Common Traits of Longevity

What do the longest living people

in the world have in common?

They say that it is the little things that matter most in life.  That is true especially when talking about the secrets of longevity.  Apparently it is the small details of daily living that add up to a healthier and longer life.  That is what the people at National Geographic discovered when they tried to explore the secrets of longevity among various people and cultures.  While looking for the common traits in lifestyle among the longest living people on the planet, they discovered certain similar practices which could be considered a formula to living a longer life. 

There are areas of the planet where people tend to enjoy longevity.  People there reach the age of 100 at extraordinary rates and reach these ages enjoying   amazing health  and strong cognitive capabilities.  The places have been geographically and demographically defined as the Blue Zones.  Blue Zone places like Greece, Nicaragua and Japan can teach the rest of the planet how to live a long and healthy life.  In the book, “The Blue Zones: Lessons for Living Longer from the People Who’ve Lived the Longest”, Dan Buettner maps out some common traits shared be these groups of people.

Lifestyle of Food

Diet is key to longevity.  Those who live in the Blue Zones share the same foundation in their diets. They all get the bulk of their protein from beans rather than meat.  High consumption of proteins from animal products can increase mortality levels by 70% and greatly increase the risk of getting cancer.  The Blue Zone centenarians eat beans, grains, fresh fruits and vegetables on a daily basis and enjoy small amounts of meat only a couple times a month.  They also drink a little wine daily which brings high levels of polyphenols and antioxidants into their diets. They live much longer than average with just a fraction of the current rate of dementia in their elderly years.

Lifestyle of Motion

People who live to the age of 100 and older are engaged in physical activity throughout their lives.  They don’t actively take part in exercise like per se but their lifestyles are set up so they are constantly in motion either through walking, gardening or doing household chores, mostly without the aid of modern conveniences.  Their daily chores keep them fit because they do them the old fashioned way: walking to the stores instead of driving, kneading bread instead of buying it sliced and packaged, planting, watering and weeding a vegetable garden…. These daily tasks create unconscious physical activity which carried out over a lifetime leads to a fit and healthy body.

                                                                                         

Lifestyle of Purpose

Having a sense of meaning or purpose in your life can add up to 7 years to the average lifespan.  The people living in the Blue Zones focus on family and relationships.  They live with or near their adult aged children and help raise their grandchildren.  They are deeply involved in the daily lives of their family because they all live, work, eat and play together.  Having a deep sense of purpose and involvement with the people you love adds years to a lifespan. 

Lifestyle of Community

Those living in the Blue Zones have a real sense of belonging to their community.  They share a commitment to social network that they have built over a lifetime.  Most live in a village setting with people they grew up with and have known for years.  The concept of being lonely, which can take 8 years off average life expectancy, would be hard for them to understand.  In addition the bulk of the centenarians are involved in a faith based group of some kind. A deep religious faith and connection to other faith based people can add up to a decade in life expectancy.

Taking a lesson from lifestyles found in the Blue Zones and adapting them to our daily lives can be a challenge but is well worth the effort.  Aging cannot be helped but how you live as you age can make an amazing difference in the quantity and quality of the years you enjoy.

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com

Kate McCarthy is Director of Operations for HomeAid Health Care which provides services for the elderly who wish to remain safe and independent at home.  HomeAid is sister company to Prairie Home Assisted Living which has served the physical, spiritual, mental and health needs of their residents since 1999.  Together the two companies provide comprehensive care for the elderly in the Fox Valley area of Wisconsin.

Sources:

“Here are the Secrets to a Long and Healthy Life” by Simon Worrall, National Geographic. April 12, 2015.

“The Blue Zones: Lessons for Living Longer from the People Who’ve Lived the Longest” by Dan Buettner.

National Geographic, 2009.

“Top Lifestyle Changes for Older Adults to Live a Longer, More Enjoyable Life” by Derek Jones, April 4, 2016.

The Costs of Aging in Place

Home Health Care allows

the elderly to age in place.

Image abandoning the place you’ve called home for the past 40 years, surrendering all your income and moving into a long-term care facility, a nursing home.  There you must share a room with a stranger, follow the facility’s schedule and spend the majority of your time alone or with nursing staff.  Of course this is a stereotype, many long term care facilities are lovely places, but this lonely scenario is what many older Americans fear to be waiting for them when they are too ill, injured or grow to frail to live independently. The majority of elderly are adamant that they do not want to end up in an institutional setting.  Today, with the rising costs of care, there is an increasing interest in home health care as an alternative to long term facilities.

Age in Place

Home Health Care provides health care and support services that can be received at home and is available for ill or disabled people of all ages.  The main goal of Home Health Care for the elderly and frail is to allow the individual to age in place.    Home Health services allow aging individuals to maintain their independence and remain comfortable in a familiar setting.  With Home Health Care, the aging can avoid moving to institutionalized long term care facilities.  Studies have shown that Home Health Care can actually improve the quality of care received and many times will reduce the need for hospitalization. 

Benefits of Home Health Care

With outcomes often as effective as care received in assisted living, rehabilitation and skilled nursing homes, Home Health Care brings a lot of benefits to those who use it.  Home Health Care providers get to really know their patients and families and can tailor their services to best meet the Client’s health care needs, finances and family preferences.  They can help families navigate the confusing web of health care resources and can effectively advocate the needs of their patients.  Another advantage is family is invited to become more involved and can participate in providing support and hands on care for their loved one.  In addition patient morale is often better at home and people tend to recover faster with less incidents and safety issues in a home setting.  Finally, there can be significant cost savings when using Home Health Care as there are no room and board costs compared to nursing home, rehabilitation centers and other institutional care settings.

Types of Home Health Care

There are two types of Home Health Care options available; Skilled Home Health Care and Non-Medical Home Health Care. 

Skilled Home Health Care is medical in nature and is used to provide skilled care or treatment or rehabilitation services to homebound patients.  This type of care is usually initiated by a physician and provided by a licensed medical professional such as an RN, LPN or Physical, Speech or Occupational Therapists.  Providers must follow specific federal guidelines and criteria regarding patient care.  Skilled Home Health Care providers are usually Medicare certified and can accept 3^rd party billing of health insurance which is great because out of pocket expenses range from $85 - $150/hour.

Non-Medical Home Health Care provided home services which are not considered to be skilled care but help the individual be safe and comfortable at home.  Services are usually initiated by social workers, family members or by the aging person in need.  Care is provided by trained Caregivers and CNAs (Certified Nursing Assistants).  Providers can be licensed by the state but requirements vary state to state.  Non-Medical Home Health is usually an out of pocket expense and ranges from $20 - $30/hour in cost.  Non-Medical Home Health Care can be covered by Medicare if coupled with Skilled Home Health Care.  Long term care insurance policies as well Veterans Aid and Assistance benefits can be used to pay these Non-Medical services.

How they work together

Let’s work through a scenario to see how Skilled and Non-Medical Home Health Care work together.  Margaret is an 83 year old female who was hospitalized due to a fall.  She was released after 3 days in the hospital.  Upon her discharge, the physicians and social workers agreed that Margaret could not be home alone during her recovery even though she was expected to make a full recovery in time.  Margaret elected to use Home Health Care rather than move into an assisted living or stay at a skilled rehabilitation center. 

Skilled Home Health Care was set up to monitor Margaret’s recovery and ensure she would not have to be readmitted to the hospital.  Weekly, 30 minute RN visits were scheduled to check her vitals, medications and general health.  Physical Therapists visited her at home biweekly to work with Margaret on her walking and balance skills to prevent future falls.  Non-Medical Home Health Care was set up to visit Margaret twice a day.  A 4 hour AM and a 2 hour PM shift came daily to help with companionship, medication reminders, assistance with exercise routines, transfers, showering, toileting and dressing as well as household chores and meals.  Within a month Margaret no longer needed the Skilled Home Health Care which was discontinued.  She retained the Non-Medical Home Health Care long term but reduced the hours to only 3 per day.  Margaret’s combined use of the services cost her very little compared to moving into a facility to recover.  The fact that she retained the Non-Medical Home Health Care means that she will be able to remain at home in the future even as her care needs increase. 

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com

Kate McCarthy is Director of Operations for HomeAid Health Care which provides services for the elderly who wish to remain safe and independent at home.  HomeAid is sister company to Prairie Home Assisted Living which has served the physical, spiritual, mental and health needs of their residents since 1999.  Together the two companies provide comprehensive care for the elderly in the Fox Valley area of Wisconsin.

Living with Urinary Incontinence

The loss of bladder control can be embarrassing

 and is a common problem among the elderly.

Joe tends to avoid company.  His peers think of him a crotchety old man and usually  give him his space.  His demeanor discourages close contact.  But all that is a guise Joe maintains to keep people at a distance.  Joe suffers from urinary incontinence and is embarrassed by his condition. 

A cough, sneeze or just laughing out loud can trigger it.  Urinary incontinence is a common problem for many people, not just the elderly, although it becomes more of an issue with age.  It is a topic which is difficult to talk about with family, friends or even a doctor.  The wetness, odor and the constant need to change clothing can be very embarrassing. 

What is Urinary Incontinence?

Defined as loss of bladder control, the term urinary incontinence covers anything from the occasional leaking of urine to the inability to make it to the toilet in time. These incontinence episodes can occur any time, even when asleep in bed. 

There are five types of urinary incontinence.

• Stress Incontinence – Pressure on the bladder from coughing, sneezing, exercising, or lifting heavy objects.
• Urge Incontinence – an urge to urinate is followed by involuntary loss of urine.  This is often caused by infections or more serious conditions such as neurologic disorders or diabetes.
• Overflow Incontinence – a constant or frequent dribbling of urine due to the bladder not being able to completely empty. 
• Functional Incontinence – a physical impairment, such as limited mobility or severe arthritis, which prevents getting to the toilet in time. Mental impairments, such as inability to recognize the need to get to the toilet are also considered in this category.  
• Mixed Incontinence – a combination of two or more types of insentience.

Factors which increase development of Urinary Incontinence

There are several factors which play a role in developing an incontinence problem.

• Gender – Women are more likely to have Stress Incontinence due to the physical effects of pregnancy, childbirth and the female anatomy.  Men with prostate gland problems have an increased risk for Urge and Overflow Incontinence
• Age – Unfortunately age causes the muscles around the bladder and urethra to lose strength.  With age the bladder reduces the amount it can hold and increases the likelihood of incontinence.
• Being Overweight – Carrying extra pounds can increase the pressure on the bladder.  The muscles surrounding the bladder can weaken and allow the urine to leak when coughing or sneezing.
• Diseases – Neurological disease or diabetes may increase risk of incontinence.  In addition a Urinary Tract Infection (UTI) and constipation can also aggravate the problem. 
• Diet – Temporary incontinence can be caused by certain drinks, foods or medications.  The diuretic stimulants which can increase the volume of urine in the bladder are alcohol, caffeine, decaffeinated coffee or tea, carbonated drinks, artificial sweeteners, corn syrup, foods high in spice, sugar or acid (especially citrus fruits).  Heart and blood pressure medication, sedatives and muscle relaxants also are diuretic stimulants as well as large doses of vitamin B or C.

Complications of Chronic Urinary Incontinence

Incontinence can greatly affect a person’s personal life by its negative influence on social, work and personal relationships.  Skin problems such as a rash, infections and sores can also develop from constantly being wet with urine.  Incontinence also increases the change of repeat UTIs and can aggravate constipation.

Overcoming Urinary Incontinence

It is important to seek medical advice if urinary incontinence is a frequent concern or is having an effect on the quality of life. Before speaking to a physician:

• Start a journal to track symptoms and frequency of incontinence.  Keep notes about what was happening at the time of the incident, i.e. laughing, lifting groceries, or sleeping.
• Make a list of all medications being taken.   Multiple physicians may prescribe medications and there is always a possibility of negative interactions from various pharmaceuticals.   Be sure to including over the counter pills.  The doctor will be able to look at all the medications being taken to see if there if incontinence is a side effect from one or a combination of medications.
• Track the kind of foods being eaten and how much fluid is consumed daily.
• Provide a brief health history and compile a list of questions to ask the physician.  It is sometimes helpful to bring along a friend or family member to take notes and help remember what the physician said.

Giving as much information as possible to the physician helps with getting the correct diagnosis and making a plan of action to correct the problem.

What to expect from the physician

The physician will review the information provided and ask questions to get a complete picture of the problem.  Possible questions that could be asked are:

• How long has urinary incontinence been a problem?
• Are there any issues when trying to empty the bladder?
• When is the problem most noticeable?

The physician will do an examination, order blood work and/or radiology testing and could recommend a specialist called an Urologist.  Those who suffer from urinary incontinence often experience different symptoms and may receive a variety of treatment plans.

For most people simple lifestyle changes combined with some medical treatment can ease the discomfort and stop the problem of incontinence.  It is a difficult topic to speak about but gathering information and taking steps to control the problem can lead to a happier and healthier life.

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com

Deb Hintz is Assistant to the Director for HomeAid Health Care. HomeAid provides services for the elderly who wish to remain safe and independent at home.  HomeAid is sister company to Prairie Home Assisted Living which has served the physical, spiritual, mental and health needs of their residents since 1999.  Together the two companies provide comprehensive care for the elderly in the Fox Valley area of Wisconsin.

Hoarding Troubles

What looks like clutter to us, represents

 memories, travels, friends and love to seniors.

Charlie was a young boy during WWII and like many of his peers he remembers how it was to make do.  He tended to keep things just in case he might need them down the road.  Yet a lifetime of storing things became something far more than being frugal when his wife passed away.   After Marge’s  death the stuff accumulating around the house grew into more than just piles of clutter.  There were newspapers, old pill bottles, and empty food containers covering every flat surface, heaps of dirty laundry on the bed and floor and no clear path to move from room to room.  Clutter took over Charlie’s home and started to have a negative effect on many aspects of his life.

The hoarding of objects among the elderly is a serious problem.  Piles of hoarded objects can be a sign of a serious cognitive disorder and present a safety concern which requires immediate intervention.

Hoarding as a disorder

We all keep things.  For some, the item has sentimental value and for others it is about a possible need in the future, but often times the elderly keep things because they suffer from a cognitive disorder.  Diogenes Syndrome is a type of obsessive-compulsive disorder which is prevalent among the elderly.  It often presents itself in those suffering from dementia or frontal lobe impairment.  According to the American Geriatrics Society, Diogenes Syndrome is usually characterized by extreme self-neglect, household squalor, social withdrawal, apathy, compulsive hoarding of rubbish and a lack of shame.  This syndrome is usually found in people who lack social interaction and cognitive stimulation, have suffered a traumatic event or have a genetic predisposition to the condition. The elderly are prime candidates for hoarding prevalent in Diogenes syndrome. 

Those who suffer from elderly hoarding tend to use their possessions as a coping mechanism.  The onset of this condition can be triggered by an emotional trauma, like the death of a spouse.  The elderly person has a hard time dealing with their loss and so fixates on something they can control.  The disorder is also associated with those suffering from fear of loss, anxiety and depression.  In some cases hoarders just don’t know how to get rid of their unwanted possessions.  In other cases the collected items are kept out of sense of loyalty to the past or a compelling need to conserve.  No matter what is the underlying cause of hoarding, the accumulation of things over time combined with the daily bombardment of junk mail, bills, newspapers, dirty dishes and laundry can very easily become too overwhelming for the elderly to deal with. 

Risks of Hoarding

Having clutter around the house is risky for the elderly. Piles of newspaper and old books not only represent a potential fall risk but can add fuel to a fire.  Old clothes lying about on the floor invite damp, mold and mildew into the home.  Dirty dishes and expired food in the cupboard lure mice, rats and insects.  Piles of mail could hide important documents, unpaid bills or checks that need to go to the bank.

 

Hoarding not only creates anxiety, stress, guilt and embarrassment for the elderly but often destroys relationships with family members.  Adult children have a hard time trying to convince their elderly loved ones to allow them to sort through things and throw the junk away.  Relationships are strained and isolation becomes more of an issue when family stays away due to the unhygienic state of the home. 

What to watch for

Sometimes it is hard to recognize and label the problem as Diogenes syndrome.  Since confronting this issue can be difficult for family members, it is helpful to know what signs indicate a real problem. 

• Piles of clothes, newspapers, mail and unpaid bills
• Difficulty navigating safely through the house
• Frustration with sorting and organizing
• Difficulty managing activities of daily living
• Expired food in the refrigerator and cupboards
• Closets and drawer crammed with things
• Compulsive shopping
• Difficulty with discarding items
• Stroke or signs of dementia
• Loneliness

Helping an elderly loved one who is struggling with hoarding requires a lot of patience.  Bombarding the home with a ‘get this done today’ attitude or secretly clearing out things behind the hoarder’s back can only aggravate the stress in their lives.  It is important to remember that the house didn’t get this way because of poor housekeeping skills.  A hoarder is suffering from a disorder and needs emotional help before they are ready to toss anything. 

What to do to help

Experts suggest taking on small areas at a time.  Help an elderly loved one clear off a table and then praise the results.  Suggest donating items to a local charity or thrift shop.  Remind that safety in the home is important to being able to remain independent at home.  Work out an agreement of not keeping unused things for more than 6 months.  Clutter is about control and hoarders have a hard time letting things go, but allowing them to decide where things go can be very helpful.  Don’t think that once the house is clean, the problem has gone away.  Hoarders will continue keeping things and the place will slowly fill up again unless the underlying emotional issues are dealt with and there is practical help in keeping the clutter at bay.

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com

Kate McCarthy is Director of Operations for HomeAid Health Care which provides services for the elderly who wish to remain safe and independent at home.  HomeAid is sister company to Prairie Home Assisted Living which has served the physical, spiritual, mental and health needs of their residents since 1999.  Together the two companies provide comprehensive care for the elderly in the Fox Valley area of Wisconsin.

Sibling Troubles Revived

Caring for aging parents can revive

relationship troubles between siblings.

You grew up together.  You learned, played and fought together as children and were the best of friends and the worst of enemies all at the same time. You know your brothers and sisters well but now that your aging parents need their children to actively help them, you may find working with your siblings to be far more difficult than you ever imagined.

Martha‘s mother recently passed away.  When looking back at the whole experience, Martha could say she was now at peace with it but deeply regretted the relationship damage that took place with her brother and sisters during the months leading up to her mother’s death.  Conflicts over large and small issues drove a deep wedge between the siblings.  There was bickering over medications and doctor appointments.  There was squabbling over spending time with mom.  There was quarreling over who was to help with specific tasks.  There were out and out fights over expenses. It was like all the adults in the family reverted back to childhood battle lines and no one was fighting fair.

United in crisis

Ideally, siblings will unite and work together to care for their parents when they are ill or become too frail to care for themselves.  Yet in real life it is often a crisis that suddenly forces siblings to unite to provide care for an aging loved one.   These crisis situations trigger a lot of family friction.   Conflicts are made worse by brother and sister’s fine-tuned ability to push each other buttons and relive childhood rivalries.  Arguments over care sap the strength out of the family at the time when their parents need them to work together.  It is also very upsetting to the aging parents who depend on their children for help. 

To avoid conflicts siblings need to face the fact early on that they will someday be called on to care for their aging parents.  Preventing disputes over how best to provide that care is ideally done long before any care is needed.  Sitting down with parents before any care issues arise and discussing the realities of aging is the first step to keeping the family intact and working together through the care years later on.

Talk it out ahead of time

Long before the need exists, when the adult children are in their 40’s and the aging parents are roughly in their early 70’s, have a serious talk about the future.  Gather the family and openly discuss the possible scenarios of the parent’s future care needs.  It may feel premature and a bit morbid to discuss your loved one’s mortality, but it is foolish to pretend they will not age or face health issues someday.  Most people avoid this uncomfortable discussion and wait until a crisis forces the issue and then they must make quick decisions which often lead to mistakes, conflicts and frustration.  It is wise to talk about the parent’s wishes and how they could be honored so the entire family has a framework for the future.  Having a general care plan in place will go a long way if a crisis hits and also will serve to lay the ground work for future long term care. 

Figure out who will do what

Recognizing off the bat that the division of labor will never be perfectly fair, discuss among the siblings who could do which tasks and how much money each would be willing to pitch in to pay for care if necessary.  Try to roughly divide up the responsibilities according to ability.  Sketch out a game plan that all members of the family can theoretically agree to. Don’t assume that since you were all raised in the same family that you naturally agree on what is best for mom and dad.  There will be some emotionally intense moments when you will not agree at all and these will test your bond as siblings, so try to define roles and rules ahead of time to ward off extra conflict.

Gather all the important documents

The sibling(s) with strong organizational and finance skills should be appointed the Power of Attorney for finances by the parents.  Everyone in the family should have a clear understanding of under what situations that power would be activated and what tasks the Power of Attorney will take care of.  This sibling should know where all the money and accounts are kept as well as all the insurance and investment paperwork. Once activated, the POA of finance should gather the titles to the house and cars, safety deposit boxes, keys and passwords for all accounts. They should review any long term care insurance and all other insurance policies your parents have set up and understand the fine print about what is covered and how it will be covered.  The sibling in charge of finances will take care of organizing all the important paperwork, arrange the payments for all bills and should keep the rest of the family informed.  The POA of finances will become knowledgeable about their parent’s financial details and be able to manage the available money to cover care and end of life costs.  They will be responsible for exploring public assistance options if the funds run short. 

Health Care Decisions

As parents age, their health care becomes an increasing concern.  From managing their medications and doctor appointments, to helping with mild cognitive issues to working out end of life care, the amount of decisions can be overwhelming.  The sibling who has been appointed POA of health care will have their hands full once their power has been activated.  If the aging parents were clear about their health care directives and where they wish to be when full time care is needed, then the many decisions will not be such a major source of stress.  Yet even with clear guidelines in place there will be many health care issues where conflicting opinions between siblings cause stain.  One family set a rule that the sibling present at the moment gets to make the decision and, once made, it cannot be second guessed.  Even though all agreed to this rule in the beginning, the siblings found it quite difficult to abide by.  Again, it is having a clear understanding of the roles and rules between siblings that make the care years easier to manage. 

With long term family ties, a little grace will go a long way, especially when stressful situations demand a unified working cooperation.  Know ahead of time that all decisions regarding the aging loved ones will not be unanimously accepted but agree to disagree nicely for the sake of the parents and future family relationships. 

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com

Kate McCarthy is Director of Operations for HomeAid Health Care which provides services for the elderly who wish to remain safe and independent at home.  HomeAid is sister company to Prairie Home Assisted Living which has served the physical, spiritual, mental and health needs of their residents since 1999.  Together the two companies provide comprehensive care for the elderly in the Fox Valley area of Wisconsin.