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Delirium

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Delirium – Information for patients, families and Friends

 

It is our hope that this article will help you learn more about:

What is Delirium?

  • The signs and symptoms
  • How it can be prevented and
  • What families, friends and caregivers can do to help
  • Where to find more information

What is Delirium?

Weaving Secret Riddle Confusion Thread Patterns

Delirium is a condition that causes a person to be confused. It is a physical problem (a change in the body) that can cause temporary change in the person’s thinking. Delirium usually starts over a few days and often get better with treatment.

Delirium can happen to anyone, anywhere. But, it often happens when someone is in the Hospital

 

Once identified, delirium is often treated as a medical emergency. Treatment is put in place right away because it can be a risk to patient safety.

 

Delirium can cause patients to slip and fall or to feel a lot of emotional and spiritual distress. A person with delirium may not be able to understand when people are trying to help them. They may become angry with family and hospital staff. They may start to think that everyone is against them or are trying to harm them. Some people with delirium may want to call the police to get help.

Delirium is like being in the middle of a very strange dream or nightmare, but the person is having these experiences while they are fully awake.

 

What is the risk of delirium?

  • About 20 out of 100 patients admitted to hospital will experience.
  • About 70 patients out of 100 admitted to the intensive care unit will experience delirium. 

 

What causes delirium?

Delirium can be caused by:

A Physical illness (that brought someone to the hospital)
  • Someone who is ill can have changes in their body chemicals, become dehydrated (not enough water in the body) or get an infection, such as a bladder infect or urinary tract infection. These kinds of problems can cause delirium.

 

Medications

  • The medications the hospitals use to treat illness or control pain can cause delirium

 

Is delirium the same as depression or dementia?

No. Delirium can happen more often in people who have dementia or depression, but it is different.

Delirium happens quickly. It can come and go at any time. This does happen with dementia and depression.

Patients with delirium cannot focus their attention. This is different from patients with dementia and depression.

 

Types of Delirium

There are 2 types of delirium:

  1. Hypoactive delirium

This type of delirium happens most often in elderly patients but can affect anyone at any age.

Patients with hypoactive delirium may:

  • Move very slowly or not active
  • Not want to spend time with others
  • Pause frequently when speaking or not speak at all
  • Look sleepy
  1. Hyperactive delirium

This type of delirium is easier to recognize.

Patients with hyperactive delirium may:

  • May be worried and afraid
  • Be restless (not able to stay still or have trouble sleeping)
  • Repeat the same movement many times
  • Experience hallucinations (seeing something or someone that is not really there).
  • Experience delusions (believe something that is not true).

At times a patient can have both hypoactive and hyperactive symptoms.

 

What are the signs and symptoms of delirium?

A check list:

Disorganized thinking                                                      YES                NO

Saying things that are mixed up or do not make sense

Difficulty concentrating                                                   YES                NO

Easily distracted or having difficulty following what is being said

Memory changes                                                                YES                NO

Not able to remember names, places, dates, times or other important information

Hallucinations                                                                     YES                NO

Seeing or hearing things which are not real

Having delusions                                                                YES                NO

Thinking or believing things which are not true or real

Feeling restless .                                                                 YES                NO

Not able to stay still, trouble sleeping, getting out of bed

Changing energy levels                                                     YES                NO

Changes from being restless to being drowsy or sleepier than usual

 

How can delirium be prevented?

All patients should be carefully screened (checked) for these factors that may cause delirium:

  • Hearing problems
  • Vision problems
  • Not enough water in the body (dehydration)
  • Not being able to sleep or other sleep problems
  • Dementia, depression or both
  • Difficulty getting up and walking around
  • Medication being taken
  • History of alcohol or recreational drug use
  • Chemical changes or imbalances in your body
  • Low oxygen in your body
  • Other health condition or illness

Having trouble:

  • Thinking clearly, reasoning, remembering and judging
  • Concentrating
  • Understanding
  • Express ideas

 

How is delirium be treated?

  1. The health care team helps the patient stay safe and calm
  1. They will try to find the cause of the delirium. Often, there is more than one cause. They also make sure any factors they find are not caused by another medical condition
  1. Then they will address the factors or ease the symptoms.

This could include:

  • Reviewing and changing medications
  • Provide fluids to rehydrate
  • Correcting chemical problems in the body
  • Treat infections
  • Treating low oxygen levels

 

What can family and friends do to help?

Family and friends and caregivers can all help to prevent delirium for their loved ones in hospital.

 

Keep a careful watch for the signs and symptoms of delirium

  • If you see any signs that could mean delirium talk with your health care team right away. Family members are often the first to notice these small changes.
  • Use the signs and symptoms check list and factors list listed on this article to guide your findings.

 

Help with healthy eating and drinking while at the hospital

  • Ask what is right for your loved one before they eat and drink.
  • Make sure they have their dentures (if needed).
  • Encourage help with eating. Feel free to bring their favourite foods from home, check with the health care team about foods they should not eat.
  • Encourage them to drink often, if that is right for them.

 

Keep track of medications

  • Share a complete list of their prescriptions and any over the counter medications they take with the health care team… including the dosage.

 

Help with activity

  • Ask what is right for your loved one before starting any activities.
  • Talk to the team about helpful and safe activities.
  • Help them sit, stand and walk.

 

Help with mental stimulation

  • Make a schedule for family and friends to visit. This will help your loved one feel safe and comforted.
  • Speak to them in a calm, reassuring voice.
  • Tell them where they are and why they are there throughout the day. If possible, place a large sign in their room or write information on it.
  • For example, you could write: Today’s date, weather, where they are and their room number… this will help them stay connected.
  • Give them instructions one at a time. Do not give too much information at once.
  • Bring a few familiar objects from home, such as photo albums and their favourite music. If your loved one needs special care to prevent the spread of infection, check with the care team first.
  • Open the curtains during the day time.
  • Talk about current events.
  • Read the newspaper out loud or use talking books

 

Help them with eyesight and hearing

  • Make sure they wear their hearing aids or glasses, if they need them.
  • Make sure there is enough light in the room.
  • Help them use a magnifying glass, if they need one.

 

Help them rest and sleep

  • Reduce noise and distraction.
  • Soothe them with handholding, a massage, a warm drink or music.
  • Bring a night light, but check with the health care team first.
  • Use comfort items like their favourite pillow and blanket.
  • Limit the number of visitors who come to see your loved one until the delirium goes away.
  • The health care team may not give your loved one sleeping medications because it could make delirium worse.

 

Take care of yourself

It is not easy to be with a person with delirium, even though you may understand the problem

  • Make sure to look after yourself and get some rest. Go out for short walks, remember to eat and drink fluids to keep up your energy levels.
  • It may help to share your thoughts and feelings with someone. Feel free to speak with the health care team.
  • Try not to become upset about the things your loved one may say during their delirium state. People with delirium are not themselves. In many cases, they will not remember what they said or did.

Who can I talk to if I have more questions or concerns?

There are many members of the health care team who can offer help and support. Talk with your doctor or nurse and any member of the health care team, including a Psychiatry, Spiritual Care or Social Work departments. They will answer any questions or concerns you may have about delirium.

 

Delirium should go away or be greatly reduced with the right kinds of treatment… although in some cases some of the symptoms may remain for an extended period of time.

More information can be found on these helpful websites:

Delirium Mayo Clinic                     www.mayoclinic.com/health/delirium/DS01064

Delirium MedlinePlus                   www.nlm.nih/gov/medlineplus/delirium.html

 

Videos:

Youtube – How to recognize Delirium             www.youtube.com/watch?v=hwz9M2jZi_o

Many other videos choices will be available when you log on to this site.

 

Myths & Facts About Aging

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elderly-womanThis article delves into ageist stereotypes dressed-up in the garb of myth that biases perceptions and experiences of being old. The article argues current ”mythmaking” about aging perpetuates that which it intends to dispel: ageism. It considers how traditional myths and folklore explained personal experience, shapes social life, and offers meaning for the unexplainable. The current myths of aging perform these same functions in our culture; however, they are based on half-truths, false knowledge, and stated as ageist stereotypes about that which is known. Recent studies in the cognitive sciences are reviewed to provide insight about the mind’s inherent ability to construct categories, concepts, and stereotypes as it responds to experience. These normal processes need to be better understood, particularly regarding how social stereotypes are constructed. Finally, the article argues that ageist stereotypes when labeled as ”myth” even in the pursuit of the realities of aging, neither educate the public about the opportunities and challenges of aging nor inform social and health practitioners about the aged.

Think you know the facts about growing older? Think again.

Take a brief quiz to determine your knowledge on myth versus fact as it relates to aging:

Myths of Aging Quiz – Answer true or false to each statement.

  1. Polypharmacy (administration of many drugs together) can lead to a change in mental status.
  2. Aging is a universal phenomenon.
  3. Older adults may present with atypical symptoms that complicate diagnosis.
  4. The body’s reaction to changes in medications remains constant with advancing age.
  5. If the rehabilitation nurse observes a sudden change in mental status in an older adult, medication side effects should be investigated as a likely cause.
  6. Primary causes of delirium in older adults include medications, dehydration, and infection.
  7. Dehydration is not common in older adults.
  8. Older adults experiencing a decline in daily function will show no benefit from early rehabilitation.
  9. A decline in functional ability for a person residing in a long-term care facility may indicate the onset of a new illness.
  10. Urinary incontinence is so common in older adults that it is considered a nor- mal part of aging.

Answers: 1. True; 2. True; 3. True; 4. False; 5. True; 6. True; 7. False; 8. False; 9. True; 10. False

In no particular order… what are the common 20 myths that are often associate with Aging

Myth: Dementia is an inevitable part of aging
“Dementia should be seen as a modifiable health condition and, if it occurs, should be followed as a medical condition, not a normal part of aging. In other words, if you or your loved one becomes forgetful, it could be related to medication, nutrition or modifiable medical issues, she said. Don’t assume Alzheimer’s.

Just consider that when doctors examined the brain of a 115-year-old woman who, when she died, was the world’s oldest woman, they found essentially normal brain tissue, with no evidence of Alzheimer’s or other dementia-causing conditions. Testing in the years before she died showed no loss in brain function.

Not only is dementia not inevitable with age, but you actually have some control over whether or not you develop it. “We’re only now starting to understand the linkages between health in your 40s, 50s and 60s and cognitive function later in life. Studies find that many of the same risk factors that contribute to heart disease—high blood pressure, high cholesterol, diabetes and obesity… may also contribute to Alzheimer’s and other dementias.

For instance, studies on the brains of elderly people with and without dementia find significant blood vessel damage in those with hypertension. Such damage shrinks the amount of healthy brain tissue you have in reserve, reducing the amount available if a disease like Alzheimer’s. That’s important, because we’re starting to understand that the more brain function you have to begin with, the more you can afford to lose before your core functions are affected.

Myth: Creaky, Achy Joints are Unavoidable
Not exercising is what makes achy joints inevitable. When Australian researchers at the Monash University Medical School looked at women ages 40 to 67, they found that those who exercised at least once every two weeks for 20 minutes or more had more cartilage in their knees. It suggests that being physically active made them less likely to develop arthritis.

In Fact – You may actually dodge the dementia bullet… Exercise your body and your brain. Physical activity plays a role in reducing the risk of diseases that cause Alzheimer’s. It also builds up that brain reserve. One study found just six months of regular physical activity increased brain volume in 59 healthy but couch-potato individuals ages 60 to 79. Other research finds people who exercised twice a week over an average of 21 years slashed their risk of Alzheimer’s in half.

Then there’s intellectual exercise. It doesn’t matter what kind, just that you break out of your comfort zone. Even writing letters twice a week instead of sending e-mail can have brain-strengthening benefits. That’s because such novel activities stimulate more regions of the brain, increasing blood flow and helping to not only build brain connections, but improve the health of existing tissue. 

Myth: If you didn’t exercise in your 30s & 40s, it’s too late to start in your 50s, 60s or 70s
It’s’s never too late! In an oft-cited study, 50 men and women with an average age of 87 worked out with weights for 10 weeks and increased their muscle strength 113 percent. Even more important, they also increased their walking speed, a marker of overall physical health in the elderly.

Myth: Your Bones Become Fragile And Your Posture Bends
Remember, only death is certain when it comes to aging. Osteoporosis is definitely more common in older people, but it’s also very preventable. 

A study of females over 100 years of age found that only 56 percent had osteoporosis, and their average age at diagnosis was 87. Not bad, given these women grew up before the benefits of diet and exercise on bone were understood. Thankfully, you know better.

Myth: Old Age Kills Your Libido
Impotence and reduced libido are related to normally preventable medical conditions like high blood pressure, heart disease, diabetes, and depression. The solution is keeping yourself in shape. Something as simple as lifting weights a couple times a week can improve your sex life. Sexual desire might decline a bit as you age, but that doesn’t typically occur until age 75A survey of 3,005 people ages 57 to 85 found the chance of being sexually active depended as much if not more on their health and their partner’s health than on their age. Women who rated their health as “very good” or “excellent” were 79 percent more likely to be sexually active than women who rated their health as “poor” or “fair.” And while fewer people ages 75 to 85 had sex than those 57 to 74, more than half (54 percent) of those who were sexually active had intercourse two or three times a month. emember – Sexually transmitted diseases do not discriminate based on age. If you’re not in a monogamous relationship, you or your partner should use a condom.

Myth: Getting older is depressing so expect to be depressed
No way! “Depression is highly treatable. If older people could just admit to it and get help, they could probably live a much more active and healthy life.” That’s because studies find that older people who are depressed are more likely to develop memory and learning problems, while other research links depression to an increased risk of death from numerous age-related diseases, including Parkinson’s disease, stroke and pneumonia.

Myth: Genes Play The Biggest Role In How You’ll Age
Even if you’re born with the healthiest set of genes, how you live your life determines how they behave over your lifespan. Your genes can be changed by what you eat, how much physical activity you get, and even your exposure to chemicals.

Myth: Women fear aging more so than men
Not so! A survey conducted on behalf of the National Women’s Health Resource Center found that women tend to have a positive outlook on aging and to be inspired by others who also have positive attitudes and who stay active as they grow older. Women surveyed were most likely to view aging as “an adventure and opportunity” and less likely to view it as depressing or a struggle.

Myth: You Lose Your Creativity As You Age
Creativity actually offers huge benefits for older people. A study found that older adults who joined a choir were in better health, used less medication, and had fewer falls after a year than a similar group that didn’t join. The singers also said they were less lonely, had a better outlook on life, and participated in more activities overall than the non-singing group, who actually reduced the number of activities they participated in during the year.

Myth: The pain and disability caused by arthritis is inevitable, as you get older
senior in the poolWhile arthritis is more common as you age, thanks to the impact of time on the cushiony cartilage that prevents joints and bone from rubbing against one another, age itself doesn’t cause arthritis. There are steps you can take in your youth to prevent it, such as losing weight, wearing comfortable, supportive shoes (as opposed to three-inch spikes), and taking it easy with joint-debilitating exercise like running and basketball. One study found women who exercised at least once every two weeks for at least 20 minutes were much less likely to develop arthritis of the knee (the most common location for the disease) than women who exercised less.

Myth: Your Brain Stops Developing After Age 3
This developmental myth was overturned in the 1990s, and ever since, researchers no longer look at the older brain as a static thing. Instead, studies show your brain continues to send out new connections and to strengthen existing ones throughout your life — as long as you continue to challenge it. It really is your body’s ultimate muscle.

Myth: Your Brain Shrinks With Age
This myth began with studies in 2002 showing that the hippocampus, the part of the brain that controls memory, was significantly smaller in older people than in younger people. This never sounded right to Dr. Lupien, particularly after she conducted groundbreaking research in the late 1990s showing that chronic stress shrinks the hippocampus. 

Was it age or stress that was responsible for the shrinking brains of older people? Probably stress. When she examined brain scans of 177 people ages 18 to 85, she found that 25 percent of the 18- to 24-year-olds had hippocampus volumes as small as those of adults ages 60 to 75.

Myth: Seniors Are Always Cranky And Unhappy
When researchers from Heidelberg, Germany, interviewed 40 centenarians, they found that despite significant physical and mental problems, 71 percent said they were happy, and more than half said they were as happy as they’d been at younger ages. Plus, when the researchers compared them to a group of middle-age people, they found that both groups were just as happy. Most important: Nearly 70 percent of the centenarians said they laughed often. What does it all mean? It means there is no universal definition of aging. How you’ll age is entirely up to you – and the time to begin writing that definition is today.

Myth: When you get older, you don’t need as much sleep
You may need as much sleep as when you were younger, but you may have more trouble getting a good night’s sleep. “It is not so much that there is a decline in the number of hours needed, but rather that sleep patterns may change with a tendency to more naps and shorter nighttime periods of deep sleep.

Myth: If you live long enough, you’re going to be senile
The odds are against it. “The probability of senility at age 65 is only about five percent. It rises to about 20 percent by age 85.

The term “senility” is no longer used to describe dementia. Alzheimer’s disease is the most common type of primary progressive dementia. Alzheimer’s is linked to age, Dr. Gorbien says, and older people worried about it should seek an assessment with a geriatrician, neurologist or psychiatrist.
“Early detection of Alzheimer’s disease is so important,” he says. New medications may slow the progression of the disease and help keep people independent.

Myth: Older adults are always alone and lonely
In proportion the number of older people living alone are greater than their younger counterparts, but they are not necessarily lonely. Relationships may grow more intense in old age, Dr. Schaie says. More people live alone as the population ages, Dr. Gorbien says. And Dr. Schaie says gender differences in average life spans leave many more women than men widowed. Widowed men are more likely than women to remarry, Dr. Schaie says, “because of the availability of a larger pool of eligible partners.”

“Most seniors are active,” adds AARP spokesman Tom Otwell. Many have paying jobs, regularly volunteer, garden or help care for grandchildren, for instance.

Myth: Old age means losing all my teeth
If you’re not worried about losing your mind when you’re old, you might fret about losing your teeth. Periodontitis, or late stage gum disease, is the primary cause of tooth loss in adults. This condition commonly begins as gingivitis where gums turn red and begin to swell and bleed, a situation experienced by too many people. Fortunately healthy gums and avoiding false teeth are both reasonable goals.

The elderly of today are much more likely to keep their teeth than previous generations. Even so, dental disease is prevalent. The New England Elders Dental Study found the beginnings of periodontal disease in over 3/4 of the 1150 persons examined. Part of the problem, said these investigators, was that education and dental care for this population are overlooked by both dentists and the patients themselves. The sad part of this situation is that proper dental hygiene and regular cleanings by the dentist are usually enough to stave off infection. Healthy people should replace their toothbrushes every two weeks; those with a systemic or oral illness more often. Everyone should use a new toothbrush when they get sick, when they feel better and again when they completely recover.

Myth: The older I get, the sicker I’ll get
It’s true that as we age, our physiology changes. These changes can lead to poor health if not addressed. But old age doesn’t have to mean feeling sick and tired. An important part of staying well into the older years is keeping your immune system operating at its peak. Aging is generally associated with lagging immunity and consequently more infections especially of the respiratory system. However, John Hopkins’ Professor Chandra discovered that when independent, apparently healthy, elderly people were fed nutritional supplements for a year, their immunity improved. Immunological responses were so marked that those who were supplemented (versus the placebo group) were plagued with less infections and took antibiotics for less days. Besides taking care of your immunity with supplementation, diet, exercise and other measures, you can prevent many age-related diseases with specific health precautions. For example, there is evidence that smoking and low plasma levels of vitamins C and E, and beta-carotene contribute to cataracts.

Calcium and magnesium supplementation helps some individuals with hypertension. Most are helped by high potassium foods (fruits and vegetables), salt restriction and weight maintenance. Keeping blood pressure under control can also decrease the risk of a stroke.

Adult-onset diabetes is usually treated best with dietary measures such as reducing simple sugars, consuming a lot of fiber and taking chromium supplements. It’s estimated that half of all types of cancer are linked to diet. This explains why less fat, lots of fruits, vegetables and fiber, vitamins A, B6, C and E and zinc and selenium all appear to play a role in cancer prevention.

Myth: Urinary incontinence is considered a normal part of aging
Although urinary incontinence (UI) occurs more frequently among older adults (10%–42% of hospitalized elders), it is not considered a normal part of aging and is highly treatable. A new onset of UI can signal problems such as urinary tract infection, electrolyte imbalances, mobility limitations, or medication side effects. Before beginning any rehabilitative interventions for incontinence, all possible causes should be investigated to rule out reversible factors. Bladder retraining for those with urge or stress incontinence is still highly effective for older adults. Behavioural management is the first line of treatment for incontinence.

Myth: Growing older means accepting the loss of independence and a Home for the Aged
There is absolutely no evidence to support that as we age we accept loss of independence or going into a nursing home as part of the aging process. In fact today’s older adults enjoy a more vibrant and vigorous lifestyle. Remaining active, engaged and enjoying a more robust social life. An ever-increasing number of older adults are adopting home care in order to preserve the very things that the myth depicts. However, older adults do share common fears… in fact the 5 greatest noted fears among older adults are:

  • Loss of independence
  • Loss of loved ones
  • Loss of friends
  • Going into a Nursing Home
  • Death

In Our Care supports the aging process so effectively that you never have to ever see the inside of Nursing Home, unless you’re visiting friends and family. We are fully equipped to handle all your care needs – Effectively, Efficiently & Affordably.

Please contact us today, to discuss any challenges you may be facing and how our services can help you remain independent, protected, safe, and in you home / community.

You got questions, we have answers: (905) 785-2341 or email us at homecare@inourcareservices.com

Water – More than an Element

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Water3Water

It’s common knowledge that you can go with out food much longer than you can without water. Fact: The human body needs air, food and water to survive. However, two out of the three requires our actions to attain it. Air intake is more like an internal instinct activated at birth and expires upon death. We can barely go 3 minutes (max) without slipping into an unconscious state.

Food: A human can go for more than three weeks (3) without food (Mahatma Gandhi survived 21 days of complete starvation). The body is an efficient machine that harvest fat and muscle store in the body and organs to sustain it.

Water: A lack of fluid intake causes problems with kidney function within just a few days, particularly if a person is active (not bed ridden). One week is a generous estimate. Three to four days would be more typical. After which time vital organs systemically shut down due to dehydration.

Do you need more water in the summer than you do in the winter months? Our bodies are constantly losing water, which is why drinking a glass of H20 once a day is not enough to keep the body replenished. We lose water when we sweat, go to the bathroom — even when we exhale. Under extreme conditions an adult can lose 1 to 1.5 liters of sweat per hour. So it really depends on your personal physical activity, heat exposure and rate of perspiration.

human_body_composition-_better_coloursWhy should I drink water?

Drinking water helps maintain the balance of body fluids. Your body is composed of about 60% water. Water aides in digestion, absorption, creation of saliva, transportation of nutrients, and maintain optimal body temperature.

Water helps energize muscles. Cells that don’t maintain their balance of fluids and electrolytes shrivel, which can result in muscle fatigue.

Water can help control calories. For years, dieters have been drinking copious amounts of water as a weight loss strategy. While water doesn’t have any magical effect on weight loss, substituting it for high calorie beverages can certainly help. Doing so will also give you that fuller feeling causing you to eat less.

Water helps keep skin looking good. Your skin contains plenty of water, and functions as a protective barrier to prevent excess fluid loss. However, do NOT expect over hydration to erase all signs of aging… but lack of hydration will certainly magnify the affects of aging.

Other reasons:

  • Cools you down, especially in hotter weather
  • Lubricates your tissues and joints
  • Dissolves soluble compounds
  • Helps flush toxins from your system

There are free phone applications on smartphones that monitor your water drinking habits:

  • Hydro drink water
  • Water your body
  • Drink water
  • Hydro Coach

Water6Tips to help you drink more water

If you think you need to be drinking more, here are some tips to increase your fluid intake and reap the benefits of water:

  • Have a beverage with every snack and meal
  • Choose beverages you enjoy; You’re likely to drink more fluids if you like the way they taste (try lemon in your water) as a substitute to high sugary drinks.
  • Keep a bottle of water, at you desk, or in your bag
  • Choose beverages that meet your individual needs. If you’re watching calories, go for non-caloric beverages

Drinking water is not the only way to hydrate. Eat more fruits and vegetables. Their high water content will add to your hydration. About 20% of our fluid intake comes from foods.

Veggies with high water content Fruits with high water content
Cucumber Watermelon
Lettuce Grapefruits
Zucchini Oranges
Tomatoes Strawberries
Radishes Cantaloupes
Celery Peaches
Eggplant Raspberries
Cauliflower Blueberries
Broccoli Cranberries 

How much is enough?

Many of us have probably heard the 8 by 8 rule stating that we should drink eight, eight ounces glasses of water daily. However, there are no studies that strongly support this theory.

The amount of water one should consume is individualized. For the most part, a healthy person should note that thirst is the first indication that our bodies need more water. Try to stay hydrated enough so that you do not feel thirsty often.

Water5

 

Water Facts:

  • An easy way to gauge how well hydrated we are, is to simply look at our urine. It should be fairly clear… if it is dark yellow, you may need to drink more water.
  • If you constantly feel hungry, try drinking more water between meals. What you believe to be hunger, may actually be your body way of saying you need more hydration.

Some factors that may require you to drink more water than the average person are:

  • Medications for heart, stomach ulcers or depression – can alter your thirst mechanism
  • Diabetes
  • The elderly can sometimes have a poorly regulated thirst mechanism
  • People who have problems with kidney stones or chronic urinary tract infections
  • Athletes, children playing outdoors or anyone working outside during a hot summer day may require more

 

Please contact us today, to discuss any challenges you may be facing and how our services can help you remain independent, protected, safe, and in you home / community.

You got questions, we have answers: (905) 785-2341 or email us at 

 

 

Living Longer, Healthier & Happier

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Women Wearing Colorful Bathing CapsPrepare Yourself – To live longer, healthier and happier

“If I’d known I was going to live this long, I’d have taken better care of myself.” So said Eubie Blake, the great ragtime composer and pianist who was still performing at the age of 99, the year before his death. Let’s face it: old age is what lies ahead. If you’re 40 or 50 or even 60, you might not give much thought to the health challenges of aging. But just as planning for future financial needs is important, so is planning for optimum health in our later years.

 

What should you prepare for, and how?

Medical experts express about the major health issues that may lie ahead. While some diseases, such as Alzheimer’s and certain cancers, continue to confound researchers, a great number can be prevented, forestalled, or minimized with a healthy lifestyle and regular health screenings. Sharon Brangman, MD, AGSF, spokeswoman for the American Geriatrics Society, says, “The more you do in middle age to prepare yourself for successful aging, the better.”

Obesity and Metabolic Syndrome

About three-fourths of adults aged 60 and older are overweight or obese. Obesity is related to type 2 diabetes, cardiovascular disease, breast and colon cancer, gall bladder disease, and high blood pressure.

More than 40% of adults 60 and older have a combination of risk factors known as metabolic syndrome, which puts people at increased risk for developing diabetes, cardiovascular disease, and certain cancers. It is characterized by:

  • Waist measurement greater than 40 inches in men, 35 inches in women (apple-shaped body)
  • Triglyceride level of 150 mg/dL or higher
  • HDL “good” cholesterol level less than 40mg/dL in men, 50 mg/dL in women
  • Blood pressure of 130/85 or higher
  • Fasting glucose level of 110 mg/dL or higher

“Women in, and post-menopausal stages tend to accumulate fat around the waist and hips, and men get the gut,” says Brangman. “The best way to fight it is with increasing exercise, reducing alcohol intake — because a lot of alcohol calories go right to the gut — and reducing calorie intake. Also, increase your healthy fat intake — omega-3 fatty acids and unsaturated fats. And eliminate trans fats completely because there’s no safe amount of those.” She also advises avoiding foods sweetened with high-fructose corn syrup. The common sweetener is found in everything from sodas to breakfast cereal to low-fat yogurt. “In middle age, we should eat foods as close to naturally prepared as possible.”

Arthritis

Arthritis affects nearly half the elderly population and is a leading cause of disability. “Old injuries from playing weekend warrior or high school football, and years of wearing high-heeled shoes catch up with us,” says Brangman. “And arthritis in the knees is the price we pay for walking upright on two legs.” The keys to prevention: avoid overuse, do steady, regular exercise rather than in weekend spurts, and stop if you feel pain. “The adage, ‘no pain, no gain,’ is not true.” And managing your weight is just as essential for joint health as cardiovascular health. The Framingham osteoarthritis study showed that a weight loss of just 11 pounds could reduce the risk of developing osteoarthritis in the knees by 50%.

Osteoporosis and Falls

Osteoporosis and low bone mass affects almost 44 million adults age 50 and older, most predominantly affecting women. According to the National Osteoporosis Association, osteoporosis is not part of normal aging. Healthy behaviours and treatment, when appropriate, can prevent or minimize the condition.

In a given year, more than one-third of adults, age 65 and older experience a fall. Twenty percent to 30% of those who fall suffer injuries that decrease mobility and independence; falls are the leading cause of death from injury in this age group.

“Stop smoking, watch your alcohol intake, get plenty of calcium, and limit foods with high acidic content,” says Brangman. “Avoid sodas. They encourage loss of calcium. Our bodies always maintain calcium, and when there’s not enough coming in from our diet, it comes out from our bones. One reason women are especially at risk for osteoporosis is that if they’ve had children; it takes a whole lot of calcium to develop a baby, and that calcium is taken from the mother’s bones if she’s not getting enough in her diet.” Adults in middle age need 1,000 to 1,200 milligrams of calcium daily.

Vitamin D, “the sunshine vitamin,” is also important. Using sunscreens to protect against harmful UV rays is wise, but sunscreens also blocks the same ultraviolet rays the body needs to make vitamin D.

Furthermore, with age our bodies become less efficient at making vitamin D from sunlight. There is a move to get the FDA to increase the minimum requirement for vitamin D to at least 800, or maybe even 1,000 units. Most multiple vitamins contain 400 units. Make sure you’re getting enough from low-fat dairy products, or take a supplement.”

Weight-bearing exercise also helps to keep bones healthy. “If you’re not exercising, starting at any age is beneficial. It’s never too late, but the sooner the better.

Cancer

Risk for developing most types of cancer increases with age.

As women age, the rate of cervical cancer decreases, and endometrial cancer increases. Sometimes women slack off gynecological exams after their childbearing years, but I still think it’s important for women to get regular exams.”

The risk of prostate cancer increases with age, and black men have a higher rate than white men. Screening should start in your 40s, and at the very least should involve a digital rectal examination.

Lung cancer accounts for more deaths than breast cancer, prostate cancer, and colon cancer combined. “Stop smoking.”

Cardiovascular Disease (CVD)

Younger baby boomers take heed: cardiovascular disease (CVD) affects more than one-third of men and women in the 45- to 54-year age group, and the incidence increases with age. Cardiovascular diseases, which are diseases of the heart or blood vessels, are the leading cause of death in the U.S. and Canada. They include arteriosclerosis, coronary heart disease, arrhythmia, heart failure, hypertension, orthostatic hypotension, stroke, and congenital heart disease.

A healthy lifestyle can reduce the risk of heart disease by as much as 80%, according to data from the Nurses’ Health Study, an extensive research effort that followed more than 120,000 women aged 30 to 55 starting in 1976. Looking at data over 14 years, the researchers showed that women who were not overweight, did not smoke, consumed about one alcoholic drink per day, exercised vigorously for 30 minutes or more per day, and ate a low-fat, high-fibre diet had the lowest risk for heart disease.

If you have high blood pressure, get it under control. It reduces the rate of stroke and heart attacks. People say the medicines have bad side effects, but there are enough medications to choose from that you and your physician should be able to find one that’s right for you.

Prepared foods are loaded with salt. Limit salt intake to control high blood pressure. The minute food comes out of a can or frozen food package or from a fast-food environment you lose control of the ingredients. This is another reason to eat foods as close to naturally prepared as possible.

Vision and Hearing Loss

Age-related eye diseases — macular degeneration, cataract, diabetic retinopathy, and glaucoma — affect 119 million people aged 40 and older, according to the 2000 census. And that number is expected to double within the next three decades.

“Eating foods with high antioxidant content may be helpful in reducing vision loss due to macular degeneration,” says Brangman. “And taking vitamin supplements for eye health may help. A lot of my geriatric patients are taking them now, which may not be as helpful as taking them when you’re younger.”

It also appears that smokers are at higher risk for macular degeneration, so that’s another reason to stop smoking. Regular eye exams should include screening for glaucoma, which is called “the sneak thief of sight” for the fact that the first symptom is vision loss. The disease can be arrested, but vision lost to glaucoma cannot be restored.

The incidence of hearing loss increases with age. Twenty-nine percent of those with hearing loss are 45-65; 43% of those with hearing loss are 65 or older.

Hearing loss takes a toll on the quality of life and can lead to depression and withdrawal from social activities. Although hearing aids can help, only one out of four people use them.

High-frequency hearing loss is common in old age and made worse by a lifestyle that includes exposure to loud sounds. The 40- and 50-year-olds who went to the rock concerts that were so loud they were pulsating in their chests are starting to pay. Another factor is working or having worked in a noisy environment, such as airports or factories.”

Her advice to people at any age: Don’t use earbuds! Any source of sound that fits in the ear canal, such as using Walkmans or iPods, really puts your hearing at risk. If you’re going to use an iPod, don’t put it directly in your ear, and lower the volume.”

She says hearing aids are not an ideal solution for hearing loss. “My patients complain that they magnify the wrong sounds. They keep their $3,000 or $4,000 hearing aids in the nightstand.”

Teeth

The good news is that you’ll probably keep your own teeth, and implants and bleaching can make your teeth look years younger than the rest of your body. Only about 25% of people over age 60 wear dentures today.That’s because of a lifetime of good dental health and diet. Unfortunately, the people who haven’t had a lifetime of good health care and healthy practices are at risk for losing their teeth.The US and Canadian Dental Associations advises brushing twice a day with fluoridated toothpaste, flossing daily to remove plaque, and visiting your dentist regularly.

Mental Health: Memory and Emotional Well-being

Forget what you think you know about memory loss and old age. It is not inevitable. So why do so many people say, “My memory isn’t what it used to be,” or “I’m having a senior moment?” Stress, anxiety, and mental overload are most likely responsible. “Stop multitasking,” says Brangman, who is professor and division chief and geriatric medicine director at the Central New York Alzheimer’s Disease Centre, SUNY Upstate Medical University in Syracuse, N.Y. “Our brains are made for us to do one thing at a time. Multitasking overloads the brain so people aren’t remembering things and get concerned they’re having memory problems.”

Doing the things that keep your heart healthy will also keep your brain healthy. The same blood vessels that go to the heart branch off and go to the brain. Exercise, control your blood pressure, quit smoking, and if you have diabetes, keep it under control.

Staying mentally active is as important as staying physically active. Join a book club, stay up on current events, engage in stimulating conversations, and do crossword puzzles. “The new rage is Sudoku puzzles. They’re absorbing and require a tremendous amount of concentration, and there’s a lot of satisfaction in getting it right.”

One of the perplexing problems of aging is Alzheimer’s disease. About 3% of men and women aged 65 to 74 have Alzheimer’s disease, and nearly half of those aged 85 and older may have the disease. We’re not aware of anything people can do to prevent Alzheimer’s or dementia, but we’re learning new things about the brain every day.

Among all age groups, depression is often an under-diagnosed and untreated condition. Many people mistakenly believe that depression is a natural condition of old age. Of the nearly 35 million Americans aged 65 and older, an estimated 2 million have a depressive illness and 5 million more may have depressive symptoms that fall short of meeting full diagnostic criteria.

When you get older, you’re dealing with life-change issues. Kids leaving home, health problems, loss of parents & friends, and advanced ageing related issues (financial, caregiver arrangements, physical challenges, etc). We notice that all the basketball players are younger than us, and the music and ads are for a younger demographic. He advises anticipating and preparing for the changes to come.

One of the biggest life changes is retirement. Many people have their sense of worth tied up with work. In retirement, depression and suicide rates rise.

Prepare for retirement by thinking about what some call “the second act”. What would you have wanted to do if you hadn’t done your career? Jimmy Carter is a perfect example. After his presidency, he went on to become a humanitarian, working on behalf of international human rights and Habitat for Humanity.”

Recognize that some physical abilities will decline, but giving up sports altogether isn’t the answer. People who are active in sports such as basketball or football should think ahead to activities such as golf or water polo that put less stress on the joints.

Also recognize in your 40s and 50s that parents and grandparents won’t be around forever. In anticipation of their getting old and dying, making contact and tying up loose ends can be useful.

Nurturing your spiritual side may be in order as you get older and face mortality. For many people who have drifted away from religion or spiritual practice, it’s sometimes comforting to reassess that. Do I need to connect with my religion or spend time becoming the spiritual person I want to become? Pay attention to it if it’s important to you.

Finally, just the way you figure out your finances, figure out what you need to make you happy, and if you have a medical problem or mental health problem, how will you deal with it. Make some strategic decisions about how you want to live your life.

Do Your Part

according to the Centre for Disease Control (CDC)Much of the illness, disability, and deaths associated with chronic disease are avoidable through known prevention measures, including a healthy lifestyle, early detection of diseases, immunizations, injury prevention, and programs to teach techniques to self-manage conditions such as pain and chronic diseases . While the future will undoubtedly bring medical advances in treatments and cures… but if you can keep all your parts original, they are the best.

Of course, this is not a road that you must commute alone. You can benefit through a service partnerships with In Our Care – Home Care Services to maximize your independence, mobility, safety and engagement in social and community events.

Please contact us today, to discuss any challenges you may be facing and how our services can help you remain independent, protected, safe, and in you home / community.

You got questions, we have answers: (905) 785-2341 or email us at 

 

 

The Most Common Age Related Issues

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The Most Common Age Related Issues

Healthy Aging

Thanks to new medications and surgical techniques, people are living longer. However, the body we had at 55 will be a very different body than the one we have at 75. Many issues, both genetic and environmental, affect how we age. The most widespread condition affecting those 65 and older is coronary heart disease, followed by stroke, cancer, pneumonia and the flu. Accidents, especially falls that result in hip fractures, are also unfortunately common among the elderly population. Numbers and statistics are climbing as the aging population continues to escalate.

 

Many of our elders are coping with at least one of the following conditions, and many are dealing with two or more of the following

 

  • Heart conditions (hypertension, vascular disease, congestive heart failure, high blood pressure and coronary artery disease)
  • Dementia, including Alzheimer’s disease
  • Depression
  • Incontinence (urine and stool)
  • Arthritis
  • Osteoporosis
  • Diabetes
  • Breathing problems
  • Frequent falls, which can lead to fractures
  • Parkinson’s disease
  • Cancer
  • Eye problems (cataracts, glaucoma, Macular Degeneration)

As our body changes, other things to be aware of are:

  • A slowed reaction time, which is especially important when judging if a person can drive.
  • Thinner skin, which can lead to breakdowns and wounds that don’t heal quickly
  • A weakened immune system, which can make fighting off viruses, bacteria and diseases difficult
  • Diminished sense of taste or smell, especially for smokers, which can lead to diminished appetite and dehydration

The list can seem daunting. However, with proper care, elders have a life filled with joy.

Please browse our many other articles relating to specific topics.

Our aim is to ensure that seniors are protected, kept safe and well cared for. For those individuals who wish to continue living in their own homes, we offer a variety of services to support that very goal and serve you in ways you did not think possible: For example, we also offer a complete home maintenance plan so that you or your loved never has to deal directly with contractor in order to access services. We take care of that and minimized any risk of fraud or sub-standard services. Your golden years are your to enjoy and we want to ensure you do.

Please contact us today, to discuss any of the above mentioned challenges you may be facing and how our services can help you remain independent, protected, safe, and in you home / community.

You got questions, we have answers: (905) 785-2341 or email us at 

Senior Care: Sleep Disorders

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Night Sky - Sleeping TimeInsomnia and hypersomnia are associated with mood disorders and depression in particular. In vulnerable individuals problems sleeping should be noted; enabling better sleep can bring significant relief and help cope with the illness.

Sleep disruption is a very common finding in patients with psychiatric difficulties. A large community study found that a much higher proportion of people with insomnia or hypersomnia (sleeping more than usual) have a major psychiatric illness when compared to people who do not have these sleep complaints. Furthermore, when someone has insomnia early in life he or she is more likely to develop depression in later life. Over 70% of patients who are acutely ill with a psychiatric condition have insomnia and unfortunately the sleep disruption may not improve even when the illness is in remission and are known to cause depression. One’s social situation is another important factor, for example, if one is living in poor housing with little income and few social supports, or in an abusive relationship, then there is an increased risk for becoming depressed.

Doctors will usually encourage the use of antidepressant medications first as it can be difficult to take advantage of therapy when one is feeling so low. Psychotherapy can be long-term, looking at the factors from the past that may have resulted in or made one vulnerable to depression, or short-term, focusing more on the current situation and teaching one strategy to deal with the negative thoughts that often accompany depression.

Do psychiatric disorders cause sleep disorders?
Insomnia co-occurs with depression more than with any other illness, either medical or psychiatric. Sleep disruption (insomnia or hypersomnia) is one of the symptoms used to determine whether or not someone is depressed. It is often one of the first signs of an episode of depression, often preceding the onset of low mood and dissatisfaction in people who have recurrent depression. Typically, people have difficulty getting off to sleep, have many awakenings across the night and awaken in the very early morning and cannot get back to sleep. They feel very tired in the daytime and this makes the other symptoms of depression difficult to tolerate. There are some people for whom depression results in them sleeping much more than they normally would. When the sleep of people with a depression is recorded in the sleep clinic, we find that they have a delay in falling asleep, less deep sleep and poor sleep quality. They often have more REM sleep (rapid eye movement sleep, which is when dreaming occurs) and it occurs earlier in the night.

As mentioned above, it may be the case that sleep may not go back to “normal” even when the depression has improved. It is important to pay close attention to sleep hygiene factors, such as eliminating caffeine and keeping a regular sleep-wake schedule. Learning and practicing relaxation strategies can be very beneficial. It may be helpful to do some therapy, such as cognitive behavioural therapy, aimed specifically at treating the insomnia. The more one can work on such strategies when one is well the easier it will be to put them into practice should the depression recur in the future. When there is a history of depression alterations in sleep may signal its recurrence. Getting the insomnia under control as soon as possible will likely improve the course of the illness. Given the strong associations between sleep disruption and depression, it may even be worth considering restarting treatment for the depression at this point before it advances to a higher level of severity.

There is no doubt that sleep disruption often appears when a psychiatric illness develops. This is not surprising since the increased arousal and anxiety that often accompanies such illnesses will make it more difficult to sleep. However, there is evidence that the opposite may be true, that is, insomnia may trigger psychiatric illness or make someone who is vulnerable more likely to have an episode of illness. It may be the case that mental health and sleep are controlled by common brain mechanisms. When these mechanisms are altered or become disrupted, both sleep problems and psychiatric illness may occur.

How do mood disorders affect sleep?
Depression is the most common mood disorder. Approximately 1 in 4 women will suffer from an episode of depression at some time during their lives. The number for men is less but a significant proportion will also suffer from this condition. An episode of major depression is diagnosed when there is a history of feeling sad or not being able to enjoy things as much as usual for at least 2 weeks (often it is much longer than this). This feeling is accompanied by several other symptoms such as having difficulty paying attention and concentrating; loss or significant increase in appetite; insomnia or hypersomnia; having recurrent thoughts about wishing that one were dead or thinking about ending one’s life; not being able to get pleasure out of things previously found pleasurable.

Do antidepressants affect sleep? 
The recording of sleep in the sleep clinic shows that antidepressants have the greatest effect on REM/dreaming sleep, decreasing the amount. Patients sometimes notice that they dream more vividly after starting an antidepressant and in rare cases, nightmares can be problematic. Excessive dreaming may occur during withdrawal from an antidepressant.

What causes depression? 
There are likely many causes. One is a genetic vulnerability. A strong history of depression in a family increases the likelihood that one will have a similar condition. Depression can also result from certain medical conditions such as hypothyroidism, stroke, head injury and HIV. There is evidence that ongoing sleep disruption contributes to depressed moods. Certain medications, for example prednisone can trigger or worse episodes of depression. Unfortunately, antidepressants can cause or worsen restless legs syndrome, periodic leg movements (PLMs) during sleep, and sleep bruxism (teeth- grinding), often resulting in fragmentation of sleep.

What happens to sleep during depression?
The main focus of treatment must be treating the underlying condition, namely the depression. This is done through the use of antidepressants and/or psychotherapy. There are many antidepressants available nowadays and most people are able to find adequate relief from their difficulties. The response to an antidepressant varies greatly from person to person. There are certain antidepressants that almost always make one sleepy and the doctor treating a patient for whom insomnia is a problem may choose one of these in order to help treat the sleep problem. Some doctors, when starting an antidepressant, may also give the patient a short-term supply of a sleeping medication such as zopiclone or lorazepam (especially when anxiety is also causing difficulties). Such medications should be used in the short-term only and should be discontinued when the depression starts to respond to the antidepressant. There is no doubt that enabling someone to sleep if they have been depressed and not sleeping well for some time, can bring significant relief and helps them cope with their illness and even get better. Most antidepressants change sleep. As noted above, some such as mirtazapine are beneficial in that they are sedating and they can, therefore, be taken at night to treat insomnia. Some antidepressants, for example, buproprion, often make one feel more alert and awake. Hence, they are useful when the patient suffers from hypersomnia. Some people find it is more difficult to get to sleep, and complain of sleep disruption, when they first start taking the medication. These disruptive effects usually last for 4-6 weeks and if they persist another medication should be tried or a sleep-promoting agent added.

How to Get a Good Night’s Sleep — Even When You’re Depressed
People suffering from depression and bipolar are usually significantly affected by disrupted sleep patterns. Sometimes spending hours in bed, unable to get out, yet you just can’t sleep. Other times you end up sleeping, but wake up at 4 a.m., your mind racing with all sorts of negative thoughts. It’s not just you, and getting the right amount of sleep as very important… actually… critical to good health.

Depression both causes and is compounded by sleep disruption. The low energy caused by sleep deprivation also affects your ability to treat depression. How on earth can you make and attend appointments with experts, exercise or eat properly when you are perpetually exhausted? And socializing? Don’t even go there — the last thing you want to do when tired is talk to people. But what if you could take control of the situation, finally get a good night’s sleep and enjoy the benefits of restorative sleep and higher energy levels?

With a little bit of willpower and a change in routine, you can do this. Sleep is important. In fact, respondents to my survey of over 4,000 people rated getting a good night sleep number 10 (out of 60) in importance for overcoming depression and bipolar.

So where do you start in finally getting a good night’s sleep?

Sleep Hygiene
In the same way that you maintain personal hygiene through washing your body and oral hygiene by brushing your teeth and flossing, sleep hygiene is a set of practices to follow as a routine, which will yield a good night’s sleep.

As a general point, this is a good idea even for those not suffering from depression, as there are many health benefits to a full night’s sleep. There’s a huge list of practices, which can form part of sleep hygiene, but it’s down to you as to which ones will work best for you.

As a general rule of thumb, though, the aim is to create a routine, which you can follow. The following points reiterate and emphasize the importance of routines & transforming your environment into the most conducive and sleep inducing space possible. Several points to enhance a good night’s rest couple here, but the one I recommend most is the one that is hardest to do:

Use your bed only for sleep
You will find it harder to sleep if you stay in your bed all day, unable to move or act. I know I did. This is because you end up associating your bed with a general state of inertia, rather than the place in which sleep occurs. So even if you transfer to a sofa or somewhere else horizontal to lie all day, this is a very important step to take.

Don’t Force Yourself to Sleep
You can’t will yourself to sleep and getting frustrated at your inability to sleep doesn’t help either… nor does glancing at the clock every few minutes. Try some meditation exercises in bed, such as paying attention to your breath, which will help clear your mind a little and take attention away from the thoughts racing around in your head.

Have a Bedtime Routine
A bedtime routine, regularly followed, signals to your body that it’s time to start winding down, which helps encourage sleep. Things like avoiding upbeat music and stimulants like cigarettes, alcohol and caffeinated drinks and trying a little bit of meditation or yoga, putting on some relaxing music or some lavender essential oil or pillow spray can all help prepare you for sleep.

Maintain the Proper Atmosphere
If your bedroom isn’t a good sleep environment, you’ll find it difficult to relax. A bedroom which is dark, quiet and cool (but not cold) is crucial achieving a good night’s sleep. Too light and you’ll struggle to sleep. Too noisy and you may be awakened by sounds during the night. If it’s the wrong temperature, you’ll be tossing and turning and kicking off the covers during the night. Consider having a fan in the room. As well as helping to regulate the temperature, the ‘white noise’ of the fan’s engine can be a helpful noise to tune in to and help encourage sleep.

Sleep Better, Feel Better, Beat Depression
Once your sleep hygiene improves, you will feel more refreshed and energized and really feel the benefits of a good night’s sleep – and wonder why you didn’t initiate good sleep hygiene earlier! Then you can start making real progress in boosting your mood. You will have the energy and motivation to take action, you’ll also have the practice and experience of making changes to your lifestyle and routine, so you know that you can do it and it is beneficial.

What Other Techniques Can Help Me Sleep?
In addition to trying medications, here are some other tips to improve sleep:

  • Learn relaxation or mindfulness-based meditation and deep-breathing techniques.
  • Clear your head of concerns by writing a list of activities that need to be completed the next day and tell yourself you will think about it tomorrow.
  • Get regular exercise, no later than a few hours before bedtime.
  • Don’t use caffeine, alcohol, or nicotine in the evening.
  • Don’t lie in bed tossing and turning. Get out of bed and do something in another room when you can’t sleep. Go back to bed when you are feeling drowsy.
  • Don’t lie in bed to watch TV or read. This way, your bed becomes a cue for sleeping, not for lying awake.

How is depression and sleep disorders related?
Depression is a mood disorder that is characterized by sadness, or having the blues. Nearly everyone feels sad or down from time to time. Sometimes, however, the sad feelings become intense, last for long periods, keep a person from leading a normal life, and interfere with sleep.

According to the National Institute of Mental Health, symptoms of depression may include the following:

  • Difficulty concentrating, remembering details, and making decisions
  • Fatigue and decreased energy
  • Feelings of guilt, worthlessness, and/or helplessness
  • Feelings of hopelessness and/or pessimism
  • Insomnia, early-morning wakefulness, or excessive sleeping
  • Irritability and restlessness
  • Loss of interest in activities or hobbies once pleasurable, including sex
  • Overeating or appetite loss
  • Persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment
  • Persistent sad, anxious, or “empty” feelings
  • Thoughts of suicide, suicide attempts (if you are thinking of acting on ideas about suicide, call your local 24-hour suicide hotline right away).

Depression in Men
While clinical depression was once considered a “woman’s disease,” more than 6 million men in the U.S. have depression each year. Unfortunately, the lingering image of depression as a female condition may keep men who are clinically depressed from recognizing the symptoms of depression and seeking treatment. Depression actually affects both sexes. It disrupts relationships and interferes with work and daily activities. The symptoms of depression in men are similar to the symptoms of depression in.

There are several reasons why the symptoms of clinical depression in men are not commonly recognized. For example, men tend to deny having problems because they are supposed to “be strong.” And American culture suggests that expressing emotion is largely a feminine trait. As a result, men who are depressed are more likely to talk about the physical symptoms of their depression — such as feeling tired — rather than symptoms related to emotions.

Men are less likely to show more “typical” signs of depression such as sadness. Depression in men may cause them to keep their feelings hidden. Instead of expressing a depressed mood, they may seem more irritable and aggressive. For these reasons, many men — as well as doctors and other health care professionals — may fail to recognize the problem as depression.

What are the consequences of untreated depression in men?
Depression in men can have devastating consequences. The CDC reports that men in the U.S. are about four times more likely than women to commit suicide. A staggering 75% to 80% of all people who commit suicide in the U.S. are men. Though more women attempt suicide, more men are successful at actually ending their lives. This may be due to the fact that men tend to use more lethal methods of committing suicide, for example using a gun rather than taking an overdose of pills.

Is depression common in elderly men?
Although depression is not a normal part of aging, senior men may have medical conditions such as heart disease, stroke, cancer, or other stressors that may contribute to depression. For example, there is the loss of income and meaningful work. Retirement is difficult for many men because they end up with no routine or set schedule to follow. These changes may increase the stress they feel, and a loss of self-esteem may contribute to depression. In addition, the death of family and friends, the onset of other health problems, and some medications can contribute to depression in men.

How is depression in men treated?
More than 80% of people with depression — both men and women — can be treated successfully with antidepressant medication, psychotherapy, or a combination of both. If you are uncertain about whom to call for help with depression, check out the following list from the National Institute of Mental Health:

  • community mental health centers
  • employee assistance programs
  • family doctor
  • family service/social agencies
  • health maintenance organizatios
  • hospital psychiatry department and outpatient clinics
  • local medical and/or psychiatric societie
  • mental health specialists such as psychiatrists, psychologists, social workers, or mental health counselors
  • private clinics and facilities
  • state hospital outpatient clinics
  • university or medical school affiliated programs

Depression is classified as major if the person has at least five of these symptoms for two weeks or more. However, there are several types of depressive disorders. Someone with fewer than five of these symptoms who is having difficulty functioning should still seek treatment for his or her symptoms. Tell your doctor how you are feeling. He or she may refer you to a mental health care specialist.

How Are Sleep and Depression Linked?
An inability to sleep, or insomnia, can be one of the signs of depression (a small percentage of depressed people, approximately 15%, oversleep or sleep too much). Lack of sleep alone cannot cause depression, but it does play a role. Lack of sleep caused by another medical illness or by personal problems can make depression worse. An inability to sleep that lasts over a long period of time is also an important clue that someone may be depressed.

What Causes Depression?
There are several factors linked to depression, including

  • Family history of mental disorders
  • Chemical imbalances in the brain
  • Physical and mental health disorders
  • Environment such as living in a place that is often cloudy and gray
  • Stress
  • Alcohol or drug abuse
  • Medications
  • Lack of support from family and friends
  • Poor diet

How Is Depression Diagnosed?
Your doctor will take your medical history, and will likely ask you whether anyone in your family has depression or other mental health problems. He or she may also ask you to describe your moods, your appetite and energy, if you feel under stress, and if you have ever thought about suicide. Your doctor will also perform  physical exam to determine if the cause of your symptoms is caused by another illness.

What Depression and Insomnia Treatments Are Available?
Treatment choices for depression depend on how serious the illness is. Major depressive disorder is treated with psychotherapy (counseling, or talk therapy with a psychologist, psychiatrist, or licensed counselor), medications, or a combination of the two. Drugs tend to work more quickly to decrease symptoms while psychotherapy helps people to learn coping strategies to prevent the onset of future depressive symptoms.

Medications used to treat depression include antidepressants such as:

  • Selective serotonin reuptake inhibitors (SSRIs), like Zoloft, Prozac, Celexa and Paxil. These medications can perform double duty for patients by helping them sleep and elevating their mood, though some people taking these drugs may have trouble sleeping.
  • Tricyclic antidepressants (including Pamelor and Elavil)
  • Serotonin/norepinephrine reuptake inhibitors (SNRIs) like Effexor, Pristiq, Khedezla, Fetzima, or Cymbalta, that raise levels of both serotonin and norepinephrine — brain chemicals that are thought to be involved in the neurobiology of depression.
  • Novel antidepressants such as bupropion (Wellbutrin)
  • Some of the most effective types of psychotherapy for depression are cognitive-behavioral therapy and interpersonal therapy. With cognitive-behavioral therapy, ptients learn to change negative thinking patterns that are related to feelings of depression. Interpersonal therapy helps people to understand how relationship problems, losses, or changes affect feelings of depression. This therapy involves working to iprove relationships with others or building new relationships.

Sleeping Pills
Hypnotics are a class of drugs for people who cannot sleep. These drugs include Ambien, Sonata, and Restoril. Doctors may sometimes treat depression and insomnia by prescribing an SSRI along with a sedating antidepressant or with a hypnotic medication. However, hypnotic drugs usually should be taken for a short period of time.

The FDA has also approved a prescription oral spray called Zolpimist, which contains the sleep drug Ambien’s active ingredient, for the short-term treatment of insomnia brought on by difficulty falling asleep.

Psychotherapy can also address coping skills to improve a person’s ability to fall asleep… because nothing beats a good night’s sleep.

 

Senior Care: Elderly Suicide

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Sad older gentleman

Loneliness & depression can bring on other challenges

The Elderly and Suicide

So we’ve all heard of depression. We even seem to be aware of what causes it & how to overcome it, but do we really?

So what’s the big deal with depression?   The deal is…

In 2011 statistical report stated that someone over the age of 65 commits suicide every 90 minutes (16 deaths per day). In 2013 it was reported that this statistic had doubled. Elders, account for one-fifth of all suicides, but it only represents 12% of the population. White males over the age of 85 are at the highest risk and completion of suicide attempts, almost six times the national average. The suicide rate among elders is two to three times higher than in younger age groups. Elder suicide may be under-reported by as much as 40% or more. Omitted are “silent suicides”, i.e., completions from medical noncompliance and overdoses, self-starvation or dehydration, and “accidents.” The elderly have a high suicide rate because they use firearms, hanging, and drowning. The ratio of suicide attempts to completions is 4:1 compared to 16:1 among younger adults. “Double suicides” involving spouses or partners occur most frequently among the aged. Elder attempters have less chance of discovery because of greater social isolation and less chance of survival because of greater physical frailty and the use of highly lethal means.

What are the causes?

Elder suicide is associated with depression and factors causing depression, e.g., chronic illness, physical impairment, unrelieved pain, financial stress, loss and grief, social isolation, and alcoholism. Depression is tied to low serotonin levels. Serotonin, is a neurotransmitter in our brains that regulates and limits self-destructive behaviour.  As we age our Serotonin levels decrease placing us at greater risk. Depression remains under diagnosed and undertreated among the elderly population.

What are some of the key risk factors of elder suicide?

  • Loss of spouse.
  • A late onset depressive disorder.
  • A debilitating and/or terminal illness.
  • Severe chronic/intractable pain.
  • Decreasing independence and self-sufficiency.
  • Decreased socialization and social supports.
  • Risk often accumulates among the elderly. An individual may be white, male, and an alcohol user and then become a widower or depressed.

What are some of the myths of elder suicide?

  • It is the outcome of a rational decision and justified.
  • Elder victims are usually seriously or terminally ill.
  • Only very severely depressed elders are at risk of suicide.
  • Suicidal elders never give any indication of their intent.
  • The suicide of an older person is different from that of a younger individual.

What are the warning signs?

The following may indicate serious risk:

  • Loss of interest in things or activities that are usually found enjoyable
  • Cutting back social interaction, self-care, and grooming.
  • Breaking medical regimens (e.g., going off diets, prescriptions)
  • Experiencing or expecting a significant personal loss (e.g., spouse)
  • Feeling hopeless and/or worthless (“Who needs me?”).
  • Putting affairs in order, giving things away, or making changes in wills.
  • Stock-pilling medication or obtaining other lethal means

Other clues are a preoccupation with death or a lack of concern about personal safety. “Good-byes” such as “This is the last time that you’ll see me” or “I won’t be needing anymore appointments” should raise concern. The most significant indicator is an expression of suicidal intent.

Why aren’t community agencies or providers doing more service involvement with older men?

Community agencies basically serve elderly women who have a suicide rate well under the national mean for all ages. Community agencies may be little concerned because elder suicide is uncommon in their caseloads.

Agency philosophy:

The prevailing value in most services for the aged is to optimize self-sufficiency in terms of individual capability and safety. A commitment to autonomy may cause community agencies to let the client or patient control decisions on referrals to other resources, alerting relatives, or involving available services.

Agency Misconceptions:

  • Community agencies and providers may accept some of the myths about suicide such as:
  • If someone’s determined to commit suicide, no one can stop him or her.
  • Those who complete suicide do not seek help before their attempt.
  • Those who kill themselves must be crazy.
  • Asking someone about suicide can lead to suicide.
  • Pain goes along with aging so nothing can be done.
  • It makes sense for an old person to want to end their suffering.
  • Old people are used to death and loss and don’t feel them like younger folks.
  • Those who talk about suicide rarely actually do it.
  • How many health or human service professionals, other staff, and volunteers believe these statements to be true?

Lack of risk assessment:

A lack of attention to elder suicide and a concentration on client or patient self-determination and self-sufficiency may limit community agencies’ response. Most community agencies do not recognize the problem and consequently do little or no screening for it among their clientele.

What can community agencies do?

Individual prevention must focus on what drives suicide. “Doing something” basically comes down to caring. Community level prevention of late life suicides will require “creative partnerships of primary care providers. This means that senior centers, home care providers, hospices, adult day care, home-delivered meals programs, para-transit, and other organizations serving the elderly are going to have to team up with community mental health centers. This must start soon as the high-risk segment of the aged population is growing rapidly and the oldest baby boomers are within a few years of turning 65. The boomers will arrive in their “golden years” having manifested higher suicide rates on the way than prior generations.

If you think… This cannot be happening here in Canada, Think again!

Canada’s elderly are at high risk of suicide experts say, and Canadian men aged 85 to 89 have the highest rate of suicide. THE CANADIAN PRESS: Dr. Marnin Heisel says public awareness about suicide lets people know their physical and mental health problems can be treated effectively. Studies show that Canada’s elderly are at a much higher risk of suicide than adolescents, and there is growing concern among mental health experts that psychological care may be out of reach for most seniors. Dr. Marnin Heisel, a clinical psychologist and professor at the University of Western Ontario, says lack of public awareness of the issue is a key problem that affects not only the elderly but also their families and the public in general.

“One of the challenges that people face is thinking ‘I’m unique in this, I’m alone, there’s something wrong with me, no one can understand it,’ and then they tend to back away from family, other supports, including professional supports” Heisel said in an interview.

Public awareness lets the people struggling with these issues know that they are not alone and their physical and mental health problems can be treated effectively, he said. It may also cue their relatives into the fact that their older family members who are struggling with depression might be contemplating suicide, he said. “They might, as a result, begin asking their family (member) ‘How are you doing? Are you struggling with some of these things?’ or even asking them if they’ve thought of suicide.” A 2009 report by Statistic Canada states that men aged 85 to 89 have the highest rate of suicide among any age group in Canada, at a rate of about 31 per 100,000, and usually do so through more violent means. A report by the chief public health officer released the following year also showed that men over the age of 85 have on average higher suicide rates than all other age groups. For most Canadians, psychological services — which can easily run $100 or $200 an hour — are not covered by provincial and territorial health-care plans, but psychiatric services and medications generally are. Psychological care is covered only if it’s hospital-based. “But many if not most hospitals, at least in Ontario, typically don’t have very much in the way of psychological services and typically not for older adults,” said Heisel. “One thing we do know is that unless somebody has extremely good third-party health coverage, or they are a child in the school system, or a veteran, or if they have access to psychological services as a result of a motor vehicle collision — most Canadians can’t access psychological services unless they pay out-of-pocket. Heisel says research has shown that 75 per cent of older adults who die by suicide had seen a primary-care physician or provider within a month prior to ending their lives. “That suggests that primary care is a key place where we should be assessing for screening for suicide risk factors and then try to implement aggressive, meaning very focused, interventions,” Heisel said. “And we really don’t see that happening, literature supports that treatments works extremely well; it just requires funding to do that.” There’s also concern that many elderly suicides go undetected due to the way they are reported by coroners across Canada. “I can envision a circumstance, for example, where an elderly male is found (deceased) in a bed alone … maybe with no history of depression or suicidal thinking that he had expressed to anybody, and the coroner could determine that the death was due to natural causes and not even order an autopsy because of the age group,” said Dr. William Lucas, Ontario deputy chief coroner for inquest. “And if the person had used a relatively subtle means like an overdose of medications … that wasn’t obvious … we wouldn’t know,” he said. Heisel says research shows that when the means of death are more ambiguous, then suicide is more likely not to be detected. He goes on to say, “It’s somewhat frustrating because we really don’t know the full scope of the issue”. The frustration stems from the fact that many suicide prevention strategies are largely aimed at youth. That’s why he says he decided to speak publicly about the issue. Victims of depression say that family is what helps them the most in combating episodes of depression, in addition to staying physically active, mentally stimulated, including social companionship in their daily lives with interaction in the community. “Those are the good things in life when periods of depression start to creep in”.  Incorporate them to combat depression and from recurring episodes. One patient says… “Well if the glass is half empty, it must be half full … I try to forget about the half-empty side but what a wonderful half full my life is.” The following posted articles also speak to this issue in the same relative terms… it a bigger problem that we think and about to get bigger. Be sure to also read the posted comments from readers, as it further illustrates the issue in the elderly communities. Suicide rates climb among elderly in Canada. Elderly suicide rates hitting new highs as traditional social networks break down. Over the past years our aging population has skyrocketed. This growth is only expected to increase exponentially over the next 15-20 years. The issues we are currently facing and learning about are just the beginning of the cycle. Growing challenges relating to care of our elderly will continue to provoke our ideals of what is acceptable in our society. Anything that we have an answer for (treatment) is therefore a preventable measure… like the treatment for depression and respectively reduce depression related suicides.

The following graphs illustrate the population growth for the following demographics.

graph1depressionsuicide graph2depressionsuicide

For a more detailed population projection statistical review visit the Canadian Statistics web page.

It is within us to create an environment whereby our elders are cared for in a manner that protects them physically & holistically, paving the way for the future. Our campaign and advocacy to enriching the lives of our elderly should be one of our primary goals… “We ourselves are becoming to ones who will require care in the near future and our actions today will dictate the outcome for ourselves tomorrow”.

Senior Care: Depression in the Elderly

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DepressionamonelderlyDepression among the Elderly population

According to Health Canada, older Canadians are living longer, more independently, healthier, and more affluent than ever before. Todays seniors are physically more active, engaged with their families, in their communities, and are becoming international globetrotters.

They are challenging many of the negative stereotypes we hold about aging and showing us that life is for living with fortitude, vitality, and vigour.

However, it is true that some seniors struggle from time to time with mental illness. For seniors living in the community, it is estimated that 5% to 10% will experience a depressive disorder that is serious enough to require treatment. The rate of anxiety and depression increases dramatically to 30% to 40% for seniors living in an institutional setting.

The great news is that for most people with depression (over 80%) do respond well to treatment and achieve a complete and lasting recovery. Sadly, 90% will NOT seek needed help or their depression will be missed or ignored, denying them beneficial treatment for mental health problems.

Why aren’t seniors getting the help they need?

  • Depression in the elderly can be difficult to recognize. It can easily be overlooked as a symptom of another medical condition.
  • Family, friends and medical personnel often see depression as a normal part of the aging process and the inevitable result of the losses of life we all will experience.
  • Family, friends and medical personnel often see depression as a normal part of the aging process and the inevitable result of the losses of life we all will experience.
  • Many seniors were raised to be self-sufficient and stoic in the face of life’s challenges making them reluctant to complain about how they are feeling or ask to for help. They are used to working hard to solve their own problems and feel ashamed by their inability to cope.
  • Some seniors (and possibly even their friends and family) don’t know that depression is an illness and that treatment is available and works!

How do I know if its depression?

Depression is more than just feeling sad. It affects the whole person including their feelings, thinking and their physical health. It also lasts a long time. It’s important to know what to watch for. Anxiety and slowing of thoughts are common symptoms. For many seniors depression is often expressed through many vague complaints of physical aches and pain. The most common symptoms of depression include:

Physical changes

  • Changes in appetite – a resultant weight loss or weight gain.
  • Sleep disturbances – trouble falling asleep, staying asleep or sleeping too much.
  • Some seniors (and possibly even their friends and family) don’t know that depression is an illness and that treatment is available and works!
  • Sleep, when it comes, does not restore and refresh. People often report feeling worse in the morning with the mood -lifting as the day goes on.
  • Decreased energy, with feelings of weakness and physical fatigue.
  • Some people experience agitation with restlessness and have a need to move constantly.
  • Phantom pains, headaches, muscle aches and pains, with no known physical cause.
  • Stomach upsets – constipation.

Changes in thinking

  • Thoughts may be confused or slowed down which makes thinking, concentrating or remembering information more difficult.
  • Decision-making is difficult and  or often avoided.
  • Obsessive ruminations, a sense of impending doom or disaster.
  • Preoccupation with perceived failures or personal inadequacies leading to a loss of self-esteem.
  • Becoming harshly self-critical and unfairly judgmental.
  • In extreme cases, there can be a loss of being in touch with reality, perhaps hearing voices (hallucinations) or having strange ideas (delusions).
  • Persistent thoughts of death, suicide or attempts to hurt oneself.

Changes in feeling

  • Loss of interest in activities that were once a source of pleasure.
  • Decreased interest in and enjoyment from sex.
  • Feelings of worthlessness, hopelessness, and excessive guilt.
  • Deadening or an absence of feelings.
  • Sense of overwhelming or impending doom.
  • Feeling sad, and down that may be worse in the morning, lifting as the day goes on.
  • Crying for no apparent reason.
  • Irritability, impatience, anger and aggressive feelings.

Changes in behaviour

  • Withdrawal from social and leisure activities.
  • Failure to make important decisions.
  • Neglecting duties such as housework, gardening, paying bills.
  • Decrease in physical activity and exercise.
  • Reduced self-care such as personal grooming, eating.
  • Increased use of alcohol or drugs (prescription and non-prescription).

Why is it important to treat depression in the elderly?

  • Depression throws a dark cloud over our emotional well-being, draining away pleasure, and robbing people of hope, further isolation, and despair.
  • Depression tends to last much longer in the elderly and can result in unnecessary or premature placement in institutional care.
  • If depression is not managed, it can compromise the treatment of other conditions and can increase the risk of prolonged disability or early death.
  • Untreated depression can also leave seniors more vulnerable to developing other serious health conditions such as heart disease, infections and immune disorders.
  • Depression can make people feel angry, irritable and anxious. This can rob families of the pleasure of their loved one’s company and place an additional burden on care providers.
  • The risk of suicide in elderly is high and it is particularly high for depressed elderly men.

What factors can increase the risk of depression in the elderly?

  • The presence of other illnesses, which compromises their ability to get around and be independent.
  • Some medications or the interaction between medications are associated with depression.
  • Living with chronic or severe pain.
  • Living alone without a supportive network of friends, social interaction, and family.
  • The recent death of a loved one or fear of own death.
  • A previous history of depression or family history of depressive disorder.
  • A past history of suicide attempt(s).

Illness increases the risk of depression

There are a number of medical conditions that are associated with depression in the elderly. Some are:

  • Heart problems including having a stroke
  • Low thyroid activity
  • A lack of vitamin B12 or folic acid
  • Low blood pressure
  • Rheumatoid arthritis
  • Cancer
  • Diabetes

Commonly prescribed medications are also associated with depression or making depression worse such as:

  • Blood pressure medications
  • Beta-blockers
  • Steroids
  • Digoxins
  • Sedatives

Treatments involving these medications may warrant a discussion with the treating physician to rule out their use as the cause of the depression. Don’t stop medications without advice as a sudden discontinuation can have serious health consequences when the body struggles to adjust.

What can we do to help our loved one overcome depression?

Medication

Usually relief is felt within a few weeks of starting medications, however it can take longer for older people to feel better. Sleep and appetite are usually the first to improve. Don’t expect a complete recovery right away. It usually takes about ten to twelve weeks to lift out of depression. Often those close to you who will see an improvement in your mood before you begin to feel it.

Build social supports

The paradox of depression is that at a time when you most need to draw people close – you may want to avoid contact with others. However, most people find that the support of family, caregivers, friends, participation in a self-help group, or talking with a professional counselor can be very helpful in overcoming depression. Dealing with social isolation is an important part of healing and can help prevent further episodes of depression. Many conducted studies show that being part of a supportive family, being part of a religious group or being active in your community is an important part of health, wellbeing and improved quality of life.

Talk therapy

Psychotherapy can be very helpful in dealing with losses, solving challenging problems or dealing with the social impact of depression. Cognitive therapy can help you look at your thought patterns, which may be negative and self-criticizing. It will also help you make the connection between your thoughts, feelings and behaviours. What you think affects how you feel and how you behave.

Electroconvulsive therapy (ECT)

ECT is a treatment that uses electrical impulses to change the chemical balance in the brain. It is often used as a treatment of last resort for those patients who have not responded well to other forms of treatment, who remain a suicide risk, or have other serious medical conditions that prevent the use of medication. It remains controversial, so it is important to do your research so you can make an informed decision.

What factors protect seniors from depression and build resilience?

Have you ever wondered why some people just seem happy or are able to weather the inevitable storms that life throws their way with wisdom and grace? So have researchers and they have learned a lot about what builds healthy resilience, makes for a happy engaged life and helps us cope during difficult times. Some of us are just blessed with a happy, easygoing temperament. The rest of us may have to work at it.

What have we learned about how to maintain good mental health throughout the life cycle?

The self-help mantra is, “Never get too angry, too lonely, too tired or too hungry”. This is really good advice for living a healthy balanced life. People who have experienced a mood disorder learn quickly how true this motto is. If your balance is off in one of these areas, it is important to take active steps to gain control of your health. Having strong family, friendships and community supports will go a long way in keeping you free from depression.

Health Canada reports that more and more elderly are spending time alone – going days at a time without seeing or talking to another person. This is not good for our mental health and can lead us to become too inward in our thinking. Changes in our social network are an inevitable part of life. Family members grow up, move away or get busy with their daily lives. Retirement takes us out of the mainstream of working life. As we age, death becomes an unfortunate companion robbing us of people we loved and cared for. Sickness can sap our strength and take away our vitality. All of these changes can cause us to lose valuable sources of support and connection. You may feel it is too late to build new friendships – that too much effort is required to add new interests and people into your social network. But it’s worth the investment. Research shows us time and time again that people with a well-developed social network have better physical and emotional health and an improved quality of life.

Tips for building social supports

Take the time to consider what you like. Start small – adding one new thing at a time. Be patient – it may take some research to find the activities that will suite you best. Become a risk taker – try doing something you have never done before. Buddy up with someone else in trying new things out. Lend a helping hand to others. There is nothing that builds confidence like helping others.

Become a joiner!

  • Check out the local community Centre for seniors clubs and social programs.
  • Join a book club, choir, bridge group, or gardening club.
  • Let your family know you would like to spend more time together. Be specific in your asking.
  • Rekindle a hobby or up a new hobby.
  • Become a mentor for a young person.
  • Volunteer your time.
  • Get involved in a political party.
  • Find out about how to get involved in your community.

Get physically active

Recent research has found that moderate exercise and weight lifting – yes lifting barbells – has a remarkable ability to treat depression in the elderly. In fact, moderate exercise has been found to be as effective in treating mild depression as medication. Strengthening your muscles has also been found to reduce the risk of falling and hip fractures – the number one reason seniors end up in institutional care.

An exercise program should include active movement to build balance and coordination, stretching to improve flexibility by moving your joints through their full range of motion, ways to strengthening your muscles, and, finally, activities to get your heart pumping. Consider joining a senior’s exercise program in your community to strengthen your social network as well as your body… Just do it!

Exercise your mind

Along with aging often come subtle changes in brain functioning. It may not seem as easy to remember names. Learning new skills can seem harder. But just like your body, a healthy nimble mind requires active exercise. Think of ways you can challenge your brain. Play chess, bridge, and computer games or do crossword puzzles. Consider taking an adult education course – anything that will exercise the grey matter.

Eat well

Diet plays an important role in preventing illness and keeping us well. The absence of essential minerals and vitamins is associated with many serious health problems including depression. Many elderly people neglect this important part of their health. If you live alone, it may not seem worth the effort to cook yourself a meal. Depression can also rob people of their appetite. Use the clock to tell you when to eat if your body doesn’t let you know when you are hungry. Restore balance by starting to keep track of what you are eating.

Tips for healthy eating:

  • Consider taking a multi-vitamin every day.
  • Build variety into your diet.
  • Keep healthy foods easily available.
  • Choose whole grain and enriched grain products.
  • Choose fresh foods over manufactured foods.
  • Choose dark green and orange vegetables more often.
  • Lower the fat level in your milk and choose leaner cuts of meat.
  • Consider poultry, fish, dried beans and lentils as an alternative to red meat.
  • Drink plenty of water.
  • Take care in your use of alcohol.
  • Strive for a healthy body weight.
  • Use Canada’s Food Guide as your reference to healthy eating.

Express your feelings

Recent research suggests that the ability to express your feelings clearly and directly has a positive and beneficial effect on mental health, life satisfaction and personal well-being. Talking about concerns helps you organize your thinking and clarify your thoughts. Keeping a personal diary is helpful even if you never share these thoughts with others. It can also help you gain insight into your moods by tracking what is going on in your life and how you are feeling. In this way you can take steps to address problems before they become overwhelming.

Feed your soul

Having a strongly held belief system has been found to be one of the protective factors for good mental health. If you are not currently involved with a religious group, consider finding a place of worship in your community that makes you feel welcome. If you don’t have strong religious beliefs or a group to which you hold affiliation, try learning more about different religious groups. Perhaps by exploring other beliefs you will find a spiritual home. But spirituality is not confined solely to religion. Many people find great conform in art, nature, theatre, and other pursuits.

Music soothes the savage breast – singing ignites the soul

There is nothing more stirring than listening to music – except perhaps playing it or singing along. In fact, music can help to sooth anxious nerves and lift your spirit. Consider joining a choir or sing along to your favourite tunes. Just make sure you add a dose of music to your day.

Turn loneliness into solitude and know the difference

Too much time alone can leave us feeling distant, isolated and lonely. This can worsen feelings of depression. We all have our own comfort level about how much time we like to be with others. Pay attention to how you are spending your time. If you are spending too much time alone, take steps to add balance. That said, finding comfort in one’s own company is also an important part of a happy healthy life.

Care for a pet

Looking after a pet is a big responsibility and a lot of work. But boy, is it worth it. Scientists have looked closely at the effect that pets have on our health. They have found that seniors who live with and care for pets have better physical health and mental well-being than those who don’t. They are also better able to cope with stress and are more physically and socially active. Pets have even been found to lower blood pressure. Having a pet has also been found to reduce the risk of suicide in people when they are depressed. Their unconditional love and affection provides valuable company, keeps you active and helps to draw others to you.

Keep a positive attitude

Being thankful is a cornerstone of emotional well-being. In fact, some research suggests that maintaining a positive outlook on life can boost your immune system and protect you from illness. Sickness and loss has a nasty way of dominating the thinking of people as they age. While your aches and pains and past surgeries are of pressing concern and interest to you – they may not make good conversation for others. Try to avoid dwelling too much on the negatives of life. Instead take time to count your blessings. Seek out positive people. Broaden your network to include people of different ages and backgrounds. Get out of the rut of daily life by trying new things. Become a great conversationalist by sharing stories. Keep up on current affairs and popular shows. Share with others what you like and what you value. Make sure to take an interest in their views too. Listen actively to what they say and ask questions. Everyone has a fascinating story to tell if you just take the time to ask. Focusing on positive communication helps to bring people close and helps you keep your thinking open to new ideas.

Laugh out loud and laugh a lot

Research again shows us that there is powerful healing in laughter. It changes our brain chemistry in a positive way and helps us look at problems in new and creative ways. So – go rent a Marx Brothers film or whatever brings a smile to your face.

Ask for help if you need it

Don’t be afraid to ask for help. It is a sign of strength, health and maturity. Working through concerns with a professional can bring out new ideas and offer a fresh perspective in solving problems. Having help can help you stay in charge of making your own decisions.

 

 

The above tips are gatherings from various sources, but for more in-depth information on some of the aforementioned topics, I offer the following readings:

Beating the Senior Blues: How to Feel Better and Enjoy Life Again, by Leslie Eckford and Amanda Lambert, New Harbinger Pub. 2002

There is an excellent review of depression treatments for older adults from the US Surgeon General at

Health Canada produces an interesting monthly newsletter updating readers on recent research related to the elderly. Division of Aging & Seniors

Wherever You Go There You Are: Mindfulness Meditation in Everyday Life by Jon Kabat-Zinn

Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness by Jon Kabat-Zinn

Senior Care: What is Alzheimer’s?

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So what exactly is Alzheimer’s

Alzheimer’s disease is a progressive neurological disease that, over time, results in the brain’s inability to function correctly. Alzheimer’s disease causes lapses in memory, communication, judgment and overall functioning.

alzheimers-article picAlzheimer’s was first identified by Alois Alzheimer in 1906 in Germany and is the most common type of dementia, a general term for impaired brain functioning. Other dementias include frontotemporal dementia, Huntington’s disease, vascular, Lewy body dementia, Parkinson’s disease dementia, and Creutzfeldt-Jakob disease. Dementia can also develop from potentially reversible conditions such as normal pressure hydrocephalus or vitamin B12 deficiency, as well as severe infections such as late-stage AIDS.

There are two types of Alzheimer’s disease: early onset Alzheimer’s, defined by onset before age 60, and late onset, or typical, Alzheimer’s.

Symptoms and Effects of Alzheimer’s

Symptoms of Alzheimer’s include problems with memory, communication, comprehension, and judgment. The individual’s personality may begin to change somewhat as well.

As the disease progresses, the individual gradually loses the ability to function mentally, socially, and eventually physically. Often in the middle stages of Alzheimer’s, he or she may also display inappropriate behaviours and emotions, which can be challenging for loved ones to handle. In its final stages, the person is completely dependent upon caregivers for basic needs.

Who Gets Alzheimer’s Disease?

There are an estimated 5.4 million people in the United States with Alzheimer’s or a related dementia, although not all are diagnosed. Additionally, researchers estimate that as many as 500,000 of those 5.4 million people in the United States have early onset Alzheimer’s. Alzheimer’s is not part of normal aging; however, as people age, the likelihood of developing Alzheimer’s increases.

Thirteen percent of individuals over age 65 have Alzheimer’s or another form of dementia, while almost 50% of individuals over age 85 have Alzheimer’s or another kind of dementia. The demographic group with the highest percentage of Alzheimer’s is Caucasian females, likely since their life expectancy is the greatest.

Diagnosing Alzheimer’s

Diagnosing Alzheimer’s disease is done, by ruling out other diseases or causes, reviewing family history and conducting a mental exam to see how well the brain is working. Some physicians also conduct imaging tests, which can show changes in the brain’s size and structure that may lead to the conclusion of Alzheimer’s.

While general practice physicians often diagnose Alzheimer’s, you can also seek an evaluation from a psychologist, geriatrician, or neurologist. Alzheimer’s cannot conclusively be diagnosed until after death when an autopsy is conducted and brain changes can be identified; however, diagnosis through the above tools is the industry standard at this time and has proven very accurate.

Treatment of Alzheimer’s

Alzheimer’s has no cure at this time, but determining more effective treatment and prevention methods, as well as finding a cure for the disease, is a high priority for researchers. Current treatment for Alzheimer’s focuses on alleviating the symptoms of Alzheimer’s, both cognitive and behavioural, by using drug therapy and non-drug approaches.

Drug Therapy

  • Cognitive enhancers are medications that attempt to slow the progression of Alzheimer’s symptoms. While these medications do appear to improve thought processes for some people, the effectiveness overall varies greatly. These medications need to be monitored regularly for side effects and interaction with other medications.
  • Psychotropic medications can be prescribed, to target the behaviour and emotional symptoms of Alzheimer’s. Psychotropics are medications that address the psychological and emotional aspects of brain functioning. For example, if a person is experiencing distressing hallucinations, a psychotropic medication, such as an antipsychotic medication, can be prescribed and is often helpful in relieving the hallucinations. As with cognitive enhancers, psychotropics have the potential for significant side effects and interaction with other medications, so they should be used carefully and be coupled with non-drug approaches.

Non-Drug Approaches

Non-drug approaches focus on treating the behavioural and emotional symptoms of Alzheimer’s by changing the way we understand and interact with the person with Alzheimer’s. These approaches recognize that behaviour is often a way of communicating for those with Alzheimer’s, so the goal is to understand the meaning of the behaviour and why it is present.

Non-drug approaches should generally be attempted before using psychotropic medications since they do not have the potential for side effects or medication interactions.

The goal of these approaches is to develop more effective interventions by adjusting the caregiver’s approach or the environment to minimize the challenging behaviours.

Preventing Alzheimer’s

There are abundant theories about how to prevent Alzheimer’s, but currently there is no sure-fire way to do this. A heart-healthy diet, an active lifestyle with plenty of physical exercise and social interaction, and regular mental exercise are strategies that some feel are effective in preventing Alzheimer’s.

Coping With Alzheimer’s

If you think that you or someone you know may have Alzheimer’s, know that we are here for you, both to provide current information and also to facilitate the sharing of ideas and suggestions from others in your situation. Being proactive and prepared can ease some of the challenges of this disease for you and your family. Coping with Alzheimer’s is not easy, but it’s not something you need to do alone.

Please contact us today, to discuss any of the above mentioned challenges you may be facing and how our services can help you remain independent, protected, safe, and in you home / community.

You got questions, we have answers: (905) 785-2341 or email us at homecare@inourcareservices.com

 

Sources:

Alzheimer’s Association What is Alzheimer’s? Accessed July 12, 2011.

Alzheimer’s Association Basics of Alzheimer’s Disease. Accessed July 12, 2011.

PubMed Health US National Library of Health. What is Alzheimer’s Disease? Accessed July 12, 2011.