Aging Parents: Maintaining Mobility into Old, Old Age–The Dangers of Sitting Too Much

Walk More. Sit Less

How limiting is life for those with curtailed mobility?

Look around…so many people with canes and walkers. Based on the Tufts U. publication–reprinted below–it seems their numbers would decease if people who sit a lot make it a point to take breaks for a brief walk. What could be easier?  This applies to us who spend hours at a desk, as well as to the elderly couch potatoes we care about. Read on.

The importance of older peoples’ walking is nothing new to longtime readers of my blog. A 2010  post features Jane Brody’s NY Times columnWhat to Do Now to Feel Better at 100, which includes the importance of walking.  Mark LachsProfessor of Medicine and Co-Chief of the Division of Geriatrics and Gerontology at Weill Medical College in NY, and author of Treat Me, Not My Age, is quoted: “If you begin a daily walking program at age 45, you could delay immobility to 90 and beyond. If you become a couch potato at 45 and remain so, immobility can encroach as early as 60.”

Sr. Advisor R, was living proof. She didn’t use a cane (didn’t own one as far as I know) until she was 97–after her broken hip episode. instead R walked daily on a treadmill from age 50 (as written previously–not the plug in kind, your feet make it go). And R continued using that treadmill daily–but for shorter time periods, until she died.

(Her best friend [93] is the beneficiary of that treadmill and phoned last week, laughingly saying she knew it was bequeathed to her and she’d send a strong young relative over to pick it up if that was OK.)

Further proof was my dad, who was 94 before I ever saw him use a cane….and then he used Mom’s old cane, which probably wasn’t the right fit; but he said he only used it when he felt weak. Out of respect, I never pushed him on the subject. (His mind was good. He looked out for his best interests). That said, he not only walked a lot, he had to walk upstairs to his bedroom and down the basement stairs to get into his car. Thus, many leg muscles were exercised daily..

A well-respected chiropractor in Westchester County, NY told me that he could always tell which patients wintered in Florida because they didn’t walk stairs and that impacted their legs. Enough said. Here’s the latest  on “sedentary sitters”–

Tufts Health & Nutrition Letter

August 24, 2015

Brief Walks May Counter Health Dangers of Too Much Sitting

Multiple studies have warned about the health risks of sitting too much. Hours spent sitting, whether at desks or in front of the television, have been linked to increased odds of cardiovascular disease, type 2 diabetes and kidney problems. But modern life can make it difficult to stay out of chairs, and alternatives such as “standing desks” don’t appeal to everyone.

A new study may offer hope to sedentary sitters: Using data on more than 3,600 adults, researchers found that brief periods of simply walking around the room substantially reduced mortality risk among people who spent long periods sitting. As little as two minutes of gentle walking per hour was associated with a 33% lower risk compared to non-stop sitting.

“We know that exercise is good for us and yet, despite this, our society has become more sedentary than ever,” says Miriam E. Nelson, PhD, associate dean of the Tisch College and a professor in Tufts’ Friedman School, author of the “Strong Women” series of books. “We are built to move, and when our bodies move on a regular basis, they are healthy; when they don’t, when we’re largely sedentary, our bodies deteriorate.”

MEASURING MOVEMENT: In the study, published in the Clinical Journal of the American Society of Nephrology, Srinivasan Beddhu, MD, of the University of Utah, and colleagues analyzed data from the annual National Health and Nutrition Examination Survey (NHANES). In recent surveys, selected participants have supplemented their questionnaire answers by wearing activity monitors called accelerometers; this gives a more accurate record of a person’s movements than depending on individual recall. Most of the participants were generally healthy, although a subgroup of 383 people had chronic kidney disease.

Researchers divided participants into four groups based on minutes per hour of different levels of accelerometer activity: sedentary/sitting, low (such as standing up but not walking around much), light (such as strolling around a room or walking into another room), and moderate/vigorous (jogging or other exercise). The study then compared activity levels to records of deaths three or four years after the assessment.

ADDITIVE ACTIVITY: There was little difference in mortality between the sedentary and low-activity groups. But people who interrupted their sitting with light activity were at significantly lower mortality risk than those who were completely sedentary; this difference was even sharper among the kidney-disease subgroup (41%). As little as two minutes an hour of light activity was enough to be associated with lower risk.

Boosting activity levels to moderate/vigorous further reduced risk, but the number of such active participants was too low to be statistically significant. Adding additional minutes of light activity, however, did make a significant difference. Getting up from your chair for two minutes or five minutes more light activity rather than sitting time, Dr. Beddhu said, could further reduce risk of premature death.

He cautioned that the study was observational, and so can’t prove cause and effect. And Tufts’ Nelson notes that a quick walking break from your chair is no substitute for regular physical activity. But if you’ve been worried about the health risks of sitting too much, apparently every little bit helps

Check out “Newsworthy” (right sidebar). Links to timely tips, information and research from top universities and respected professionals–to help parents age well.

 

Aging Parents–Summer Heat: How Often Should Elderly People Bathe?

Summer heat makes daily showering/bathing a necessity for many. But what about  elderly people’s more fragile skin?

I remember my Dad’s talking about his oldest sister–in her early 90’s. She had recently moved to assisted living and her daughters (Dad’s nieces) had complained to him that she was only allowed to shower once–or twice (I’ve forgotten–it was many years ago) a week. I was young then; no doubt overheard the conversation and found it strange.

R at 99 Something to Laugh about

Laughing at a joke–R at 99       Click to enlarge

But it surfaced from deep in my memory recently when cleaning out Sr. Advisor R’s home. In spite of living in the Southwest desert 3/4 of her 101-year-old life, she had amazingly firm arms for her age and relatively few wrinkles. She told every younger female friend living in the desert her secret: “moisturize, moisturize, moisturize.”

I knew R used–and changed–moisturizing lotions over the years and ended up using Curél products; so I shouldn’t have been surprised to find their plastic containers by every sink in her home.IMG_0964

R bathed (unaided other than by a grab-bar) whenever she felt like it–I’m thinking until she broke her hip at 97. She then had the stall shower refitted and bought a shower bench. She continued to shower (unaided). I have no idea how often. I do know she was always well-groomed.

One wonders if assisted-living administrators require their “residents” to have an aide assist them when bathing or showering?  And/or is the two-day-a-week bathing/showering limit to save money and time? Or is it better for elderly skin not to have too much soap and water exposure?

Sr. Advisor D, now 90,  to the rescue. She went for her annual dermatologist appointment recently and put the question to her dermatologist–a well-known “Top Doc” in Westchester County (NY), who said in essence:

Older people’s skin doesn’t slough off and renew itself as easily and often as that of younger people. Baths/showers help skin to slough off; otherwise it can become a breeding ground for bacteria. It follows that elders confined to one or two showers/baths a week won’t have the sloughing off and renewal that more frequent bathing provides.

Frequent bathing/showering calls for using lotions to combat dryness..

For infrequent bathers, the creases–arm pits, under breasts, private parts–need to kept clean. This means washing them more often. One wonders about using antibacterial lotions, which I believe the dermatologist mentioned.

Since hygiene is important in helping parents age well, if there’s any doubt about bathing/showering recommendations doesn’t it make sense to check with elders’ doctors, as opposed to a care facility’s personnel.

Check out “Newsworthy” (right sidebar). Links to timely tips, information and research from top universities and respected professionals–to help parents age well.

Related: CNN Health: Is Bathing Just Once a Week Healthy?
              

Aging Parents’ Gift: Easy, Thoughtful, Expensive—or Not.

Le Bernardin - New York, NY, United States. Delicious scallops in brown butter dashi. A must!

A Thoughtful Gift Than Can be Used Up: A Winning Combination for Elders and Us

It’s a custom that on birthdays my husband and I get to choose what we want to do. It’s always a wonderful day. This month I decided a meal at a fine restaurant was exactly what I wanted..

Expanding on this idea, we know–as people get older–they want to get rid of things, not accumulate them. So something that gets used up (like food) is preferable unless older people have specific needs.

As we were half-way through our meal, I overheard the mâitre d’ saying to the elderly couple being seated nearby something like, “Your children have arranged for your meal with us to be a gift from them.”

(My mind flashed back to the time we planned something like this for my parents who went up to Victoria, British Columbia for one of their birthdays. My brother found out where they planned to have dinner and I, credit card in hand, phoned the restaurant and asked that the meal be charged to me. It was a special occasion and–although far away–we wanted to have a part in it.)

Seeing the old man’s face light up and his wife’s big smile when the mâitre d’ announced the meal would be a gift from their children, made me want to take a picture. It would have been in bad taste, of course, so writing about it on my blog is the next best thing.

Thoughtful gestures. Gifts that can be used up. Expensive or not. A winning combination as we do our best to help parents age well.

For the remainder of August there will be one post a week on Tuesday or Saturday.

Check out “Newsworthy” (right sidebar). Links to timely tips, information and research from top universities and respected professionals–to help parents age well.

Cleaning Out Elderly Parents’ Home After Death: 7 Tips–Part 2 Efficiency, Emotional Considerations

EFFICIENCY, VALUE. AND EMOTIONAL CONSIDERATIONS

Phase 5. Cleaning Out–Unwanted Books and Valuables. In both homes there were unwanted things that we thought had value. In most cases, upon checking, the value was far less than we thought.

I don’t know how “value” affects the donation slips nonprofit organizations willingly provide, where we are responsible for writing in the value of each item. I somehow have wondered for many years how the IRS looks at that.

I do know, since we didn’t live close to our parents, keeping unwanted inherited stuff takes up room, can be costly to store or ship. Thus we usually gave it away in hopes someone else or a nonprofit would appreciate it. (Didn’t bother with the donation slip.)

Some of my parents’ books had religious themes. I took those to the care facility run by the religious institution. They were grateful to have them. Since the famous Powell’s Book Store was close, I took some books there. However, carrying heavy books for the small amount of money they generated, wasn’t worth it to me. (Powell’s link says they cover freight costs.)

Some local used books stores may pick up when there are lots of books. The estate sale people got rid of all of the books that I hadn’t taken elsewhere. They designated a special shelf for the more valuable books at the sale.

Another option for getting rid of things: having a yard sale or having someone do a yard sale for you.

Phase 6. Furniture–take it or leave it? If the home will be sold, the realtor may–or may not–want the furniture to remain. In any case all will ultimately need to go, unless the home buyers want some, in which case heirs need to decide asap how to handle this.

Common knowledge?–or not. Used furniture’s resale value isn’t high. When we moved into NYC we brought as much furniture as the apartment would hold and reupholstered some pieces. This was more economical and offered better quality than purchasing new. That said, some antique furniture and that made by famous designers holds, or appreciates in, value.

In many communities nonprofits work with social agencies to furnish needy people’s homes. It felt good to give them some usable furniture–once I finished wrestling with it to get it into, then out of, the car.

Phase 7. Emotional Considerations  If you can give some household contents away without a family member’s having a melt-down, and someone can use them, you’ll feel good.  On the other hand, there may be a family member who wants to sell on eBay or craigslist, so have the discussion before attempting any cleaning out. Also work out compensation details beforehand. An obvious goal is to head off problems before they arise.

Fairness: Many parents find it fair, early on– before moving or death, to let each child have a turn “claiming” the piece (s)he wants, going round after round until the kids have selected all wanted items to be received at a later date.

I recently learned from a friend whose parents used this system, that her sister, Kay, ended up selling things she got in the rounds–some of which my friend thought should stay in the family. She said Kay needed the money for something. Understandable. But my friend says if asked, she would have gladly purchased them from Kay in order to keep them in the family. Something else to think about.

Good organization provides efficient structure. What it can’t take into consideration is a family’s emotional history, which may contain unfinished “business” going back even to childhood.

Unresolved conflicts have a way of surfacing; “fair” may have different meanings to different family members. Here is where an only child or 2 siblings may have an easier time cleaning out the family house. Here too is where good planning makes it easier for all.

Check out “Newsworthy” (right sidebar). Links to timely tips, information and research from top universities and respected professionals–to help parents age well.

Cleaning Out Elderly Parents’ Homes AFTER Death/Moving: 7 Tips–Part 1–Efficiency

Family Photos and Memorabilia Two family homes cleaned out in 12 months. Whether this makes me an expert at emptying elderly parents’ homes is questionable; but I am experienced and more efficient. Here’s what I’ve learned.


First: Background

73 years of accumulation in my parents’ home of 4000+ square feet.
67 years’ accumulation in R’s 2100 sq. ft. home plus its garage (used for storage–remember the car was in the car port as a burglar deterrent).

My parents had randomly gotten rid of things over the years; Sr Advisor R was more deliberate in reducing her belongings. In both homes, however, there was soooo much to clean out.

Last July I basically cleaned out my parents’ home by myself in two weeks. (My brother was happy to let me do it.) Thanks to a wonderful estate sale company that held an estate sale the third week, the home was broom clean at the end of three weeks. (“Dressed for Success,” a nonprofit, took many of Mother’s clothes immediately after she died, but vintage clothing remained.) And while we gave much away to family and some friends, by using the estate sale people, we also made some money as opposed to having to pay for a dumpster or drag unneeded/unwanted stuff to a charity.

This July my husband and I worked three weeks on R’s home. We each worked in different rooms. We estimate there’s another week’s work, which we will do in August. It’s hot in the desert. In spite of air-conditioning we had less energy. We also spent 1 1/2 hours daily driving to and from her home. This was in sharp contrast to my staying in my parents’ home–basically alone– while I was cleaning it out. It was easy to spend countless hours there, surfacing only to have lunch or dinner with a friend and sleep.

Here’s what I learned:
Quickly get rid of walkers, canes etc. if parents died. It’s easy and you’ve accomplished something.
Sorting things in phases and by rooms works best.
Always keep other family members in mind.
Doing the clean-out with just one other person at a time probably saves time and problems.

FOR EFFICIENCY–

Phase 1.  Immediately gather all financial and legal documents in one place, do a quick read. If you unearth–like we did– family mail, photos and memorabilia that you want to carefully read, reread or share with others, put them in another place. Speak to a lawyer before giving anything away if you don’t know your parents’ wishes or what/whom they’ve provided for.

Phase 2.  Dedicate a room or space for everything Identified as having value (monetary or sentimental). Begin by segregating things of value (jewelry, family memorabilia, art, accessories [china, silverware]) from drawers and closets as you “attack” each room– bedrooms, bathrooms, kitchen etc., going through–completely- one room at a time. Take valuables to that space–to be given to/divided by family and friends at a later date.

I used a spare bedroom at my parents’ home (photo above), lining up and piling up family photos on a card table (and the floor beneath), putting my mother’s family photos and memorabilia on one side; my dad’s on the other.  China, silverware, and accessories went on beds and an ironing board. I also cleared out hats, boots, umbrellas and coats and used the front hall closet.

Phase 3.  Concurrently– LEAVE remaining things identified as not being valuable–in their closets, drawers, or cupboardsDO NOT BOX. Let family/friends select from the closets, drawers, and cupboards. If on high shelves, however, do move them to within reach. This ultimately saves you time and energy.

Phase 4. Cleaning Out–At R’s home it made sense to empty clothes closets first.I invited family members who wore a parent’s size clothing–to come over, select and try on clothing that still hung in closets. Once the clothes left the house, people could do as they wished with them, but they couldn’t be returned.

We boxed and took R’s unwanted clothing to a charity. Doing this got me out of the house and provided a welcome break in the routine. Additionally each empty closet was instant gratification!

With clothing gone, family members and friends came again to select everything except the valuables. The reason for saving valuables until almost the end was because I kept finding them–left in a purse, put in hiding places…. (You may wonder what happened to x or y and find it after a lot of cleaning out–in a surprising place.)

Note: I put empty boxes in each room for no-brainer throw-aways (broken, torn, badly soiled stuff) and recyclables  (paper, glass, etc.) –and leftovers after family and friends had taken what they wanted.

Also note: The people doing my parents’ home’s estate sale didn’t want anything thrown out.
*            *           *

We’ve heard about fights over Aunt Tillie’s teapot….Don’t all families all have peculiarities?  Phases 5, 6,–and 7 (Emotional fall-out) in Part 2 on Saturday.

Related:  Cleaning Out My Elderly Parent’s Soon-to-be Sold Home
                 Aging Parents: My Parents’ Home–The Long Farewell
http://www.nextavenue.org/9-tips-cleaning-out-your-late-parents-home/   
for another “take,” More effort on your part; more–I think–potential for sibling problems; more expense (eg.using appraisers), and some similarities to this post.

                

Check out “Newsworthy” (right sidebar). Links to timely tips, information and research from top universities and respected professionals–to help parents age well.

Traveling again today–limited internet access.

Come back tomorrow night. This is going to be a summer of comings and goings…actually it already has been; but it will need to continue as we integrate previous vacation plans with our efforts to complete cleaning out R’s home.

FYI–Since March of 2014 I’ve moved my brother into 2 places and out of one, cleaned out 70+ years of things and sold the home I grew up in, in the northwest, and now am doing–what I hope is–the last cleaning out of a home ……..for many years to come. This week is vacation for us.

I’m debating doing another post on how to clean out a home efficiently. I think I have it down pat. See you tomorrow night!

Aging Parents: How One Elder Lived Independently, Alone and Well To 101–Part 2

How 101-year old, R, staves of loneliness and remains connected and independent–continued from last post

Staying Connected

–Telephone: R used it to its full potential. Long conversations with friends and relatives were part of her daily life before and after being widowed. I think phone calls take on greater value for people living alone. R’s line was always busy–her social life and most business was handled on the phone.

–Taxi: 50 years ago as a recent, non-driving widow, R had no desire to drive. Indeed her husband’s car remained–unused–in the car port–as a burglary preventive! R took taxis.

She used that mode of transportation for decades. When she found a taxi driver she liked, she got his number and used/requested him from then on–phoning ahead to arrange a pick-up time.

She also organized her errands by location–one location on a given day (eg. grocery store/bank/pharmacy), giving the driver a time to return to take her home (long before cell phones). It always worked out for her.

–Entertainment: R enjoyed music and other cultural offerings. She’d purchase 2 tickets to the symphony, for example, inviting a friend, neighbor or family member. They drove. She’d take them or lunch or they’d take her.

Our Role in Combatting Social Isolation

As those we care about enter old age, we tend to visit them–in their home; in assisted living; in a rehab center–or nursing home if allowed. Why not make the effort to take them out and give them a change of scenery? Otherwise, doesn’t our visit usually go something like this: We visit. We make conversation. They listen and respond. They remain in place. We leave.

It’s easier for us for many reasons, but is it better for them? Taking them out provides:

  • Stimulation (obvious)–there’s a lot to look at out there
  • Exercise–getting in and out of a car, in addition to walking, especially important for people who should–but don’t–exercise….like my mother. See Related for my strategy with Mother.
  • Feelings of accomplishment–doesn’t accomplishing something make everyone feel good. What about including elders on short shopping trips to buy groceries or things at the drug store?
  • Fun–a meal, driving back to old neighborhood; visiting aging parents’ elderly friends; watching (the last inning, quarter?) of grandchild’s team playing sport; visiting a zoo, or any production (ballet, symphony, lecture)–handicap accessible  [if needed].
  • Change of Scenery (lake, river, mountains, ocean…)
  • A “carrot”–Sr. Advisor R always said knowing–ahead of time–that she was going out to something was “a carrot”– gave her something to look forward to

Lastly, being around a sweet babies or young children is especially uplifting to most older people. Barb, one of R’s helpful neighbors, cares for her grandson while her daughter works. Since infancy, when Barb realized she could count on his being good for a while after his nap, she would put him in the car, pick up Sr, Advisor R, and do quick errands she saved for these occasions. All was arranged around his nap schedule and included R. How thoughtful is that! P.S. Barb is quick to say her grandson: “has his moments” (was a typical 2), but R never experienced those moments.

Throughout her life R. took an active interest in–what we were doing; her neighbors and their children and grandchildren; world affairs; the latest styles of living, fashion, restaurants. In addition–even in her last months, she continued to do her part for others, saving her magazines for one neighbor and financial newsletters and each week’s Baron’s for another. Clearly not the norm, she models an elder who remained engaged and embraced connections with others.

And since we know “connections with others” is one of the 3 most important “ingredients” in aging well (MacArthur Foundation Report), don’t we think Sr. Advisor R’s life is further proof of this?

While loneliness is a great threat to longevity (last post), it isn’t a given for those who live alone. Some people can live alone and not be lonely.

…Hoping that some of preceding ideas can be used to stave off loneliness–as we try to help parents age well.

*                   *                     *
Related: R’s 10 sayings (she made them up) that influenced the way she lived life.
Strategy with Mother to include (sneak in) exercise.

Check out “Newsworthy” (right sidebar). Links to timely tips, information and research from top universities and respected professionals–to help parents age well.