In a New York Times Well blog post, critical and palliative care physician Dr. Zitter recommends that “physicians need to relearn the ancient art of dying.”
Dr. Marcy Adelman has presented recommendations on LGBT Alzheimer’s/dementia care to the San Francisco LGBT Aging Policy Task Force. Task force recommendations will be presented to the Board of Supervisors this spring. Look for future announcements about the LGBT Aging Policy Task Force recommendations and presentations in the SF Bay Times Aging in Community column. LGBT couples experience many challenges when caring for their partners with dementia since many of them do not count with the support of family members. Read more.
Guest Post by Jan Bolder, lead content writer for LivingSenior.com
The top desire of seniors is to maintain dignity, independence and quality of life as long as possible, and one of the easiest ways of achieving that is to age in place, or staying in their own home instead of transferring to an assisted living facility. For many seniors, though, this may seem unattainable, but all it requires is a few minor adjustments around the home.
Seniors—all people—spend about a third of their lives sleeping, and outfitting the room is the most important priority. It doesn’t take much to redo a bedroom so it’s safe and easy to navigate for seniors, but it does take a bit of time and planning.
The bed doesn’t need many alterations, but there are a few things that should be fixed so seniors can get in and out with ease, which is important if they wake up a lot during the night, and stay in comfortably.
- Handrail: Affixing a handrail to the side of the bed is really easy and doesn’t cost much at all. Handrails specifically for adults don’t resemble the ones on children’s beds at all, as these ones look more like one side of a cube with a lip at the top and bottom. One of the lips slides in between the box spring and mattress, while the other one—the top lip—sits above the mattress and usually features curved, polished wood that’s easy to grip.
- Footstool: Seniors shouldn’t sleep in beds too low to the ground because it can be hard on the joints, particularly the knees. As well, seniors with poor muscle strength may find it difficult to generate enough leg muscle power to stand up unassisted. With a footstool, though, seniors can bypass knee and muscle problems easily.
- Floor Mat: Regardless of the surface of the floor in a senior’s bedroom, placing a walkway mat made of grippy rubber can help tremendously for walking around. If the floor is carpeted, the softness may make it hard to feel where the foot goes but it’s more cushioned for falls; a hard bare floor may be easier to navigate but is more unforgiving for trips and slips.
- Nightlight: As seniors age, their eyes undergo two major changes—more rods than cones are lost (the photoreceptors that allow us to detect movement), and the muscles in the iris weaken (which control the dilation and restriction of the pupil and how much light is let in). Plugging in a small nightlight, such as in the corner or hallway, can often be enough of a difference maker to prevent falls in the night.
Remodeling a bathroom to make it more senior-friendly will take a bit more work than the bedroom, but not much, and the results will be instantaneously beneficial. One of the habits of seniors is to “birdbath”, where they stand in front of the kitchen sink and bathe themselves that way because it’s more physically secure.
To maintain dignity and quality of life, using the bathroom for its designated purpose and eschewing birdbaths is highly important, and the following changes can achieve that:
- Guardrail: Coming in either portable plastic or permanent metal, guardrails are an essential part of showers and tubs for seniors. A good guardrail will have a roughened grip on it so it’s easy to hold, and be at a height that doesn’t require overextending the shoulder or arm.
- Bathmat: The bottom of a shower or tub is slippery enough on its own, but add in water and soap, and it can quickly become extremely dangerous. Adhering a suction-cupped bathmat to the bottom of the tub or shower gives seniors extra stability.
- Shower/Tub Chair: Some seniors may find it difficult to stand for long periods of time, and so a bath-ready chair provides an easy alternative. Look for a chair with arms on both sides, a slightly roughened seat for grip and stability, holes in the seat for water drainage, and rubber pads on the bottom of the feet for reduced movement.
- Toilet Seat: A raised toilet seat makes it infinitely easier for seniors to sit down and stand up without worrying about getting stuck or falling. And because they’re made of plastic, they’re also easier to clean than regular toilet seats. As well, placing a handrail beside the toilet also assists the senior with getting on and off easily.
Getting between floors in their house can be one of the most difficult tasks for a senior, and one of the largest barriers preventing them from aging in place. There are many services for seniors, such as driving them to appointments and activities or delivering meals, but if the senior can’t get to their front door, it’s all for naught.
One of the easiest ways to amend this is to install a handrail on the staircase, if there isn’t one there already. Other alterations may be a bit more costly, but just as necessary. For example, rebuilding the stairs to make them wider and shallower makes it much easier for seniors to get up and down on, and removing carpeting can also make a difference.
Because everybody needs to eat, a senior’s ability to cook for themselves is key to aging in place. Remove the ability to do that, and necessary assistance means non-independent living. However, making a kitchen senior-friendly is far easier to do than it looks.
The first step is to make it walkable, and that can be done with rubber, no-stick floor mats in front of key areas like the stove, sink, fridge, table, and door entrance. It’s better to spend a bit more money and get one with beveled edges to avoid tripping, and the better quality ones also have the added bonus of absorbing shock so seniors can stand for longer periods of time.
Small changes like bottom-weighted cups, an electric can opener, a footstool for high cabinets, pull-down shelves, and countertop microwaves all make it easier for a senior to use their own kitchen, thus enabling them to age in place much longer.
Karen Weintraub, in a Special for USA TODAY reported that “… Although people with the memory loss of Alzheimer’s disease and the physical problems of Parkinson’s disease look very different, a growing body of research suggests that their biological damage is quite similar. To better understand those similarities — and why some people end up with one condition versus the other — three foundations that support research into the diseases are joining forces…”
The Alzheimer’s Association, the Michael J. Fox Foundation for Parkinson’s Research and the W. Garfield Weston Foundation of Canada announced that they will offer joint research grants to study the similarities and differences between these degenerative diseases, which together affect 6 million Americans. The hope is that by collaborating on research, scientists will gain insights that will lead to early diagnostics and better, more targeted treatments for both diseases.
The National Council of Aging reported in 2012 that while a large majority of seniors give themselves high marks when it comes to maintaining good health, just 52 percent of those surveyed said they exercise at least four days per week and 11 percent are never physically active at all.
Leading an active lifestyle and eating right are essential for optimal health and become even more important as we age, according to Laser Spine Institute. As falls are considered a significant public health problem, especially in older adults with as many as one in every three senior aged 65 and older falling every year, increasing flexibility can help decrease the chances of falling and improve freedom of movement for everyday activities.
Improving flexibility can make it easier to perform many tasks that are often taken for granted such as bending over to tie your shoes, reaching for items on a shelf, getting dressed or even swinging a golf club. When performed properly, stretching can often alleviate at least some of the pain and symptoms associated with sciatica, bone spurs, herniated or bulging discs and other common health issues when performed properly.
Improve flexibility and manage pain with simple stretches:
Hamstring stretches can help reduce lower back pain. Aim to perform this stretch three to five times, stopping if you feel any discomfort.
Use a floor mat if you have one to help cushion the body, or you can use a towel or blanket. Lie on your back with your legs bent, and hold one thigh behind your knee on the same side. Slowly begin to straighten the knee until a gentle stretch is felt in the back of the thigh and hold for about 20 seconds. Relax and then repeat five times on each side.
Neck Side Stretch
Neck side stretches can help increase the range of movement in the neck and the back as well as improve the ability to perform such tasks as looking under the bed for a missing sock. For this exercise, just sit comfortably in a chair and reach your arm behind your back. Place your left hand on the top of your head, and gently tilt your head to one side. Repeat on the other side, making sure to hold for no more than five seconds each time. As with this and any other exercise, always stop if any pain is experienced.
Arm stretches, like this overhead reach, help to increase flexibility and help with daily functional movements that require the upper body like reaching up for an item on a high shelf. These exercises can also help relieve shoulder stiffness and pain.
To perform an overhead reach, just sit comfortably in your chair, inhale and interlace your hands on your lap. Exhale and raise your arms up overhead. Return to the starting position and repeat 10 times.
Hip twists are also beneficial for relieving back pain. Lie down on your mat or towel on your back with the knees bent. Try to maintain a flat back, and move your hips at a slow pace to the left, lowering your legs down to the floor until a gentle stretch is felt. Hold this pose for 10 to 15 seconds, or as long as comfortable and return to the initial position. Repeat, this time rotate your hips to the right side.
This stretch can help you to improve the ability to reach behind and increase the range of motion in your shoulders as well as to stretch your chest muscles. To perform the stretch, stand with a chair behind you and inhale while you interlace your hands behind your back. Next, exhale and gently move your arms backward; pause and then return to the starting position, repeating 10 times.
The New York Times on December 27, 2013 announced some favorable changes.
“…On Jan. 1, for the first time since Medicare’s creation seniors who seek psychological therapy will be responsible for 20 percent of the bill while Medicare will pay 80 percent, the same percentage it covers for most medical services. (Payment kicks in once someone exhausts an annual deductible — $147 next year.) In 2008, Medicare covered 50 percent of the cost of psychological treatment. Last year, it covered 65 percent.
For decades, older adults with depression, anxiety and other psychological conditions have received unequal treatment under Medicare. The program paid a smaller share of the bill for therapy from psychiatrists, psychologists or clinical social workers than it did for medical services. And Medicare imposed strict lifetime limits on stays in psychiatric hospitals, although no such limits applied to medical care received in inpatient facilities. Read the article