Transitions: Senior to Elderly - Slowing




Slowing is a natural part of aging.

Most seniors don’t usually categorize themselves as "elderly".  Many will bristle at being treated as frail or dependent and will actively work at remaining as young as possible. Seniors look forward to retirement age with plans of finally having time to enjoy family, the opportunity to travel or pursue personal interests. They are encouraged with opportunities to do things, go places and experience life like no aging generation has been in the past.  So when today’s senior reaches advanced years and frailty begins to be an issue, the transition into being truly elderly can be very difficult.

There are four psychological phases that the aging pass through as they transition from senior to elderly. These stages are 1) Slowing; 2) Life Review; 3) Transmission; and 4) Letting Go.  Recognizing and understanding the characteristic behavior of being elderly of each stage is helpful for families and the aging alike.  For the aging themselves, recognizing the transition into advance age can be difficult, frailty often just sneaks up on a person before they are really ready for it.  Knowing the signs of that transition can help with acceptance of the next stage in life.  For family it is often necessary to assist their loved one through each stage of advancing age and knowing what to expect can make it easier on all involved.

 Slowing

 

One of the most visible indicators of the transition from senior to elderly is the process of slowing down.  Except in the cases of illness, slowing is a very gradual process.  For most healthy individuals, advanced age is noticeable by the lack of speed in all functions.  This is the time of slowing in pace, motor skills and biological processes.  There is also a reduction in speed in certain intellectual and memory functions.  The physical slowing of advanced age takes over all aspects of life and brings with it formidable physical and psychological implications.

·         Focus on bodily maintenance - For the advanced elderly, a trip to the bathroom may take a half an hour and buttoning up a sweater or finding one’s socks may take another 20 minutes.  The basics of living occupies the bulk of the day, leaving the elderly essentially only time to focus on the routine tasks of daily care.

·         Focus on details - Rather than quickly completing multiple tasks as one does in youth, the elderly pay attention to the details of the one task at hand.  Their focus on minute details may be frustrating when it comes across as being particular or difficult, yet taking the time to listen and help with those details is an act of love.

·         Focus on routines – For the advanced in aged life is simplified into daily routines and schedules.  These routines, which are followed strictly, provide stability as the elderly is face with an ever increasing fast paced world they can no longer keep up with.  Asking an elder to interrupt or change his routine can be met with resistance and needs to be approached gently and with advanced notice.

·         Focus on the negative - The advanced in age are often traumatized by personal losses of health and loved ones. They may feel of isolated from family and harbor resentment of being relegated to institutions for the old.  The elderly face many challenges in keeping a positive outlook on life and not succumbing to hopelessness and it is often interaction with family and friends that help put problems in perspective.

·         Focus on fears – Many elderly people grow confused and tend to panic when confronted with the fast pace of life.  These moments of forgetfulness and disorientation create great anxiety.   Humiliation at loss of memory, loss of physical competence and occasional states of confusion all create paralyzing fears of being incapacitated and being unable to care for one self.  This cycle of fear can cause the aging to shut down emotionally, psychologically and physically.  

·         Focus on being rather than doing – The challenge for the elderly lies in making a healthy relationship with slowing.  It requires abandoning the pace of life from the past.  There is no longer the future to consider, but a focus on the present.  To be able to relax and accept just being rather than doing is a great challenge for the elderly, who have clung to remaining active and productive all through their senior years.

Today’s aging often faces the transition of slowing without the support of a safe and loving environment.  It used to be that the elderly remained centered in the family life, helping with the raising of children and acting as the living history of a family.  The youth were taught to slow down to a pace acceptable to their elders and to wait on them respectfully.  Without that loving and patient support an the elderly can perceive their natural process of slowing as being a nuisance.

Natural aging for the elderly unfolds best  in a caring atmosphere; one enriched with life and love, communication and relationships.  It is in such an environment the aging are accommodated as they go through the first transition stage of becoming elderly. 

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:  “The Psychological Tasks of Old Age” by Victoria Fitch, www.windhorseguild.org. 5/15/13.

                   “The Old-Old Years” by Brenda Sue Black, M.S., www.wvu.edu.com. 6/1/13.

Proper Nutrition for Elderly: Quiz

Learn about the link between nutrition and health among the aging.

We all know about the correlation between diet and health. For the elderly, a nutritious diet is essential to maintaining health and promoting longevity.  A proper diet keeps aging muscles, bones, organs and other body parts in good working order for the long haul. Getting the necessary vitamins and minerals from healthy food boosts immunity and fights off illness-causing toxins.  Beyond reducing the risk of heart disease, stroke and high blood pressure, eating a proper diet also fights against type -2 diabetes, bone loss, anemia, cancer and Alzheimer’s disease. Yet studies show most elderly don’t eat a nutritious diet.  Test your understanding of diet and nutrition for the aging by taking this quiz and see if you know the essentials of a healthy diet for a healthy senior.

1)  The average person puts on 10 to 20 pounds from 45 to 65.  This is_____?

A.    quite normal.  We need to expect body changes as we age.

B.     to be avoided.  A person’s recommended weight should remain the  
  same throughout the adult years. 

C.    caused by aging, not by inactivity or overeating.

D.    not that common.  Most people don’t put on weight as they age.

ANSWER:  B   In fact, dramatic changes in weight can lead to negative health issues. Maintaining a proper weight through a lifestyle of health diet and exercise, even if started later in life, contributes to longevity and a better quality of life.

 2)  Being notably underweight _____.

A.    is a sign of possible health problems.

B.     is wonderful!  Don’t we all want to shed a few pounds?

C.    can lead to fatigue, cognitive confusion and depression.

D.    both A and C.

ANSWER: D Significant lose of weight is a red flag to many health concerns.  Many of today’s elderly suffer from malnutrition from not eating enough food or getting the proper nutrients from the food they consume. Poor diet increases risk of falls, mental confusion and osteoporosis.

3)  Elderly get all their nutrients or vitamins and minerals from the food they eat.

A.    true

B.     false

ANSWER: B In fact, the aging are less able to absorb some nutrients from their diet and may need to take vitamin supplements.   For example, after 50, the stomach produces less gastric acid making it difficult to absorb vitamin B-12 from food, which is necessary to keep blood and nerves vital.  Another important nutrient combination is calcium and vitamin D.  Calcium is needed for maintaining bone strength, but cannot be absorbed without vitamin D. With age, the body is less able to synthesize vitamin D on its own and so supplements become necessary. 

4)  Elderly with urinary incontinence should _____.

A.    cut back on the amount of water they drink each day.  We don’t want 

to risk any embarrassing accidents.

B.    supplement with coffee or soft drinks.

C.    drink eight 8 oz. glasses of water daily.

D.    not worry about drinking water unless they feel thirsty.

ANSWER: C  Incontinence can be embarrassing, but should not stop an elder from drinking enough water.  Getting enough fluids can be an issue for the aging because they do not always realize when their body is thirsty.  Usually drinking eight eight-ounce glasses of fluids per day is enough but if in doubt, check the urine color.  Pale yellow urine is best.  Bright or dark yellow means you need to drink more liquids.

5)  Elderly are less active and so should consume fewer calories to avoid
     putting on weight.

A.    True

B.     False

ANSWER:  B   For the majority of elderly, diet isn’t about losing weight anymore; it’s about eating healthy meals.  Eating a balanced diet is more important than counting calories, but for those who count this is a good guideline.

Women over 50:  not physically active = 1,600 calories a day

                               some physical activity = 1,800 calories a day

                               very physically active = 2,000 calories a day

Men over 50:        not physically active = 2,000 calories a day

                               some physical activity = 2,400 calories a day

                               very physically active = 2,800 calories a day

 

6)  Elderly often lose interest in food due to _____.

A.    changes in sense of taste and smell.

B.     poor fitting dentures make eating painful.

C.     medications affecting their appetite.

D.    eating alone.

E.     All of the above.

ANSWER:  E   All of the above can affect the eating habits of the elderly causing them to lose interest in eating properly.  Not maintaining proper meals is a leading cause of malnutrition among this age group.

7)  Food choice has nothing to do with Alzheimer’s disease.

A.    True

B.     False

ANSWER: B  Key nutrients are very important for the brain to function at its best.  Eating a selection of brightly colored fruit, leafy veggies, fish and nuts packed with omega-3 fatty acids can improve focus and decrease the risk of Alzheimer’s disease.

8)  The best diet for the elderly to follow is _______.

A.    Vegan Diet

B.     Atkins Diet

C.     Mediterranean Diet

D.    Western Diet

ANSWER: C  Known for increasing lifespan by 8-14%, the Mediterranean Diet is also credited with lowering the risk of heart disease.  A veggie loaded diet with legumes, fruits, fish and unsaturated fats like olive oil, the Mediterranean Diet is ideal for the elderly.

9)  Seniors and the Elderly need 1,200 mg. of calcium daily to maintain good bone health.  A common source for calcium is milk, yogurt and cheese.  Non-dairy sources include ______.

A.    tofu, broccoli, almonds and kale

B.     mushrooms, molasses and salmon

C.     basil, soybeans and sardines

D.    All the of the above

ANSWER:  D There are a lot of great sources for calcium even for those who don’t tolerate dairy easily.  Getting enough calcium prevents osteoporosis and bone fractures, which to the aging, is a major issue. 

10)  Being carb smart for the aging means limiting consumption to about 6-7 ounces of grains daily.  An ounce of grain is equal to _______?

A.    a crouton

B.     a croissant

C.     a slice of bread

D.    a loaf of bread

ANSWER:  C   A couple of slices of bread a day sounds fine, but most people don’t realize that pasta, cereals, beans and many vegetables all are considered carbs.  Filling up on carbohydrates is a problem for everyone, but for the elderly it means missing out on getting the proper nourishment from their diets.  Eating carbs labeled “whole” is better option, as they have more nutrients and fiber.

As people age, eating well can be an important element of maintaining a positive mental outlook and remaining emotionally well balanced.  Eating a healthy diet is no longer about sacrificing and watching one’s weight.  It is about enjoying fresh, colorful foods and being creative in the kitchen.  Enjoy a healthy meal with friends today and you will feel vibrant and healthy, inside and out.



 

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com



HomeAid Health Care which provides non-medical home services for the elderly who wish to remain safe and independent at home.  HomeAid is a 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 that meets the needs of the elderly in the Fox Valley of Wisconsin.

Malnutrition Among the Elderly

Many of America's elderly are going hungry.

Malnutrition is now being recognized as a major health risk among the elderly.  Studies show that an increasing number of Americans over 65 are not getting the calories, proteins or essential vitamins and minerals necessary for good health.  In fact, according to the National Health and Nutrition Examination Survey, only 17% of the older adult population is actually consuming a quality diet.  Surveys show that 30% of seniors skip at least one meal a day and many are living on less than 1000 calories daily.  An estimated 15 – 20% of the over 65 population suffers from malnourishment.  At a time when the entire country is concerned about obesity and overeating, it sounds amazing that a substantial segment of American’s elderly are going hungry.

There are many reasons why the elderly are not eating the quality or quantity of food they need.

·         Reduction in sensitivity to taste and smell.  A loss of appetite is often related to an older person’s loss of ability to taste and smell foods. 

·        Medications. Side effect of medications or combinations of medications can cause a reduction of appetite, increase instances of nausea and make food taste differently.   

·        Poor dental health. Poorly fitted dentures, jaw pain, mouth sores and missing teeth make chewing difficult and can lead to avoidance of eating protein laden meats.

·        Financial difficulties. Living on a fixed income often means the elderly must decide between purchasing quality foods and paying bills.

·        Inability to shop.  Navigating busy street and crowded shops can be daunting for the elderly, especially in bad weather.  Many forego shopping for fresh produce and try to get by with what is on hand.

·        Physical frailty.  Lack of strength, arthritic pain, dizziness or disabilities can make even simple meal preparation too much of a task.

·        Forgetfulness.  Dementia, Alzheimer’s disease and poor memory can hinder a senior from eating a proper variety of foods on a regular schedule.  It is common among elderly with cognitive challenges to skip meals and not be aware of when they last ate.

·        Depression.  Sadness due to difficulties with health, loss of family and friends or loneliness can affect appetite and cause an elderly person to lose interest in food.

Dangers of malnutrition for the elderly

Malnutrition leaves an elder open to nutrient deficiencies, muscle atrophy, and a weakened immune system. It plays a role in morbidity, mortality, recovery from illness, overcoming functional disabilities and physical complications.  Malnutrition is directly related to increases in infections, imbalances in electrolytes, loss of skin integrity, anemia and overall weakness and fatigue.

Common conditions associated with aging are really due to malnutrition

It is not always easy to recognize if an elderly loved one is suffering from malnutrition.  Weight is not always a good indication. According to Dr. William B. Bateman Jr. of the Montefiore Medical Center in the Bronx, a person can be quite overweight and still be nutritionally starving to death from a protein point of view.  The obvious signs of malnutrition are loss of appetite and an unintentional loss body fat.  Other indicators include dry and dull hair, conjunctive dryness and a receding of the gums. An onset of mental confusion, light-headedness, loss of taste and smell, weakness in motor skills, falls and fractures, and skin sores are all indications that dietary imbalances exist.

The problem is that many of the symptoms of malnutrition among the elderly are commonly thought of as a natural part of the aging process and not seen as signs of a treatable condition.  Even among medical professionals, many older patients with nutrition risks have their symptoms treated without care providers addressing the root of the problem. The fact that elderly experience a physiological decline, grow frail, and become increasingly susceptible to illness had long been accepted as just an unfortunate part of aging.  Yet recent findings show that many of the common conditions associated with aging are largely related to malnutrition.

Gerontologists are now excited about recent evidence that indicates that the illness and disease burden experienced by elderly could be significantly lightened by following a better diet.  According to Dr. Ranjit K. Chandra of the Memorial University of Newfoundland, Canada, it is not impossible for 80- or 90-year-olds to have immune systems similar to that of a 40-year old if their dietary needs are not compromised.  Even those elderly who have suffered from malnutrition can begin to restore their immune systems, improving their resistance to diseases, by correcting dietary deficits. 

Following a proper diet is essential to the health and longevity of seniors and the elderly.  By consuming a nutritionally balanced diet seniors can add years of health to their lives.  To learn more about the specific nutritional needs of the elderly check out the “Elderly Nutrition Handout” available at www.scribd.com.

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com

 

Sources:

Malnutrition in the Elderly: An Unrecognized Health Issue by Danielle Maher, Student Nurse &Carol Eliadi, EdD, JD, APRN.

Nutrition and the Elderly, by Leanne Beattie and Nicole Nichols, www.sparkpeople.com, retrieved 6/18/12.

Ten Reasons Why Your Aging Parent May Not Be Eating Properly, by Leonard J. Hansen. www.agingcare.com. Retrieved 6/19/12.