Smart Senior

Senior Living: Slips, Trips and Falls

 

A fall can’t always be blamed on personal health issues.   Have you ever been walking along minding your own business, when for no apparent reason you stumble, slip or trip over something?  Of course there was a reason, but it wasn’t something that grabbed you attention and warned you to be careful.   It could have been a rough patch on a sidewalk, grease or food spilled on the floor, a misplaced throw rug, or maybe you just tripped over your own feet.  Slips, trips and falls happen every day.  You can slip if there isn’t enough traction between your foot and the surface you are walking on.   A water spill, food or grease on the floor, or a loose unanchored mat may be all it takes to land you in the hospital.   A trip is a little different.  Your foot hits against an object that probably shouldn’t have been there in the first place.  It doesn’t take much to cause a momentary loss of balance.   Different words but the same result.   You may laugh and feel dumb for not paying attention but a stumble, a slip, or a fall is not a laughing matter.

Falls that occur from other than medical reasons are lumped under the category of “extrinsic factors.”  Extrinsic factors are the things that affect your ability to move around safely, but don’t have anything to do with your health.  Common culprits are throw rugs, unsecured bath mats, clutter, and poor lighting.  Another common mistake is not having something to grab if you lose your balance.  For example, a shower curtain or a towel bar will not support your weight no matter how reassuring they may seem.

People tend to ignores things that are right in front of their noses.  It is hard to be objective about your own home. It is never a bad idea to have a physical or occupational therapist come to your house to make recommendations.  An outsider can quickly see what you do not, and can recommend quick and inexpensive ways safety proof your home.  It is easier to eliminate these extrinsic risk factors than you might imagine.   Let’s look at a few trouble areas, just so you know what I am talking about. 

• Eliminate doorway thresholds and scatter rugs.  Remove clutter, consider railings along stairways (indoors and out) and have wooden stairs carpeted or fitted with non-skid treads. Good indoor and outdoor lighting is a must.  Decide if a ramp or a stair lift would make life easier for you.

• Remove high-pile or shag rugs.  I shouldn’t have to tell you that throw rugs that slide across the floor are a major hazard.  If you really need throw rugs they should be tightly woven and secured to the floor with nonslip adhesive tape.  If you shop around you can find non-skid throw rugs and slip resistant mats, and while you are at it, ask for recommendations about carpeting that is walker or wheelchair friendly.

• Pay attention to the ground when you are walking outside, especially if the area isn’t familiar to you.  Rain, snow, ice, or leaves hide rough patches and/or make surfaces extra slippery.

 Safety-proof your home before a stumble, a slip, or a fall takes the decision out of your hands.  If you think I am over reacting I want you to take a look around your house right now, and then tell me that there aren’t at least six trouble spots waiting to trip you up.  

Independent Living: When A Senior Falls

 

Everyone falls.  Toddlers learning how to walk fall, kids riding bicycles fall, and rough-housing while playing can result in a fall.   We thought nothing about falling down when we were kids or even as young adults.   I’m not sure of the exact day, but somewhere around the time of your 60^th birthday, a fall suddenly becomes a big deal.   It is scary when words like bone density, osteoporosis, and balance become a part of your vocabulary.   If you feel unbalanced at time or are having near falls more often than you should, it is time to familiarize yourself with words like fall prevention and safety proofing your house.

Right now you are probably more concerned about your parents or grandparents than about yourself, but your time is coming too.   A friend of mine got tangled up in a pile of bedding and lost her balance.  She fell and sustained multiples fractures in her foot and ankle.  It took nearly a year for her to recover and get her life back.  She was older, but she wasn’t that old.  A fall can happen to anyone.   Tripping over a dangling bedspread, bobbling when you stand on one foot to get dressed or bumping into bed franes are all signs that you need to start thinking about your balance.  

Why are you falling?  What is going on in your life that makes you feel unsteady on your feet?  Usually it is a combination of environment hazards (how safe is your home), chronic conditions that you may be dealing with, or medications that you are taking.  Some of these issues are treatable so don’t ignore them or suffer in silence.  A few common conditions that can contribute to falls are:

• Arthritis:  Today much can be done to treat or minimize discomfort and disability from arthritis.  Medications, surgeries and physical therapy are known to work wonders.
• Sensory deprivation:  Vision and hearing loss contribute to falls because they affect how you move around our environment. Eye conditions and hearing loss are often treatable.
• Medications:   Studies show that the risk of falling increases with the number of medications you might be taking.  I know people who take 14-20 different medications every day.  It isn’t surprising that side effects and drug interactions often contribute to falls.
• Muscle Weakness:  A sedentary lifestyle or a prolonged illness can result in muscle weakness. Muscle strengthening exercises can make you less vulnerable.  Certain diseases can cause muscle fatigue and weakness, but you won’t know unless you are tested.  Neurological problems can affect stride, balance and judgment.  Parkinson’s disease, recovery from a stroke, and dementia are a few of the culprits.
• Depression as well as substance abuse might be difficult to detect but certainly contribute to falls

When you get older a fall is a big deal.   It doesn’t take much to influence judgment, balance or motor function in an older person.   Worrying about your elderly parent or even about yourself is a good thing.  Stop falls before they happen!

 

 

 

Senior Health: Home From the Hospital

 

Being released from the hospital is a liberating experience.  It is the day that every patient looks forward to.  Getting out of the hospital is less dramatic than getting in, but it requires more thought than you might have imagined.   You should be asking yourself why it is that so many people end up being readmitted within a month after discharge.  Readmission statistics have been so alarming that hospitals are beginning to question their discharge policies.

At the time of discharge many patients are so anxious that they don’t hear what is being said to them.   The transition from being taken care of by nurses and therapists to understanding how to manage on your own is wildly confusing.   What happens?  What happens is that you don’t understand the instructions, forget to make follow-up appointments or don’t fully grasp whether to continue old medications along with the new ones. 

Several of my friends were recently hospitalized.  They both mentioned that they found the discharge instructions confusing.   I know this is true.  I worked in an assisted living facility for many years. I can remember how frustrated I would feel when packets of generic forms were thrust into my hands.  It took a considerable amount of time to sort through those papers, and more often that not, found that they said nothing at all about home care and convalescence.  What happens if you don’t have someone to do that for you?

Transition from an acute care hospital situation back home is difficult.  Discharge instructions arrive within minutes before a patient is wheeled out of the door.  This important part of the process is rushed and misunderstood.  Physician orders get mixed in with patient education forms and you get little chance to ask questions or express your fears.   It is no wonder that these instructions usually end up lost or in the garbage can.

I read an article in The Wall Street Journal (Monday, March 18, 2013) last week that reflected my concerns.  Laura Landro (encore@wsj.com) wrote about how to simplify your convalescence and avoid having to be readmitted.  First and foremost was accepting that recovery takes time.  You don’t get much rest in the hospital so the idea of returning to work or resuming your full schedule should not even enter your mind.  Being in bed for any length of time (especially for a senior) can leave you weak and listless.  Trying to make heads or tails out of your discharge instructions is often the last thing on your mind.   You need to speak up.  Ask for a follow up visit within a few days or even better; ask for a home health visit.   Allow yourself to rest; build up your body by eating well and exercising gently, as you ease into your routine.   Understand that it may take months to rebuild your strength and stamina.

 If you were hospitalized for a major illness, you must understand that you are susceptible to a relapse.  Hospital stays are shorter than they used to be and this is generally thought to be a good thing, but it means that you have to understand that you are responsible for your at home convalescence. 

Senior Living: What Home Care Can Mean For You

 

Surveys indicate that most seniors want to age-in-place.  This means that they want to be independent and they want to stay in their own homes.  This isn’t a new concept, but it is being revisited because people are living longer than ever before.  Aging in place is clearly a popular option but it requires a certain amount of planning to make it successful. 

We all know that age brings on certain limitations, and these limitations may make it difficult to manage. It is not unusual for seniors to require help performing basic activities.  You may have hated doing housework and couldn’t boil water all of your life, and that was fine.  Now, all of a sudden, everything you do is under scrutiny.   Housework, cooking, and shopping have become indicators of whether you are capable of managing on your own.

 Most seniors who remain in their own homes get help from an informal network which includes friends, neighbors, and family.  As you grow older your network shrinks or disappears altogether. You may find it necessary to hire help via a home care agency or move to be near a family member.  This is your support system.  We have all heard about the seniors in the community who are teetering on the edge but refuse to leave their own homes.  Hopefully a plan has been put into action long before the hair pulling stage.  The plan needs to include your physical, emotional, and financial capabilities.

Needing help is nothing to be ashamed of.  Needing help does not mean that you are not capable of managing in your own home.  Think of accepting help as a safety net.  It is a known fact that older people who do not have help with daily tasks are more apt to be hospitalized than those who do. Seniors are less likely to experience medical catastrophes such as hunger, dehydration, falls and skin problems if someone is checking in with them on a daily basis

Moving into a retirement community is always an option but it doesn’t have to be the only option.  Many older adults can continue to live in their own homes if they receive assistance with basic needs.   Many of them do not need round-the-clock medical care, just some a little help with activities that elude them.  Area Divisions on Aging can provide a wealth for information about community services to help beleaguered families do what is best for their loved ones.

Senior Living: What Home Can Can Mean For You

 

Surveys indicate that most seniors want to age-in-place.  This means that they want to be independent and they want to stay in their own homes.  This isn’t a new concept, but it is being revisited because people are living longer than ever before.  Aging in place is clearly a popular option but it requires a certain amount of planning to make it successful. 

We all know that age brings on certain limitations, and these limitations may make it difficult to manage. It is not unusual for seniors to require help performing basic activities.  You may have hated doing housework and couldn’t boil water all of your life, and that was fine.  Now, all of a sudden, everything you do is under scrutiny.   Housework, cooking, and shopping have become indicators of whether you are capable of managing on your own.

 Most seniors who remain in their own homes get help from an informal network which includes friends, neighbors, and family.  As you grow older your network shrinks or disappears altogether. You may find it necessary to hire help via a home care agency or move to be near a family member.  This is your support system.  We have all heard about the seniors in the community who are teetering on the edge but refuse to leave their own homes.  Hopefully a plan has been put into action long before the hair pulling stage.  The plan needs to include your physical, emotional, and financial capabilities.

Needing help is nothing to be ashamed of.  Needing help does not mean that you are not capable of managing in your own home.  Think of accepting help as a safety net.  It is a known fact that older people who do not have help with daily tasks are more apt to be hospitalized than those who do. Seniors are less likely to experience medical catastrophes such as hunger, dehydration, falls and skin problems if someone is checking in with them on a daily basis

Moving into a retirement community is always an option but it doesn’t have to be the only option.  Many older adults can continue to live in their own homes if they receive assistance with basic needs.   Many of them do not need round-the-clock medical care, just some a little help with activities that elude them.  Area Divisions on Aging can provide a wealth for information about community services to help beleaguered families do what is best for their loved ones.

A Hired Companion: A Different Kind of Senior Home Care

 

The senior care industry is growing, and by all indications will continue to grow as seniors opt to stay in their own homes.  It is unfortunate that the medical model is the only type of home care that most people know about.   Visions of matronly nurse-types come to mind and you think of them as caregivers in the true sense of the word, but home care isn’t always about personal care and medical check-ups.   Some home care franchises offer companionship and non-medical assistance

 Let’s face it.  Even independent seniors like and need to get out and about on occasion.   Your mother/father might be doing fine at home but they may long for the days when they could go out on their own.  A hair cut, a physical therapy session, lunch in town, a trip to the grocery store, or even a movie could be very librating.   Asking a family member to provide transportation, and an arm to hang on to, is not the same feeling as having a friend to go places with. A companion not only provides all important human contact, but also served to reassures family members that someone is checking in on a loved one when they cannot.

Generally speaking the family takes it on themselves to provide transportation to appointments outside the home or facility.  Working families have to rearrange their lives in order to meet these needs and it is difficult.  It is difficult for them because they have jobs, and it is difficult for the senior who already feels that they are a burden.   Sadly, most outings occur only when medical attention is required.  In all of my years working with seniors, I only knew one lady who took advantage of a companionship service, and I remember thinking what a great idea that was.  It gave her an excuse to get dressed up and to go out into her old community on a regular basis.   Medical and housekeeping personnel definitely have a role in home care, but there may be times when a parent doesn’t want to be seen in public with someone that looks like a caregiver.

Some home care agencies offer non-medical assistance with services that include everything from meal preparation and light housework to companionship.    One of the CNN channels aired a segment on what might be called “concierge care” last week, which could best be described as a rent-a-daughter, granny nanny, or a Girl Friday to take seniors out and about.  Home care is not covered by Medicare so has to be privately arranged, but what a wonderful gift.  It isn’t that expensive and it is a gift that can be appreciated by everyone in the family.

Senior Health: Nutrition and Convalescence

 

The first thing that comes to mind when you feel a cold coming on, or are being discharged from a hospital bed, is how tired you are.  Nutrition is probably the last thing that you worry about.   Rest is important, but what you eat and drink will play an important role in your recovery.   

If the procedure is elective you will have plenty of time to plan for your convalescence.   It is a little different if the surgery or illness occurs unexpectedly, but give it some thought anyway.    Illness is rarely planned for but cold and flu season comes around pretty regularly.  It wouldn’t hurt to have a small stash of easily prepared food items, medications, and a list of resources grouped together for emergency situations.

After your surgery or illness it may be awhile before you feel well enough to go grocery shopping, cook meals, or even clean up after yourself.   When friends and acquaintances ask what they can do to help, swallow your pride, and let them know that a few simple meals or a grocery store run would be heaven sent.   If you live alone make arrangements for a service such as Meals on Wheels until you get your strength back.  Keep phone numbers at hand and even splurge a little on take out foods from your favorite restaurants.  Call around and ask if your favorite grocery stores offer home delivery services.

The hard part of planning ahead is mustering up enough enthusiasm to prepare for the days when you just don’t feel like eating. These are the most important days, because you absolutely must keep your strength up and your body well hydrated.  Dehydration can be a real problem for older people and it happens very quickly.   Always keep plenty of fluids in your refrigerator as well as soups (canned or homemade).  Popsicles and puddings count so don’t deny yourself anything that will makes nutrition palatable. There are times when bland comfort foods like chicken noodle soup, cinnamon toast, and tea with honey will hit the spot when nothing else appeals.  Ready prepared meals on supermarket shelves make it easy to keep a small stash on hand.   In addition to complete frozen meals there are liquid and snack items designed to boost energy and add calories.

Most people start slowly with clear liquid fluids (water, apple juice, jello, broth packets, tea, cranberry or white grape juice and even soft drinks).  When you can tolerate clear liquids you can move on full liquids (cream soups, milk, puddings).  If that tastes good you can start eating easily digestible comfort foods.   Take care of your nutritional needs before and after a surgery, but don’t forget that colds and flu symptoms can take a lot of you too.  You need your strength to fight infections and stay hydrated.  How well nourished you are can affect how quickly you will recover.

 

 

 

 

 

 

Nutrition and Senior Health: Feed a Cold and Starve a What?

 

What is the first thing that comes to mind when a good friend tells you that he/she feels a cold coming on, or that she/he has been discharged from the hospital?    You either tell them to put over a big pot of chicken noodle soup or you hand deliver your favorite comfort food.   That’s what friends are for.   A bowl of hot soup is a cure-all, and anything with melted chocolate is sure to make anyone feel better.

Good nutrition is important.  When you are ill you hardly have enough strength to make it to the kitchen, much less prepare nutritious meals.  If you are a student away from home for the very first time or a senior trying to recuperate on your own, a little help would be appreciated.   In the old days whole communities would gather around with enough food to feed an army, but times have changed.  Most of us aren’t that close to family and friends any more.  For the most part you can consider yourself lucky if anyone notices that you haven’t been out and about for a few days.

Money is always an issue. When I worked with seniors I found that most would accept food offerings if we slipped them something on the sly, so to speak, but they wouldn’t ask for anything if they thought they had to pay for it.  They would suffer in silence rather than ask for help.  Family members who live far away may sense that something is wrong, but for the most part don’t know how to offer help by long distance.

I was intrigued by a mini-article in The Herald (Sunday, February 17, 2013). Andrea Brown wrote about “comfort by mail”.  She mentioned a business called Spoonful of Comfort that mails care package filled with nutritious goodies.  The specialty seems to be gourmet soups that can be delivered quickly to anyone needing a hug and some tender-loving-care.  Please check out (www.spoonfulofcomfort.com) if you know someone who needs a care-package to help them through a tough time.

Care packages don’t always have to be soup and recipients don’t have to be sick in order to love the thought.  A care package is a lovely way to let someone know that you are thinking about them.  Free up a moment in your busy schedule and send your favorite senior, college student, or soldier a care package today.

 

.

Senior Health: Do You Lie To Your Doctor?

 

People lie to their health care providers all the time.  It is easy to blame the doctor for a missed diagnosis, but have you ever thought that it might be your fault?  We’ve talked about the importance of list making and having frank discussions with your doctor, but if you aren’t telling him/her the whole truth you won’t get the treatment that you deserve.   Sumathi Reddy wrote an article for The Wall Street Journal (Tuesday, February 19, 2013) about the lies people tell their physicians, and she wasn’t just talking about senior moments or dementia.

You probably thought it was outrageous when Dr. House on the well known television series would say that “all patients lie”, but it seems he wasn’t that far off base.   Lies, from half truths and deceptions to all out lies, are pretty common.  I know this because I do it myself.   Do you always answer truthfully when the dental hygienist asks you how often you floss and brush?   We tell them what they want to hear because we are embarrassed or because we don’t want to be seen as failures.  You may down-play your symptoms because you are afraid of what the doctor will say, or you may embellish a little to get your own way.  Perhaps you need a slip declaring how sick you are to satisfy your employer or you want a handicap sticker just because it would be nice to have, but are you being truthful?

Your doctor is one of the few people in your life who will not judge you. He/she needs to know the details, but it is not up to them to have ESP.  They need to know about everything related to your health and well being.  Are you taking supplements or diet pills, using a laxative regularly, using stimulant? Do you smoke or do you exercise regularly?

People often go to the doctor because a family member or acquaintance recommends it, and they feel pressured.  Because the visit isn’t entirely voluntary they tend to clam up or try to hide issues that they don’t want to talk about.   Health care providers care about you but they don’t care in the sense that they will judge you for your imaginary shortcomings.  If you are doing anything that you feel guilty about it you should probably be talking about it.

 No matter what your excuse, it isn’t a good idea, and you know it.  Your appointment will never be long enough to address your health issues if the doctor has to pry correct information out of your lips.  Omitting important information could lead to the wrong treatment, the wrong medicine or even a wrong diagnosis.  

 

 

 

 

Senior Health and Fitness: Osteoporosis and Dowager's Hump

 

Yoga is the perfect exercise.   Our Senior Center yoga instructor is determined to keep her students from developing a dowager’s hump.  Her other passion is making sure that we can swivel out necks around to look behind us, which is not as easy as it sounds.   I think about her and appreciate her efforts every time I look over my shoulder to change lanes or back up my car.

Last week the entire session focused on exercises and stretches that involve the spine.   A proud erect posture may require some effort on your part.   I am sure you will agree that there are days when your head feels really heavy.  Your neck and shoulders may ache, and it takes a conscious effort to roll your shoulders back and look straight ahead.  It is at times like this that a good yoga session is worth its weight in gold.  If you haven’t tried yoga you might be missing out on something really important in your life.

When we were kids our mother’s were always reminding us to stand up straight and not to slouch.  I am not sure when that piece of advice stopped being in vogue, but Elizabeth Welch reminds us (Chiropractic Journal: January 2012) that the bent over posture seen in older people starts at an early age.   A youth slumped in front of a television or computer for hours on end may very well be inviting problems further on down the road.  The head is heavy and letting it slouch forward habitually may lead to tiny breakdowns throughout the spine.

 Age related changes in the body increase the odds of getting osteoporosis, dowager’s hump, and fractures.   Many undesirable changes (waning strength, flabby physique, failing health, faulty memory and dowager’s hump) were once thought to be inevitable signs of old age, but that isn’t necessarily written in stone.   Today we know that bone disease can be prevented and walking around looking down at your feet is not inevitable.

What does that dowager’s hump mean to you and to your bid for independent living?  If you lose the ability to walk, stand up straight, or dress yourself without pain it is difficult to take of yourself.   Bone health is important but it isn’t all about taking the right drugs.  Get moving now and you can slow, stop or even reverse some of these changes.  You’ve heard all of the recommendations: calcium, vitamin D, maintaining a health weight, being physically active and minimizing the risk of falls.

Good posture is still important. Osteoporosis doesn’t happen overnight.  The slow erosion of bone happens slowly and quietly, without your knowing it.  Tiny fractures can steel inches from your height and collapse your posture and ultimately the dowager’s hump.  Learn all that you can about bone disease and stride into the future confidently.