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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

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

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.

If we each made a list of things we couldn’t live without, we’d probably have a number of entries in common: food, water, our cellphones, our computers, and perhaps, our cars.

Driving enables us to live independently, but for many of us, it is a privilege that we take for granted; when we are no longer able to drive, we become acutely aware of our powerlessness. As we age, our bodies undergo inevitable physical changes, and some of those changes involve visual acuity, reflexes, muscle strength and mobility–all physical attributes that are necessary for safe driving.

Physical Changes

• Hearing loss and vision impairments that result from age can make driving significantly more difficult.
• Pain in the legs, arms, and neck can hinder an older driver from reacting as the situation requires, because their movement may be restricted.
• Some health conditions and the medications used to manage them might impact a senior’s ability to safely drive.

Cognitive Changes

• Elderly people generally have a harder time multi-tasking than younger adults. Because driving involves absorbing and processing a variety of visual stimuli, older people may not be able to concentrate to the degree necessary for quick decision-making on the road;
• Dementia and other cognitive impairments can impede a senior driver’s ability to determine where they are going, as well as their knowledge of driving mechanics.

Whether it’s a change in vision, decrease in mobility, or an inability to concentrate, these age-related impediments can put the lives of older drivers at risk. After the age of 70, fatal crash rates tend to increase. This is not to say that all seniors should stop driving once they reach a certain age; the onset of risk factors for an accident differs among older drivers, and some are still able to drive long after others have had to surrender their keys.

Most seniors do not willingly cease to drive. As new health conditions and limitations become part of their reality, the idea of sacrificing their independence becomes unthinkable. In giving up the ability to move and do as they please, some seniors may suddenly be faced with the belief that they have become “old,” and in the worst sense of the word. They may feel irrelevant or isolated without a car, and their self-esteem may plummet.

Usually, an older person will stop driving either because of an accident that warrants the removal of their license, or as the result of some sort of familial intervention. But how do we start that difficult conversation?

Remember first and foremost that your older loved one’s feelings about driving are valid. You are suggesting that they sacrifice a precious freedom, and although you are absolutely in the right, you have to anticipate and respect their resistance to such a massive change.

Provide them with concrete examples of their dangerous driving: dents in the car, citations, running a red light or stop sign, nearly colliding with other drivers at an intersection. Remind them that not only are they putting their safety at risk when they operate a vehicle, but the safety of other drivers as well.

If they refuse to consider your points, try enlisting the help of their doctor.  A doctor can order tests to determine whether or not your loved one should continue driving, and their recommendations may be taken more seriously. Recruit other family members and your loved one’s close friends to give your appeals more weight; if more than one person thinks they should give up driving, they may have a harder time dismissing your concerns.

To ease their fears, propose alternative transportation options. If you live close by, offer to drive them to appointments and other outings. Help them find a driving service or public transportation. It is vital that they don’t feel cut off from the world; if they live in a rural or suburban area where driving by car is the only way to get around, it might be time to consider moving them to an area where there are more transportation options for them to utilize.

If you help them find a substitute for driving that still provides them with a sense of independence, the transition will be slightly less difficult. But giving up their ability to drive will be a major adjustment, so offer them plenty of support and encourage their desire to be self-sufficient.

The good news is that cars are safer than they used to be, and many older adults take initiative with certain precautions, like not driving at night. As a significant portion of the population ages, we need to find new ways to tackle the problem of compromised driving. Whether there are more frequent and strict tests to determine driving capabilities, or whether it’s something decided among families, we’ll need to develop better procedures for assessing eligibility.

If public transportation is broadened and improved in this country, cars will not be quite as essential to one’s independence. Perhaps as the older generations age we will see these steps taken to fill a widespread need; in the meantime, what we can offer our senior loved ones is support, understanding, and patience.

By Meredith Kimple

One of the first posts I wrote for this blog focused on insomnia in the elderly; an inability to sleep at night is often misunderstood as a normal part of aging. Our senior parents and grandparents who seem to fall asleep any time they sit down, regardless of time or place, are not necessarily tired because they are advanced in age. There are a number of factors that may contribute to their fatigue, ranging from a disrupted circadian rhythm to sleep apnea.

Insomnia is not the first thing that comes to mind when we consider senior health issues, but it can still have a critical impact on an older person’s overall wellness. We might be more likely to associate widespread, well-known conditions with senior health; heart disease, adult-onset diabetes, hearing loss, dementia, and impaired mobility in the elderly may be some that first come to mind.

But how many of us think of depression?

Depression is a medical condition that most of us are familiar with, but despite the great strides we have made in the de-stigmatization of mental illness, the mental health of the elderly may be easy to overlook. That is not meant to imply carelessness on the part of loved ones or caregivers; depression presents differently in seniors than it does in younger individuals, so the symptoms can be more difficult to spot.

Because aging brings with it an abundance of changes in health, ability, and independence, an older person’s depression is often misconstrued as a natural reaction to life’s vicissitudes.

So how can we determine if our senior loved ones are suffering from depression?

The following are some of the more common symptoms:

• Persistent feelings of guilt, worthlessness, and hopelessness
• Strong feelings of anxiety and emptiness
• Loss of interest in favorite activities
• Increased irritability and restlessness
• Difficulty concentrating and making decisions
• Insomnia or oversleeping
• Involuntary weight gain or loss
• Aches, cramps, and physical pains that persist
• Thoughts of suicide or self-harm**

An elderly person dealing with depression may not show all of these symptoms, but if they show any combination from the list for at least two weeks straight, then they should see a doctor. Pay attention to the duration of the symptoms; we all have days where we’re sad, or feel hopeless and empty, but someone who has depression will feel that way for weeks and months at a time.

There are certain factors that increase an older person’s risk of developing depression. For example, women are more likely to have depression than men. Seniors who do not have a significant other are more at risk than those who are married or dating. Those who have a disability, chronic illness, or brain disease are more likely to have depression than an otherwise “healthy” senior. And of course, social isolation and the experience of stressful life events (such as a divorce, or the loss of a spouse) can increase a senior’s risk. A family history of depression should also be considered, as well as prior suicide attempts or episodes of self-harm.

Helping a senior loved one receive the treatment they need may prove challenging, but it is vital that they do for the sake of not only their mental health, but their overall health as well. Depression can have a negative impact on a senior’s ability to rehabilitate after an injury or surgery, and is associated with a greater risk of death from cardiac disease and other chronic illnesses. Mental health is important in its own right, but it has an enormous influence on physical health in that it can determine one’s ability to recover from trauma. Depression can render an elderly person even more vulnerable, so seeking treatment immediately is crucial.

Luckily, depression can be treated using a variety of methods:

1. Use of Antidepressants.

Taking antidepressants is often an effective way to treat depression. Because an older body may take longer to process the medication and cannot handle a high dosage, results will not be instantaneous. It is important that once they start taking an antidepressant, they don’t stop without consulting their doctor; it may take weeks or months for the medication to make a difference, so a lot of patience is required. While this method is usually effective, there are some drawbacks. Certain side effects and the long-term cost may lead to an older patient refusing to take the medication; additionally, interactions with other drugs can impair the effectiveness of the antidepressant.

Talking with a professional can be helpful in treating depression. Psychotherapy can aid the patient in changing their negative thought patterns and habits, as well as helping them work through stressful situations in a healthy way. This method can be as effective as taking antidepressants, and is a good alternative if an older person cannot add another medication to their regimen. Of course, if medication is necessary, supplementing with psychotherapy can strengthen a senior’s treatment plan. Psychotherapy can provide insight into one’s relationships and feelings, as well as coping mechanisms to help with future distress.

3. Alternative, Complementary Therapies.

While they are not a substitute for medical intervention, activities like yoga, daily walking, and other physical exercises may help to relieve some people’s depression. Physical activity can improve one’s mood, and is a great way to focus the mind and body. Their doctor should be consulted before additional exercise is added to their daily routine.

Though depression is common in the elderly population, it often goes undiagnosed. There is still to this day a stigma that accompanies mental illness, and for the older generations this is especially pronounced. They may perceive depression as a weakness, personal failure, or a burden on others; for seniors who are not familiar with the symptoms of the condition or who have never known someone with depression, it may be difficult to acknowledge what they are suffering from, or to acknowledge that they are suffering at all. They may perceive their thoughts and feelings as “normal” and try to carry on through the pain because they don’t want to worry their friends and family.

We must be their support system.

They may not be willing to discuss how they feel with us, but we can let them know that we are there for them. We can encourage them to see a doctor who can start them on an appropriate treatment, and help them keep track of appointments. We can assure them that they are not alone, and that while what they are feeling is not abnormal, they deserve to feel better. Include them in your activities, and help them get involved in classes, exercise groups, or community service.

Let them know that you love them, and often.

Our society is cultivating a greater awareness of the importance of mental health in maintaining a healthy lifestyle, and people are more willing than ever to be candid about their experiences with mental illness. However, depression is still frequently overlooked in the elderly. As their family and friends, we must be vigilant; do not take mentions of self-harm or suicide lightly. Help them pursue treatment, and offer them your support as they begin their healing process.

Depression is not a normal part of aging, but aging brings a host of new challenges that not everyone can easily adjust to. It is of the utmost importance that we help our older loved ones live lives that are emotionally healthy and fulfilling.

Here is a great article by Sam Ferris on Houzz about modifications to the bathroom for seamless transitioning into later years:

https://www.houzz.com/ideabooks/60576589/list/11-ways-to-age-proof-your-bathroom .

Check it out!

Of the many incurable diseases which plague humanity, none may experience so prevalent a rise in a few decades’ time as Alzheimer’s. As those of the “Baby Boomer” generation age, it is estimated that as many as 13 million Americans could develop the disease by 2050; the global escalation of Alzheimer’s and the absence of any concrete treatment is disheartening, to say the least.

But in the last few months Alzheimer’s research has yielded potential methods by which the disease may be reversed.

In June, the exciting findings from a study produced by the Buck Institute for Research on Aging and the UCLA Easton Laboratories for Neurodegenerative Disease Research were published, showing the first objective evidence that Alzheimer’s can be reversed. Ten participants, most in the early stages of the disease, followed a personalized program incorporating dietary changes, sleep improvement, supplement usage, and regular exercise, among other things.

The study was designed to test the hypothesis that Alzheimer’s, like cardiovascular disease and HIV, can benefit from a combination of therapies tailored to the patient and their specific needs. A drug may only treat one aspect of the disease, which would ultimately prove ineffective if, like some researchers believe, Alzheimer’s is the result of a series of molecular interactions and not simply a disease of “toxicity”. Dr. Dale Bredesen, a professor at the Buck Institute and UCLA Easton Laboratories, likens a brain affected by Alzheimer’s to a roof with 36 holes; while medication could patch up one hole, there are 35 other holes that require a combination of various treatments.

Following their personalized programs, nine of the ten participants saw significant improvement, and in some cases, they were able to retain the functions lost in their initial decline. Those who had been forced to quit their jobs because of memory impairment were able to return to work with improved performance.

Though the results of the study are very encouraging, they have not yet been replicated in a larger sample size. While nine out of ten improving is astounding, it is worth noting that the participant who did not improve was in the later stages of the disease. All other participants were either in the very early stages of Alzheimer’s, or in a pre-Alzheimer’s stage; these 36-point therapeutic programs may primarily benefit those who are diagnosed early. Most participants tested positive for the APOE4 allele, which put them at an increased risk of developing the disease; as the majority of Alzheimer’s cases in the United States are caused by APOE4, Dr. Bredesen encourages people to have this same test so that they can begin preventative measures as soon as possible.

And just last month, Tel Aviv University published the results of a study to observe the APOE gene’s role in Alzheimer’s disease. APOE moves lipids in and out of cells, but can appear in one of two forms: the effective APOE3 and the impaired APOE4. Researchers studied the APOE4 gene in mice, and found that its presence led to memory and learning difficulties, as well as damaged synapses in the brain. They then activated ABCA1, an enzyme that can help APOE4 with the transport of lipids through cells; this process reversed the impairment of APOE4 and, amazingly, seemed to reverse the impaired mental faculties of the mice.

While neither of these studies offers us an immediate solution to Alzheimer’s disease, the progress evident in their results are exciting and should give us hope for the future. It goes without saying that Alzheimer’s is extraordinarily complex, and the answer to the disease will be equally so. There is no such thing as an overnight cure, or a wonder drug. There are no foolproof diets or other health programs that can guarantee protection.

But a few decades ago researchers had no idea of the role APOE4 plays in the development of Alzheimer’s. There was no evidence that a multi-therapy approach to the disease could have any impact, let alone lead to a reversal of memory impairments. And these new developments in Alzheimer’s research have only occurred in the last few months; the prognosis of the disease can only improve over time, and by exploring multiple potential methods, the odds that a variety of treatments may be found increase.

In the meantime, all we can do is continue to take care of our bodies to the best of our ability, and ensure that our senior loved ones do the same. There is still so much we don’t understand about Alzheimer’s, and our efforts to eat healthily, keep our minds sharp and bodies fit, may not be enough to prevent development of the disease. But maintaining a healthy lifestyle, making sure we get enough sleep, exercising, and staying positive can only help us as we age.

Contributed by Meredith Kimple