Do Parents Get Enough Exercise? How Much Should They Get? HHS Guidelines for Older Adults’ Physical Activity

man using weights

Older People Worry About Falling
Older People Want Independence
Older People Don’t Wish To Be Limited By Physical Problems

I doubt anyone will dispute these assertions. On the other hand, are we–or most older people–aware of the physical activities that help aging adults retain independence so they can continue to age well?

Do we know older people who are couch-potatoes or elders whose leg muscles are so weak they can’t get out of a chair or off of a toilet seat without using chair arms (or equivalent)–or aging parents who can’t walk far without tiring? Won’t we help them age better by encouraging them to do some degree of exercise, so infirmities that could have been prevented don’t limit them?

In 2008 the Department of Health and Human Services published Physical Activity Guidelines for Americans, the first comprehensive guidelines on physical activity ever issued by the Federal government, with a section that focuses on “Older Adults.” Tufts provided this update this week:

Tufts Health & Nutrition Letter

Special advice from the Physical Activity Guidelines for Americans:
– When older adults cannot do 150 minutes of moderate-intensity aerobic activity a week because of chronic conditions, they should be as physically active as their abilities and conditions allow.

- Older adults should do exercises that maintain or improve balance if they are at risk of falling.
– Older adults should determine their level of effort for physical activity relative to their level of fitness.
– Older adults with chronic conditions should understand whether and how their conditions affect their ability to do regular physical activity safely.
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The following is excerpted from the Physical Activities Guidelines, Older Adults section: Click link to read complete CDC article. Also Click “More Videos” below for a quick demonstration of recommended exercises.

“If you’re 65 years of age or older, are generally fit, and have no limiting health conditions you can follow the guidelines listed below.

Older adults need at least:

jogging 2 hours and 30 minutes (150 minutes) of moderate-intensity aerobic activity (i.e., brisk walking) every week and
weight training muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).
OR
jogging 1 hour and 15 minutes (75 minutes) of vigorous-intensity aerobic activity (i.e., jogging or running) every week and
weight training muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).
OR
walking jogging An equivalent mix of moderate- and vigorous-intensity aerobic activity and
weight training muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).

Need more help with the guidelines?
Watch this video:
Physical Activity Guidelines Introduction Video
Windows Media Player, 4:43
More videos

10 minutes at a time is fine

We know 150 minutes each week sounds like a lot of time, but it’s not. That’s 2 hours and 30 minutes, about the same amount of time you might spend watching a movie. The good news is that you can spread your activity out during the week, so you don’t have to do it all at once. You can even break it up into smaller chunks of time during the day. It’s about what works best for you, as long as you’re doing physical activity at a moderate or vigorous effort for at least 10 minutes at a time.”
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Also note: “…some people should check with their doctor before they start becoming more physically active. Experts advise that if you have a chronic disease, such as a heart condition, arthritis, diabetes, or high blood pressure, or symptoms that could be due to a chronic disease, it’s important that you’re under the care of a doctor and talk to him or her about the types and amounts of physical activity that are appropriate for you.”

As we try to help parents age well, this is good information to have–not only for aging parents, but for ourselves as well.

 

Related: –Physical  Activity Guidelines for Older Adults from the CDC 2008 study
                   –CDC information  for older adults with chronic problems or disabilities
                   –“Growing Stronger,” Older Adult Exercise Program from Tufts and the CDC
2008 Health and Human Services Guidelines Physical Activities Guidelines for Americans–complete publication for all ages

Aging Parents: “Time Takes All But Memories”

Can the elderly be sustained by memories?

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 I came across a speech excerpted from a 1965 memorial service. A sun-dial inscribed “Time Takes All But Memories” inspired a sermon (in part below) making me wonder: What’s it like for the isolated elderly? Do they have only memories?

“What is true for the dead, is equally true for the living. When there is no one to think of us, no one to care for us–even though we be alive, is it not as though we are dead? To be sure, I am not speaking of mere physical survival, for a man might breathe and eat and pump blood for 969 years like the legendary Methuselah in the Bible–but who wants to live if he has no one who loves him, no one who cares for him, no one who remembers him? Total, perpetual endless loneliness is, I daresay, even worse than death itself.”

Old people must work hard to maintain relationships. We know loneliness is an issue for them. Contemporaries move away; many die; many are incapacitated. There are those who can’t “get out” because they no longer drive and public transportation isn’t easily available. And while pets can fill a void, personality and needs must be carefully and thoughtfully weighed before placing additional responsibility on an elderly person.

So that leaves us. If we’re already burdened with responsibilities (caregiving, work, child-rearing), we can only do what we can do. On the other hand, a quick note (snail-mailed), every week if we can manage, translates: someone remembers…someone cares. A faxed note can carry the same message and be more efficient (although not quite as nice). Inquiring at a nursing home and/or assisted living facility whether a fax will be accepted for someone living there, can offer that possibility. Of course, there’s always a phone call, which elders say always means a lot and is next best to a visit. It may come down to the amount of time we have. And if we have time, what about an outing for those who are able?

One of the best examples of caring that I know of, was the plan two cousins in their 70’s made to get their mothers (sisters in their 90’s, living about 2 hours apart in Oregon) together….which meant an outing. One had mobility issues, the other dementia. They were in care facilities; hadn’t seen each other in 2 years. The cousins’ careful planning made the reunion a wonderful success. Won’t a get-together like this serve as a catalyst for sharing a commonality of  memories (which exist even in dementia patients).

Skype has enriched many lives. By the time we get old there may be even better technology to keep us connected and thus, ward off loneliness. In the meantime for today’s elders, who fall into the “isolated” category and don’t use a computer (as well as others), it seems the old-fashioned ways of showing we care are the best we have.

Changing often: “Newsworthy” (right sidebar). Links to timely information and research from top universities, plus some fun stuff–to help parents age well.

Related: Dementia, Mobility-Challenged, 90 year-old Sisters Meet After Two Years for a Summer Outing 

Aging Parents: Do We Help or (Inadvertently) Diminish Them–3 Self-esteem

Good job!” How often parents say this simple phrase to their children. Good parents praise and reinforce self-worth. No elaboration needed. What is needed is the reminder of how easily self-esteem can be unwittingly undermined in the elderly–be it by strangers, acquaintances, or family members.

Is it due to assumptions people make about older people?
Is it that a well-meaning phrase, used to show affection, is actually belittling to a proud elder?
Is it that an unthinking remark, in response to an elder’s age-related issue, hurts?

Assumptions

While Katie’s mother, at 85, had mobility problems, her mind was excellent. When she went places where much walking was involved, she preferred a wheel chair. Katie–a perceptive daughter–realized the wheel chair caused receptionists, sales people, and other strangers to aim conversations at her, not her mother. Katie quickly and nicely told them they needed to speak to her mother, not to her.

That said, we don’t always catch the disrespect in time. I took my m-i-l, then 99, to a specialist when she visited NYC two years ago. We sat in his office on one side of the desk, he on the other with her X’ray images on his computer. My m-i-l sat across from him. I was farthest away on her right. He could look straight across at my m-i-l, but turned to me when he spoke. The words to nicely make him aware, didn’t come to me fast enough. I heard my m-i-l’s voice–strong and clear–saying something like: “Dr., I pay the bills for my care, please direct your remarks to me.”

Older people who have learned to stand up for themselves, speak up. But whether they’re take-charge elders or “shrinking violets,” the result is the same: they feel belittled, disrespected. My m-i-l would not go back to him regardless of how skilled he was. She still brings up the experience and it was over two years ago.

Affectionate Expressions and Informality Can Convey Disrespect 

While Katie was a pro at deflecting disrespect, she too had a surprise. She took her mother to a bridal shower. While they were not seated at the same table, Katie could see her mother was animated and engaged in conversation throughout the afternoon. On the way home Katie asked about the girl her mother was talking with. “She was insulting,” was the response. Katie was taken aback. It seems they had a “very nice conversation,” but when it was time to leave the girl said “It was so nice talking with you, Grams.” “Grams?!” Katie’s mother had felt equal, not old; and no amount of explaining that this was undoubtedly a friendly expression, could placate Katie’s insulted, aging mother.

Unwanted informality can also cause problems. I remember a representative from a California college who came to speak with our 12th graders. Looking at her watch, she mentioned to me the 3-hour time difference and her worry about her elderly mother who had undergone difficult surgery the day before.

She explained that her mother was a strong woman, accustomed to being treated with great respect. If the hospital staff used the “honey-sweety” language, she feared her rather helpless-after-surgery mother would feel lessened, and her will to embark on the difficult recovery process ahead could be affected. “She needs to be called Mrs–not even by her first name…that’s too familiar,” said this college rep.” She planned to phone the hospital as soon as the morning shift was on duty to alert them.

Mrs. M (who died at 104) had one child–a dutiful son. While not needing hospitalizations until she  was 100, her son quickly realized that she would not cooperate with staff she decided was “beneath” her intellectually or otherwise. When she was given a room, the first thing her son did was to apprise the staff that she should be called “Mrs. Miller.” Things went perfectly for those who did. We won’t discuss the fallout when they didn’t.

Unthinking responses

On the other hand, Bebe, another strong woman who said her daughter was the best, admitted she had one complaint. Being somewhat hard of hearing, but not yet needing a hearing aid according to the audiologist, Bebe related a common occurrence that emotionally “hurt.” While she knew it wasn’t purposeful, she said it happened time and time again.

Bebe and her daughter would be having a conversation and Bebe would ask a question (that no doubt she’d asked before). Her daughter would say something like “Mother, this is the second time I’ve answered that question” or  “This is the second time you’ve asked that question.” Should we call attention to elderly parents’ imperfections–like hearing or benign forgetfulness– when they aren’t threatening life and limb?

It’s a delicate balance–physically and emotionally—where aging parents are concerned. There’s so much we can’t control. Yet we can try to control unthinking responses that tip that balance and cause hurt.

The flip-side is finding ways to help aging parents feel good. Praise, compliments, acknowledging past things we’ve learned from them, asking for advice–all raise feelings of self-worth………. as we try to help parents age well.

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Changing often: “Of Current Interest” (right sidebar). Links to timely information and research from top universities, plus some fun stuff–to help parents age well.

Aging Parents: Do We Support or (Inadvertently) Cripple Them?–2 Independence

AGING AND INDEPENDENCE

The second way we inadvertently cripple elders can be deceptive. We think we’re being helpful when, in actuality, we don’t allow elders the independence they have and need to age well. Are we all guilty of this?—–more or less?

We don’t think of it that way. That’s understandable. We’re younger, stronger, quicker and possibly impatient; while older people are weaker and slower.  Those who are going to age well have learned they need more patience to compensate for their age-related changes and continue life as they’ve known it. Independence is fragile.

Is it safe to say we’re all guilty of interfering with our parents’ independence at one time or another? When we’re busy–because of our other responsibilities to work, family, caregiving–it’s perfectly normal to want to get it done and move on, rather than wait for an older person to do it at his–or her–slower pace.

Some elders fight this, like supremely independent, energetic Eloise. At age 85 she and her husband, Earl, moved to a one-story private home in Delaware to be nearer their daughter and her husband. The adult children helped with the moving in since there was much lifting involved. But there came a point when Eloise decided the help was encroaching on their independence. Eloise told her wonderful, tuned-in-to-older-people daughter (who told me): “Your father and I are not ready for role reversal yet, when we are, we’ll let you know.”

Some older people like Eloise, have the moxie. We all know them and many live long, busy lives. They ward off unwanted help; they maintain independence to the last breath. (Eloise died in her sleep in her own bed at 95.)

Most older people aren’t Eloise, however; and we don’t want to cripple them with kindness or unnecessary efficiency. If aging parents accept dependency we’re the ones who will have the burden as they will rely on us more and more and more……

Is it dogmatic to say “Never do for aging parents what they can do for themselves?” Perhaps. Nevertheless, it’s an important concept to keep in our minds.

Last post in this series, Aging Parents and Crippling Self-esteem, (it’s pretty widespread, not necessarily by us) will be published tomorrow or Saturday.


Related: “Is Helping Aging Parents Always Helpful? 

Changing often: “Of Current Interest” (right sidebar). Links to timely information and research from top universities, plus some fun stuff–to help parents age well.

Aging Parents: Do We Support or (Inadvertently) Cripple Them?

One of the key thoughts in helping parents age well:
IS IT BETTER FOR THEM (PARENTS)
OR
BETTER FOR US?

Clearly doing what’s better for them is the goal. (Exceptions:–when our health and family functioning are at risk or when parents, who still have a good mind, are unreasonable and disrespectful.)

That said, there are well-meaning actions that can have negative consequences. They affect mobility, self-esteem, and independence. 

It’s easy to do things out of love and wanting to help that are not necessarily in older people’s best interest. It’s easy to do what we think is right–or is the only way we know how–without realizing it isn’t helpful and may, indeed be harmful. What’s at risk? What are the options?

Mobility 

We know the adage: “If you don’t use it, you lose it.” Why then do we–without asking or being asked–do things that prevent elders from using their muscles when, indeed, they can–and should. Difficulty walking and “getting around” impacts quality of life, ultimately making it harder for both elderly parents and adult children.

IMG_24021.  Do we use the handicap parking permit and park as close as we can to the destination? Or are we aware of the fact that it would be better for older people, who are capable of walking farther, to park a reasonable distance away so they get the additional exercise walking provides and strengthen their muscles? (If in doubt, check with parents’ doctor.)

2.  When elders must use a walker, do we pull them up from their seated position? Or do we have them grab onto our wrists or hands (once our feet are firmly planted so we have balance) and pull themselves up–thus strengthening their legs and arms? Also elderly skin is fragile and if we’re pulling it can be bruised.

3.  Do they–and we–have at least one firm chair with arms, that makes it easier to get up from without help? The time may come when arm and leg muscles weaken to the point that getting up from a toilet without the aid of a raised seat or a grab bar is impossible. Mother needed someone to help her get up from the sofa when she was in her mid-80’s; not Dad. His leg muscles were such that he could get out of a chair or off of a sofa without help and he was proud of that. (It’s a good thing to practice for our  eventual old age.)

Shopper (with cane in shopping cart)

Shopper (with cane in shopping cart)

4.  While doing errands at the grocery store, big box stores, TJ Maxx, Home Goods– can we include elders so they get exercise pushing a shopping cart? The sturdiness of the cart offers the support to walk without worry. There’s a certain feeling of freedom and normalcy for those who usually use walkers, canes or have concerns about balance. (Those little electrical scooters and other “vehicles,” don’t offer the exercise.)

**This is getting too long. Independence and Self-esteem tomorrow.**

Changing often: “Of Current Interest” (right sidebar). Links to timely information and research from top universities, plus some fun stuff–to help parents age well.

To Help Parents Age Well: US News & World Report: Best Hospitals 2014-2015

U.S. News Ranks Best Hospitals 2014-15

Again this year US News & World Report has published its Best Hospitals issue. Of the 17 hospitals to make the 2014-15 Honor Roll, top honors in Geriatrics are earned by Mayo Clinic in Rochester, followed by Mt. Sinai in New York, UCLA Medical Center in Los Angeles, Johns Hopkins in Baltimore, and Massachusetts General in Boston. Click above link for Geriatrics honor roll.

For difficult and out-of-the ordinary diagnoses and procedures the best hospitals are most likely to have the most experience, so aren’t we’re also talking about best doctors here? It makes sense to have the above list should especially worrisome health issues arise.

For more “garden-variety” health issues there are many fine regional hospitals which are recognized in the US News and World report. To find the one(s) near you or aging parents, here’s the map of the best regional hospitals. 

Also know that the several changes were made to the ranking methodology this year. They may account for some of the changes from last year’s rankings. Check out the details at: http://health.usnews.com/health-news/blogs/second-opinion/2014/01/11/us-news-hospital-rankings-to-boost-role-of-patient-safety-cut-back-reputation 

Lastly, for a quickie snapshot and information about the 17 best hospitals, take the “photo tour.”

To help parents age well–(or for all challenges it would seem)–the more good, solid information we have beforehand, the better prepared we are. And isn’t this especially true when it comes to health issues.