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Could Having a Sense of Purpose Lengthen Our Lives?

Over the last few years, aging experts have been looking at the role played by a sense of purpose—the feeling that our lives have meaning, and that we have a place in the world, that we make a difference. A number of studies have found that having a sense of purpose motivates us to take care of ourselves, reduces stress, and lowers the risk of a host of ailments that become more common as we age.

In November 2014, an article appearing in The Lancet suggested that having a sense of purpose can even add years to our lives. As reported by University College London (UCL), seniors who experienced a certain type of well-being were 30 percent less likely to die over the course of a study that was conducted by researchers from UCL, Princeton University and Stony Brook University. The researchers explained that “eudemonic well-being” is the positive feeling we get when we feel that what we do is worthwhile and that we have a purpose in life.

Explained study leader Professor Andrew Steptoe, Director of the UCL Institute of Epidemiology, “We cannot be sure that higher well-being necessarily causes lower risk of death, since the relationship may not be causal. But the findings raise the intriguing possibility that increasing well-being could help to improve physical health. There are several biological mechanisms that may link well-being to improved health, for example through hormonal changes or reduced blood pressure. Further research is now needed to see if such changes might contribute to the links between well-being and life expectancy in older people.”

The study appeared in the Nov. 6, 2014 issue of The Lancet. [optional link: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2813%2961489-0/fulltext]

Source: AgeWise reporting on news release from University College London.

 

Retirement Communities Encouraged to Promote Muscle-Strengthening Activities

A University of Missouri expert encourages staff and administrators to include a well-rounded fitness program in order to keep residents healthier.

The majority of adults aged 65 and older remain inactive and fail to meet recommended physical activity guidelines, previous research has shown. However, these studies have not represented elders living in retirement communities who may have more access to recreational activities and exercise equipment. Now, researchers at the University of Missouri have found that older adults in retirement communities who reported more exercise experienced less physical decline than their peers who reported less exercise, although many adults—even those who exercised—did not complete muscle-strengthening exercises, which are another defense against physical decline.

“Physical decline is natural in this age group, but we found that people who exercised more declined less,” said Lorraine Phillips, an associate professor in the University of Missouri Sinclair School of Nursing. “The most popular physical activities the residents of the retirement community reported doing were light housework and walking, both of which are easily integrated into individuals’ daily lives, but these exercises are not the best choices for maintaining muscle strength.”

Phillips and her colleagues studied the physical activity of 38 residents at TigerPlace, an independent living community in Columbia, four times in one year. The researchers tested the residents’ walking speed, balance and their ability to stand up after sitting in a chair. Then, researchers compared the results of the tests to the residents’ self-reported participation in exercise. Phillips found that residents who reported doing more exercise had more success maintaining their physical abilities over time.

Phillips says the national recommendations for exercise include muscle strengthening exercises, such as knee extensions and bicep curls. Most of the study participants did not report completing these types of activities despite daily opportunities for recreational activities and access to exercise equipment. Phillips says muscle strength is important to individuals of this age group in order for them to maintain their ability to conduct everyday activities such as opening jars, standing up from chairs and supporting their own body weight.

“For older individuals, walking may represent the most familiar and comfortable type of physical activity,” Phillips said. “Muscle-strengthening exercises should be promoted more aggressively in retirement communities and made more appealing to residents.”

To combat the lack of physical activity among seniors, Phillips says health care providers should discuss exercise programs with their patients and share the possible risks associated with their lack of exercise, such as losing their ability to live independently. According to the Centers for Disease Control and Prevention, individuals 65 years of age and older that have no limiting health conditions should do muscle-strengthening activities that work all major muscle groups at least two days a week.

Phillips’ research, “Retirement Community Residents’ Physical Activity, Depressive Symptoms, and Functional Limitations,” was published in Clinical Nursing Researchhttp://cnr.sagepub.com/content/early/2014/02/10/1054773813508133.abstract

Source: University of Missouri News Bureau.

 

Home Care Supports Seniors Who Want to Age in Place

The U.S. Census Bureau reported last year that the percentage of seniors who are living in a nursing home dropped by 20 percent over the last decade. Are seniors just healthier today? The truth is, older adults today need as much care as did previous generations, but more of them are receiving it in assisted living communities, adult day centers and, in growing numbers, in their own homes.
This information comes as little surprise to the 65 million Americans who are already serving as family caregivers for older loved ones who need help managing health conditions and the activities of daily living. Many of these caregivers are members of the baby boom generation, who are reaching the age when they themselves might be expected to need care! From the local to the federal level, government agencies, too, are taking notice of the financial impact resulting from this population shift. The discussion about how to best and most cost-effectively care for our seniors is taking center stage.
The Census study showed that 90 percent of seniors would wish to receive care in their own homes. Is this realistic? Can they be safe and well-cared for even if they are living with age-related illnesses such as heart disease, diabetes, arthritis, or memory loss? Several demographic changes in our society make this more of a challenge than it was in the past:
• A University of Michigan study showed that almost 40 percent of chronically ill older adults in the U.S. live alone, and the majority of those who are married have spouses who are themselves facing health challenges.
• Our lower birthrate equals fewer adult children to help out as parents’ care needs increase.
• Adult children are more likely to live at a distance, having moved to find employment.
• A higher divorce rate means more seniors live alone, and family caregivers’ financial and time resources are stretched when parents live in different households, or even in different parts of the country.
The cost of institutional care continues to grow. For some seniors with medically complex health challenges, nursing homes and other residential health facilities are the best choice. But for many other seniors, home care is a desirable and cost-effective arrangement.
Dr. Soeren Mattke of the RAND Corporation noted, “The aging of the world’s population and the fact that more diseases are treatable will create serious financial and manpower challenges for the world’s healthcare systems.” He added, “Moving more healthcare into the home setting where patients or family members can manage care could be one important solution to these challenges.”
A wide variety of care services can be provided right in a patient’s home:
Skilled healthcare services can be provided at home and are cost-effective. Visiting nurses and rehabilitation professionals provide skilled medical services in the home. Registered nurses (RNs) and licensed practical nurses (LPNs) perform hands-on procedures such as wound care and IV therapy. Rehabilitation professionals include physical, occupational and speech/language therapists.
Nonmedical home care provides companionship and homemaking services that support the senior’s independence, at a much lower cost than nursing care. Caregivers provide supervision, assistance with dressing grooming and other personal care, laundry and housekeeping, meal preparation, transportation, socialization, and respite for family caregivers.
Dementia support is also available. Even when adult children live close to home, dementia complicates the caregiving dynamic. Trained in-home caregivers who understand the challenges of Alzheimer’s disease and similar conditions can help patients remain home longer, even as the need for assistance and supervision grows.
Many experts believe that bringing more care into seniors’ own homes will allow them to take better charge of their own care—and will save seniors and the healthcare system money.
Source: IlluminAge AgeWise, 2015

Healthy Lifestyle Choices to Reduce the Risk of Heart Disease

Most of us know that we can take “heart smart” steps to promote cardiac wellness. But sometimes, even the researchers are amazed at what a difference these lifestyle choices can make.

The American College of Cardiology recently reported on a new study, this one on a group of over 20,000 healthy Swedish men aged 45–79. The researchers from Karolinska Instituet in Stockholm, Sweden studied the men for 11 years, questioning them regularly about their diet, exercise and other wellness factors.

Said study author Agneta Akesson, Ph.D., “It is not surprising that healthy lifestyle choices would lead to a reduction in heart attacks. What is surprising is how drastically the risk dropped due to these factors.”

The researchers found that each healthy lifestyle factor decreased the risk of coronary heart disease. The healthy choices include:

  • A healthy diet including fruits, vegetables, legumes, nuts, reduced-fat dairy products, whole grains and fish
  • Not smoking
  • Walking or cycling at least 40 minutes per day
  • Amount of belly fat under 95 centimeters (37.5 inches)
  • Moderating alcohol consumption

According to the study authors, these preventive choices also help patients avoid the potential side effects of heart medications and, as a side benefit, save patients and the healthcare system money.

Akesson and her team report that, at present, less than 2 percent of the American population follow all these recommendations.

February’s American Heart Month is a great time to make some heart-smart resolutions for ourselves, and to promote heart health for everyone. This is not just an issue for seniors. Says Akesson, “It is important to note that these lifestyle behaviors are modifiable, and changing from high-risk to low-risk behaviors can have great impact on cardiovascular health. However, the best thing one can do is to adapt healthy lifestyle choices early in life.”

Learn More

The Centers for Disease Control and Prevention (CDC) offers resources and information for American Heart Month.  http://www.cdc.gov/features/heartmonth

Source: IlluminAge AgeWise reporting on information from the American College of Cardiology. Read the entire study in the Journal of the American College of Cardiology  http://content.onlinejacc.org/article.aspx?articleID=1909605

 

What Does Successful Aging Really Mean?

When we talk about “successful aging,” many Americans think of models in senior product advertisements who—apart from their silver hair—seem to be untouched by age as they pose on the golf course, walk on the beach or dance the night away.

But few of us retain our physical and cognitive health indefinitely. Most of us will deal with increasing disability as the years advance, and while disease and disability aren’t “a normal part of aging,” they are challenges we are likely to face. According to a recent report from the U.S. Census Bureau, nearly 40 percent of people older than 65 have at least one disability.

A researcher from University of Louisville recently urged that we reconsider our preconceptions of “successful aging.” Nursing professor Valerie Lander McCarthy, Ph.D., RN, collaborated with a visiting professor from China to develop a different definition of positive aging.

McCarthy says that it is unrealistic to measure “positive aging” solely on physical and mental capacity. She says that if they don’t fall into the 10 percent with exceptional physical and cognitive health, “older adults feel guilty when they get sick because they think they are not succeeding—and in the U.S., succeeding is important.”

McCarthy’s work with Shandong University’s Ji Hong appeared in the Journal of Transcultural Nursing. The team said, “Transcendence—a sense of meaning, well-being and life satisfaction—is the best predictor of positive aging. The concept involves relationships, creativity, contemplation, introspection and spirituality.”

McCarthy has worked with interventions to increase this type of positive aging. These include encouraging “a time for quiet solitude in natural beauty followed by a discussion about a person’s outlook, helping to develop a broadened perspective on life or a feeling of being an integral part of the cycle of life.” McCarthy says storytelling can also be beneficial.

“Successful aging is important for the rapidly growing population of older adults and their families and caregivers,” says McCarthy.  She urges more attention to interventions that promote a sense of successful aging, and reminds us:  “It is also significant for society as a whole, which will bear the burden of unprecendented demands on health and aging services.”

Source: IlluminAgeAgeWise reporting on study from University of Louisville [optional link to: http://tcn.sagepub.com/content/early/2014/05/16/1043659614526257.full.pdf?ijkey=ifzmJkLq4agorci&keytype=ref]

 

Leading Physician Group Releases Guidance for Treatment of Urinary Incontinence

It’s a subject few people openly discuss—yet millions of senior American women are living with urinary incontinence (UI), a troublesome problem that if not managed, can lead to infection, isolation, falls, inactivity and an overall decline in health. Many of these women and their families fail to realize that UI can be treated, often without surgery.

The American College of Physicians (ACP) recently reported that each year, treatment for UI costs upwards of $19.5 billion. In September 2014, the organization released updated, evidence-based recommendations for non-surgical treatment options “to help doctors and patients understand the benefits, harms, and costs of tests and treatment options so they can pursue care together that improves health, avoids harms, and eliminates wasteful practices.”

Treatment recommendations depend on the type of incontinence a woman is experiencing:

Stress incontinence means that urine leaks from the bladder when a woman laughs, coughs, exercises or lifts something heavy. It is caused by physical changes in the muscles of the pelvic floor caused by factors such as childbirth, menopause and obesity. This type is most common in women. For this type, the ACP recommends a specific series of exercises of the pelvic floor called Kegel exercises.

Urgency incontinence, sometimes called “overactive bladder,” happens when the bladder begins to empty itself suddenly, perhaps when the patient thinks about going to the bathroom or hears running water. It can be caused by damage to the nerves or by irritation from infection or certain foods. For urgency incontinence, the ACP is recommending “bladder training, a form of behavioral therapy that involves urinating on a set schedule and gradually increasing the time between urination.” If bladder training is unsuccessful, the ACP recommends medication as recommended by the patient’s physician.

Mixed UI is a combination of stress and urgency incontinence. For this type, the ACP recommends Kegel exercises with bladder training. They also recommend weight loss and exercise for women who are obese.

ACP president Dr. David Fleming states that about half the women who experience this problem don’t even report it to their healthcare provider. He says to doctors, “Urinary incontinence is a common problem for women that is often under-reported and under-diagnosed. Physicians should take an active approach and ask specific questions such as onset, symptoms and frequency of urinary incontinence.”

The information in this article is not meant to replace the advice of your doctor. If you are experiencing incontinence, seek the advice of your healthcare provider.

Source: AgeWise reporting on material from the American College of Physicians. You can read the entire “Nonsurgical Management of Urinary Incontinence in Women” set of guidelines in the Sept. 16, 2014 issue of the Annals of Internal Medicine [link to: http://annals.org/article.aspx?articleid=1905131]

 

Can Seniors Fight Depression By Going on the Internet?

According to the Geriatric Mental Health Foundation, more than 6 million Americans older than 65 experience feelings of persistent sadness, hopelessness and lack of energy. Two million of these seniors have been diagnosed with a severe depressive illness.

Depression is caused by a chemical imbalance in the brain, resulting from illness, a loss or accumulated losses, chronic pain, the side effects of medication and other causes. You might be surprised to know that retirement can be the trigger event for depression. Even though most of us look forward to having our days to ourselves, with more time to do the things we want to do, retirement may create a “vocation gap” that leaves some retirees without a feeling of purpose and a place in the world. Retirement may also mean the loss of an important social context.

It’s important to seek treatment for depression. Treatment might include medications and therapy. But often, lifestyle changes provide a powerful mood boost. These include everything from exercise to volunteering to watching humorous TV programs. And over the past few years, several studies have shown that internet use can be an effective tool for reducing feelings of boredom and isolation.

This was confirmed recently when a team of researchers headed by Shelia R. Cotton, Ph.D., from Michigan State University examined results from the large Health and Retirement Study, an ongoing survey that provides data on more than 22,000 older Americans. As reported by the Gerontological Society of America, the team asked study subjects: “Do you regularly use the World Wide Web, or the internet, for sending and receiving email or for any other purpose?”

The results showed that the internet users had a 33 percent reduction in the probability of depression. Said the study authors, “This provides some evidence that the mechanism linking internet use to depression is the remediation of social isolation and loneliness. Encouraging older adults to use the internet may help decrease isolation, loneliness, and depression.”

Online socialization is a great way to supplement and increase “real life” friendships. Surfing the Web provides mental stimulation and helps seniors feel informed and connected. Something as small as watching a few cat videos—and sharing them on Facebook—can raise the spirits. And today, many young people who were raised with the internet are providing their older relatives with a little intergenerational tech support. If you or an older loved one is experiencing depression and isolation, check out the resources in your community to help seniors learn to use computers and connect with others online.

Read more about the study here.

Copyright © IlluminAge AgeWise, 2014; with excerpts from news release from the Gerontological Society of America.

 

Geriatrician Looks at Sensitive Issue of Senior Gun Ownership

In the United States the debate around gun ownership often focuses on teenagers; however, research shows that elderly Americans are the most likely to own a gun and that presents both medical and legal problems for physicians and carers.

Writing in an issue of the Journal of the American Geriatrics Society, Dr. Ellen Pinholt explored these issues and proposed a series of “red flag” questions which caregivers must ask.

While there is no upper age limit on owning a firearm, Americans aged over 65 have the highest prevalence of dementia, depression and suicide. Federal law prohibits mentally incompetent persons from possessing a gun; however, this only applies to a formal finding by a court and not necessarily to a physician’s diagnosis of dementia.

Using a series of case studies to explore the medical and legal dimensions of the issue, Dr. Pinholt suggested “5 Ls,” questions about gun ownership which should be asked as routinely as questions about driving.

  1. If there is a gun present, is it LOCKED?
  2. Is it LOADED?
  3. Are LITTLE children present?
  4. Does the gun owner feel LOW?
  5. Is the gun owner LEARNED about how to safely use the gun?

Source: Wiley Online Library News Release; Journal of the American Geriatrics Society, 4 June 2014

Learn More

The U.S. Department of Veterans Affairs offers a free online brochure, “Firearms and Dementia.”

Choosing a Quality Hospice

When a loved one is diagnosed with a serious or life-limiting illness, the questions facing an individual or a family can be overwhelming. The National Hospice and Palliative Care Organization (NHPCO) recommends that people learn more about hospice as an important option before they are faced with a medical crisis.
Hospice is not a place but a kind of care for people who have a life-limiting illness and are making the choice to focus on quality and comfort if more conventional treatments have become burdensome.
Hospices provide high-quality care specially tailored to your needs and valuable support to family caregivers.
With multiple hospices serving some communities, it can seem challenging to select one. NHPCO suggests the best way to begin is by reaching out to the hospice providers in your community to find the one best equipped to meet your specific needs.
“Choosing a hospice to care for yourself or a loved one in the final months or even days of life is an important and stressful process,” said J. Donald Schumacher NHPCO president and CEO. “Each hospice offers unique services and partners with specific community providers – so it’s important to contact the hospices in your area and ask them questions to find the one with the services and support that are right for you.”
Your physician, other healthcare providers or family friends that have taken advantage of hospice services in the past are other good ways to get a recommendation for a provider in your area.
Some of the questions important in choosing a quality hospice include:
1. Is the hospice Medicare certified?
2. When was the last state or federal survey of the program?
3. Is the hospice accredited by a national organization?
4. What services should I expect from the hospice?
5. How are services provided after hours?
6. How and where does the hospice provide short-term inpatient care?
7. What services do volunteers offer?
8. How long does it typically take the hospice to enroll someone once the request for services is made?
Another question is when to begin hospice care. Every patient and family must decide that based upon their unique needs. However, professionals encourage people to learn about care options long before they think they may need them.
To help families make a decision at a difficult time, the NHPCO has created a free worksheet to help consider and answer some of the important questions to consider when learning about or choosing a hospice. Down load the worksheet (www.momentsoflife.org/sites/default/files/public/moments/Choosing%20a%20Hospice.pdf) from NHPCO’s Moments of Life website.
Source: The National Hospice and Palliative Care Organization (www.nhpco.org).

Can Weight Loss Improve Problems with Incontinence?

Can weight loss improve problems with urinary incontinence?  It may, according the American Institute for Cancer Research expert Karen Collins.

Urinary incontinence is an involuntary leakage of urine. It can occur as stress incontinence (which comes at a time of some form of exertion or when sneezing or coughing), urge incontinence (which occurs with or immediately following a sense of urgency), or a mixture of both. Excess body fat, especially in the abdominal area, is strongly linked to greater risk of urinary incontinence. Researchers say this could be a physical effect, due to pressure of excess fat pushing down and stressing the pelvic floor.

However, since studies also show that fat tissue is metabolically active and linked to inflammation and hormonal changes, it’s possible that these conditions are involved in the link between overweight and urinary incontinence. A recent review pulling together the results of six studies on this link concluded that modest weight loss may help reduce urinary incontinence. The good news is that a 5 to 10 percent weight loss seemed to make a difference, which could mean losing less than 10 pounds for some people.

However, excess weight is far from the only reason for urinary incontinence. It can be related to medications, hormone changes, surgery, childbirth and other causes. It’s unfortunate that many people who experience urinary incontinence are embarrassed and don’t discuss it with their healthcare provider. That is a shame, because in addition to weight loss, other remedies can also be considered. If you are overweight, modest weight loss also can make a difference in controlling or reducing risk of so many other health problems, including Type 2 diabetes and high blood pressure. Making a few changes in eating habits and activity to support a modest weight loss is a good idea. But don’t leave your doctor or other healthcare provider in the dark as you face this problem.

Source: Karen Collins, MS, RDN, CDN, FAND, of the American Institute for Cancer Research (AICR). The AICR is the cancer charity that fosters research on the relationship of nutrition, physical activity and weight management to cancer risk, interprets the scientific literature and educates the public about the results. Visit the AICR website (www.aicr.org) to find a wide variety of consumer information on healthy diet.