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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

 

New Census Bureau Report Underscores the Need for Senior Care

The Baby Boom is now creating a Senior Boom. According to a new report from the U.S. Census Bureau, the number of individuals age 65 and older is projected to reach nearly 84 million by 2050, almost double the size from 2012. Another factor contributing to the boom is the fact that people are living longer. Currently, the average American is living to be almost 79 years old, up from about 71 years in 1970.

 

This raises the question of how we, as a country, plan on taking care of our aging citizenry. According to the Congressional Budget Office, about one-third of people age 65 or older report functional limitations of one kind or another—limitations that require assistance in dressing, bathing, preparing meals, managing medications, etc. Among people age 85 or older, about two-thirds report functional limitations. And experts project that two-thirds of all seniors will need assistance to deal with a loss in functioning at some point during their remaining years of life.

“Changes in the age structure of the U.S. population will have implications for health care services and providers, national and local policymakers, and businesses seeking to anticipate the influence that this population may have on their services, family structure and the American landscape,” says Jennifer Ortman, chief of the Census Bureau’s Population Projections Branch.

The aging population presents numerous challenges and great opportunities for agencies and companies that provide senior care. Home care and home health care services, community care facilities for the older population, and continuing care retirement communities are all expanding. All showed an increase of 20 percent or more in their number of employees between 2007 and 2011. Additionally, age-restricted communities are becoming more and more popular. One such community, The Villages in Sumter County, Florida, was the nation’s fastest growing metro area from 2012 to 2013.

Fortunately, the Senior Boom wasn’t an unforeseen phenomenon. We’ve known for nearly 60 years that Baby Boomers would eventually grow old and need greater care. The associated industries caring for these individuals have, so far, been able to keep pace with demand, although occupancy at senior living communities is on the rise, reaching 89.9% in the second quarter of 2014. Fortunately, construction of new communities is also on the rise. It’s safe to say that senior care will be a growing industry for many years to come.

 

Source: IlluminAgeAgeWise

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.

 

From Woodstock to the Audiologist: Mom Was Right About That Loud Rock Music

Boomers who grew up with lectures from Mom to “turn down that hi-fi!” may now be paying the price for their love of decibels.

According to hearing loss researcher Richard Salvi, Ph.D., “Baby boomers now have reached an age where hearing loss and tinnitus (ringing in the ear) become major health problems. Many have already lost much of their hearing and developed tinnitus due to years of listening to loud rock music.”

Salvi explains, “Hearing aids, not yet considered a fashion statement, will become a necessary part of the boomers’ dress code as the prevalence of age-related hearing loss begins to accelerate beyond age 65. While hearing aid technology and miniaturization have steadily advanced, restoring the hearing of our youth remains a formidable challenge.”

Salvi, Professor of Communicative Disorders, Otolaryngology and Neurology, is Director of the Center for Hearing and Deafness at the University at Buffalo in New York. He says, “Hearing healthcare costs are skyrocketing due to noise exposure and aging.” Salvi has also studied hearing loss in combat veterans. He says, “The Veterans Administration ranks hearing loss as one of its top five major disabilities. In 2010, the VA paid out more than $1 billion for tinnitus disability claims alone.”

And this trend also appears in the general population, where, according to the National Institute on Deafness and Other Communication Disorders, 18 percent of baby boomers are already dealing with some degree of hearing loss from continued exposure to loud noise and age-related changes in the ear. The figure is expected to double during the next decade, though some experts point out that in certain ways, the boomer generation is better off than their elders when it comes to hearing, having benefited from tighter regulations on workplace noise and better treatment for childhood ear infections.

It’s important to seek treatment for hearing loss. “Severe to profound hearing loss and tinnitus associated with aging and noise exposure are not just hearing problems; they can lead to social isolation, anxiety and depression, contributing to an overall decline in one’s general health,” Salvi says.

Source: AgeWise reporting on research from the University at Buffalo Center for Hearing and Deafness

 

Planning Ahead When a Loved One Has Alzheimer’s Disease

When a loved one is diagnosed with Alzheimer’s disease, you need to start getting their health, legal, and financial affairs in order. You want to plan for the future, if possible, with help from your loved one while they can still make decisions. You need to review all of their health, legal, and financial information to make sure it reflects their wishes. Here is a planning checklist from the National Institute on Aging’s Alzheimer’s Disease Education and Referral Center:

Update health care, legal, and financial information

  • A Durable Power of Attorney for Finances gives someone called a trustee the power to make legal and financial decisions for the person with Alzheimer’s.
  • A Durable Power of Attorney for Health Care gives someone called a proxy the power to make health care decisions for the person with Alzheimer’s.
  • A Living Will states the person’s wishes for health care at the end of life.
  • A Do Not Resuscitate (DNR) Form tells health care staff how the person wants end-of-life health care managed.
  • A Will tells how the person wants his or her property and money to be divided among those left behind.
  • A Living Trust tells the trustee how to distribute a person’s property and money.

Check for money problems

People with Alzheimer’s disease often have problems managing their money. As the disease progresses, they may try to hide financial problems to protect their independence. Or, they may not realize that they are losing the ability to handle money matters. Someone should check each month to see how your loved one is doing. This person might be a family member or the trustee.

Protect your loved one from fraud

Scams can take many forms, such as identity theft; get-rich-quick offers; phony offers of prizes or home or auto repairs; insurance scams or outright threats. Here are some signs that a loved one with Alzheimer’s is not managing money well or has become a victim of a scam:

  • Your loved one seems afraid or worried when he or she talks about money.
  • Money is missing from your loved one’s bank account.
  • Signatures on checks or other papers don’t look like your loved one’s signature.
  • Bills are not being paid, and your loved one doesn’t know why.
  • Your loved one’s will has been changed without his or her permission.
  • Your loved one’s home is sold, and he or she did not agree to sell it.
  • Things that belong to your loved one are missing from the home.
  • Your loved one has signed legal papers (such as a will, a power of attorney, or a joint deed to a house) without knowing what the papers mean.

Reporting problems: If you think your loved one may be a victim of a scam, contact your local police department. You also can contact your state consumer protection office or Area Agency on Aging office. For help finding these offices, contact Eldercare Locator at 1-800-677-1116 or www.eldercare.gov. For a list of state consumer protection offices, see www.usa.gov/directory/stateconsumer/index.shtml. You can also look in the telephone book for a listing in the blue/Government pages.

Who would take care of your loved one with Alzheimer’s disease if something happened to you?

It is important to have a plan in case of your own illness, disability, or death.

  • Consult a lawyer about setting up a living trust, durable power of attorney for health care and finances, and other estate planning tools.
  • Consult with family and close friends to decide who would take responsibility for your loved one. You also may want to seek information about your local public guardian’s office, mental health conservator’s office, adult protective services, or other case management services. These organizations may have programs that could assist your loved one in your absence.
  • Maintain a notebook for the responsible person who would assume caregiving. Such a notebook should contain the following information:
    • emergency phone numbers
    • current problem behaviors and possible solutions
    • ways to calm the person with Alzheimer’s
    • assistance needed with toileting, feeding, or grooming
    •  favorite activities or food
  • Preview long-term care facilities in your community and select a few as possibilities. Share this information with the responsible person. If your loved one is no longer able to live at home, the responsible person will be better able to carry out your wishes for long-term care.

Contact the Alzheimer’s Disease Education and Referral (ADEAR) Center at 1-800-438-4380 or www.nia.nih.gov/alzheimers for more information on planning for health, legal, and financial matters.

Source: National Institute on Aging, adapted by AgeWise, 2014.

 

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).