Aging Parents: Maintaining Mobility into Old, Old Age–The Dangers of Sitting Too MuchCONTACT SUSAN at: helpagingparents@gmail.com

Sedentary Seniors and Couch-Potato Elders—Walk More. Sit Less

How limiting is life for those with curtailed mobility?

Look around…so many people with canes and walkers as our population ages. Based on the Tufts U. publication–reprinted below–it seems their numbers would lessen if the elderly couch potatoes we care about (as well as those of us who now spend hours sitting at a desk), make it a point to take breaks for a brief walk. What could be easier?

The importance of older peoples’ walking is nothing new to longtime readers of my blog.  “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.” So says Mark Lachs, author of Treat Me, Not My Age.   (Dr. Lachs is Chief of the Division of Geriatrics and Gerontology at Weill Medical College in NY among other positions, and first written about in my 2010  post featuring Jane Brody’s NY Times columnWhat to Do Now to Feel Better at 100.) 

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–until she died.

(R’s 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.) 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 and mobility was never an issue other than that he walked slower than in his younger days.

A well-respected chiropractor in Westchester County, NY told me that he could always tell which patients wintered in Florida because they didn’t get the exercise walking stairs provided. 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.”

Last January (2015) Time magazine’s online article discusses the sitting dangers and recommends “standing up and moving around every half hour

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

Related: Helpful information from his book in ABC 2010 interview with Dr. Lachs.
Jane Brody’s NY Times columnWhat to Do Now to Feel Better at 100
Time Magazine online, 2/
2015 . It Doesn’t Matter How Much You Exercise if You Also Do This
USA Today 2/2014. Don’t just sit there! It could be harmful in later life.

Aging Parents Who’ve Lost Interest in Appearance and Healthy Routines

Flowers for sale lining doorway to marketOregon. The emphasis on healthy lifestyles is evident from the many joggers and bicyclists (major downtown streets devote space for bicycles only).

I’m in a residential area, looking out my second floor window.  An elderly woman, attractively dressed in a V-neck shirt and kakis, just walked by. I can see the top of her head is balding, yet her short gray hair is stylishly cut. I’m certain very few at street level see the top of her head. She’s walking a black and white pooch, and is stiffly bending over with plastic bag in hand, picking up its droppings. I notice she also walks stiffly–but she’s walking. And that’s the point: she’s exercising, even if her joints aren’t what they once were. (Aren’t animals a great impetus to get people of any age up and out for a walk!)

Along comes a trim 30ish woman in jogging gear, never missing a beat as she overtakes then passes the woman and pooch. I wonder if this younger woman will continue a fitness routine 30- 40-50 years from now, stay slender and value looking good.

What Can We Do About Parents Who No Longer Make the Effort?

Let’s face it. People change, not much. If people never cared about appearance or any semblance of a healthy lifestyle, short of a traumatic event or therapy from a good psychiatrist or psychologist, behavior is unlikely to change.

Thus, we focus on three factors to help aging parents who cared once upon a time, before life got in the way.

1.  Ruling out depression. Statistics tell us depression affects many elderly people.  Diagnosing depression initially requires an appointment with an aging parent’s doctor then, if appropriate, referral to a psychologist or psychiatrist specializing in geriatrics. Click https://helpparentsagewell.com/2011/08/06/aging-parents-and-depression-2/ for an 8/2011 UCLA report on depression.

2. Understanding that a lessening of energy accompanies aging at some point. Sometimes there’s not enough energy (psychological and/or physical) to spark the effort required. Can we provide the spark? While there’s no guarantee, why not try?

3.  Remembering or figuring out what aging parents still love–or they once loved doing.  Then developing an improvement strategy involving exercise and appearance.

An example from my mother’s life: Exercise

My mother loved flowers, liked to eat and–in her heyday–loved shopping for clothes and make-up. Figuring out what inspires a woman in her mid-80’s, when osteoporosis and later a stroke make any suggested exercise seem like drudgery, is a challenge. (I put trying on clothes in the “drudgery” category–of course ill-fitting clothing also impacts appearance.)

Because my mother seemed uplifted by a new top and slacks that I brought her, it motivated her to–somewhat tentatively–agree to get some needed clothes. That motivated both of us to learn to gracefully get her walker–and her–in and out of the car. We could go together to a mall. The necessary walking provided needed exercise. We could eat a healthy, tasty lunch and perhaps look at clothing if energy permitted–or even cosmetics. Would she ultimately want to sit long enough for a complimentary make-up/makeover at the department store anchoring the mall?

Food shopping was then added to Mother’s favorite outing list and that’s easy exercise–pushing the shopping cart involves walking as past posts have detailed.

Summer in Oregon inspires beautiful floral displays flanking markets’ entrances (photo above). Buying flowers to take home–or even bringing an elderly person flowers–is good for the spirit. It also provides exercise and good busy work for one who is able to get out vases etc. and make a pretty arrangement.

….continued tomorrow

 

When Helping Aging Parents Isn’t Helpful

4 Common Mistakes We Make When Trying to Help Parents Age Well

Some “courtesies” today may be considered good manners, but in fact don’t help older people age well.  They chip away at independence and work against physical fitness–so necessary for successful aging.

I’ve become conscious of this since my 97-year-old mother-in-law (and Senior Advisor to my blog, R) has made a full recovery from her broken hip and is again living alone (with an alert pendant) in her home of 60+ years.

She continues physical therapy twice a week, where she’s being trained to walk confidently on her own–without cane. Surprisingly I realize my instincts weren’t helping this goal.

1. After spending 4 months in a rehab center doing physical therapy to strengthen muscles and regain her ability to walk, her handicapped parking permit is readily available.  But why use it to park up close (except in emergency situations) when walking is excellent exercise for her?

2. Nor do I open the car door for her any more.  She was taught how to open a car door and get in properly–cane and all. It took hard work on her part to accomplish this. Do I reinforce independence or contribute to her muscle strength by opening the car door? or closing it?

“It’s nice to let people do for you,” says R, “but pretty soon you get used to it and you begin to lose independence.  And that happens with too many people.  I’ve been watching it.  Pretty soon they can’t do for themselves what they really are capable of doing–and they lose a lot of their life.”

When/if this happens it lose-lose for everyone, except perhaps for assisted living facilities and 24/7 caregivers.  Don’t we want to avoid this as long as possible–if not forever?

3. Are we helpful, when we help old people out of a chair? If they can get up by themselves they exercise leg and arm muscles. Older people get up–unaided–more easily from a chair with a sturdy seat and sturdy arms (like the arm chairs at a dining room table). Every older person’s home should have one–as should their children’s.

Fact: countless older people can’t get off of the toilet due to weak leg and arm muscles. (Worry not–they’ve found raised seats in the catalogs and surgical supply places, but why help parents get into that situation?)

4. When parents use a walker but are seated, for example at a restaurant, it’s common to see well-meaning children pull them up from their chair. This deprives the walker-user from exercising arm and leg muscles, but equally–if not more–important, elderly people have thin, fragile skin–so easily bruised and not so easily healed. Bottom line: stand firm, reach out and let the walker-using person grab our hands and pull him/herself up.

What else is not helpful? Basically–even with the best of intentions– doing anything for aging parents that they can do for themselves.

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



Aging Parents: Lack of Exercise, Weakened Muscles–Do We Enable?

Knowing that “ify” balance and loss of confidence contribute to aging parents’ concern about falling, and just having written about falling and “alert” pendants, reminded me of one of those “ah haa!” moments.  I realized that Mother, recovering from a stroke, was not conscientious about doing her physical therapy exercises at home. For one thing, she needed to walk more, her muscles needed strengthening. As we know, muscles weaken for lack of use.

Being a far-away living child, I wanted to make the most of my time with her. My suggestions only made her feel less adequate when I flew out to visit. I wanted to empower.  What better than a short outing to Nordstroms? We’d have fun. She’d have to walk.

Underway and armed with handicapped tag (and walker just in case), I felt tension thinking about the availability of a handicapped parking space.  But there it was–just waiting for us.

As I was preparing to get out, then help Mother out–flash of brilliance: “Why am parking so close? The primary purpose of this outing is for Mother to walk more…I’m trying to help an aging parent, not trying to park as close as I can which limits her walking.”

When parents can–and need to–exercise their leg muscles, doesn’t it make sense to avoid the handicapped space? Of course we needn’t park blocks away–but we know our parents, we can guage their capability (if uncertain check with doctor) and gradually increase it.

Walking–as we know–is a best exercise and costs nothing (unless we do a lot of shopping).

If parents need the stability of your arm, check out the dignified, preferred way of doing this in my August 21st post. And of course shopping carts at the big box stores, grocery stores etc. provide the stability to make walking easy for older parents.

Bottom line: skip the handicapped spaces, unless there’s a good reason to use them. This is one more way we can help our parents age well.

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: Falls and Fall Prevention-Part 2

Older people and the increased likelihood of their falling has been a major concern–no doubt for decades. The drug industry has come forth with medications to improve bone density. More recently gyms and senior centers offer programs aimed at improving balance, flexibility, muscle strength, and bone strength, among other things. And in the last 10 years or so–probably because people are living longer and the likelihood of falling increases the older one gets–the subject of older people falling has spawned considerable literature with ideas for prevention.

To say that older women suffer more fractures than older men probably comes as no surprise. But the statistics may surprise. After age 50–and increasing with age as just indicated– up to one out of four women and one out of fifteen men can anticipate breaking a bone. Is this because: a) women outlive men; b) their bones are less strong; c) all of the preceding? No matter. If we have aging mothers we must be proactive (if they aren’t) in our quest to help them age well. And let’s not slight aging fathers. Bone density is also a problem for some men, so it may bear checking out in older men with slight frames.

It seems obvious that there is proactive prevention–to ward off problems before they become problems; and reactive prevention–to deal with immediate problems. Of course, the proactive is easier. The reactive is difficult to begin with, but is made more difficult because many parents don’t tell when they fall (see October post).

Starting with the proactive: When aging parents aren’t already taking measures to ensure–to the extent possible–that they will not fall, what can be done that is effective, respectful, and supports self-esteem and competence. Note: I didn’t write “confidence.” Parents may think they have will never sustain a fall, or may be in denial, because they consider themselves healthy (they are) and “in charge.”

It’s best to begin this conversation before it’s needed. Don’t put it off if you think your parent is presently at risk of falling. If a friend should fall, this news usually travels quickly among older people and is sobering. It also provides a natural opening to suggest certain check-ups and provide some information–“some” information because we don’t want to sound like “know-it-alls” (even when we think we do) or cause overload.

The following are often associated with risk of falling, so check-ups to rule them out or identify them before they become problems makes sense.

Vision–Natural aging may cause problems distinguishing shades of dark colors that could result in missing a step at, for example, a curb or on uneven pavement on cloudy days or at night. (A small flashlight is a good gift.) Cataracts at a certain point may make night driving NOT advisable, but shouldn’t affect daytime driving, until they worsen. And outdated prescription-glasses pose obvious risks.
Hearing–if balance seems to be a problem, rule out inner ear problems.
Balance, dizziness, falling asleep at the wheel (yes, it happens). Check with pharmacist to rule out medication reactions and/or contact doctor. An exam may be in order.

Proactive prevention:
Bones weaken, which makes falls more dangerous, thus becoming familiar with bone density medication, vitamins, and certain kinds of exercise (ie. walking, dancing, tai chi) to strengthen bones makes sense.
Muscles weaken, flexibility lessens, and reflexes can slow down. While this occurs naturally to some degree with aging, these changes become more pronounced for inactive people because of the “If you don’t use it, you lose it” truism. Thus, take steps to “use it”…or them.

An awareness of the above has led to fall-prevention offerings at senior centers and gyms.  Example: tai chi, a gentle but proven effective exercise for balance.  No doubt this is why these classes are popular and offered at senior centers, as are yoga and chair yoga (the latter for the less physically able). Check out “Silver Sneakers” (www.silversneakers.com), a nationally-offered exercise program designed for seniors, given at fitness centers, and covered by insurance companies (which vary by state).

Lastly, one of my two fall-prevention tips (tip 2 next post). An octogenarian tells me, that–at least with women– vanity enters into the falls and fractures discussion. How? By the shoes women wear, that can make good balance very “ify” and perhaps even more worrisome if it’s your aging mother who is teetering in them. This fall prevention “head’s up” will probably be met with resistance. Indeed, this kind of discussion may be better coming from a physician. I’m not ready to give up my shoes yet and perhaps will never think I should. What about you?

“Fall Prevention” continues on Tuesday.  In the meantime, you might want to order a free copy of “Taking Steps to Prevent Falling Head Over Heels” using AARP’s “Home and Community Booklets Online Order Form.”