As a home care agency we don’t provide care for our elderly clients in a vacuum. We get to know the family and offer support and guidance for them as well. Being involved with the family means seeing and understanding the issues they are facing and dealing with. We are constantly seeing new issues arising as a result of our aging population. Many adult children are enduring stress and frustration trying to work with their siblings to do what is best for Mom or Dad.

Sadly, the difficulties seem to rise with the number of siblings involved. There are many “Only Childs” out there, wishing they had siblings to help with Mom or Dad’s care and all the decision making. However, those locked in mortal combat with their siblings might say those “only children” don’t realize how good they actually have it. A 2001 study published in The Conflict Resolution Quarterly showed that about 40% of adult children caring for an elderly parent described “serious conflict” with a sibling over issues related to care. That study is about 11 years old now and I am willing to bet that present day percentages would be even higher. However, one thing that I feel probably HAS stayed consistent is what that study uncovered was the biggest gripe: The feeling that one sibling was shouldering all the care and stress that went with it. This is the biggest complaint I hear and from what I have personally seen, many times it’s true. Even if there are several siblings, many times we see one doing 95% of the care. Most of the time it is the sibling who is geographically closest that does not only the hands on care but also most of the decision making, etc. But it doesn’t have to be that way. There have also been times when I have seen four or five siblings’ work beautifully together, even with the majority living out of town. So it CAN be done!

I think many times the male siblings are not comfortable seeing their Mom or Dad declining or acting in a manner that embarrasses them, as with Alzheimer’s. It is not that they don’t care. They just don’t know what to do or how to act. I don’t think they realize there are countless other ways to help! Each sibling needs to think about what their strong suit is or what talents they bring to the table. Then, be creative as to how you can use those talents to contribute to some aspect of the care. First there needs to be an initial meeting with all the siblings and their spouses present.  If everyone can’t be in the same room, have the meeting via conference call. Before the first meeting, have each sibling write down how they will contribute to an aspect of care whether directly or in a supporting role. For example, if a sibling lives far away, he or she could contribute monetarily towards respite care to give the main care giver much needed breaks. Does anyone have a background in law or finance? They can help the other siblings navigate through complex Medicaid or Medicare issues, important financial decisions, end of life decisions, etc. A sibling can offer to do all the research concerning all the different options of care and their cost and report back. Out of town siblings can create a rotating schedule for visits. These are huge things to take off the main care giver’s plate! You just need to think outside the box!

Once everyone has their role defined, it is each person’s responsibility to keep everyone else informed via email.  That means everyone. Having side communications or gripe sessions is a recipe for disaster. Don’t be tempted!  Also, decide at the first meeting how often communication is going to occur and stick with it. The main care giver should not fire off a one sentence email only when a crisis occurs. Regular emails are a must. There is a payoff! Regular updates serve as a dated document that can be referred back to time and again. When you need to know the date of Mom’s last seizure but you’re too tired and frazzled to remember, you will be so glad to have that dated email you sent your siblings when it happened.

When talking to the children of aging parents, the first thing I try to emphasize is that patterns of decline they are seeing are not going to get better. So by waiting to put care into place one is just delaying the inevitable. It is very important to: Begin having talks early and frequently with the person who needs care. Since many children know how much their parent (s) is against the idea of accepting help, they avoid that conversation. And that’s just what your parents want you to do! But you cannot afford to avoid it or shy away from it. You have to send a firm but loving message that this issue is not going away and I am serious about developing a plan of action to keep you safe before a crisis occurs. Here are some tips that might help.

1. DO expect resistance and understand that it may take several conversations to get to the point of agreement.

2. DO understand that you must start this process EARLY! That way you have the time to spread out several talks and more time to let the idea sink in.

3. DON’T go into the conversation unprepared or thinking you can wing it. Get everyone together who will be present and have a clear agenda on how it will go.

4. DO make your parent the focus of all discussions and let her be totally involved (depending on mental capabilities)

5. DO voice your opinion using “I” statements

6. DON’T assess any blame and avoid using “You” statements

7. DO be very respectful of your loved ones opinion. You must give her time to express her thoughts and let her see you are really listening.

8. DON’T push or try to accomplish too much in that first conversation. The first one should stress the fact that you have noticed some things lately (be specific) that indicate she could use some assistance in the home and how much you love her and want her to be safe.

9. DON’T confuse being respectful with being “wishy washy”. As the conversations progress, you must be firm in your stance that she is no longer safe being at home by herself and because you love her, you cannot continue to let her be unsafe.

10. DON’T expect this to be easy. There may come a point where “tough love” comes in. Sometimes giving the option of “Nursing Home” or “staying in your own home, which you love, but with some assistance” is an excellent tool to use. When put in those terms sometimes a light bulb goes off and they realize how lucky they are that they can stay in their own home and don’t have to go into a nursing home!

Many times when your loved one won’t listen to you, they will listen to a 3rd party whom they respect and trust. As the owner of Heavenly Helpers Senior Care, I am pretty successful in reassuring loved ones that we are not about coming in and changing their life or ordering them around. I tell them it’s like having an assistant or a friend come in just to help you do the things you can’t. It’s as simple as that. I tell them it will open up their world-they can get out and do things or go places that they currently are unable to do-we are about increasing independence not taking it away!

When I tell people I run a home care agency for the elderly, many people ask me how they will know when their elderly loved one needs assistance. So I made a list of the things in which, in my experience, are definite signs that help – in whatever form you choose-is needed.

1. Neglecting themselves by not bathing or brushing teeth or combing hair. You will notice body odor, bad breath, or a general appearance of looking unkept. They may have sores on their skin or infected toenails due to negligence.

2. Has there been a change in appetite? Weight loss? Missing meals or eating inappropriately (just eating candy or having ice cream for breakfast). No signs of cooking being done.

3. The cleanliness of the home is a big tip off and often the first and earliest sign things are slipping. Dirt and grime go unseen due to poor eyesight, vacuuming, scrubbing the bathtub or mopping cannot be done because of physical limitations, etc.

4. Personality changes such as talking too loudly or unable to contribute appropriately to a conversation. They may be listless or ask you to repeat the same thing a dozen times in an hour. There may also be angry denials that anything is wrong.

5. Do you see examples of forgetfulness? Mailbox overflowing with mail, newspapers piling up in yard, utilities being shut off for non payment are common signs.

6. No longer able to grasp their finances. Bills may not be paid or paid twice. Checkbook no longer balanced. Not depositing Social Security check or other funds.

7. Evidence of physical harm such as burns from the stove or water, bruises or cuts from falls or urinary tract infections from lack of hygiene all point to someone who is no longer safe by themselves.

8. No longer interacting with friends or neighbors, no longer attending the usual social events and not interested in former hobbies are all clues something has changed with your loved one.

9. Spending all day watching infomercials or the shopping channels and making large, unnecessary purchases that begin to pile up—many times unopened is very common with women.

10. Forgetting to take or taking wrong amount of their medicine means they are no longer able to keep up with which pill should be taken at what time. We also may be “self medicating” with alcohol.

Even one of these signs is a cause for concern and a time to be proactive!! Begin discussing need for assistance and learning about the different types of care available (home care, nursing home, etc.)

I was in a restaurant the other day and the waiter, a man who looked to be in his 30’s, took my order.  He was professional, polite and spoke to me in a normal manner.  As I waited for my food, I watched as an elderly couple came and sat near me.  I looked on as my waiter approached them and completely changed his demeanor.  His voice took on this patronizing quality as he cooed “and how are we today?”   He hovered over them throughout their meal, making ridiculous comments the whole time. “Well! Look at that! You cleaned your plate! A gold star for you!”  (He, by the way, did none of this with me).  I noticed the couple was completely unresponsive to him (which only increased his theatrics). When they got up to leave, the man caught my eye and we smiled.  So they walked over to my table and commented on how beautiful the weather was, etc.  We talked for about 10 minutes. They were bright, articulate, smiling- the change in their demeanor was striking. 

This whole episode stuck in my mind, so when I got back to the office, I did some research.  And sure enough, this type of talk, aimed at the elderly, has a name!   Talking to an elderly person the way my waiter did, I found out, is called “elderspeak”.  It involves speaking unusually slow, using a restricted vocabulary, a simplified syntax and exaggerated prosody. Prosody, in case you are wondering, is the “rhythm of speech” and so if it is exaggerated, it would include overly stressing some words and talking in a “sing song” type way.  Remember my waiter’s “And how are we today?”

And although the definition of “elderspeak” didn’t include this, personally I would include the annoying habit of addressing a singular elderly person as “we”.  “And how are we doing today Mr. Brown?” 

The assumption being of course, that the elderly are all cognitively impaired.  And evidently “elderspeak” is more than just patronizing and disrespectful. 

Recent research has shown that this communication style can negatively affect seniors’ physical and mental health.  This did not surprise me as I thought back to how quiet and serious that couple looked during their meal and how they brightened up during our conversation.  I realized the implications this had for those of us who work with or have any sort of interaction with an older person.  We possess the ability to positively (or negatively) affect our clients’ mental and physical health.  Just by the tone and manner in which we speak and interact with them.  I feel this is just huge! 

I urge everyone reading this to honestly evaluate your own manner of speech when talking to an older person (who does not have Alzheimer’s or dementia.)  Does it change?  It’s acceptable to speak louder if you know (do not assume!) the person is hard of hearing. As far as anything else, the only difference perhaps should be an increase of respectfulness.

I remember my mom in her later years going to her doctor for her monthly Vitamin B12 shots.  She swore it gave her more energy (chalk up another win for the placebo effect!).  While there has never been any evidence that taking Vitamin B12 gives you more energy, studies have shown that a deficiency in this vitamin can be the cause of memory problems, fuzzy thinking or confusion, balance problems, fatigue, loss of appetite and weakness, just for starters.  Looking at these symptoms you may notice something: they are common complaints of the elderly. Running a home care agency with many senior and elderly clients, has really heightened our awareness of how common these symptoms are and how they can be confused with those of Alzheimer’s or dementia.

As we age, our stomachs do not produce as much acid as when we were younger.  Doctors typically set the age that this occurs around 50 and older.  (There are exceptions however which I will explain in a minute).  This has an important impact on our ability to absorb Vitamin B12.  Why?  Because B12 is only found in animal products like meat, dairy and eggs.  B12 is “tied up” or bound to proteins and we rely on the acid in our stomachs to break down the proteins and make the vitamin available for absorption.  So, less acid equals less B12 absorbed.

If you are concerned that an elderly loved one might be deficient in B12, the only way to find out is through a simple blood test from the doctor.  Since the symptoms of deficiency are so commonly associated with aging, I really feel it is important for seniors and those who care for the elderly, be proactive about this issue.  Since a deficiency can cause balance problems, this could lead to a fall which can have devastating consequences.  Memory problems or confusion can not only be distressing to an elderly person but can lead to a stove being left on or becoming lost more easily.  These symptoms can also be mistaken for Alzheimer’s.

The good news about this issue, besides it being easily detected through a blood test, is that the cure is equally simple. The way to get more B12 is to either take supplements or eat foods (commonly breakfast cereals) that are fortified with B12.  Why?  Because these forms of B12 are synthetic and so are already in a free form that can be easily utilized by the body.  And by the way, your body doesn’t care if the vitamin is synthetic-it still works the same way!  Just make sure to read the label on your cereal (or soy milk, etc.) to make sure it is fortified with B12 if you decide to go that route instead of taking a supplement.  For most people, a bowl of fortified cereal a day should do the trick.

As I mentioned earlier, there are others, besides those over 50, who are susceptible to vitamin B12 deficiency.  Vegetarians, those on acid reducers such as Tagamet or Zantac, persons with Crohn’s or celiac disease  are all more susceptible to deficiency.   Also, a study has shown that diabetics, who take a drug called Metformin, have a greater incidence of B12 deficiency.

The take home message?  The Institute of Medicine has recommended that persons over 50 get most of their Vitamin B12 from supplements and fortified foods.

Breast cancer. I don’t know of any two words that strikes more fear in women.

Logically we know that heart disease kills many more women a year than breast cancer. Yet we still fear it more. Perhaps, as in the case of our own St. Louis senior home care agency, we see it take our sisters at far too young of an age-many in the prime of their lives. This was the case with one of our most dearly loved Care Givers, Leslie Weiser. She had beaten breast cancer earlier but it returned with a vengeance. She lost her battle and in turn we lost a beautiful, dedicated woman whose clients adored her as we all did.

I know of no one that doesn’t have a heartbreaking story like this about breast cancer. So I feel frustration. Doesn’t it seem we are raising millions upon millions for breast cancer research but we keep losing our moms daughters and sisters and friends to it? (And to be fair, men also die of breast cancer, but it is overwhelmingly a women’s disease).

Many oncologists and surgeons on the front line in the war against breast cancer would argue there have been advances in treatment and diagnosis but many people are unaware or unimpressed with the progress so far.

I can understand the “unimpressed” part. As an example I recently read about two “great advances” in the treatment of breast cancer. In the first one, the study compared using one drug versus using two. In this study, some of the patients received one hormonal therapy ( exemestane) while the other patients received exemestane plus everolimus (everolimus has been used to treat other cancers) . The impressive result? The women receiving the two drugs had 7 months longer of progression free survival then the other group. In other words, in both groups the cancer came roaring back. But the study was hailed as a success because one group had a 7 month longer reprieve than the other. This result didn’t make me want to celebrate; it made me want to…cry.

The 2nd study, also deemed an advancement in survival, was presented at a worldwide cancer symposium in Sweden. Only totaling 137 patients, the study involved two groups of women. One group received the combination of a new cancer drug trastuzumab (where do they get these names?) and emantasine. The other group received standard chemo plus trastuzumab. The two drug combo group experienced 5 (count em: five!) more months of life before their cancer returned than the standard chemo group did. Yes this is technically an improvement. But am I the only one who feels like screaming? I wonder how long this study took (not to mention how much it cost) for this outcome. It just seems to be going at a snails pace. Where is the urgency!?

My comments may be viewed as ungrateful and unappreciative of the advances we have made. Or perhaps viewed as not understanding that each bit builds on the last? But surely I am not the only one who is wondering if there will ever just be an outright “CURE” for breast cancer? Or will we just continue to do more of the same? Continue to add to this ever growing arsenal of highly toxic drugs and radiation that push a woman to the brink of death in order to eek out 5 more months of life? Can’t we do better?

At first glance the sentence above seems preposterous.  However, with a bit of explaining, it will make more sense.  Personally, I feel this is a huge breakthrough for explaining many things, including the rising rates of obesity, depression, diabetes, and breast cancer in the Western world.

When we were evolving, we experienced about 12-14 hours of darkness every 24 hours. We did not have lights or TV’s or computers to occupy our time at night.  In the modern world, this is exactly what is going on.   Most of us spend our night time hours surrounded by light.  Our homes are lit up with TV’s, computers, cell phones and other gadgets.   City lights from outside our homes also reach our eyes.   What is the effect of all this “unnatural” light at night on our bodies?

According to doctors and researchers, all this light interferes with our body’s natural rhythms (called circadian rhythms).    Enter melatonin.    Melatonin is an important hormone that has been proven to be protective against cancer.   Our pineal gland produces melatonin, but only when it is dark.   Completely dark. Light will stop the production of melatonin – even a little bit of light.  The reason this is so important is because melatonin is what makes us sleepy.  It enables us to sleep soundly and deeply.  The way it should theoretically work is when the sun sets, the body begins to produce the melatonin.   After an hour or so we begin to become sleepy and eventually fall asleep at a decent hour – say 9pm.   We would sleep soundly and only be awakened by the sun coming up.

But what is happening in present day society is far different.   Many of us actually ratchet up the light around us as night falls.  At this point I need to explain I am speaking about a particular light called blue light.  Blue light is picked up readily by a photoreceptor in our eye that has nothing to do with vision.  Blue light penetrates this photoreceptor more than green or red lights.  Thus, blue light is very powerful at regulating melatonin and our circadian rhythms.

This blue light is emitted from our computers, TV’s, light bulbs, iPads and other gadgets.  Researchers are warning us that as we stare into these things at night, our melatonin is suppressed and our bodily rhythms are disrupted.  Our bodies are confused as to whether it is day or night.  Which hormones to secrete or shut down?   This creates havoc in the body and been directly related to insomnia, depression, obesity, cardiovascular disease and of course cancer.  Because blue light at night can disrupt our hormones, studies are showing that breast cancer in particular, to be related. In primitive countries where they do not have all this blue light at night, the incidence of breast cancer is much less.  And as countries “westernize” their rates of breast cancer increase.

When researchers want to study the effect of disrupted body rhythms and melatonin, they look at shift workers.  Shift workers, such as nurses, have been shown to have higher incidences of many health problems including depression, diabetes, cardiovascular disease and breast cancer.   A study by Dr. Eva Schernhammer, an epidemiologist at Harvard, found nurses who have worked the night shift for 15-30 years had higher risks of breast and colon cancer.  “People who work at night will always have lower levels of melatonin than the normal population (who are not exposed to light all night)”.

In fact, the World Health Organization in 2007 classified shift work as a risk factor for breast cancer.  And in 2009, the Danish government began compensating female shift workers who have breast cancer.

So now that we are aware of the implications of blue light at night, what are some of the things we can do to protect ourselves?

• Use full spectrum bulbs in your house and office during the day.  Because remember this VERY important point: blue light is not dangerous! It just signals your body to be awake.  You want to have that during the day but not at night where it disrupts your body’s rhythms.  (In fact, studies show we are not having enough bright light around us during the day when we need it and too much at night when we don’t.)
• Turn off computers and electronic gadgets once the sun sets, and avoid watching TV late at night.   You especially do NOT want to fall asleep in front of the TV all night long!  Some remotes have timers on them so you can program the TV to turn off by a certain time.
• Use “low blue lights” in areas where you spend most of your time in late evening, such as your living room, bedroom and bathroom.
• If you have to get up to go to the bathroom in the night, make sure your path is clear and resist turning on the light for even a few moments.  That short of time is enough to stop all melatonin production and disrupt things.
• Sleep in TOTAL darkness.  This means no night lights, no clock radio or cell phone glowing on the bedside table and use blackout shades and drapes if ANY light from outside is coming through your window.   Many experts say you should not be able to see your hand in front of your face.
• Sleep when it is dark outside and get up when the sun comes up.  At the very least try and be asleep by 10pm and be up by 6 am.
• Avoid working the night shift.  This one cannot be stressed enough.  Experts strongly suggest you trying to switch your hours if you are currently working at night.  At the very least try not to keep the shift longer than a month or two to give your body time to readjust in between.  Perhaps give your supervisor this article to read!
• If you have to do shift work, when you come home to sleep, make your bedroom as dark as possible by using black out shades.  Use all the tips above to simulate night so you will produce melatonin.  Also try wearing eye pads to shut out the last bit of light.

Remember that constipation itself is not a disease, but a symptom that something within the system is not quite right.  Here are some guidelines to help you decide if you truly are constipated:

1. You seem to have difficulty passing stools, or it seems to take forever
2. The stools are hard or lumpy
3. You feel blocked up, like you can not empty your bowel completely
4. You have fewer than 3 bowel movements a week

Why do we get constipated?  There are many different reasons — poor diet, lack of exercise, and overuse of laxatives are the most common offenders.  Other factors include medical conditions, certain medications, and consciously holding back bowel movements.

A poor diet is one of the leading causes of constipation.  Lack of fresh fruits, vegetables, and whole grains in the diet is a prime cause.  Research increasingly shows that regularly eating these foods can help prevent constipation.  Too much fat, sweets, dairy products and eggs also can be a problem, and is not a healthy way to eat.  So is the consumption of prepared foods on a regular basis.

A lot of seniors live alone, and just don’t enjoy cooking for one or eating alone.  It’s easy to adopt a constant diet of instant meals, already prepared. The problem is that too often these meals are lacking in fiber, as well as other vital nutrients, and contain way too much salt and fat.  Folks who have problems with their teeth will often choose foods that are soft and overly processed, containing small amounts of fiber, if any.

Not drinking enough liquids is also a leading cause of constipation.  We cannot stress enough the importance of adequate fluid intake.   Water is always the cheapest and the best, but any liquid counts — juice, milk, coffee, tea, soup.  In fact, so many people enjoy a good bowl of soup at mealtime, why not add plenty of vegetables and broth, and get some of your daily liquids this delicious way?  Just watch out for the salt.  If you buy canned or packaged soup,  ALWAYS CHECK THE LABEL FOR SODIUM CONTENT!   Please do try the many varieties of low-sodium soups available now.   Why not spend some time cooking up a batch of your own?  If that seems a bit overwhelming, perhaps you could enlist the help of a friend, neighbor, or family member to give you a hand.  Many seniors have treasured, time-tested soup recipes that have been passed down through the years. Soup freezes well, and can be put into smaller containers ready to take out and heat when needed.   Nothing beats the taste of home-made soup in my book, and eating a bowl often brings back happy memories of a pleasant day spent in the kitchen, chopping, blending, and stirring, as well as thoughts of that special person who first made it for you.

Overuse and dependence on laxatives and enemas can only spell trouble for your bowels. Rather than being a cure for constipation, their frequent use will cause your bowels to “forget” they can work on their own.   Eventually this will lead to your body no longer having any natural bowel movements.   Frequent diarrhea is usually the end result, with resultant loss of even more liquid from the body, not to mention the discomfort, unsanitary conditions, and difficult clean-up that diarrhea brings.

We’ve all been lectured to the nth degree about the importance of exercise, but it is so very true, especially in regulating bowel movements.  Too much sitting around by couch potato types makes for too little bowel activity!   If you’ve been ill or otherwise confined to bed, you will probably suffer from constipation until you’re back on your feet and moving around.  Keeping active, even if it’s just walking around the house or yard is always the best bet.

Try not to hold in your bowels on a regular basis — if you wait too long to go, or practice this on a regular basis, it may result in constipation.  Most of us prefer to use our own bathroom at home.  Make a visit to the bathroom before going out.  Perhaps you can schedule your excursions well before or after a visit to the bathroom is expected.

There are certain serious medical conditions that can lead to constipation.  Among them are stroke, diabetes, intestinal blockage, and irritable bowel syndrome.  These conditions can cause a malfunction in the nerves and muscles that your body uses for moving the bowels.   Speaking with your doctor about this is a good first step in determining if this is a problem for you.

Quite a number of commonly used medications may cause constipation. Antidepressants, antihistamines, antacids containing aluminium or calcium, and medicines to treat high blood pressure and Parkinson’s disease are often offenders.  Speak with your doctor if this seems to be the case.

Let’s put a positive spin on all this and discuss what we can do to help keep constipation at bay as much as possible.  As we mentioned, first rule out that a medical condition or medicine is the root cause by speaking to your doctor.  If that is not the case, here are some time-tested ways to help get things moving again.

The number one remedy is to simply add some fiber to your diet!  Try fresh fruit or vegetables, whatever kind you like.  Bear in mind that corn and potatoes should not be your first choice — they’re not particularly helpful.  Dried fruits such as prunes, figs, apricots and dates are tasty and full of fiber.  They make a wonderful sweet dessert or snack.   Small doses will work fine — dried fruits are concentrated sources of fiber.  Be aware that you can get too much of a good thing!

Try incorporating some whole grains into your diet.  Eating oatmeal (rolled oats, not the instant kind in a little envelope) is a great way to start your day, especially with some fruit on top!  Make your toast and sandwiches with whole grain breads or English muffins. Brown rice is better than white rice.   Eat your potato baked, with the skin on — try a sweet potato rather than your usual russet, and you’ll get a leg up on healthy beta-carotene, so necessary for healthy vision and immune system.  Have you tried barley in your soup instead of noodles, rice or potatoes?

Take some beans, please! They’re inexpensive, loaded with fiber, easy to keep and store. You should always have a can or two in your pantry.  Try them in a salad instead of croutons (you are eating fresh salad greens, aren’t you?) or in chili (make it with ground turkey instead of beef to reduce artery-clogging fat).  Need a quick, healthy, fiber-rich snack?  Scoop up a small handful of nuts (unsalted if you please) or pop some corn — both have plenty of fiber.  Once you get on the bandwagon of fiber-rich foods, you’ll find there are many more you like than you realized — they’re everywhere you look!

Yes, you can use fiber-rich additives — the kind you mix with a glass of water.  But nothing beats eating healthful, fiber-rich foods at every meal.  It’s easy to get in the habit once you educate yourself and become aware of the nutrition value in what you eat every day.

Don’t forget to drink enough liquids to keep yourself hydrated.  As we age, our tastebuds and thirst indicator don’t function as effectively.  Don’t rely on feeling thirsty — you may not be.  Drink something at regular intervals during the day to keep yourself properly hydrated, and this will also help regulate your bowels.  And do keep as active as you can. Couch potatoes do not have healthy elimination, especially as they age.  Walk around the house or the block, go out and get your mail, do some yardwork if you’re up to it physically.

If you follow these tips and still have problems, talk to your doctor.  Perhaps there is an underlying condition that you’re unaware of.   But take heart, this is not rocket science! Some simple changes in diet and exercise may be just what you need to feel better, and they’re all simple steps you can take on your own.  Give it a try — what have you got to lose but that awful constipation?

By: Amy Weisser, Case Manager

Seniors know that keeping safe at home is paramount.  Falls are the leading cause of injury death among the senior population.  A fall can often make the difference between staying at home and having to move to an assisted living facility.  Since most people vastly prefer staying in their own home if at all possible, preventing falls is of primary importance.  We have put together some common-sense tips to help you stay safe at home and maintain your personal independence.

The bathroom is a prime location for falls.  Some recommendations:

1. Put up grab bars on the bathtub/shower surround.
2. Install a senior-friendly elevated toilet seat that screws on securely to stay in place, and install grab bars alongside the toilet.
3. If practical, replace your toilet with a taller senior-friendly model, and install those grab bars, too!
4. Don’t stand while showering. Buy a sturdy, plastic bathing chair or bench to put in the shower or tub.  Install a hand-held flexible shower head that you can use while seated.
5. If possible, replace a bathtub with a walk-in shower stall. Stepping over the side of the tub to get in and out is an accident just waiting to happen, and often prevents many seniors from bathing.
6. A shower curtain is preferable to glass shower doors.
7. Put a non-slip rubber mat in the tub or shower stall.

Your living room can be made safer by following these recommendations:

1. Get rid of old, sagging furniture.  Replace it with newer pieces that offer firm back and seat support.  That way, you can sit down and get up again more easily.
2. Make sure your carpeting is firmly secured.  If you must use area rugs, secure them underneath with a non-slip pad.  Don’t use small throw rugs anywhere  in your home—they’re a shortcut to falling.
3. Keep your living areas as uncluttered as possible.  Trailing electrical or telephone cords will easily trip you up.  Get rid of old newspapers and magazines before they clutter the room. They’re so easy to recycle today.
4. Make sure your rooms are well-lit, with lamps and light switches easily within reach. Replace burnt-out bulbs immediately. Keep a flashlight within easy reach in the rooms you spend the most time in for insurance if you lose electrical power. Don’t forget to periodically check the batteries.

Here are some common-sense safety rules for the bedroom:

1. Keep a light on at night in a room adjacent to your bedroom. Always have a nightlight on in your bedroom, bathroom, and hallway.
2. Make like a log when you get out of bed. Roll over to the side of the bed. Swing your legs carefully over the side until your feet touch the floor. Sit there for a minute or two to get your balance. Stand up SLOWLY!  This  helps avoid a low blood pressure fluctuation that could make you dizzy.
3. When you put on slacks, socks, hosiery or shoes, sit in a chair or on the edge of your bed.  It’s best to always wear shoes or slippers inside, rather than going about in stocking feet.  Low-heeled, supportive shoes with non-skid soles are best. If you wear slippers, make sure they fit snugly, have a closed heel, and a non-skid sole.

You’ll want to keep your kitchen safe, too, by following these tips:

1. Arrange your kitchen with a sensible, easy-to-navigate flow. Place appliances, especially your microwave, where they’re convenient and easy to use.
2. Place your most often-used items within easy reach. Pots and pans, dishes and grocery items should be put where you can get them without having to bend over, squat or get on a stepladder. Don’t stand or chairs or stepladders! Rearrange frequently used items.  Use a hand-held grabber when you need something that’s stored out of reach, or has fallen on the floor.
3. Never try to move heavy, awkward items on your own. Ask for help.
4. Forget the high-wax shiny floor!  Safety is much more important.
5. When you cook on the stove, always position the handles of your pots to the side, away from the front.

Stairways present a special hazard. Here are a few safety tips to follow:

1. Make sure you have a handrail on each side of all stairways. Also, you should have a light switch at both the top and the bottom of the stairs. Put in a nightlight at both the top and the bottom of the stairs, too.
2. If your stairs are carpeted, make sure it’s secured firmly, with no folds.
3. For basement stairs, affix brightly colored tape on the top and bottom tread. Limit, or eliminate entirely, trips down to the basement if possible.

Remember, falls in the home are a senior’s most frequent occurring accident.  Preventing falls and the serious injuries that often accompany them can go a long way towards maintaining your independence!

I have exercised regularly for years and logged many hours outside as well as in the gym.  Since I am an avid “people watcher”, I have watched how other people spend their time at the gym.  And much of the time I find myself irked at what I see.  I am irked because I see the mistakes that are being made as “missed opportunities”.  And because I know what the consequences will be 20-40 years down the road.  So I thought I might climb up on my soapbox and gripe about a few things I have noticed over the years in hope of eliciting some positive changes…

First and foremost on my list is women and strength training.  Hello?  Could it be that the word still has not reached women how important this is?  To be fair, I do see some of the younger woman lifting.  But I rarely see middle aged women and I never see elderly women lifting weights.  Why not?  Is that pesky rumor that you will “get so buff you’ll look like your on steroids” still going around? The only way a woman is going to get that muscular IS to be on steroids!  Why is lifting weights so important? Oh, my, where to begin?

Ok, first, you will look great! Your triceps will not continue to wave after your hand has stopped.  Your rear end will halt its journey south.  And it will increase your metabolism because muscles burn calories more than fat.  You will also start noticing that everyday things you do have become easier, like lifting groceries or getting in and out of that SUV.  Weight lifting will strengthen your bones and prevent osteoporosis.  And the grand daddy of them all:  Picture a frail, elderly person hesitantly taking baby steps and holding on to furniture to get across the room.  This picture is not normal and not inevitable.  Losing your sense of balance is not a normal part of aging!  It is due to muscles loss (from aging) and muscle weakness (from non use), period!  If you strength train, you will build muscle mass that you would normally lose as you age.  The result?  You will stride strong and confident across a room at 85 because your balance is fine and your legs are strong. That’s called payback!
Another problem I see with many elderly people (I am not picking on you all, really!) is that there will be 3 or 4 of them walking very slowly around the track talking up a storm.  Now, there’s nothing wrong with taking a leisurely walk with your friends as long as you’re not counting it as your exercise for the day.  It seems we have become reticent to tell seniors they need to pick up the pace!  They need to break a sweat!  They need to be breathing harder! (good rule of thumb is that you could talk if you had to but you would rather not) Remember, just because you are in a gym, on a track, wearing warm ups and sweat bands, doesn’t make it exercise.

Time to pick on the middle aged set now.  Year after year I see the same ones come in faithfully yet they never lose a pound and never gain a muscle.  I think I might see some of the reasons.  One is called a cell phone.  If you are on the treadmill, Stairmaster, walking the track, etc. and are yakking on your cell phone the entire time, you are not exercising! (Remember the rule about being enough out of breath that talking is unpleasant?) What about bringing books to read?  Since when did we start bringing books to read while we exercised? When I see someone kicked back on the bike leisurely thumbing through their latest edition of People, I notice something:  they never work up a sweat.  How could they?  When you are truly “present” when exercising you are concentrating on your breathing, your muscles, how you are feeling, can I push a little harder and of course, how much longer do I have?  But if you are intently reading your novel?  Exercise has taken a back seat.

In closing, I want to stress that what I am not saying is that everyone needs to become an uber-athlete or gym rat.  I think many of the situations I have described are just examples of ways people try to avoid the same thing.  And that “thing” is the discomfort of feeling fatigued.  Because yes, exercise makes you sweat, breathe harder and it makes you…tired.  There are many people who just intensely dislike feeling that way whether they are lifting weights or running and will go to great lengths to avoid it (read above).  Others learn to endure and push through.  My article talked about the long term benefits of exercise.  But there’s also a delicious short term benefit.  The people that learn to push through the discomfort and fatigue know what it is.  It is how fabulous you feel afterward.  What goes up must come down.  The level of discomfort is directly proportional to the level of euphoria you feel afterward.  The harder you work the more of those endorphins that flood your brain.  It’s nature’s way of getting you to come back!