Archives October 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.