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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]

 

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.

 

Do Working Caregivers Provide Less Care for Loved Ones?

There’s a common assumption that when a loved one needs care, family members who do not work outside the home will be first to step up and provide support. Of course, in reality this is not the case. Many other factors come into play as a family’s caregiving arrangement takes shape.

In a series of studies over the past year, the United Hospital Fund and the AARP have been looking at the facts about family caregiving in the U.S. One thing they’ve discovered is that family caregivers today are performing more and more medical and nursing tasks for their elderly relatives. Family members are providing medication management, performing wound care, monitoring their loved ones’ health conditions and operating specialized medical equipment. The researchers also looked at the level of care and number of care hours provided by family members who were also employed outside the home, compared with those who were not. Said Susan Reinhard of the AARP Public Policy Institute, “We expected that caregivers who didn’t have to manage the demands of a job would have more time to take on these challenging tasks—tasks that would make a nursing student tremble—but our data shows that there’s little difference between the two groups.”

Though working caregivers were only one percentage point less likely to be providing this kind of care (45 percent of them, versus 46 percent of non-working caregivers), the percentages diverged dramatically in another category. Said Carol Levine of the United Hospital Fund, “Where we did find a difference was in the stress associated with juggling the demands of caregiving with other responsibilities.” Levine reports that while 49 percent of family caregivers who are not employed report feeling stressed, fully 61 percent of the working caregivers reported such stress.

This study is yet another reminder of how important it is for our nation to support family caregivers, whose unpaid work is worth billions of dollars each year, and many of whom are also productive members of the workforce.

Read the entire study [link to: http://www.uhfnyc.org/assets/1157] on the United Hospital Fund website.

Source: AgeWise reporting on research from the United Hospital Fund and AARP.

 

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.