Friday, 31 May 2019

GUEST POST - 5 Ways to Improve Sleep for Seniors


There’s no getting around it. Sleep can be a struggle for seniors. Insomnia and snoring increase as do instances of dementia and the need for medications that may cause wakefulness. But seniors need the same seven to nine hours as other adults. Sleep problems can primarily be reduced with good sleep habits and a plan that addresses individual sleep issues.  

Incorporate Daily Exercise

A 2010 study found that aerobic exercise can help seniors fall asleep faster and reduce night wakings. While insomnia isn’t the only sleep issue seniors may be facing, any kind of exercise can help wear the body out while helping to maintain muscle tone and heart health.

Exercise doesn’t need to be vigorous or strenuous to bring sleep benefits. Yoga, swim aerobics, and walking are low impact forms of exercise that can be tailored to the needs of seniors. Activities that can be enjoyed with others also offer social opportunities. While thirty minutes per day is recommended, any exercise is always better than none.

Bright Light Therapy

Sunlight, and other forms of blue spectrum light, naturally suppress sleep hormones during the day. As light fades, sleep hormones get released. Aging eyes often don’t let in as much light as they once did. When the eyes cannot absorb as much sunlight as is necessary to regulate sleep hormones, sleep irregularities like daytime sleepiness and nighttime insomnia may follow.

Increasing daytime exposure to blue spectrum light can help put the sleep cycle back on track. Seniors who participate in bright light therapy spend a few minutes each morning in front of a lamp with a specially designed light blub that mimics sunlight. The increased exposure to blue spectrum light supports the body’s natural rhythms and can improve the regularity of the sleep cycle.

Try Meditation

Stress can be a major sleep loss factor at any age. Seniors may face the loss of a spouse, financial changes, and/or moving out of a beloved home. The stress of life changes can compound sleep problems. Meditation is a simple, time effective way to manage stress.

Meditation has been shown to strengthen connections between the brain’s emotional and logical centers to aid emotional control. With practice, it can also reduce heart rate and improve blood pressure both of which can reduce stress and improve sleep. Seniors can participate in classes with a live instructor or meditation CDs or apps. Even 10  to 15 minutes per day can be enough to reduce stress levels.

Create a Bedroom of Comfort

Comfort can be an issue for seniors as aches and pains tend to increase with age. A heating pad, over the counter pain medication, and a glass of water on a nightstand provide easy access to nighttime pain relief.

A supportive mattress that’s the right firmness level for height and weight can make a big difference. Adjustable beds are other good option as they allow seniors to make adjustments for injuries and can be easier to get out of. Environmental conditions like cool to moderate bedroom temperatures, complete darkness, and absolute quiet make a difference too. Motion sensor nightlights are often a good idea as they allow seniors to see during nighttime trips to the bathroom, yet the light won’t keep them awake.

Set a Reasonable, Regular Bedtime

The human body, no matter the age, relies on consistency and behavioral patterns to correctly time the release of sleep hormones. A regular bedtime and calming bedtime routine are key to a consistent sleep pattern. The familiarity of routine also helps with dementia and other neurological issues that may come with age as they may reduce fear and irritability related to sundowning.

Conclusion

Seniors need just as much sleep as other adults. They face unique challenges, but a plan and support from family, friends, and health professionals can help.

Contributed by Amy Highland, SleepHelp.org

_______________
Amy Highland is a sleep expert at SleepHelp.org. Her preferred research topics are health and wellness, so Amy's a regular reader of Scientific American and Nature. She loves taking naps during thunderstorms and cuddling up with a blanket, book, and cats.

Friday, 17 May 2019

Lasting Legacies

A couple of years ago, a very close aunt of mine passed away. She was the keeper of the family history. She found relatives we never knew we had and even created an extensive family tree that could plaster the walls of a decent size bedroom. She knew connections and remembered events and dates like no one else I knew. As I started noticing changes in her physical health, it occurred to me that when she was gone, no one would be able to fill that role. So much of the history of our family would be lost. So I asked her to start writing about her life. She couldn't understand why. To her, her life was unremarkable. To me it was incredibly special and a story I wanted preserved for future generations. I wanted her to leave us a legacy by transferring the knowledge of those connections, people and history to me. Unfortunately, by the time I asked her to do this, her abilities were already declining. She wrote some, but not enough to give me the story I wanted. I realized, it was something I should have asked her do years before or sat with her to create when I had the chance. Sometimes we get so caught up in the day to day, that the years fly by and things get forgotten or put off until it is too late.

When I worked as a hospital social worker, the concept of leaving a legacy for family came up often, especially with people who were nearing the end of their lives. There were many ideas people had - some talked about a video or audio tape, some were more inclined to write letters and others wanted to gift something special to a person in their lifetime. I remember one woman saying that she wanted to give her grandchild a special necklace from her "living grandmother, not her dead one". As a young mother, immersed in a job where illness was commonplace and things happened to people regardless of age or circumstance, I decided to start creating a legacy for my family from when my children were born. Every year, on their birthday, I would write them a letter from me - I would talk about what they had done, learnt and accomplished in that year, how proud I was of them and how much I loved them. Some years those letters were long, other years, not so much, but I would always write that letter. Those letters went and still go in a box and one day, they will each get their own box to go through. Perhaps I am simply nostalgic; I think of it as something beyond that though, something that will give them a sense of history and belonging, perhaps at a time when they need it the most.

I wonder how many of our readers think about legacies and how to leave them for their loved ones. Would you consider making a video? Writing a letter? Recording your life history? Do you have seniors in your life who you would like to write out their family history? How important do you think this is?

We'd really like to hear from some of you about this topic!

Thursday, 2 May 2019

Relocation Fears

Our regular readers will know by now that relocation to a care setting is not something to be feared. There are several options, depending on need and finances and for many, concerns about safety, socialization, care and nutrition are quickly replaced with a new lease on life and improved health and well-being. That being said, many seniors and their families are concerned that such a significant move will prove to be a mistake.
From a family perspective, letting go of what may be a family home filled with memories and possessions can be daunting. As well, financial concerns abound especially when the choice is a private retirement setting that is without government subsidy or assistance. And finally, there is the fear that the person will decline because everything will be done for them and they will lose the will to be independent.
While its difficult to speak in generalities and everyone's experience is different, this last worry is usually completely unfounded and more often than not, with the environment in most retirement communities, people thrive and improve both mentally and physically, especially if they have been somewhat isolated and shut-in while living on their own. In addition,  the relationship between caregiver and senior will change for the better as their visits become actual visits rather than errands and household tasks that may have consumed their time together in the past.
Seniors who are relocating may share some of the same concerns as their family; downsizing can be a monumental task especially when one may have lived in the same home for decades. Financial issues often impact decision making as most are worried they will outlive their money or won't have anything left to will to their family. The other concern that often surfaces, especially if they have had regular visits from family members to assist with care or tasks, is that once they go into a care home, those visits will diminish.
In terms of the downsizing worry - it's important to separate memories from possessions - there are many ways to ease this process including, hiring a downsizing company to assist, passing down special items to loved ones (that they can 'visit') and photographing items in order to create a memory book, to name a few. Our latest edition of the Comprehensive Guide to Retirement Living available at no charge on our website at https://www.senioropolis.com/BookInfo.asp has information in Part 1 about downsizing and making the transition easier.
Finances are a common concern, especially since most seniors live on a limited budget. Often the sale of a family home is used to fund living in a private setting and the concern is that it will only last so long. For this issue, you should contact an investment advisor who can suggest ways in which to make your money last and calculate an affordable monthly budget to maximize your length of stay. Do keep in mind that if you require extra care or support in the future, the monthly costs may increase over time.
And finally, in terms of the worry a senior may have about less family visits, do everything you can to let them know that this is not the case. Visit often, take them out, involve them in family celebrations (if necessary hold celebrations at the retirement home), share information on the family and what is happening in everyone's life, take the kids to visit, stay for a meal and attend events in the home.

Monday, 15 April 2019

Private Solutions in a Public System

How do you feel about reaching out to the private sector for care or services? I think this is a question we are going to be called upon to answer more and more frequently in the coming years as our population demographic changes. It seems as if our healthcare system is already stretched and limited resources means that wait times for care and services will simply increase. For those that need or want services quickly, reaching out to the private system, for those that can afford it, seems like the next likely step.
This of course means that our system will increasingly become two-tiered but I would argue that to a certain degree, it already is. There are private medical clinics. There are private home health care services. There are retirement homes - all private. All of these services are provided for a fee outside of our public health system. They are responsive, provide quick services and resources, meet a need and fill in some significant cracks in our existing system.
Our current public system has some major holes. There are many who simply can't afford private service and must wait for what our government funded system can provide. For some this means living at risk in the community - needing care they simply can't access, until things worsen enough that they end up in hospital or in a nursing home. This is a problem that will only get worse, stretching our system further. For those on basic pension, this is truly an unfortunate scenario that there is no immediate solution to unless our government looks at innovative ways to resolve it.
But what about those who have the means to pay for extra care? There is an expectation of many that we should not have to pay for healthcare which is indeed what universal healthcare is all about. But what happens when what exists can't meet the needs? Is it fair to close the door to the private options, or simply not present them to people we help even if they can afford them? I ask this because I do know of colleagues who stand by the belief that people should not be 'told' or 'asked' to seek private solutions when our healthcare plan is meant to provide for us.
I would argue that you are doing people a disservice when you do not present all available options - public and private - allowing them to decide if they want to purchase care or services to supplement or replace what our government is able to provide. People need to be given the option of choosing for themselves, and if they can afford private care, it may indeed be their preference and a better option than waiting on the limited services our public system can provide.
When I first started visiting retirement homes many years ago, I was amazed at the stories of people who moved in needing assistance but who, over time, with proper care, nutrition, social stimulation, exercise and medication management, improved and became substantially more independent. If many of these people stayed in their homes, they would have eventually ended up in nursing homes. It speaks to the importance of retirement homes in our system on so many levels - of a private solution to a problem in our public system. So, I ask you, if an option exists that can meet a need, isn't it important to explore it, even if it is private pay?

Monday, 1 April 2019

Ontario's Changing Health Care Landscape

When I first worked as a hospital social worker close to 30 years ago, there were no LHINs, no CCACs, no central processing agency. If you needed to arrange home care for a patient, you called the home care office; if you needed to arrange for a nursing home, you completed an old photocopied form and sent it to every home you wanted and hoped it made it to the top of their pile. There was no standardized waiting list, no organized way of ensuring your patient got the same priority as someone else and no verification that the patient was competent to consent.

When CCACs were created, there was some resistance on our part without doubt. We had to do things differently. There were different forms. More forms. Capacity of an applicant became an issue and something we had to assess for. We couldn't rely on relationships we had created with long-term care homes. And our script for talking to families had to change.  Eventually, we all got on board. There was no choice but also, we eventually recognized that it did make our lives easier and it was a far more patient-centred way of doing things.

And then, about a dozen years ago, came the LHINs. The LHINs were created out of the idea that in a province as large as Ontario, health care should be decentralized. Given that different areas had different populations, it was surmised that those who live, provide services and use those services within a defined community were best equipped to determine where they needed to direct their health care dollars. The concept that one central government agency was not conducive to making decisions for the whole province was why the 14 LHINs were created. Each LHIN was a non-profit entity with a board of directors and was allotted their portion of the health budget to provide health services to their community through hospitals, CCACs, community health centres, long-term care homes, mental health and addiction services.

Another change happened again last year. it was decided that the CCACs needed to be  be disbanded as an agency because of the money spent on unnecessary management salaries, so the agencies that were once CCACs simply became the LHINs. It did not seem to disrupt patients when the transition happened though I'm certain there were jobs lost and it caused some internal agency disruption.

And now with a change in the ruling political party, our province is seeking to get rid of the LHINs completely. In fact, not just the LHINs. We are going to a 'super-agency' model that will house a host of other health care agencies including Cancer Care Ontario, eHealth, Trillium Gift of Life Network, Health Shared Services, Health Quality Ontario and Health Force Ontario Marketing and Recruitment Agency. So essentially, we are going back to 30 years ago; to a system that was flawed enough to require the creation of CCACs and LHINs. Except now we have many more seniors. And more people in general in Ontario. And an established system for some of those agencies that worked well. Yes, there are problems. And a shortage of nursing home beds. And a shortage of  staff/money for home care. And too many people in hospital emergency rooms. There are parts of the system that are broken, but not the entire system. Do they need fixing or scrapping completely? Are we 'throwing out the baby with the bathwater'? Are we really going to save money by doing this or will it cost us far more in the long run? We only seem to be hearing about what is being 'taken away', not about what we will be given to function and live better lives. Will this massive overhaul really result in better service, more service, less people waiting in hospital hallways for beds or service? How will  we transition from one system to another one seamlessly; how do we ensure that people will be adequately and properly served during this time? And what about emerging private sector services; will we end up with a two-tiered system as our public sector gets lost in the monumental changes to the way they do business?

I don't believe there is one easy solution to the flaws in the current system. It's a complex mechanism that can take years to fix, if that is even possible. But to try to fix it, really means to understand it and its complexities by living in it and talking to the people that work in it. There are many, many questions that Ontarians have about this monumental change in healthcare delivery but unfortunately, no one is giving answers to some very fundamental questions right now. I, for one, am worried about what this means for us; for our children; our seniors; and everyone in between.

Friday, 15 March 2019

Fraud Prevention Month

Did you know that March is Fraud Prevention Month? The more I read about people, especially seniors, who are duped but people who seem to think there is nothing wrong with tricking people out of their hard earned money, the more I think that every month should be Fraud Prevention Month.
We have all heard or received email scams telling us we inherited money; I've also received ones using someone's stolen email identity letting me know that they need money to get out a bad situation. And, everyone I know gets phone calls from fake CRA telling us we will go to jail unless we pay taxes that we supposedly owe. And it seems, these are all the tip of the iceberg. The list goes on... there is credit card fraud, debit card fraud, identity theft, etc.  
I do wonder if social media has resulted in an increased number of fraudsters because people put so much online that anyone searching up 'opportunity'  is able to garner a boat load of information on people just by looking at their profiles. For years there have been warnings not to post online that you are on vacation because you are setting yourself up for a house break in. Yet, we all know people who still love posting their vacation pictures all over Facebook. People let down their guard by thinking that 'only my friends' can see what I post.
I would hope that with all of the publicity out there about fraud and scams, most people are aware that this is happening and are wary of opening and responding to emails that do not sound quite right. And the same goes for those pesky CRA calls. But what about a senior who is unaware of the depth of the problem or are trusting enough to believe what they are told? 
This week in the news, there was a story of an older lady, who was tricked into sending someone thousands of dollars simply because she was under tremendous stress and didn't pay attention to the little things that would have tipped her off had she been stress-free. She had used UPS to send the money and when she realized she had been tricked, with the quick action of the staff at her local UPS depot who were able to stop the package in transit, she was able to recover the money in its entirety. She was lucky. But how many people, are not as fortunate? How many seniors are duped out of their savings by crooks who are able to find out enough details about a person to trick them into believing help is needed for someone they know and care about? 
From the plethora of articles online, it is clear that there are many people who have no problem tricking others and stealing their money. All we can do, is educate ourselves and others around us, about what is happening. If you hear of a new scam, let your network know. Let the seniors in your life know. Check out www.canada.ca/en/revenue-agency/corporate/security/protect-yourself-against-fraud.html and www.td.com/privacy-and-security/privacy-and-security/how-you-can-protect-yourself/preventing-fraud/preventing-fraud.jsp. Report fraud and scams if you know of someone who has been victimized. The only way to stop fraudsters, is to educate ourselves and others so no one falls prey to them. 

Friday, 1 March 2019

Fall Prevention in Seniors

          To say we've had a bad winter is an understatement. There have been days where going outside is treacherous and I am certain that the emergency rooms in every hospital are filled with people who have fallen on the ice. For a senior, the prospect of a fall can be disastrous, especially if a broken bone is the result. We all know a story of someone elderly who broke a hip and ended up with severely compromised mobility and/or permanent disability/dependence.
          And weather isn't always the culprit. Not all falls happen outside. Often a senior can fall inside their home as a result of a slippery floor, an unsteady gait, or tripping hazards like area rugs. I know of people who refuse to use a cane or walker; and others who only use them outside even though they need them indoors as well. Few think they will fall; and most think that if they do, they can get up without a problem and without broken bones.
          So what's the solution? I suppose prevention is always the ideal and to that end there are Fall Prevention classes that could help. However, as with most 'bad' things that 'may' happen, we are all in denial that we could be subject to a debilitating fall and, attending prevention classes means acknowledging that something could happen..... I would venture to guess that most people wouldn't attend such a class unless they or someone they know has taken a nasty spill and suffered as a result.
         If you know a senior who you are concerned about, be proactive and ask them if you can have an OT come to visit who can assess their home for hazards. At the very least, ensure there are no tripping hazards in the home; loose area rugs, wires, etc. Bathroom safety is a big issue too - install bath bars if they will allow you to, so they have some support if the floor or tub is slippery. Speak to their family doctor about your concerns and arrange for a referral to the local LHIN where they can send in an OT to do a safety assessment. Sometimes a doctor the senior trusts will have better luck getting them to accept an assessment than you might!
        In one area in Southern Ontario, when an EMT gets a call about someone who has fallen, an OT goes along to assess the situation and discuss prevention. What a great concept! And one that should be rolled out across the province. With advancing technology, I have read stories of all sorts of devices that can detect falls or provide hip padding so falling doesn't result in breaks. We can only hope that in time, prevention with be the norm rather than anecdotal stories we read in the news. 
        For seniors living alone, encourage them to get an emergency button they wear that they can press if they do fall, so help will come quickly. Encourage them to exercise - many local community or seniors centres have exercise programs for seniors. Exercise has been shown to be good for your bones, balance and fall prevention.
       The key to preventing unnecessary falls and injuries is to encourage safety and be proactive about prevention.