Archives 2017

By Meredith Kimple

How many of us were encouraged to drink a glass of milk every day when we were children? The importance of strong bones is drilled into our heads from an early age, but the effects of an inadequate calcium intake are not obvious until we are much older. We all lose a significant quantity of bone mass throughout the aging process, and our bodies are no longer able to effectively absorb the calcium and vitamin D needed to maintain bone strength and density.

What factors contribute to this loss of bone mass in older adults?

A diet that is lacking in both calcium and vitamin D may leave older adults vulnerable to weak or brittle bones. As mentioned in previous blog posts, a senior’s poor diet can be the result of numerous factors, including financial constraints, the physical challenges of food preparation, or a decreased appetite. However, even if an older adult ingests the daily-recommended amounts of calcium and vitamin D, their bodies may not be able to properly absorb them; this in turn means that they require an even greater intake of vitamins and minerals than younger adults.

While we tend to associate bone strength with the intake of calcium, vitamin D is an equally vital part of supporting and preserving healthy bones. One of the easiest natural ways to acquire vitamin D is to spend time outdoors; our bodies absorb direct sunlight through the skin and then process it as vitamin D. Some older individuals do not receive an adequate amount of sunlight, either because they are institutionalized or confined indoors by severe mobility impairments. As with calcium, an older body has greater difficulty converting sunlight into vitamin D than a younger body.

Post-menopausal women are particularly at risk for reduced bone strength, primarily due to their rapid loss of estrogen; men face a greater risk for weaker bones after they reach 70 years of age. Up until the age of 40, our bodies constantly remove and replace any lost bone mass with new bone, but as we age, this process occurs far less frequently. Certain medications can also contribute to the loss of bone mass.

You might think that having brittle or weak bones is not the worst condition a senior could face, considering the prevalence of Alzheimer’s disease, stroke, and cancer. But frail bones can lead to truly devastating accidents.

An older adult with weaker bones may be more prone to falling, which can then lead to broken bones or other serious injuries. Changes in their bone structure can cause an unsteady gait or stooped posture, both of which make walking a greater challenge and reducing mobility. And, of course, an older person may develop osteoporosis, a bone disease characterized by severe loss of bone density. An older adult with osteoporosis is more likely to break at least one bone if they fall, but their bones are so weak that even a strong sneeze or cough can cause a serious fracture.

At an advanced age, our bodies are not as well equipped to handle even the most minor fractures or broken bones. More serious injuries, like a broken hip, can subject an older individual to a debilitating surgery and long recovery, both of which may leave them susceptible to disease and decline. Brittle bones can bring an otherwise healthy older adult to the brink of frailty, and limit their ability to move without causing irreparable damage to their body.

Though the optimal time to reinforce our bones with calcium and vitamin D is prior to our 30s, there are things we can do now to help our older loved ones (and ourselves). Absorption may not be nearly as effective, but it is crucial that our loved ones are getting enough calcium in their diets; the first foods that come to mind are dairy products, like milk or yogurt, but calcium can also be found in certain vegetables, like broccoli and kale. Vitamin D deficiency is fairly common across all age groups, and our older loved ones may not be getting enough from sun exposure or their diets. Calcium and vitamin D supplements may help bolster your older loved one’s balanced diet, filling in the gaps caused by inefficient absorption; make sure they speak with their physician before adding any vitamins or supplements to their diets.

Exercise is another great way to improve and maintain bone strength. For many seniors, physical changes and limitations can mean the loss of their preferred form of exercise; strenuous activities, like running, stair-climbing, or weightlifting, may prove too difficult, taxing, or dangerous. Instead, they may benefit from gentler forms of exercise that do not wreak havoc on the joints, like short daily walks, jogging, yoga, Tai Chi, or dancing. If your older loved one cannot exercise due to mobility impairment, encourage them to see a physical therapist, who can help them adapt activities and design a unique exercise regimen that is tailored to their abilities. In addition to strengthening their bones and muscles, regular exercise can help to improve an older adult’s sense of balance, which gives them more confidence when walking.

It’s easy to believe that by the time we reach old age there is very little we can do to fortify our bones. While there is certainly no way to reverse the aging process or make up for lost time, to say that we are utterly powerless would be a gross exaggeration. If we can help our older loved ones eat better and exercise, we are helping them to make modest improvements in their health; on the other hand, if we do nothing, their bones can only grow weaker and continue to lose mass. As is the case when tackling many of the ailments that afflict the elderly, small lifestyle changes like an improved diet and regular exercise can have a positive impact on overall health and wellness.

You’re never too young or too old to be proactive in protecting the strength and health of your bones, so after you pour that glass of milk for your older loved one, make sure you pour one for yourself too!

By Meredith Kimple

There is a lot to look forward to when the weather changes; the oppressive summer heat dissipates, the leaves change to vivid shades of orange and gold, and the holiday season is fast approaching. But in these cooler months, our chances of catching the flu or developing a respiratory infection increase significantly. For an otherwise healthy young person, fighting these ailments can prove difficult, but for the elderly, it is a far greater challenge, particularly if their initial illness becomes pneumonia.

Are older individuals more susceptible to pneumonia than younger adults?

Yes, and there are several reasons for this. Some seniors suffer from coughing or swallowing impairments, which increases their risk of infection settling in their lungs. If a senior is physically frail or already has a chronic pre-existing condition, like diabetes or COPD, they may be especially vulnerable to pneumonia. If they spend most of their time indoors with the windows closed, they may unwittingly create the perfect environment for harmful bacteria. Older individuals also have weaker immune systems that leave them unable to fight or stave off infection.

Because older bodies are especially susceptible to illnesses and infections and are not as well equipped to fight them, the potential for a less threatening ailment to develop into pneumonia is of great concern. Help your older loved one take the following steps to prevent pneumonia.

1. Get Vaccinated

For both the very young and the elderly, receiving a flu vaccine every year is imperative, partially because in a weakened body the flu can develop into something more serious, like pneumonia. Though the vaccine may not prevent your senior loved one from coming down with the flu, it will help to lessen the severity of their symptoms; this in turn may decrease their chances of getting pneumonia. Keep in mind that the vaccine needs about two weeks to fully take effect, and the height of flu season is in February.

Also, encourage your older loved one to speak with their physician about receiving pneumococcal vaccines. It is now recommended that adults over the age of 65 receive 2. Individuals who have dementia or other chronic conditions, like heart or cerebrovascular disease, are particularly susceptible to pneumococcal pneumonia.

2. Maintain Good Hygiene

Although certain strains of pneumonia-causing viruses and harmful bacteria are transmitted through the air via a sneeze or a cough, many people become ill simply by touching contaminated surfaces. Doorknobs, shopping carts, elevator buttons, and railings are just a few examples of things that are regularly touched and handled by several people every day; when we touch these things and then touch our faces without first washing or sanitizing our hands, we run the risk of ingesting a host of nasty germs.

As we’ve discussed in previous blog posts, it is not always easy for our older loved ones to maintain good hygiene. Bathing, brushing teeth, and washing hands may either be too physically demanding, or our loved ones do not remember to perform them with the necessary regularity. Encourage them to wash their hands whenever they come home from running errands, and remind them that even rubbing at their eyes with dirty hands can lead to illness. Buy them a miniature bottle of hand sanitizer that they can easily use when out and about.

It is also important that they keep their homes clean; a dark, poorly ventilated, messy, cluttered living space is the perfect breeding ground for bacteria. If you live close by, help them do a thorough cleaning at least every two weeks, particularly in the winter months. If you live far away or don’t have the time, speak with your older loved one about hiring someone to clean their home weekly. Because they tend to have weaker immune systems, it is vital that their environments be as free from harmful bacteria as possible.

3. Fortify Immune System

As mentioned above, older adults have a weaker immune system than younger adults, which leaves them particularly vulnerable to infection. Still, there are steps they can take to help fortify their immune systems to defend against pneumonia. Eating a healthy, balanced diet filled with fresh fruits and vegetables and engaging in regular physical activity are excellent ways for our older loved ones to bolster their bodies’ natural defenses.

If cooking their own meals or getting regular exercise is physically difficult or nearly impossible for your older loved one, talk with their physician about sending them to see both occupational and physical therapists. These professionals will help your older loved one develop a personalized plan to accomplish these tasks that is tailored to their needs and abilities.

If your older loved one does have pneumonia, catching the symptoms earlier rather than later is equally important. In addition to the standard fatigue, fever, nausea, vomiting, phlegmy cough, chest pain, and shortness of breath, adults age 65 and older may also exhibit confusion or a sudden change in their level of awareness. If you notice these symptoms in an older loved one who is 65 or older, it is crucial that you take them to see a doctor; you must be especially vigilant if your loved one has Alzheimer’s disease, dementia, or a significant cognitive impairment, as they may be unable to communicate their symptoms.

While not all cases of pneumonia are fatal, older people are more likely to die from the infection, particularly if they are hospitalized because of it. Pneumonia is also the most common post-surgical infection in hospitals, and when contracted in a hospital, is even more likely to prove deadly. Though most hospitals have plans in place to prevent or minimize infection, it is important that you and your loved one carefully follow your doctor’s postoperative instructions.

As with many ailments that are prevalent in the elderly population, pneumonia is especially likely to affect those who are already frail or compromised by other illnesses. With this in mind, we should do everything we can to promote our senior loved one’s overall health; a strong immune system, good hygiene, healthy habits, and the recommended immunizations are all necessary to provide them with the best defense against infection. Though we can’t protect them from every germ or bacteria, understanding their risk factors and taking the proper preventative measures can help ensure minimal damage to their bodies.

By Meredith Kimple

Ageism is discrimination or prejudice against individuals belonging to a certain age group, particularly the elderly population. In a previous blog post, we explored the importance of older individuals having a sense of purpose, especially since our culture worships at the altar of youth, physical fitness, competitive drive, and achievement. Because our culture highly values these aspects of the human experience, older individuals may feel that they no longer have a valuable role to play in society. Ageism promotes the idea that growing old, while certainly preferable to an early death, is a truly terrible process that should be resisted at all costs. In fact, the fear of aging is used to hawk countless wrinkle-reducing skin creams, hair dyes, and plastic surgery procedures to the masses, as the prospect of facing the physical changes associated with aging is met with collective distaste.

Though there have been more positive portrayals of old age in commercials and various other forms of entertainment in recent years, this long-held, widespread rejection of the elderly is not to be easily uprooted. As the Baby Boomer generation ages, a significant portion of our population is attaining elder status, and while this change in demographic may help combat negative perceptions of old age, the harmful effects of ageism on our senior loved ones are of a significance that warrants our immediate attention.

Ageism in the healthcare community is surprisingly prevalent, often to the detriment of older patients’ health outcomes. Doctors may either overestimate or underestimate the medical concerns of their older patients, with no conscious effort to do harm. Certain conditions or pain may be dismissed simply because a patient has reached an advanced age; on the other hand, some doctors overprescribe medication or order rigorous examinations and tests primarily due to a patient’s advanced age. In both cases, some medical professionals make decisions based on the age of their patient and the general assumptions that age gives rise to, rather than on the individual patient’s actual physical condition and medical needs. Doctors may unintentionally patronize and talk down to their older patients in an attempt to communicate effectively, mistakenly assuming that these individuals suffer from hearing loss or cognitive impairment. They may also carry preconceived notions about the health issues seniors encounter while dismissing others that do not fit their understanding, such as those relating to sexual intercourse. If you accompany a senior loved one to doctors’ visits, allow them to answer and ask questions as much as possible while speaking to their physician; some doctors address the friend or relative rather than their patient when explaining various test results or procedures, which removes agency from the older patient.

But of perhaps greater significance is the toll ageism takes on our older loved one’s self-concept and esteem. In the past, we’ve discussed the emotional impact aging has on a person; the loss of various physical abilities, cognitive decline, depression, isolation, and numerous other changes can chip away at even the healthiest self-image. Ageism compounds these problems by socially reinforcing the idea that growing old is a terrible experience, rather than one that is as rewarding as it is challenging. Older people have been conditioned since childhood to view aging as an unfortunate consequence of survival, or as a sort of “half” existence that shakily straddles the fence between life and death.

Those of us who have older loved ones know that the reality is far different. While the elderly often find participating in communal activities and staying engaged a bit more challenging than their younger counterparts, many older individuals continue to lead active lives. They volunteer their time and talents, attend church services and classes, join clubs, eat meals with friends, support the arts, watch sporting events, and continue to pursue their favorite hobbies. When our society callously reduces the vibrant, active seniors we know and love to a pastiche of cruel and cartoonish stereotypes, it attacks their right to enjoy their later years. They have been bombarded their whole lives with unflattering portrayals of aging, and have internalized the notion that their bodies are broken and useless, and their lives no longer have value. This negative self-perception is bad enough on its own, but when it leads older individuals to believe that certain serious symptoms and pains are simply a normal part of aging, they may not report them to their primary physician, putting their lives in jeopardy. Additionally, if an older individual has a low opinion of themselves, it can put them at greater risk of mortality when battling illness and recovering from surgery; a positive self-image plays a pivotal role in a senior’s physical health and stamina, and therefore, it is imperative to foster and nurture our older loved one’s self-esteem. There is even evidence to suggest that the more optimistic an older individual is about aging, the healthier and younger they feel.

So what can we do to combat ageism?

Because ageism is so entrenched in our culture and will likely take quite a while to even partially eradicate, the changes we can make will have to be on a smaller scale. Start with yourself; treat older individuals you encounter with respect, and notice when you make snap judgments about their functioning based on their age or how frail they appear. Avoid making assumptions about their level of comprehension, and do not talk down to them or behave in a condescending way. Some seniors genuinely may need you to speak loudly or repeat yourself, but do not do so unless prompted by an older person. Refrain from making disparaging comments about old age, and approach your own aging with optimism and energy. Speak up if you witness hostility or blatant discrimination towards an older individual.

If you hear your older loved one making negative comments about themselves or putting themselves down over their advanced age, remind them of all the good aspects of their lives. Aging can be frustrating physically, socially, and emotionally, and even the most self-assured person is subjected to bouts of hopelessness and anger at the changes it brings. As their loved ones, we should be encouraging and empathetic in these difficult moments; we should do whatever we can to focus our older loved ones’ energies in a more positive direction. If you notice that they are down or in despair for a prolonged period of time, talk with them about speaking to a licensed counselor. Kind words are not always enough to end deeply internalized ageism, but our support for the elderly and efforts to monitor our own thinking can bring meaningful changes to our society’s current view of aging.

By Meredith Kimple

Many older people find it difficult to get an adequate amount of sleep at night. In a previous post, we explored some of the reasons for this change; an older person’s circadian rhythm (sleep-wake cycle) may be disrupted, they may wake frequently to urinate, or they may not receive enough exposure to sunlight during the day. While elderly insomnia is certainly not an uncommon occurrence, we should never dismiss this condition as “normal” or “inevitable.” Sleep impacts our overall health, and there are steps we can and should take to ensure our older loved ones are getting enough rest during the night.

But what about our older loved ones who live with Alzheimer’s disease?

Alzheimer’s can have a significant impact on a person’s ability to sleep well, due in part to a condition known as “sundowning.” Sundowning often occurs in the late afternoon and early evening, when the sun begins to set; when sundowning, a person with middle or moderately advanced stage Alzheimer’s tends to become more restless, agitated, aggressive, and confused. They may experience intense mood swings, pace aimlessly around the house, accuse family members and friends of being “imposters,” or convey a general sense of suspicion towards their surroundings.

Caring for a loved one who is exhibiting sundowning behaviors can prove challenging in and of itself, but when their agitated state prevents them from sleeping at night, it can take a considerable toll on our own health and peace of mind as their caregivers. Not only does sundowning exacerbate restlessness and disturb a person’s sleep-wake cycles, but sleep troubles can also, in turn, lead to and worsen sundowning behaviors. You might say that, to an extent, sleep issues and sundowning are two interconnected problems; though it goes without saying that there is no all-in-one solution to these complications, there is the possibility that in minimizing our loved ones’ discomfort and helping them sleep better, we might at least improve their quality of life.

The following are just a few ways we can combat sundowning restlessness and other factors that inhibit sleep.

1. Create a Schedule

Frequently, sundowning is a reaction to new or unexpected stimuli, like unfamiliar places, activities, or things. For our older loved ones who have Alzheimer’s disease, there is a great deal of comfort in what is familiar; making a schedule and helping them stick to it will establish a sense of order and routine in their ever-changing lives. Having a set time for sleeping and rising may help them grow accustomed to sleeping at night and gradually recalibrate their shifted sleep cycles.

2. Shorter Naps

Many people with Alzheimer’s will sleep for a considerable portion of their daytime hours, in the form of long, unplanned naps. While naps are not bad, they can interfere with our loved ones’ sleep cycles; the more they sleep during the day, the more trouble they may have sleeping at night. If they are tired from exercising or the physical strain of moving, they can still take naps, but these should be limited to about 30 minutes at most.

3. Let There Be Light

Light is a very important component in our sleep cycles; the presence or absence of light signals to our biological clock that we should be awake during the day and asleep at night. Keeping the house light and bright from the moment they wake up and dimming the lights closer to their bed time can help to gradually adjust our loved ones’ circadian rhythm (their sleep-wake cycle). Light also helps when our loved ones are displaying sundowning behaviors; darkness and shadows can sometimes agitate, scare, or disorient them, so keeping the house bright in the early evening may somewhat alleviate their symptoms. At night, keep their bedroom partially lit, either with a dimmer, a lamp, or a few nightlights; this will keep them from panicking if they wake in the middle of the night and become disoriented in the darkness.

4. Make Healthy Choices

As with many of the topics we discuss on this blog, exercise and a nutritious diet are a great place to start when we want to improve our older loved ones’ health. Light exercise, like a short walk down the street, dancing to music, or swimming early in the day can help keep them active and awake; because it will tire them out, they may find falling and staying asleep at night an easier task. Sugar, caffeine, alcohol, and large meals should be limited, particularly before our older loved ones go to bed, as they can lead to nighttime restlessness and agitation.

5. A Comfortable Environment

Make sure your loved one’s sleeping environment is cool, quiet, and comfortable. If you keep the temperature too warm or too cold, they might find it difficult to fall asleep. If they like to fall asleep to the sounds from the television, quietly enter their room and turn it off before you go to bed; the bright lights and loud noises may make it difficult for them to stay asleep. Keep precious and sentimental items close by, and surround them with their favorite things to put them at ease.

These are simply a few suggestions, but the solution to your older loved one’s sleep difficulties and sundowning may not be so straightforward. Sometimes, restlessness and poor sleep at night are caused by other medical conditions, such as sleep apnea or a urinary tract infection. Do not hesitate to speak with your loved one’s doctor about their sleep troubles, because there may be something else going on for which an effective treatment option might be available.

While coping with the stress of caring for our loved ones who have Alzheimer’s, it may feel as though we as their caregivers are helpless. Not only in watching them struggle, exhausted, through day after day of disheartening losses, but in our own fatigue and anxiety as we try to give them the very best care. Helping our loved ones sleep will also help us sleep, and this will enable us to better provide them with the attention and love they need.

By Meredith Kimple

When an older loved one is diagnosed with dementia or Alzheimer’s disease, we must prepare ourselves for a thousand changes. Among the many difficult adjustments we make to preserve a sense of normalcy, perhaps one of the most challenging is finding engaging activities for our loved ones.

Your parents and grandparents may once have enjoyed playing instruments, watching movies, reading novels, solving crossword puzzles, cooking, or dancing. However, cognitive impairment often renders these and other activities either too difficult or entirely impossible; tasks that require concentration, coordination, and memory may become a source of frustration and confusion rather than enjoyment.

While we all want our older loved ones to participate actively in the world around them, finding such opportunities isn’t always an easy undertaking. For those of us who care for someone with Alzheimer’s or dementia, it can be extraordinarily difficult to balance the demands of daily life with supervising and entertaining our loved ones. Activities that they once enjoyed, the activities that we first attempt, may no longer provide them with a sense of fulfillment.

Whether you’re facing this challenge for the first time or are convinced you’ve tried everything, hopefully the following list will give you some fresh ideas.

1. Household Chores

While many of us would agree that household chores don’t exactly scream “fun”, they can provide our loved ones with a genuine sense of accomplishment. When we ask our parents or grandparents to assist us with these daily responsibilities, we give them an opportunity for active participation in their environment. Being allowed to contribute can make them feel useful and necessary, and this does wonders for their self-image. The trick is finding tasks that are easy enough for them to complete, which will depend largely upon the severity of your older loved one’s cognitive impairment. Watering the plants, setting the table at meal times, collecting the dirty dishes, polishing silverware, dusting, sweeping, and making their bed are just a few examples of tasks that are simple and straightforward; you may have to help them complete these assignments, or even “re-do” them, but the important thing is that your older loved one feels included.

2. Organization

One popular activity for those who have dementia or Alzheimer’s disease is the sorting and organization of various objects. Give them a box filled with different colored beads, miscellaneous buttons, or coins; have them sort these items into groups based on similarity. This activity not only offers them a clear, specific objective, but also engagement with colors and textures that stimulate the senses, which can help to keep them interested for a prolonged period of time. You can also have them organize mismatched pairs of socks, or have them help you sort papers and old photos.

3. Food Preparation

Depending on the degree of their cognitive impairment, your loved one may be able to prepare simple dishes with your help and supervision. For their safety, do not let them use a knife, the stove, or the oven by themselves; there are plenty of recipes that do not require the use of these appliances, but you will have to help them measure, cut, and cook. If you don’t have the time for them to assist you with meals, or you are concerned about their cleanliness, assign them responsibility for preparing their own afternoon snacks. Peanut butter on celery or crackers, pre-sliced veggies and dip, and instant pudding mix are all easy and safe to prepare.

4. Arts and Crafts

Painting, knitting, scrapbooking, decorating ornaments, and other crafts are an excellent way for our older loved ones to express themselves. If they are not interested in creating their own art, coloring books are a great alternative; they don’t have to come up with an idea for the picture, but they can color the printed image however they’d like. These activities can be performed alone or with the whole family, so they’re incredibly versatile.

5. Music

Music not only stimulates the mind, but also brings old memories to life. If your older loved one used to play an instrument or simply loves listening to music, putting on a favorite CD or the radio can provide hours of relaxation. While you can certainly play music that has lyrics, classical or instrumental music may be the more relaxing option, since there are no words for them to follow.

6. Images

It’s difficult to see our bookworm loved ones struggle to finish novels; being unable to follow or remember the details of a story may make reading a frustrating task. Instead, provide them with books of photos that pertain to an old interest or a favorite place; there are plenty of subjects to choose from, including kittens, Renaissance paintings, and the Irish landscape. If they remember family, or even if they don’t, you can give them family photo albums to look through. Magazines and catalogs with plenty of pictures are also a great choice.

7. Videos

While you probably do not have the time to sit and watch television with your senior loved one all day, taking an hour or half an hour to spend with them may make this solitary activity more fun. Sitcoms, game shows, and nature documentaries do not rely on a plot or complicated story, so these may be better options. Old home movies are another great way to relive memories; your senior loved one may not remember everyone or everything they see, but they’ll still enjoy watching these filmed moments (especially cute baby videos). If you see a funny YouTube or Facebook video, share it with them! They may not understand what is happening, but the important thing is that you make an effort to include them in something you enjoyed.

8. Outings

Sometimes, the best thing is just to get out of the house and go do something fun! Bring your older loved one with you to run errands, like grocery shopping or picking the kids up from their various activities. If you have the time, take them window-shopping; smell candles and soap, touch interesting fabrics, and admire sparkly jewelry. Stores provide a lot of interesting sights and textures, and walking around from aisle to aisle gets in a bit of exercise too! Visit botanical gardens, the planetarium, or have a picnic in the park.

Finding fulfilling activities for our cognitively impaired loved ones is no simple task. We may find that at first they love one activity, only to watch them grow disinterested as they experience further cognitive decline; or, like most of us, they still crave variety. Through the unsettling changes that Alzheimer’s disease and dementia bring, one of the most important things we can do is to reinforce our older loved ones’ comfort and sense of self-worth. It is beyond painful to watch the people we love standing in a confused daze, bored, isolated, and at a complete loss for how to spend the hours we race through; there is a sense that they have infinite time, and nothing to fill it.

As challenging as finding ways to include them can be, leaving them lost and detached from their surroundings is twice as difficult. We should strive to provide them with plenty of opportunities through which to interact with the world, and to feel a sense of pride in their accomplishments. When they complete or contribute to a task, no matter how small, we should cheer for them, and cheer loudly.

In the mad scramble for normalcy, we tend to forget that “normalcy” is itself merely a series of adjustments. Instead of futilely wishing for things to remain the same, let’s focus on giving our older loved ones a sense of belonging, through every adjustment.

By Meredith Kimple

Stroke affects more than 700,000 people in the United States each year. It is currently the fifth leading cause of death, killing more than 130,000 annually, and is the leading cause of adult disability. While strokes can happen at any age, they are most prevalent among the elderly. Despite our society’s awareness of the prevalence of stroke, we may not know how best to help our senior loved ones prevent or recover from such life-altering attacks.

What causes a stroke?

A stroke occurs when blood is unable to reach an area of the brain. Deprived of the necessary oxygen, the brain cells in the affected region begin to die, resulting in various degrees of brain damage or, in a worst-case scenario, death. Though not all stroke survivors are crippled by their accident, an estimated 2/3 of survivors are left with some sort of disability.

There are two types of stroke. The first, Ischemic Stroke, is the more prominent of the two (approximately 80% of cases) and has a greater impact on the elderly. Ischemic Stroke occurs when a clot blocks the blood flow to a certain area of the brain; these clots may originate in the brain or, in some cases, they travel to the brain from a different part of the body. The second type, Hemorrhagic Stroke, occurs when a blood vessel bursts or leaks; this excess of blood places immense pressure on the brain, depriving certain areas of oxygen. Though not nearly as common as Ischemic Stroke, Hemorrhagic Stroke is more likely to prove fatal.

Stroke’s prevalence among older individuals depends upon several factors. Perhaps the most likely explanation is that the longer we live, the more chronic health conditions we acquire. For instance, diabetes, high blood pressure, heart disease, cardiovascular problems, and high cholesterol can all increase a person’s risk of having a stroke. However, certain aspects of an older person’s lifestyle can also contribute to their risk of stroke; a poor diet often exacerbates the aforementioned health conditions and, coupled with a lack of physical activity, can lead to weight gain. Many older people find exercise extremely difficult, making them more likely to live a sedentary life.

Given these conditions, we might mistakenly assume that there is little that can be done to prevent stroke in our older loved ones. While there is no foolproof method by which we can entirely protect them from stroke, there are steps we can take to help them lower their risk.

1. Encourage Healthy Eating

Your senior loved one may find grocery shopping and food preparation physically difficult, time-consuming, and expensive. Instead of eating a balanced diet full of fresh fruits and vegetables, they may choose quick, instant options like microwave meals or fast food. Help them come up with a plan; you could help them find simple, healthy recipes, assist them in making their grocery list and doing the shopping, or brainstorm new ways to make food prep easier.

2. Get Them Moving

In previous blog posts, we’ve addressed the challenges seniors face when it comes to regular, effective exercise. Physical limitations can force older people into a sedentary life, which in turn increases their risk of developing severe health problems. Talk to your senior loved one about seeing a physical therapist, who will help them devise an exercise regimen that is tailored to their needs. You can also suggest more gentle forms of exercise, like Tai Chi and swimming.

3. Reduce Smoking and Alcohol Consumption

Both smoking and excessive alcohol consumption increase a person’s risk of stroke. If your senior loved one frequently smokes or drinks, voice your concerns to their regular physician. A doctor may be able to have that difficult conversation with them, relieving you of the burden; the advice of a professional may seem less judgmental and prove more effective in the long-term.

4. Manage Other Health Conditions

Make sure that your senior loved one is taking their medication. Diabetes, high blood pressure, high cholesterol, and heart disease all require careful monitoring; life can be busy and overwhelming, and our senior loved ones may forget to test their blood glucose levels or check their blood pressure. They may view such necessary maintenance as a hassle, or find the process too involved. If you notice or strongly suspect that they are neglecting their health, consciously or unconsciously, do not hesitate to make your concerns known.

These are just a few of the steps we can take to lower our senior loved ones’ risk of having a stroke. However, if your senior loved one does have a stroke, knowing the signs and symptoms is of the utmost importance. The following commonly precede a stroke event:

• Numbness in the face, arm, or leg, usually on one side of the body.
• Sudden changes in eyesight, including blurred and blackened vision.
• Difficulty speaking, particularly slurring words.
• Confusion and difficulty understanding.
• Sudden, severe headaches, vomiting and / or dizziness.
• Difficulty walking, impaired movement and loss of balance.

It goes without saying that when a stroke occurs, time is of the essence. The longer the affected area of the brain is deprived of oxygen, the more damage is done. Recovery is possible, but it can be extremely difficult, particularly on the elderly. If you notice any of the symptoms listed above, do not take any chances; caution is always prudent, and in the case of a stroke, it can mean all the difference in the severity of their injury. It can mean the difference between life and death.

Stroke is sometimes, though not always, fatal. Survival is often accompanied by significant physical and cognitive changes; depending on which area of the brain was affected, a person may now struggle with speech impairment, limited motor function, or the loss of certain senses. Recovery is a slow, strenuous process of adjustments and, of course, frustrations. As their loved ones, we can and should provide them with all the love and support they need as they adapt to these enormous changes.

Though we have no way to guard our older loved ones from stroke, it should comfort us to know that there are actions we can take to improve their overall health that will also lessen their risk. We must recognize that a healthy lifestyle is often more than a simple matter of choice; living healthily is far more complicated for the elderly, but we can help them by providing the resources and encouragement necessary to transform a seemingly unattainable ideal into an accessible reality.

By Meredith Kimple

We have all fallen at one time or another.

Whether we trip on the edge of a rug or an uneven walkway, slip on a wet floor or a patch of black ice, a fall always ends in a combination of shock, pain, and humiliation (particularly if other people witness it). Mid-fall, we are suddenly aware that there are limits to our bodily control; but standing up after the incident, bruised and a bit shaken, we dismiss that feeling of temporary vulnerability until we experience our next mishap.

That is, if we’re younger and physically fit. For the elderly, the impact of a fall extends beyond the event itself.

It is estimated that more than one out of four adults over the age of 65 falls each year, and that is based only on falls that have been reported. Falling not only takes a critical toll on an elderly person’s body, it can also increase their hospital visits, medical expenses, and do irreparable damage to their confidence.

Why are the elderly at greater risk of falling?

There are several factors that contribute to an older person’s increased risk of falling, including:

• Balance and Motor Impairments

Age-related physical changes may affect an older person’s gait and ability to balance. A lack of exercise, muscle weakness, arthritis, and other medical conditions can also leave older people highly susceptible to falls.

• Vision

Poor eyesight, an outdated eyeglasses prescription, as well as glaucoma and changes in depth perception, can all increase the likelihood of a fall.

• Wrong Footwear

Wearing shoes that are impractical and / or uncomfortable can sabotage an older person’s sense of balance. Slippers, flip-flops, high heels, and smooth-soled shoes provide little traction and support, making walking twice as difficult and falls twice as likely.

• Medications

Certain medications may cause confusion, unsteadiness and dizziness, all of which can lead to falls. Taking four or more medications also increases an older person’s risk of falling.

These are not the only risk factors, but they are a few of the more prominent ones. Other health conditions, sudden drops in blood pressure, poor diet, and advanced age can influence an older person’s stability while moving.

Because approximately six out of every ten falls occurs in the home, we may be especially concerned for our senior loved ones who live alone. If they fall and are unable to get up or access their phone, they could remain hurt and helpless for a prolonged period of time.

The following are a few of the steps we can take to help our senior loved ones minimize their risk of falling.

1. Adapt the Home

Since the majority of falls happen within the home, making the necessary modifications to your senior loved one’s living space is very important. Installing handrails (particularly in the bathroom and on the stairs), removing clutter and wires that might be tripped over, securing rugs to the floor, and improving lighting are just some of the changes that can be made to lower an older person’s risk of falling. Mobility aids, like a walker or a wheelchair, may be helpful for moving within the home and out in public.

2. Exercise

Though an older person who struggles to maintain their balance may not be able to engage in vigorous physical activity, there are certain gentle exercises that can help improve motor function, like Tai Chi and swimming. Tai Chi in particular provides seniors with a stronger awareness of their bodies, which can reduce their fear of falling, restore their confidence, and improve their balance. If these physical activities are too difficult or strenuous, a physical therapist can help your senior loved one develop an exercise regimen that is tailored to their abilities.

3. Consult A Medical Provider

Encourage your senior loved one to report any falls to their doctor. Falling may be an indication of a new health problem, or it could be caused by one or more medications; keeping their doctor informed will help ensure the best decisions are made for their health. Their physician can also assess their fall risk and provide additional ideas for minimizing it.

Falling at an advanced age is more than a little painful or embarrassing; one out of five falls results in serious injury, and once an older person has one, their chance of having another increases significantly. A fall can lead to broken bones, hip fractures, head injuries, a decline in overall health, and, not surprisingly, a crippling fear of falling. If you notice your older loved one suddenly uses furniture or walls to maintain their balance when walking, or if they mention that they fell recently, encourage them to discuss these developments with their doctor.

Instability significantly undermines an older person’s sense of control over their own body, so as their family and friends, we should be there to provide reassurance, suggestions, and a listening ear.

By Meredith Kimple

In a previous blog post, we discussed the importance of monitoring and supporting our older loved ones’ emotional health. Depression is more prevalent in the elderly population than we might think, and yet, it is frequently overshadowed and unconsciously dismissed in the face of more prominent physical and cognitive illnesses. Without undermining the enormous impact diseases like Alzheimer’s and cancer have on an older body, I would like to once again emphasize the importance of, and acknowledge the challenge in, promoting senior mental health.

We all have our fair share of worries. Giving a presentation in front of an assembly, paying our children’s college tuition bills, watching the Heels play Duke, mulling over the state of the world – any of these things can cause us to break into a sweat. Though very unpleasant, worrying is perfectly normal, and in fact, fear can prove to be a powerful motivator when it comes to thoroughly preparing for the future.

But there’s a big difference between the occasional worry and an anxiety disorder.

An individual who has an anxiety disorder lives in a state of excessive, prolonged anxiety, to such an extent that it impedes their ability to function. Though they tend to appear most strongly in the years between adolescence and middle adulthood, anxiety disorders can develop at any time.

It is estimated that anxiety disorders affect about 15% of older adults every year. In the past, research seemed to indicate a decline in anxiety disorders with age, but in recent years, there has been greater recognition of the condition’s occurrence in the elderly.

So what causes anxiety disorders in older people?

There are several factors that can leave our older loved ones susceptible to an anxiety disorder. Though the majority of older people who have an anxiety disorder have had it since their youth, certain aspects of the aging process can worsen or even cause this condition. Many of the illnesses and diseases that affect the elderly population, like heart disease and diabetes, can aggravate an anxiety disorder; even some medications can cause older adults to experience chronic anxiety.

Anxiety disorders frequently occur alongside other psychiatric illnesses, particularly depression. As they age, seniors undergo countless physical changes, suffer the loss of friends and family, sacrifice their independence, and experience feelings of loneliness and uncertainty. These events and adjustments are emotionally taxing, leaving many older people vulnerable to both depression and anxiety.

While anxiety disorders are not fatal, they can exacerbate other physical and psychiatric illnesses, increasing the likelihood of hospitalization and decline. Compromised mental health can, at its best, lower an older adult’s quality of life and harm their self-confidence.

Anxiety disorders can be difficult to spot in older individuals, in part because seniors are often reluctant to vocalize their symptoms. This may come either from ignorance or from a fear of being labeled “mentally ill”; for centuries, mental illness has been unfairly stigmatized, and your older loved one may be afraid to admit their anxiety, even if they suspect they are suffering from that condition.

To further complicate matters, other medical conditions may mask the usual physical symptoms of anxiety; headaches, muscle tension, and pain can be misidentified as part of a pre-existing problem. Cognitive impairment can make identification all the more difficult; a person with Alzheimer’s disease or dementia may exhibit behaviors that could easily be mistaken for the symptoms of an anxiety disorder, and they may be unable to communicate or understand their feelings.

As their loved ones, how can we determine if they actually have an anxiety disorder?

Different disorders present different symptoms, but Generalized Anxiety Disorder (GAD) is the dominant variation among older adults. If your senior loved one has trouble sleeping, is restless, tired, and tense, and has spent at least six months worrying about everything from their relationships to their finances, they might have GAD. It is important to note that these behaviors must impede their normal day-to-day functioning, and their worrying must be uncontrollable. Things happen that cause all of us to worry, but an individual with an anxiety disorder experiences excessive, often irrational worry for a prolonged period of time.

If you suspect that a senior loved one is suffering from an anxiety disorder, it is very important that you act as soon as possible. First, try talking with them about any recent changes in their lives, and ask them about their feelings; having your support may help them to honestly share their concerns with you. However, they may be more willing to speak to a doctor they know and trust. Calling your older loved one’s primary physician can help to rule out other health issues; as mentioned above, anxiety can be aggravated by certain diseases, conditions, and medications. Anxiety disorders are treatable, both with medication and cognitive behavioral therapy.

Crippling anxiety may not be life-threatening in and of itself, but it can keep our older loved ones from living their lives to the fullest. Fear is powerful, and it is, above all, incredibly isolating. Age brings a plethora of rich experiences, some of which are wonderful and uplifting, and some of which serve to reinforce negative thought patterns. If there is nothing to counter these doubts and fears, our loved ones are in danger of losing their resolve to live and participate actively in the world around them.

You might think that at the end of our lives, many of our daily worries would abate. But the lives of our senior loved ones are often far from carefree, and they may have fewer coping strategies. Anxiety disorders cannot be managed without professional intervention, and we must be there to encourage them to seek help. In supporting and caring for their mental health, we are bolstering both their physical wellness and self-esteem through times of tremendous change.

By Meredith Kimple

Often when we consider the health issues that plague the elderly population, we tend to think of those that are strongly associated with advanced age, like dementia or heart disease. However, there are certain problems that, because of their seeming prevalence across all age groups, might be overlooked or underestimated when they occur in an older person.

One such problem is the urinary tract infection, or UTI.

Urinary tract infections are painful at any age, but for our senior loved ones, they can be particularly difficult and dangerous. A UTI is, generally, any infection in the urinary system, and while it typically begins in the urethra and bladder, it can spread to the kidneys if it goes untreated. The primary cause is the spread of gastrointestinal bacteria from the anus to the urethra; because the anus and urethra are in much closer proximity on the female body, it is estimated that 40 to 60% of women develop a UTI in their lifetime.

Older individuals are also especially susceptible to UTIs. There are several reasons for this, including:

• Urine Retention.

Compared to younger individuals, the elderly tend to have weaker bladder muscles, making it difficult for them to empty their bladders completely. Bladder prolapse and certain medications can also lead to urine retention.

Incontinence, coupled with an older person’s inability to clean themselves thoroughly, increases the likelihood that bacteria will enter the urethra.

• Health Conditions.

Certain pre-existing health conditions, like diabetes or kidney stones, increase a senior’s chances of getting a UTI. A weakened immune system and poor hygiene can also substantially increase their risk.

• Decreased Estrogen (Women).

Post-menopause, a decrease in estrogen level can allow for the cultivation of bacteria in the vagina and urethra, which in turn can cause infection.

To further complicate matters, the typical symptoms of a urinary tract infection do not always appear in older individuals. Rather than painful, frequent urination, pelvic pain, and fever, they may exhibit changes in their mental state and behavior. UTI symptoms in the elderly are often misconstrued as the onset of dementia or Alzheimer’s disease, and include behavioral changes, confusion, heightened irritation, falling, and dizziness.

A urinary tract infection brings pain and discomfort regardless of age, but for our senior loved ones, it poses greater danger. If a UTI is left untreated for a prolonged period of time, there is a significant risk that the infection will spread to the kidneys or the bloodstream, which can ultimately lead to organ failure and death. This is especially problematic if an older person has dementia or Alzheimer’s disease, as the behavioral and mental changes a UTI brings may be more difficult to detect.

How can we, as their friends and family, help our senior loved ones protect against a urinary tract infection?

1. Encourage Good Hygiene

In a previous blog post we discussed the importance of helping our older relatives maintain good hygiene. Making sure that they can comfortably bathe and clean their privates properly is one way to ensure that they are not spreading harmful bacteria to their urethra.

2. Ensure Regular Water Intake

Drinking plenty of water throughout the day helps to keep urine clear, and prevents the accumulation of bacteria in the bladder.

3. Maintain a Bathroom Schedule

Using the bathroom as soon as they feel the urge to urinate will help ensure that they are emptying their bladders as much as possible. If feasible, monitor the frequency of their bathroom visits and remind them to use it if they go several hours without a trip.

If your senior loved one is at a higher risk of developing a urinary tract infection, then preventative efforts may not be sufficient. Luckily, UTIs can be easily treated with antibiotics when caught early; this is why it is of the utmost importance that we remain vigilant for any of the warning signs. If you notice a sudden and alarming mental or behavioral change in an older loved one, suggest that they see their physician to rule out infection.

Because the symptoms of a urinary tract infection present differently in the elderly, we should educate our older loved ones so that they know what to watch for and can take the proper precautions. If they have a cognitive impairment, they may require more active observation, either from you or their caregiver; they may have difficulty communicating and recognizing their own symptoms, so if you suspect a UTI, it is better to err on the side of caution.

As we age, our immune systems weaken, leaving us especially vulnerable to infection. Though UTIs are certainly not unique to the elderly strata of the population, they should be taken seriously when they occur; though they are not life threatening in and of themselves, urinary tract infections pose a significant risk of death if left untreated. Our senior loved ones cannot easily withstand the strain a major infection inflicts on an older body; it would be a mistake to underestimate the impact a UTI can have beyond the urinary system. Though we may not be able to prevent them, having a grasp of the symptoms and communicating these concerns to our older loved ones can only help to protect the quality of their health.

By Meredith Kimple

Our sense of smell is something we rarely think about until we’re greeted by a particularly nice, or particularly nasty, scent. The olfactory sensory cells in our noses enable us to appreciate the colorful aromas of the world around us; without them, we could enjoy neither the gentle fragrance of a spring flower, nor the familiar taste of our favorite meal. The ability to detect odor is a gift that many of us assume we will always have, but as with hearing loss, the aging process can alter even our most basic capabilities.

Presbyosmia, or age-related loss of smell, occurs in approximately 60% of adults over the age of 80. There are several theories as to the role the aging process plays in olfactory impairment:

1. Changes to the Olfactory Bulb

The olfactory bulb is an organ located in the forebrain that processes smell. There is evidence that as a person ages, the fibers and receptors that inform the bulb are significantly decreased.

2. Loss of Sensory Cells

Aging seems to impede an individual’s ability to replace depleted olfactory sensory cells.

3. Health Conditions

Certain health conditions that are prevalent among the elderly population, including Alzheimer’s disease, dental problems, and even some medications can inhibit an older person’s sense of smell.

We would all agree that being unable to detect scent is far from ideal, but we might not be aware of the extent to which an impaired sense of smell can negatively impact an older person’s life. There are numerous medical problems that appear with age, and these more glaring issues can eclipse less conspicuous ailments. You can live without the ability to smell the world around you, but this does not mean we should ignore the unique set of dangers such a condition can bring.

An elderly person who has an impaired sense of smell will have trouble determining if perishable foods have gone bad; they may ingest something expired and not realize it until they become sick. Because much of what we perceive to be taste is actually smell, food loses a lot of its flavor when one’s olfactory system is compromised. To combat blandness, an older person may add too much salt or sugar to their meals, which, over a prolonged period of time, can exacerbate pre-existing health problems like high blood pressure or diabetes. Most concerning of all, an older person with an impaired sense of smell cannot detect odors that could indicate a gas leak or a fire; in a worst-case scenario, a senior could lose their life because they do not perceive the typical warning signs.

Of course, these examples exclude perhaps the most detrimental effect of an impaired sense of smell. Not being able to appreciate the little things in life, like the taste of good food or the scent of the earth after it rains, can lead to depression; smell is strongly connected to memory, and to no longer have such a powerful connection to scents can be disheartening and lonely, to say the least. Not being able to enjoy the world around them with their friends and family can lead to even greater isolation.

A recent study found that there seems to be a compelling association between older women’s social lives and their olfactory function. Researchers examined data collected in 2005 and 2006 by the National Social Life, Health and Aging Project; the 3,000 participants were women between the ages of 57 and 85. They found that individuals whose olfactory abilities were unimpaired tended to be more socially active than their peers who had compromised olfactory function. Though the results are intriguing, researchers have not yet determined the connection between olfactory ability and a woman’s social life.

Despite the study’s lack of conclusiveness, it does illustrate a possible relationship between sense of smell and social isolation. Because an impaired olfactory system can alter the way in which older people experience and interact with the world around them, it is perhaps not a stretch to suggest that the inability to smell increases their feelings of alienation.

If you are concerned that your senior loved one has lost the ability to smell, encourage them to speak to their doctor. While there is no cure for age-related loss of smell, we can help our loved ones adapt their lives. Counseling with a licensed professional can aid our older relatives and friends in coping with the emotional weight of an impaired sense of smell.

While there are more concerning ailments to watch for when it comes to our senior loved one’s health, we should never write off any changes their bodies undergo during the aging process. Just because they can survive with an impaired sense of smell, doesn’t mean that they should have to cope with it alone. Though certainly not fatal in and of itself, a compromised olfactory system can lead to dangerous situations. We must not make the mistake of thinking that an advanced age brings with it an unconditional resignation to a lesser quality of life; there may not be anything we can do to return what they’ve lost, but we can be there to offer our love and support. Our older loved ones deserve reassurance that what they are experiencing, while incredibly difficult, is normal, and that they are still relevant and appreciated.

“Stop and smell the roses,” we’re told.

But there is more than one way to enjoy a rose.

Stopping to experience the seemingly frivolous, beautifully humble things around us is always possible, no matter our limitations.