Smart Senior

Senior Health and Fitness: Walking Safely After Dark

Walking is a good exercise.  Many walkers find walking a dog both motivating and gratifying.  If you walk your dog two or three times a day it becomes a routine.  Actually, anything that you do more than once (or even just once) becomes a routine to a dog.  This means putting on your walking shoes and heading out the door morning and night.

I am always pleased when I read newspaper articles about walking.   This time of the year, it is especially gratifying to read articles that stress safety concerns, especially if you walk after dark.  During fall and winter the pleasant after dinner walk becomes rather unsettling.

 In case you haven’t noticed, it is dark out there.  Visibility is poor.  Drivers can’t see you.  The street lights are not as bright as they should be, and there are an unbelievable number of people out driving after dark.    You probably wonder why they aren’t home having dinner or settling in for the night, I do, but nevertheless they are out there and often driving quite rapidly down quiet residential streets.

Last night, driving home from the gym in the dark, I counted 2 bicyclers, 2 people crossing in the middle of the street, and 8 people walking dogs.  Guess what they all had in common?  They were all wearing dark clothing.  If we didn’t know that the locals were often out there, we might have missed them (or hit them).    Age doesn’t have anything to do with it, but many dog walkers are older people.   I am afraid for them, even though I admit that I am not always as careful as I should be either.   Many of us are guilty of using poor judgment when it comes to our safety when we go out after dark.  

Theresa Goffredo (www.goffredo@heraldnet.com) wrote an article for the Herald about the importance of making yourself visible.  We all know this, but I think we’ve already established that we don’t do it.  The only people I have seen using lights, light reflective materials and reflected tapes are joggers.  Good for them.

Whether you are doing a one mile circuit for exercise or just going to be out for a few minutes is immaterial.  It only takes a second for a pedestrian accident to happen.   What can you do to ensure that your walk will be a safe venture for you and your dog?  The article in the Herald focused on dog walking, but the information is prudent whether you are walking with your dog, a human friend, or alone.  They key is to be visible.

Before you step outside tonight, enjoy a shopping spree at your local sporting good store.   Shop for yourself and for your dog.  Light colored clothing, flashing lights and strips of reflective tape at the very least.   A pet store will have collars with blinking lights or at least one that will reflect light.  Be safe, keep your dog on a short leash and take this walking business seriously. Movement, reflections and dancing bright lights will catch the eye of any driver.  It just makes good sense.

Fall Prevention: "I'm not hurt, but I can't get up!"

First of all I want to thank the ladies who responded to my piece on fall prevention, and were interested enough to ask questions.  I wish I had all of the answers, but I am going through a period of trial and error myself. I am not a physical or occupational therapist, but I am terribly impressed by the work that they do.    I did work as a nurse in a retirement center for many years so I do know that falling is a real concern.  Indeed, what does happen if your knees are bad or you fall somewhere where you can’t get to a chair to pull yourself up? What I can do is help you think this through.    Hopefully we can get other people to share their own fears, concerns, and solutions.

Older people are prone to falls for all sorts of reasons.  The only person who can keep a fall from turning into a catastrophe is you.  You absolutely must entertain the idea that a fall could happen to you, BEFORE it happens.  I did learn when working in long term care that you have the right to fall.  Does that make sense?  What it means is that no one else can prevent you from indulging in risky behaviors.

If you plan on aging in place, especially if you live alone, you need to think about what measures to take to ensure your own safety.   The best ways to reduce risks is to:

• Beginning a regular exercise program to improve strength, balance and coordination.
• Fall proofing your home
• Reviewing your medicines with your doctor and pharmacist to make sure that dizziness, sleepiness or other side effects are not setting you up for a fall.
• Vision and wellness check-ups on a regular basis.

Get down on the floor right now and practice getting up (under supervision).      Read books or watch videos if you don’t know where to start.  The easiest way (now that you are computer savvy) is to type the words “getting up after a fall” into your search engine.  You will find some excellent videos that will walk you through the process.   If you aren’t brave enough to try on your own, take a better balance class at your local hospital or senior center.  If you have difficulties with balance and walking because of poor muscle strength or a chronic illness, you can ask your doctor to refer you to a physical therapist for a one-on-one evaluation.

Basically it is up to you to make sure that you can get up or at least summons help.  Wear a voice of help pendent or keep your cell phone on your person at all times. Write and tell me what you are doing to make sure that a fall does not end life as you know it.

 

Senior Health: What Your Vision Says About You

I like to read.  I have been dubbed legally blind since childhood so I have never taken my eyesight for granted.  I think we all know that as we grow older, we don’t see as well as we used to.  You may be able to get by with reading glasses, brighter lights or by using magnifiers, but don’t take this precious gift for granted. Decreasing vision means that you need to make adjustments.  If you have been lucky enough to enjoy perfect vision for most of your life, it may be difficult to admit that you need help.

What lengths are you willing to go to preserve and enhance your eyesight?  If you haven’t been to an eye doctor in awhile you may be surprised to learn that science and technology have found unimaginable ways to help you out.     But wait, there is more.  In addition to monitoring degrees of visual acuity, your eye doctor is able to pinpoint things that might be happening elsewhere in your body.

Shirley S. Wang (Shirley.want@wsj.com) wrote an interesting article about some of the latest findings in the world of visual care (The Wall Street Journal: Tuesday, August 14, 2012).  Diabetes, autoimmune diseases such as rheumatoid arthritis and lupus, or other impending disasters are often noticed (a clue, so to speak) during routine visual exams.  So, if you are thinking that an eye doctor is just someone who takes measurements and prescribes glasses, it is time to give them the credit they deserve.  Your eye doctor is indeed a member of your health care team.

 What do they mean by regular examinations?  Experts suggest that everyone should have a baseline examination by the time they are 40.  After that people age 40-54 should be seen every 2-4 years, people 55-65 every 1-3 years and those over 65 every 1-2 years.  It makes sense to schedule an eye exam prior to your physical examination.  If anything alarming is pinpointed your primary care physician can do a follow-up.  Never accept a loss of visual acuity as just another sign of aging.  Report any vision changes or injury immediately, but make a point of having regular eye examinations too.

Instead of resigning yourself to the inevitable, think about what you can do to help yourself.  When a problem is identified, look for solutions.  Regular eye care can serve as a way to reduce visual impairments and improve the quality of your life.  It is unfortunate that so many people do not take advantage of eye care solutions. The reasons cited usually have to do with cost, lack of insurance, or simply because people don’t see a need.   Your eye sight and your health are important if you want to live independently.  It is never too late to listen and learn.

 

 

 

Senior Living: Home Safety With Well-placed Lights

A well lighted home is a safer home.   Most people are not resistant to the idea of using motion sensors and timers to deter criminal activity, but they are often oblivious to how important adequate lighting is in the role of fall prevention.

We grew up in a time when power conservation was the norm.  Stumbling around in the dark and making do was a part of our vocabulary.  I can remember being harped at relentless about turning lights off when leaving a room.   When dad announced it was time for “lights out” we were expected to snap to.  Older people are amongst those that take the call to reduce power consumption seriously.   Problems surface when it becomes such an issue that they put themselves at risk.  There are times when a 15 watt bulb will just not cut it.  The chances of falling multiply when conservation efforts work against best interests. 

Bryan D. Vargo wrote a short article for (Arthritis Today: January/February 2011) about increasing home safety through adequate lighting.  One of the topics was motion sensors.  Motion sensors shouldn’t just be for outdoors.  Think of a motion sensor as a way to get light quickly without having to grope for switches.

Flood-style security lights will illuminate large exterior areas quickly, but smaller versions are available to illuminate porches and doorways.  Motion sensor nightlights can be plugged into an outlet or removed and used as a flashlight. Motion sensor nightlights are ideal for bedrooms, hallways, and bathrooms.  Motion lights are also available to use in closets, basements, garages and attics and can detect motion up to 15 feet away.  The idea that these lights are not constantly is use should set well with frugal conservationists.

The need for adequate lighting (more than adequate lighting) goes above and beyond motion sensors.  We all know that aged-related vision loss accompanied by mobility issues can increase the risk of falling.  Older people are prone to reduced visual acuity, restricted fields of vision, sensitivity to glare, change in depth perception, impaired ability to adapt to changes in light levels, and contrast sensitivity.

 I think we can safely assume that you are interested in decreasing your chances of taking a fall.   Experts agree that there are a number of factors to take into consideration:  

• Improved lighting
• Higher light levels
• Even illumination
• Elimination of glare
• Task lighting
• Balanced daylight and electric light
• Combination of direct and indirect lighting
• Gradual change in light levels as when entering and building from outdoors
• Strong grab bars
•  Handrails

You will notice that eight of the ten recommendations had to do with lighting.  If you could only change one thing in your home to improve your safety and well-being it should be the lighting.   Not only has lighting become an integral part of interior design but it should appeal to you on a practical level. 

 

Senior Living: How Important Are Social Connections To You?

 Nearly 2/3 of people over age 75 live alone. Social connections are important at any age, but seniors have fewer opportunities to make social connections than most, and they may not feel comfortable asking for help.    Sensory impairments could very well be part of the problem.  Symptoms of sensory deprivation are gradual and may not be noticed unless you are looking for them.   Social withdrawal could easily be interpreted as memory loss or dementia, when it fact it could be caused by vision or hearing changes.   If your senior is becoming withdrawn and acting depressed it could be that they don’t see or hear what is going on around them. 

Without sensory stimulation an older person might begin to lose mental alertness and responsiveness.  Your parent might want not to admit that they do not see or hear well because it is an admission of old age.  Be vigilant and do not accept poor vision or decreased hearing as normal.   It is okay for you to take the role of a therapist by encouraging them to express how they feel about what is going on in their lives.  If you don’t ask, you will never know.

Adults over 65 should have an eye examination at least every other year and a hearing test every five years unless problems crop up that need to be addressed sooner.

Encourage social stimulation as well.  Dozing in front of the television is not good enough.  Take mom out for lunch at the senior center, do a knitting class together, play cards or go to a movie, and don’t just assume that mom is too old to be introduced to a computer.  Take a computer class at the senior center with her if she is too shy to do it alone.   

An article by Stephanie Clifford (The Globe and Mall: Toronto, Ont.: June 3, 2009) introduces the concept of computer groups and Facebook friends.  More and more seniors find that on-line communication skills are opening a new world to them.  Boredom is problem a problem for seniors who are homebound.

Seniors are faced with many loses. Loss of social connection is even more devastating than the lost of health.  The new future for older adults is staying connected, and technology is going be a big part of that.  It provides new ways to make connections, make new friends, and gives them a sense of purpose.   Via the internet friends can interact without having to ask friends or family members to take them places.  Online communication is a vehicle for making new friends and sharing lives.

Senior Living: Lighting Can Make A Difference

Tired of fumbling around in the dark?  A little automation, when it comes to lighting up your home, adds immeasurably to a sense of security and safety.

Sensor light switches can be used throughout your house.  You can install inexpensive hands-free devices without rewiring your whole house.  The sensor detects movement and turns the lights on automatically when you enter a room.  Does that sound too complicated or too expensive?    Think again.  The lights also turn off automatically when the room isn’t in use.  Think how many gray hairs that would have saved your parents.  Remember how they were always nagging at you to turn the lights off?  The only downside is that if you are sitting still for a long period of time, the sensor may think you have left the room and pitch you into darkness.  If that should happen you must stir and wave your arms around every once in awhile, so much for meditation.

Oh boy, another remote.  Hand held lighting remotes are still the easiest solution.  Wouldn’t you like to be able to control the lights from your chair or from your bed?  The easiest version of this wireless smart remote is available in most home stores.  The receiver plugs into a standard outlet and you just plug your lamp into the receiver to activate it.  You can purchase several if you want to be able to control more than one lamp.

Sight is important to independent living.  Thousands of people with decreased vision sit in the dark, because they just accept poor sight as a part of normal aging.  They might not even consider that better lighting would improve their visual acuity.  Many people do not appreciate the benefits of using good light.

According to Andy Fisher in his article “No light, no sight,” for (The Optician: Sutton: August 13, 2010), light has a significant impact on the visual system.  Older people need more light in order to function well.  It is generally accepted that most people with sight loss, benefit from increased illumination.  Careful assessment and identification of individual lighting needs are important.

Problem Areas to Assess:  Inappropriate and poor light levels.  Different levels of light between rooms and poor distribution of light creates dark areas and shadows. The best way to light a room is to illuminate the ceiling and the tops of the walls so that light reflects around the room without glare.  Lighting technology is rapidly improving.   Energy efficiency is also important and LEDs are the wave of the future.

Speak to your optical practitioner about information specific to your disability.  His/her recommendations will consider:

• The purpose of the light source:  what the person wants to do and where.
• Even levels of light should be installed throughout the house to make it easier for the eyes to adapt as you move from one area to another.
• In the kitchen install small fluorescent lights to illuminate work surfaces. The main kitchen light should be bright with a diffuser cover to decrease glare.
• In the lounge a three-tiered system with a main ceiling light, secondary wall mounted fittings, and free standing task lighting lamps.
• Light sources should illuminate edges of stairs, landings and hallways.
• Pay attention to floor color and contrast (avoid patterned carpets).
• Appropriate shades and diffusers let will let light through but distribute evenly.
• Use task lights to support reading and writing, personal care, cooking, food preparation and other tasks.
• Use security lights on sensors to aid outdoor navigation.

Senior Living: Does Your Home Have Adequate Lighting?

You would not believe the number of older houses that I visit that are bathed in gloom. When we were kids leaving the lights on when we left a room was considered a grievous sin.  I am sure that a lot of our thrifty ideals are carry-overs from those days.   It is hard to break old habits, but being able to see is important to your safety, health and well-being. You aren’t doing yourself or anyone else a favor if you think that pinching pennies and living in a world of darkness is a good idea.  Good lighting really does helps you see and function better.

 

The average person spends 90 percent of their time indoors so it is important to let as much light into your house as possible.   Install abundant lighting and redesign your house to make it airy and filled with light. Fill your house with light by using skylights and have windows everywhere.  Consider updating outdated fixtures with energy-efficient ones.  Use natural daylight to your own advantage and look at how light colored walls, floors, and ceilings reflect more light than dark colors.

 

Did you know that that we need a lot more light as we grow older?  Eye specialists say that we need three times more light in order to see well than we did when we were in our 20s.  We also have a harder time compensating for glare.  

 

You are already aware that when moving from bright to low light levels (like entering a dark foyer on a bright sunny day) that your eyes need time to adjust.  It takes longer for older eyes to adjust.  Adjustable light levels using three-way bulbs or dimmer switches can make it easier to customize lighting to meet your needs. In certain situations, too much glare can make it difficult for you to see.  You can filter bright light using blinds, sheer curtains and shades, while still enjoying the benefits of natural light.

 

 Night lighting plays an important safety role.  It is also wise to use rocker light switches so you aren’t fumbling for light switches in the dark.  Nightlights serve to protect you from night time accidents.  I don’t know about your house but my 100 pound dog likes to sleep in the hallway leading to the kitchen.  For the most part she hears me coming and gets out of the way, but I have tripped over her a time or two.

 

Never underestimate the convenience of hands-free light sensors that turn on a light when you pass through its detection range, or tabletop lamps that you can turn on by simply tapping the base. You can choose from dozens of different kinds of light fixtures depending on if you need a faint glow for walking around purposes to close up task-lighting.  Tall table lamps with light colored shades and a wide bottom shade opening enhances over all-lighting; the shade bottom should be at eyes level when you are sitting.  Pick floor lamps with fluorescent bulbs that direct light toward the ceiling.

 

Lighting is a key design element but also promotes healthy living because you can see and function better.  Configure abundant lighting into your design.  Get the right bulbs.  Research CFLs, recessed lights, task lights, and full spectrum bulbs that filter out yellow light. Let the light shine.

Eye Health: Age Related Vision Problems

 Unfortunately there are no magic bullets to prevent age related visual changes.  Despite heeding dire parental warnings about not reading with a flashlight or not sitting too close to the television, visual changes are going to happen.   Brent Agin, M.D. in “Healthy Aging for Dummies,” reminds us that vision changes are inevitable as we age.  There are no real cures, but modern technology gives us hope and gives us tools to help us compensate.  Some people have good vision well into their 70s and 80s but most people can expect some impairment.

 

You are probably already experiencing some presbyopia. Many jokes have been coined about older people having to hold newspapers at arms length, but I find “funny” reference less humorous as time goes on.  Presbyopia means that you have difficulty reading or performing other tasks that involve things that are near-by.  You will most likely need glasses even if your vision has been perfect up until now.  Eventually you may graduate to bifocals or trifocals, or opt for surgical intervention, but regular visits to your eye doctor are in order.

 

Seeing an eye doctor at regular intervals will help you recognize eye problems early and decrease further damage.  Never ignore visual changes or figure that they are normal signs of aging.  Your eyes are too important.  Beginning at 65 you need to see your eye doctor every 1-2 years unless asked to come in more often.

 

Vision examinations are important as they are closely related to your overall health.  Studies show, as discussed in the October 15, 2009 issue of Ophthalmology Times, that VSP doctors are often the first to detect early symptoms of chronic conditions.  Through the eyes, a doctor can see blood vessels that reveal a lot about what is going on in the body.

 

A number of diseases do cause vision changes.  Never assume that changes in your vision are inevitable and unpreventable until seen by your doctor.  Many diseases can be treated and the damage to your vision can be diminished or halted.  Report any changes in your vision to your doctor immediately.  Take care of your eyes above all things. 

Senior Living: Combating Failing Vision

 

Two of my friends have just had cataract surgery and a third has rapidly progressing macular degeneration.  Despite modern technology the thoughts of deteriorating vision looms large in the life of many seniors.  Make annual visits to your eye doctor a priority, even if you are on a strict budget, because early detection and treatment can keep some disorders at bay.  There are some things that are more important than money and being able to see is one of them.  

 

In many instances people with low or failing vision can still manage very nicely.  Tips included in Elder Care for Dummies by Rachel Zukerman are worth thinking about.   She points out that sometimes it is the little things that can make a difference. Consider painting the woodwork around doorways or painting steps in bright colors to make them stand out and easier to see.

 

You can’t go wrong with extra lights on stairs and in reading areas.  More lamps and increased wattage in the lamps you have may help.  It is a known fact that older people need three times more light than a younger person does.  Evenly distribute the light so your eyes aren’t continually trying to adjust as they shift from one area to the next.  Purchase nightlights that come on automatically at dusk and use them generously throughout the house. 

 

Keep a small flashlight on your person to use when entering a dark theater or a dimly lighted restaurant. This just makes good sense. I find negotiating the stairs in a darkened theater quite scary.  Call for restaurant reservations and request a well lit table.  Leave candle light dining to the young romantics.

 

When it is time for a new television, splurge on a new large screen set with an easy to use remote control.  Invest in magnifying devices for reading.  One of my friends got a second hand reader machine and is delighted that she can do hand work as well as read with it.  Borrow large print books or audios from the library or from The National Library Service for the Blind and Physically Handicapped.  There are many services available for people who are blind or have low vision.  It is amazing how well people can adapt to their losses. You quickly learn that if you are going to continue enjoying life you have to make the most of what you have, even if it means replacing old pleasures with new ones. 

 

 

 

 

Seniors: New Technology for The Bifocal Set

 

Eye conditions, like everything else, will vary from individual to individual as they age.  We won’t all be subject to glaucoma or macular degeneration but we will all experience decreased flexibility of the lenses.  Decreased flexibility means that the eye loses it ability to focus on nearby objects.  This explains why so many people over the age of 45 have succumbed to reading glasses, bifocals, or progressive lens glasses.

 

You may have noticed by now that lenses that combine reading and distance prescriptions require you to tilt your head so that you are looking through the precise area where you need the most clarity.  I was first introduced to bifocals when I was eight in an effort to retard my rapidly progressing near- sightedness.  I didn’t like them then and I don’t like them now.  I had all sorts of trouble with stair steps and curbs and even today I complain because I can’t read or watch television from a recliner or my bed

 

Laura Johannes wrote an article for The Wall Street Journal (March 16, 2010) about a “bridge for the bifocal set” that sounded interesting to be.  A new type of eyeglass called TruFocals (Zoom Focus Eyewear LLC) has been designed so that you can manually focus the lens.  The glasses are made up of two lenses (normal distance prescription on the outside and a flexible plastic lens containing fluid behind it).  It all sounds rather complicated but when the slider is moved to the left, the reading magnification is off and distance vision is on, as it is moved to the right the reading magnification increases.

 

Optometrists, according to the author, give them high reviews but the drawback is that they come in Harry Potter-like frames.  It is ideal solution for home use but if you are looking for a fashion statement this won’t be for you.  However, we know that design stylists won’t be far behind.

 

The adjustability is useful for computer work because you won’t need to bend your head to line up your sweet spot.  These lenses are safer. If you have ever had trouble with stair steps or curbs because of your bifocals you will understand what I mean.  Making the adjustments is a little hard to get used to but an experiences user can soon figure out how to do it with one hand.

 

A more fashion conscious version by PixelOptics Inc. is due out next year with a larger choice of frames.  The newer version will be more like regular progressives but with a switch to make adjustments easier.  I already think that glasses were the best invention ever and I am doubly pleased that researchers are still working on ways to make life more comfortable for us.