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: 101-Year-Old, 4 Years After Broken Hip Surgery, Still Mobile and Living Alone

To begin the New Year, a happy follow-up–on Sr. Advisor R’s once broken hip.

Four years ago this month R left the rehab center after spending 4 months there. At the time Medicare only covered 3 months. Fortunately R had a secondary policy that helped with the 4th month. Don’t know what Medicare covers today. Do know that getting all information about insurance coverage, in advance, makes sense. It provides a framework for decision-making. That’s always helpful.

Today, at 101, R is completely mobile. She now walks with a cane when she goes out (which she didn’t do before she broke her femur). She uses her cane at home when she “feels unsure.”

While “feeling unsure” isn’t something younger people normally experience when walking or driving a car, it seems to be a feeling older people are attuned to. For example, I remember Edie (a Woman’s Club member in her late 90’s who aged well) saying something like “On days I don’t feel sure of myself, I don’t drive.”  “Know Thyself” seems important for aging well independently.

What has changed since R’s surgery:

R says she has no mobility problem–gets around fine, however–

The leg affected by her broken hip has never been as limber or as strong as it was before the surgery and is weaker than her other leg. Exercise is a must.

The muscles are weaker (even though she has religiously done the exercises learned in rehab since returning home). That leg also has less range of motion. For example, she says “I can’t just raise that leg (while sitting down) to put on a sock without help from my hand to rest my leg on a stool that I put in front of me. Then I can put the sock on.”

“If you don’t exercise that leg you’ll have trouble walking. So many just sit in a chair and don’t bother to do the exercises and pretty soon that leg doesn’t work so they walk less and sit more,” says R. “Many people just give up. I don’t want that to happen. I’m either going to be out of here (dead)–or I’m going to continue doing what I have to do. If you want your independence, you have to keep doing–your exercises and everything else.”

R credits the right cane (see next post) for giving her ease of mobility. She’s certain that the cane she’s now using is a big reason she’s been able to continue to go out with friends and live independently, alone. It was an important purchase that has helped her age well.

Check out “Newsworthy” (right sidebar). Links to timely information and research from top universities and respected professionals, plus practical information–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.

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.