Nutritional Drinks and the Elderly

“My elderly mother isn’t eating and she has lost a lot of weight. Should I give her a nutrition supplement drink to replace the meals she should be eating?”

Under-nutrition due to lack of eating is a common problem among elderly people. It is also dangerous. Under-nutrition and extreme thinness can lead to higher mortality rates, according to a study published in the American Journal of Clinical Nutrition. It is a problem that can’t be ignored.

Geriatricians (specialists in treating the elderly) take weight loss among the elderly very seriously and caregivers should, too. However, some caregivers feel that feeding their parent a nutrition supplement drink, such as Boost, in lieu of meals ensures the elderly loved one is getting the nutrition they need. This isn’t the case, according to Dr. Amy Ehrlich, Associate Professor of Clinical Medicine and Interim Division Head of Montefiore Medical Center’s Geriatrics Division.

“Just giving them a can of Ensure for dinner isn’t enough,” she says. “It is always better to try to use regular food to maintain a person’s weight.” If a caregiver wants to use nutrition drinks, they should be used between meals, as a snack or supplement to add calories to the senior’s diet – not as a meal replacement.

Work with a doctor to determine elder’s nutrition needs

Weight loss is a marker of frailty. However, it is not a normal part of aging. Dr. Ehrlich stresses that it is critical to find out what is causing the senior’s loss of interest in food. A doctor should conduct a detailed medical evaluation to determine the cause of loss in appetite and weight loss. “There are a variety of treatable conditions that could be the culprit: ulcers, thyroid disease, dementia, depression, even ill-fitting dentures. All are treatable, so rather than immediately turning to a supplement, work with your doctor to address the cause of the problem,” Dr Ehrlich says.

If a caregiver does decide a nutrition drink is right for their elderly loved one, a doctor should still be consulted to determine the type of supplement to use. For example, diabetics must choose a low-sugar product.

There is a misperception that frail elderly people should adhere to the same low-fat, low-calorie diet that is recommended for the general population. However, Dr. Ehrlich says that for frail elderly who have substantial weight loss, the opposite is true. “I’ll see a 94-year-old person who is losing weight and he is restricting everything, eating a low-calorie, low-fat diet. It would be better to eat a bowl of ice cream, for the caloric intake!”

Elders who have experienced weight loss should eat what they like. And don’t be afraid to incorporate eggs, cheese, peanut butter…even ice cream into the diet. There is no need for low-fat milk or cheese.

The bottom line is that nutrition drinks are a not a magic fix for lack of eating or under-nutrition. These products are not bad when used as a dietary aid and supplement to regular meals. However, they should not be used as a meal replacement for elders – especially those who are frail or thin.

Source:  Agingcare.com

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 Checklist: Emergency Planning for Frail Elders

In addition to the standard supplies of food, water and first aid kits, if you have an elderly or disabled relative living with you or nearby, there some additional precautions to consider when preparing for natural disasters and emergency situations.

• Wheelchairs: If your parent is in a wheelchair or has mobility problems, plan for how he or she will evacuate. If you use a motorized wheelchair, have a manual wheelchair as a backup.
• Durable medical equipment: Most emergency shelters do not have durable medical available on site. You must bring your own.
• Blind or visually impaired: Keep an extra cane by the bed and attach a whistle to it. Remind your parent to exercise caution when moving, as paths may have become obstructed.
• Hearing impaired: Keep extra batteries for hearing aids with emergency supplies. Store hearing aids in a container attached to the senior’s nightstand or bedpost, so they can be located quickly after a disaster.
• Have ID information on hand for the elderly person as well as copies of relevant emergency documents, evacuation plans and emergency health information card.
• Talk to your doctor about stocking up on a week’s supply of all prescription medication.
• Make sure elders know where the first aid kit and emergency supplies are located.
• Establish a communication plan. Your family may not be together when disaster strikes, so plan how you will contact one another.
• If your relative has Alzheimer’s or dementia, know that even cognitively impaired people oftentimes have an innate understanding that something is wrong. Remain calm during an emergency. Explain what is happening clearly and simply, but don’t expect them to remember specific details. Validate their concerns, but provide clear direction without condescending or losing patience.
• If your elderly parent lives at home alone and receives assistance from a home healthcare agency, find out how they respond to an emergency. Designate backup or alternative providers that you can contact in an emergency.
• If your relative lives in a nursing home or assisted living, check the facility’s website for updates and 800-number that are typically established for communication with families.

Source: Agingcare.com

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Helping Your Older Parents Stay Happy and Healthy

If you’re fortunate enough to have one or both parents still living, you may have noticed a role reversal taking place in your relationship. Remember the days when Mom shuttled you to the doctor whenever you were sick? Now, it may be you who’s driving her to her medical appointments. Perhaps you’ve become even more involved in managing her healthcare needs – serving as her healthcare proxy, moving her into your home to care for her, or even having to select a nursing home for her to live in.

Whatever the case, it’s natural to feel challenged – and, yes, intimidated – in the role you’ve undertaken. But if you stay positive and proactive, you’ll be in a great position to advocate for your parents’ optimal care. And, really, what better way is there to say “Thank You” for all they’ve done for you over the years?

The following recommendations will help you understand what may be happening to your parents as they age – and what you can do to help.

1. Stay vigilant to sudden changes. Typically, sudden changes arise from sudden problems. Your elderly father who becomes confused one week but was alert and oriented the week before, or becomes unsteady walking and starts falling, is likely experiencing an acute problem – an infection, medication side effect, or perhaps, a heart attack or stroke.

2. Investigate the source of gradual decline.  A host of conditions can cause gradual decline. Before jumping to the conclusion – as many people do – that Alzheimer’s disease is the culprit, recognize that your parent may be experiencing an altogether different problem: a vitamin B12 deficiency, an under active thyroid, Parkinson’s disease or depression, to name a few. When discussing your parent’s decline with her physician, make sure the two of you consider all the possibilities.

3. Know thy parent’s medicine cabinet.  Familiarize yourself with the medications your parent takes: what each one is for and how often he takes them. Make sure you notify each doctor your parent visits of all the medicine he takes, including over-the-counter products. Ask what side effects you might observe from each medication and whether it’s potentially dangerous if your parent takes them together.

4. Discourage ageist attitudes.  Simply put, ageism is prejudice against the elderly. It exists in many forms but can be particularly damaging to an older person’s self-esteem when it assumes that all of her woes are age-related.    

5. Strive to maximize your parent’s quality of life. 
No matter our age, we all want to enjoy life to the fullest and have the capability to do the things we want to. Improving the enjoyment of life and a patient’s functional ability are the cardinal goals of geriatric care. But you don’t need a medical diploma on your wall to help your parent achieve either of those goals.

Sometimes, it’s the small gestures that have the most profound impact. As the child of an elderly parent, you are uniquely positioned to deliver these life-changing gifts.

Source: Longtermcarelink.net

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What is Dementia?

The word dementia comes from the Latin de meaning “apart” and mens from the genitive mentis meaning “mind”. Dementia is the progressive deterioration in cognitive function – the ability to process thought (intelligence). Progressive means the symptoms will gradually get worse. The deterioration is more than might be expected from normal aging and is due to damage or disease. Damage could be due to a stroke, while an example of a disease might be Alzheimer’s.

Dementia is a non-specific syndrome in which affected areas of brain function may be affected, such as memory, language, problem solving and attention. Dementia, unlike Alzheimer’s, is not a disease in itself. When dementia appears the higher mental functions of the patient are involved initially. Eventually, in the later stages, the person may not know what day of the week, month or year it is, he may not know where he is, and might not be able to identify the people around him. Dementia is significantly more common among elderly people. However, it can affect adults of any age.

What are the symptoms of dementia?

• Memory loss – the patient may forget his way back home from the shops. He may forget names and places. He may find it hard to remember what happened earlier on during the day.

• Moodiness – the patient may become more and more moody as parts of the brain that control emotion become damaged. Moods may also be affected by fear and anxiety – the patient is frightened about what is happening to him.

• Communicative difficulties – the affected person finds it harder to talk read and/or write.

As the dementia progresses, the patient’s ability to carry out everyday tasks diminishes and he may not be able to look after himself.

In the majority of cases dementia is incurable. Researchers are making inroads into treatments that may slow down dementia’s progress. Cholinestaerase inhibitors are frequently administered during the early stages. Cognitive and behavioral therapies may also be useful. Several studies have found that music therapy helps patients with dementia. It is important to remember that the patient’s caregiver also needs training and emotional support.

Source: Medicalnewstoday.com

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A Natural Product Does Not Mean a Safe Product

Here are some important facts about dietary supplements such as herbs and vitamins:

They may affect how well other medicines work in your body.

Herbs and some plant-based products may prevent medicines from doing what they are supposed to do. These medicines can be ones your doctor prescribes for you, or even ones you buy off the shelf at the store.

For example, the herbSt. John’swort, which some people with cancer use for depression, may cause certain anticancer drugs not to work as well as they should. A pharmacist can warn you when your prescription drugs will cause a dangerous drug interaction, so you should be sure your pharmacist knows what supplements you are taking.

Herbal supplements can act like drugs in your body.

They may be harmful when taken by themselves, with other substances, or in large doses. For example, some studies have shown that kava, an herb that has been used to help with stress and anxiety, may cause liver damage.

Vitamins can also take strong action in your body.

For example, high doses of vitamins, even vitamin C, may affect how chemotherapy and radiation work. Too much of any vitamin is not safe–even in a healthy person.

Tell your doctor if you are taking any dietary supplements, no matter how safe you think they are. This is very important. Even though there are ads or claims that something has been used for years, they do not prove that it is safe or effective. It is still important to be careful.

Supplements do not have to be approved by the Federal Government before being sold to the public. Also, a prescription is not needed to buy them. Therefore, it’s up to consumers to decide what is best for them.

Source:  Agingcare.com

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Cognitive training including puzzles, handicrafts and life skills are known to reduce the risk, and help slow down the progress, of dementia amongst the elderly. A new study   showed that cognitive training was able to improve reasoning, memory, language and hand eye co-ordination of healthy, older adults.

Research has already shown that mental activity can reduce a person’s risk of dementia but the effect of mental training on healthy people is less well understood. To address this researchers from Chinahave investigated the use of cognitive training as a defense against mental decline for healthy older adults who live independently.

To be recruited onto the trial participants had to be between 65 and 75 years old, and have good enough eyesight, hearing, and communication skills, to be able to complete all parts of the training. The hour long training sessions occurred twice a week, for 12 weeks, and the subjects were provided with homework. Training included a multi-approach system tackling memory, reasoning, problem solving, map reading, handicrafts, health education and exercise, or focusing on reasoning only. The effect of booster training, provided six months later, was also tested.

The results of the study were positive.  Compared to the control group, who received no training, both levels of cognitive training improved mental ability, although the multifaceted training had more of a long term effect. The more detailed training also improved memory, even when measured a year later and booster training had an additional improvement on mental ability scores.

This study shows that cognitive training therapy may prevent mental decline amongst healthy older people and help them to continue independent living longer in their advancing years.

Source: Medicalnewstoday.com

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If aging parents are complaining about pain and stiffness, it could be arthritis. Arthritis is one of the most common diseases in this country. Millions of adults and half of all people age 65 and older are troubled by this disease.

Arthritis can attack joints in almost any part of the body. Some forms of arthritis cause changes you can see and feel—swelling, warmth, and redness in your joints. In some the pain and swelling last only a short time, but are very bad. Other types cause less troublesome symptoms, but still slowly damage your joints.

Warning Signs

Here are some warning signs that might point to arthritis:

• Lasting joint pain
• Joint swelling
• Joint stiffness
• Tenderness or pain when touching a joint
• Problems using or moving a joint normally
• Warmth and redness in a joint

If any one of these symptoms lasts longer than 2 weeks, have your parent see their  regular doctor or a rheumatologist. If your loved one has a fever, feels physically ill, suddenly has a swollen joint, or has problems using their joints, see your doctor sooner. Your health care provider will ask questions about the elder’s symptoms and do a physical exam. He or she may take x-rays or do lab tests before suggesting a treatment plan.

Types of Arthritis

Osteoarthritis (OA) is the most common type of arthritis in older people. OA starts when cartilage begins to become ragged and wears away. Cartilage is the tissue that pads bones in a joint. OA symptoms can range from stiffness and mild pain that comes and goes with activities like walking, bending, or stooping to severe joint pain that keeps on even when the elder is resting or trying sleep.

Rheumatoid Arthritis (RA) is an autoimmune disease. In RA, the body attacks the lining of a joint just as it would if it were trying to protect you from injury or disease. For example, if your elderly parent had a splinter in their finger, the finger would become inflamed—painful, red, and swollen. RA leads to inflammation in the joints. This inflammation causes pain, swelling, and stiffness that lasts for hours. This can often happen in many different joints at the same time. Your aging parent might not even be able to move the joint. People with RA often don’t feel well. They may be tired or run a fever. People of any age can develop RA, and it is more common in women.

Gout is one of the most painful forms of arthritis. An attack can begin when crystals of uric acid form in the connective tissue and/or joint spaces. These deposits lead to swelling, redness, heat, pain, and stiffness in the joint. Gout attacks often follow eating foods like shellfish, liver, dried beans, peas, anchovies, or gravy. Gout is most often a problem in the big toe, but it can affect other joints, including the ankle, elbow, knee, wrist, hand, or other toes. Swelling may cause the skin to pull tightly around the joint and make the area red or purple and very tender.

Reactive Arthritis is a form of arthritis, or joint inflammation, that occurs as a “reaction” to an infection elsewhere in the body. Reactive arthritis is also known as Reiter’s syndrome. Besides this joint inflammation, reactive arthritis is associated with two other symptoms: redness and inflammation of the eyes (conjunctivitis) and inflammation of the urinary tract (urethritis).

Other forms of arthritis include psoriatic arthritis (in people with the skin condition psoriasis), ankylosing spondylitis (which mostly affects the spine), reactive arthritis (arthritis that occurs as a reaction to another illness in the body), and arthritis in the temporomandibular joint (where the jaw joins the skull).

Each kind of arthritis is handled a little differently, but there are some common treatments for arthritis. Rest, exercise, eating a healthy, well-balanced diet, and learning the right way to use and protect the joints are key to living with any kind of arthritis.

Source:  Agingcare.com

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Brisk Walking Can Rebuild Your Brain

As little as three hours a week of brisk walking can actually reverse the brain deterioration brought on by aging. According to new research at theUniversityofIllinois, aerobic exercise can increase the brain’s amount of “gray matter”—neurons —as well as its “white matter,” the connections between neurons, in older adults.

Until recently it was believed that age-related brain shrinkage and cognitive decline were inevitable, and that the brain can’t grow new neurons. This view has changed with demonstrations in animals that older brains can show positive changes in response to exercise, diet, social and environmental stimulation.

A recent study of older human subjects found that exercise can actually reverse the brain shrinkage and natural wear and tear that starts in mid-life. The research involved 59 healthy but sedentary volunteers, ages 60-79, who participated in a six-month randomized clinical trial, meeting three times a week. Half did aerobic exercises such as brisk walking, while a control group did only non-aerobic stretching and toning exercises. Researchers compared high-resolution magnetic resonance imaging (MRI) brain scans before and at the end of the exercise program. After six months, those in the aerobic exercise group showed significant increases in brain volume, while those in the control group did not. The prefrontal and temporal cortices of the brain—areas responsible for memory and information-processing that are especially prone to age-related deterioration —showed the greatest gains from aerobic exercise.

Moderate levels of exercise—in particular, walking—are relatively easy to do and may result in increased cognitive flexibility and the ability to lead independent lives for longer periods of time. You don’t have to be a marathon runner—a brisk walk works well. In addition, swimming and biking ways that people can get these anti-aging brain benefits as well.

Source:  Tufts Health and Nutrition Newsletter

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Trimmer Waistline May Mean a Sharper Mind

Evidence continues to mount that keeping fit may help protect your brain. Scottish and French researchers, in two separate studies published in the journal Neurology, recently concluded that people with a greater degree of lifelong fitness are more likely to have better cognitive function into old age.

In the Scottish study, 460 surviving participants of the 1932 Scottish Mental Survey were given the same general cognitive test at ages 11 and 79. Subjects also were tested on their grip strength, six-meter walk time and lung function. Results showed a positive correlation between physical fitness and improved cognitive aging.

In the French study, researchers at Toulouse University Hospital also looked at the fitness-cognition connection and found that the higher the subjects’ Body Mass Index (BMI), the lower their scores on cognitive performance tests, both at the beginning of the study and at a five-year follow-up. The study compared cognitive function data on 2,223 subjects, ages 32 to 62 at the beginning of the study. Participants were tested on their ability to learn and retain lists of words, substitute symbols and maintain attention.

After adjusting for physical, psychosocial and other covariables, researchers found that participants with a higherBMIhad lower cognitive scores. In fact, a higherBMIat the beginning of the study was associated with even higher cognitive decline at follow-up, suggesting that the earlier in life people get fit, the better for their long-term cognitive health.

American scientists concur. Research suggests that “middle-aged spread” may be linked to a greater risk of Alzheimer’s disease. Though researchers stopped short of saying a leaner waistline can prevent cognitive decline, the results add yet another reason to trade your rocking chair for walking shoes.

Source:  Tufts Health and Nutrition Letter

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Swinging Summer Temperatures May Put Seniors’ Health at Risk

In the warmer seasons, temperatures can vary a lot in a 24-hour period. Depending on where you live, the sun may rise on a 60 degree morning, and set on an 80 degree evening. These   temperatures could be harmful to seniors, according to a recent study from Harvard University.

After gathering data on two decades of chronically-ill Medicare recipients, researchers concluded that irregular temperature fluctuations may cause as many as 10,000 extra deaths among the elderly nationwide each year.

Even tiny temperature increases (less than two degrees Fahrenheit), may increase an elderly person’s risk of death as much as four percent, depending on which chronic health conditions they suffer from.

The study found that seniors suffering from heart disease, heart failure, diabetes and chronic lung disease were highly susceptible to changing temperatures.

While prior research has made the association between heat waves and a heightened risk of death, this is the first study to connect long-term mortality and minor temperature variations, a link that study authors say is becoming increasingly relevant as the consequences of global climate change begin to appear.

Across the board, we can expect to see an increase in the length and strength of heat waves this summer.  But this doesn’t mean that seniors and their caregivers should hole up in their homes and crank up the A/C—it just means that outdoor odysseys should be carefully planned.

If you and your elderly loved one want to enjoy the summer air, encourage them to wear clothing that is breathable and lightweight, with a broad-brimmed hat to shelter their head and neck from the sun.

Also, be sure pack enough water to keep both of you hydrated, and seek out places with a lot of trees and bushes. One of the key findings from the Harvard study was that people in areas with plentiful plant life weren’t as negatively affected by changing temperatures.

Source: Agingcare.com

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