical and emotional stresses involved. They can help plan the move, participate on the day of the move, and provide love and support after the move.

Moving to a nursing home is an important long term care option for many older or disabled adults. Sometimes, a person moves to a nursing facility because the care they need just isn’t available or practical at home. Or, they may have special rehabilitative care needs after leaving the hospital, but before they return home.

Whatever the circumstances, there are a few simple steps you and other family members and friends can take to help the person you care for make a smooth, hassle-free transition to new surroundings.

Before the Move

Moving to a long-term care facility usually means making do with less space than the person is used to. Long-term care residents have the right to keep and use items of personal property, to the extent space permits. But space is almost always in short supply. So choices may have to be made about what to take along…and what to leave behind. Friends and family can help by:

  • Learning from the facility exactly what space limitations apply
  • Helping prepare for the move, including arranging for storage or other disposition of items left behind
  • Discussing the facility’s policies for safeguarding resident property; for example, you may be advised to mark all clothing and personal belongings with the person’s name, and to make (or helping the resident or facility make) a list of the resident’s things
  • Anticipating and responding to special concerns, such as care for a pet.

On the Day of the Move

Moving to a new home is always stressful. You can help minimize feelings of disorientation and dislocation by:

  • Helping your loved one unpack…and making sure that pictures, personal mementos and other similar items are placed where they will create a feeling of home
  • Sharing a meal at the new facility
  • Getting to know staff members  and learning about all the various programs, services, and activities the facility has to offer
  • Spending some quiet time after everything is unpacked to make sure your family member or friend is as comfortable, relaxed, and reassured as possible.

After the Move    

When people move to a care facility, they often fear that the move will come between them and people and activities they love. They may worry about being alone and out of touch. It may take some time and effort to get over these concerns, to be reassured by the support of loved ones, to make new friends, and to settle into new and interesting patterns of living. You can help by:

  • Staying in touch right from the beginning…communicating frequently and positively
  • Working closely with your loved one and staff to make sure any difficulties are ironed out
  • Establishing regular visiting times so your loved one can plan ahead for them
  • Making a few surprise visits as well
  • Visiting individually or as a family group for special occasions, such as birthdays and anniversaries
  • Attending care conferences and family support groups
  • Working with your loved one and staff to make the new living situation a happy, successful one.

15 Great Ways to Help Your Loved One Feel Connected

  1. Send flowers or balloons on a special day.
  2. Write frequent cards, notes or e-mail.
  3. Give a prepaid, senior-friendly cell phone or calling card.
  4. Set up Skype chats with your loved one
  5. Visit as often as you can.
  6. Send pictures or videos of family events, grandchildren, or friends.
  7. Bring a card or small gift when you visit.
  8. Get to know the resident’s new friends and care providers, and greet them during your visits.
  9. Check to see what types of food items would be appropriate as a gift, and include them occasionally when you visit.
  10. Remember to acknowledge and thank members of staff whenever appropriate.
  11. Offer to take along other long-time friends, so they can visit also.
  12. Go for a stroll outside if weather permits.
  13. Take the resident on a day trip, or come along on a resident outing.
  14. Inform friends, family and your loved one’s faith community of their new contact information.
  15. Become a volunteer in your loved one’s new home.

Source: AgeWise

The AMA Says Obesity is a Disease

The American Medical Association has announced that the organization has designated obesity as a disease requiring treatment and prevention efforts.
The American Heart Association believes the additional focus is needed on this important risk factor for heart disease and stroke. The organization works with individuals, industry, healthcare professionals and national, state and local governments to recognize the severity of the issue and the need for more coordinated and comprehensive solutions.

Obesity is defined as a body mass index of 30 or higher. Over one-third (33.7%) of U.S. adults are obese (nearly 75 million adults) and about 12 million (16.9%) of U.S. children ages 2 to 19 are obese and nearly one in three (31.7%) U.S. children (23,500,000) ages 2 to 19 are overweight or obese.

“Obesity is mainly caused by taking in more calories than are used up in physical activity and daily life, but other factors may also contribute to obesity including genetics, limited access to healthy foods or unsafe environment for physical activity,” says Donna Arnett, Ph.D., president of the American Heart Association. “When people eat too many calories, or too much saturated fat, trans fat and cholesterol, their blood cholesterol levels often rise. But even taking off a few pounds can provide you with cardiovascular benefits, so every step in the right direction is a step toward healthier living.”

If you have too much fat — especially around your waist — you’re at higher risk for health problems. Obesity…

  • raises blood cholesterol and triglyceride levels.
  • lowers HDL (“good”) cholesterol. HDL cholesterol is linked with lower heart disease and stroke risk, so reducing it tends to raise the risk.
  • raises blood pressure levels.
  • can induce diabetes. In some people, diabetes makes these other risk factors much worse. The danger of heart attack is especially high for these people.

When your weight is in a healthy range your body more effectively circulates blood, your fluid levels are more easily managed, and you are less likely to develop diabetes, heart disease, certain cancers and sleep apnea. The American Heart Association can help you get there. To determine your risk for heart disease and stroke, visit www.mylifecheck.org and learn how you can lower your risk.

Source: American Heart Association

August is National Immunization Awareness Month

Aug. 24-30 spotlights vaccines for adults; what immunizations do seniors need?

During August’s National Immunization Awareness Month, experts remind Americans that vaccines save lives and protect health. Some people think that vaccines are only for children. But the Centers for Disease Control and Prevention (CDC) tells us that vaccines also are important and encouraged for adults. To promote adult vaccination, the CDC also has named August 24-30 as “Not Just for Kids” week, promoting the fact that adults, too, should be immunized.

Seniors in particular are at higher risk of side effects and even death from a number of the preventable diseases targeted by vaccines. Unvaccinated seniors might pass dangerous illnesses on to children and others. Yet only a small percentage of seniors have received all the vaccinations that are recommended for them.

This isn’t just a national issue: In a new report, “Life-Course Immunization: A Driver of Healthy Aging,” the Global Coalition on Aging called for a greater awareness worldwide of the role of vaccines as a preventive measure as the number of people older than 65 soars worldwide.

Here are the vaccines recommended by the CDC and the U.S. Food and Drug Administration for most older adults. Of course, you should consult your healthcare provider before receiving any vaccines, and about which form of each vaccine is best for you.

Influenza (Flu). Seniors are at high risk of complications and even death from the flu. Get your annual flu shot as soon as the vaccine is available in your area. Ask your doctor which flu shot you should receive.

Pneumonia (Pneumococcal Disease). This disease can lead to serious infections of the lungs, blood and brain. One dose is recommended for all adults age 65 and older.

Tetanus/Diphtheria/Pertussis. Tetanus (sometimes called “lockjaw”) and diphtheria are severe, often fatal diseases. Pertussis (“whooping cough”) causes spasms of severe coughing. The vaccines for these three diseases are given in different combinations; consult your healthcare provider about the type that is recommended for you.

Shingles (herpes zoster). Shingles causes a painful skin rash, and can lead to long-term pain and disability. All adults 60 years old or older should get the shingles vaccine.

The CDC also recommends additional vaccines for people with certain health problems, immunization histories and lifestyles. These vaccines include the Measles/Mumps/Rubella (MMR) shot, vaccinations for Hepatitis A and B, and for Meningococcal disease. Your doctor can tell you if you should receive any of these immunizations.

Vaccines are safe. The CDC says, “Vaccines are thoroughly tested before licensing and are carefully monitored even after they are licensed to ensure that they are very safe.” Side effects and allergies are rare and usually temporary. Talk to your healthcare provider about the vaccines that are right for you based on your age, health, lifestyle, occupation and other factors.

Learn More

Vaccines.gov (www.vaccines.gov) is the government’s consumer portal for immunization information.

Find materials for the 2014 National Immunization Awareness Month here [link to: http://www.nphic.org/niam], including the “Not Just for Kids” information (www.nphic.org/niam/1215-toolkits/immunization/niam/3984-niam-intro).

Read the Global Coalition on Aging report here [add link to: http://www.globalcoalitiononaging.com/v2/data/uploads/documents/life-course-immunization_gcoa-for-web.pdf ].

The American Geriatrics Association offers a factsheet about vaccines for seniors (www.healthinaging.org/files/documents/tipsheets/vaccinations.pdf ) which includes recommended vaccinations, instructions on when to get them, and any cautions associated with specific vaccines.

The information in this article is not intended to replace the advice of your healthcare provider. Talk to your doctor about the vaccinations that are right for you.

Copyright © AgeWise, 2014

Hospitalized Seniors Often Need Surrogate Decision-Makers

Nearly half of hospitalized American adults age 65 and older require decision-making assistance from family members or other surrogates because the patient is too impaired to make decisions independently, according to a new study from the Regenstrief Institute and the Indiana University Center for Aging Research.

More than 13 million older adults are hospitalized annually in the United States, and that number is projected to increase as the population ages. This means that each year, millions of family members will have to make serious decisions for a hospitalized older adult. The vast majority of surrogates are children or spouses, and some patients have two or more family member making decisions together.

Surrogates will commonly face decisions about life-sustaining care, such as whether to revive a loved one if his or her heart were to stop, as well as decisions about medical procedures and whether to send the patient to a nursing facility upon discharge. “As the population ages, family members of older adults should prepare for the crucial role they may play when their loved ones are hospitalized,” said Regenstrief Institute investigator Alexia Torke, M.D., M.S., associate professor of medicine at Indiana University School of Medicine, who led the study.

A higher proportion of intensive care patients needed surrogate decision-making, but the majority of patients in the study who required a surrogate were admitted to the general medicine wards, suggesting that families are needed to make decisions throughout the hospital.

When patients cannot make decisions for themselves due to dementia, delirium or other types of cognitive impairment, physicians turn to surrogate decision-makers, most commonly a close family member. In some instances, a surrogate may have been previously designated by the patient who completed a Health Care Power of Attorney form, but in many cases the individual is not fully informed about the patient’s wishes. Surrogates are asked to make decisions in critical areas including code status, ventilators and other life-prolonging therapies, surgery options, and post-hospital placement. All are vital to the patient’s care and outcome.

The presence of a surrogate requires fundamental changes in the way clinicians communicate and make decisions for patient, according to the study authors. “Many hospitals treat family members as visitors rather than as members of the patient’s health care team,” Dr. Torke said. “In-depth interviews with surrogates conducted as part of my ongoing research has found that surrogates often have trouble contacting hospital staff and struggle for information about the patient. Clinicians also frequently report making decisions with surrogates to be highly stressful.”

The study authors call for redesign of hospital functions to account for the large and growing role of surrogates and to provide support for surrogates as they make health care decisions.

Source: Indiana University School of Medicine. “Scope and Outcomes of Surrogate Decision-Making Among Hospitalized Older Adults” was published in the March 2014 issue of JAMA Internal Medicine. [link to: http://archinte.jamanetwork.com/article.aspx?articleid=1813222]. The study was supported, in part, by the National Institute on Aging and by the John A. Hartford Foundation.

Are Emergency Rooms Senior-Friendly?

A report from the American College of Emergency Physicians calls for increased training in geriatrics for emergency room personnel, as well as ER features that support the needs of older patients. Researchers examined data from around the world and found that many senior patients experienced functional and cognitive problems after a trip to the hospital after a fall or other health event.

Said study author Dr. Leonard Gray of the University of Queensland in Brisbane, Australia, “These patients have complex profiles before they come to the ER, and even more complicated needs once they get there. Dependence on others and geriatric illnesses, such as cognitive impairment and mobility problems, affect the majority of older emergency patients across a wide range of nations with different health systems and cultural contexts. They require specialized care to avoid missed diagnoses, pressure ulcers and a range of other potential problems associated with this particular population.”

With the growing senior population, more hospitals in the U.S. have established specialized ER facilities for older adults. Said Dr. Gray, “Frailty, confusion and dependence on others make these our most fragile emergency patients. Specialized training in geriatric care and even specialized layout and procedures can help us provide the best assessment and care.”

The study appeared in the Annals of Emergency Medicine.

Source: AgeWise reporting on study from the American College of Emergency Physicians (www.acep.org)