|
‘Young at heart, slightly older in other places’ – Eating and drinking problems and ageing. Swallowing difficulties (Dysphagia) are a common consequence of many health conditions, and head and neck surgeries, however swallowing difficulties can also be associated with ageing. Estimates suggest up to 20% of all adults over 50 may be affected.
Changes might include such things as reduction in muscle strength for chewing, taste and smell, dental issues, dry mouth or throat, or recurrent illness such as pneumonia. These changes may result in poor nutrition and hydration, unintended weight loss, avoidance of eating in public, loss of enjoyment in previously enjoyed food, and/or a risk of food/fluid entering the lungs (aspiration) leading to pneumonia and chronic lung disease. What might you notice?
Who can you talk to?
For further information or advice please contact Therapy Professionals Ltd as follows: Phone (03) 3775280, Email: [email protected] Website: http://www.therapyprofessionals.co.nz Our Dietitian or Speech Language Therapist will be happy to help. New technologies reduce falls Among fall-prevention technologies, whole body vibration is gaining momentum From Aged Care, Issue 02, 2021 The statistics are familiar: each year, one in three people aged 65 or older will fall, and falls are the second leading cause of death among older adults. The National Institutes of Health, state, and local agencies have published volumes of information about the perils of elders’ falls, but no comprehensive, feasible program to prevent falls has emerged. There is little excitement or consistency in the programs, and many produce lackluster results.
Of course, we understand the risks. But often, despite the statistics and our best efforts at motivation, many older adults make little or no effort to exercise or adopt physical activity. So, where do we go from here? The answer lies in education. In addition to identifying elders at risk of falling, it’s important to emphasise the proactive solutions that can be effective. There are scientifically researched tools available that can help significantly reduce the incidence of falls. Among the major causes of falls are: environmental, such as home trip hazards or electrical wires, footstools, elevated thresholds, and uneven outdoor terrain, including sidewalks and curbs; vestibular problems’ neuropathy and other diseases; diet; physiological problems affecting ankles, feet, knees, and hips; muscle deterioration; and obesity. Most agree that exercise, particularly weight resistance, presents the best option for older adults. However, many older adults who would benefit from such training are strangers to lifting weights or running on treadmills. For individuals in the 80s, this form of training was not widespread years ago and health clubs offering such exercises simply weren’t in existence. But there are alternatives. Whole body vibration As early as the 1970s, the East Germans and Russians were experimenting with technology that came to be known as whole body vibration (WBV). Basically, it involved a metal platform to adjust involuntarily in order to achieve balance, WBV also caused the muscles to fire at different frequencies, thereby taxing muscle strength. At first, the technology was used to train athletes, improving coordination, muscle growth, and calorie burn. During that era, the Soviets found that this new technology could be used during orbital space flight for their cosmonauts to combat the ravages of weightlessness, which caused muscle and bone density platforms and held on with straps. Concurrently, American astronauts had to abort long-term space flights because of the deleterious effects of extended weightlessness and often had to be carried on stretchers after disembarking from the capsules. Evolving technology Throughout the 1990s, WBV technology took flight in Europe; many universities and medical establishments began to quantify its results. Numerous studies were commissioned and most of the early studies emanated from Europe. Around 2000, the technology was introduced to the United States via trade shows specific to the fitness industry and directed to, for example, health clubs. There was a barrier to market entry through that means of distribution, as fitness devotees refused to believe that a few minutes on a WBV platform could deliver benefits similar to those achieved in an hour on traditional fitness equipment. However, the concept ultimately took hold in universities and physical therapy clinics, and hundreds of additional studies were conducted to understand the benefits of WBV and how it could benefit various segments of the population. The conclusions on its benefits included the following:
These results were achieved through WBV’s causation of the following responses:
About 10 years ago, competitors attempted to enter the market. Fast-forward to 2015 when researchers identified a new demographic that could benefit from WBV. It appeared ideally suited for the older adult population for the following reasons:
Measuring program success How is this success measured in terms of fall prevention? There are several means of testing individuals’ likelihood of falling, and a variety of balance-testing assessments. The fear of falling plays a role in fall risk as well. By utilizing specific measurement tools, a practitioner can advise older adults regarding the following:
A new device features insole sensors that relay to the practitioner real-time information regarding walking patterns, balance, and sway with dynamic rather than static measurements. A Bluetooth relay switch attached to the shoestrings sends the information to an iPad for recording the results. Early diagnosis provides older adults and their physicians or practitioners detailed information about individuals’ fall and likelihood so recommendations on training, medication, diet, physical therapy, and other corrective measures can be made. This new science has augmented, if not surpassed, the merits of casual observation such as sit-to-stand, get-up and go, and other subjective observational tests. Other helpful devices Once older adults experience a fall or a near miss, they frequently stop moving in favour of sitting, for fear that their next move might lead to a catastrophic break of limb, hip, or skull. This results in weight gain, muscle loss, and balance deterioration, the expected physiological results of inactivity. Ankle-foot orthotics (AFO), which can enhance stability when standing and walking and sometimes correct physiological problems, can be prescribed. Confidence associated with AFO use can directly influence an older adult’s psyche regarding walking ability, helping to avoid falls. Falls are so deleterious, and physically and financially costly, that additional proactive solutions must be devised and, more importantly, implemented. Author: Brian Lewallan, Aged Care Issue 02, 2021  They care. We care. Do you Care More than a million New Zealanders care for family members and whānau who are ill, frail, injured, or have a health condition or disability. But family carers can feel invisible, taken for granted. They aren’t getting the support they need to keep going. That’s why the Carers Alliance of 50+ national not for profits is calling for a home in government for family carers, and for action to protect their mental, physical, and financial wellbeing. Help us by adding your voice to ours! Take one action, or do them all. The action we take together for family carers will make a real difference. Together we stand for family carers The Carers Alliance was formed in 2004 to call for a Carers’ Strategy for New Zealand. This was achieved in 2008, with three five-year Action Plans since. But progress has been too slow. That’s why the 50+ national not for profits in the Carers Alliance are taking action. Family carers need us – and you – to make sure they can get support, stay well, and keep caring. We are seeking a Minister or Commissioner for family carers, and true commitment to help them have breaks (respite), financial recognition for their work, flexible employment, help for children and young people who are carers, and legislative recognition and wellbeing protections for our country’s 1m+ family, whānau, and āiga carers. Please join us in taking action to support family carers – sign the petition and take some of our other actions. Your support will make a real difference. · Sign the petition calling for a home in government and better support for family carers · Send us a photo message calling for action or to support the campaign · Share your story about caring · Send our e-card to all MPs, Ministers, political party leaders, and the Prime Minister Find out more about how to add your voice at We Care If you would like to sign it, or send it on to others, here is the link: https://wecare.nz/testimonial/ Why should you care? You may already be a family carer, or maybe someone in your whānau has this role. Tomorrow, it could be you. Are you losing your mobility? As we age most of us want to keep our independence, this requires us to be mobile. The ability to get up and about with ease is essential for everyday life.
How might you know if you are in danger of losing your mobility? To help, here are some early signs of immobility. They include:
There are many reasons why immobility may happen as we age, some common ones are:
The good news is in most cases we can improve our mobility by dealing with the underlying problem and doing regular strength and balance exercises. The sooner we start the better off we will be. Regardless of our age, regular exercise keeps us fit and makes us feel better. Being physically active strengthens the heart and lungs while supplying increased oxygen to the body. This nourishes and strengthens muscles and joints making them work more efficiently. The spin-off is you have greater mobility, feel more energetic, look better and possibly have more fun. If you or someone you know is showing signs of immobility our friendly Physiotherapists can help just contact us at Therapy Professionals. Ph: 03 377 5280 Email: [email protected] Osteoporosis and DIet Bone is a living tissue that is continually remodelled and rebuilt throughout a person’s life. Calcium deposits make bones strong. Eating a balanced diet that includes calcium rich foods is important in maintenance of bone strength. As the body grows, bones become stronger, peaking in mass at about age 30. After this, bones lose calcium as part of natural ageing both in women and men. Oestrogen helps to keep calcium in bones, so when levels drop at menopause, women lose calcium from bones more rapidly than men do. Things that reduce bone strength Smoking Among the many health benefits of stopping smoking, this will improve absorption of many nutrients from the diet, including calcium. Alcohol Four or more alcoholic drinks a day can reduce calcium uptake by the bones despite dietary intake. Weight Being overweight may add stress to bones, however generally leads to a decrease in mobility and weight bearing exercises. Research shows being underweight or having a slight frame also can increase the risk of osteoporosis.  How to keep my bones strong? Exercise Regular weight bearing exercise where some strain is placed on the bones builds up bones in young people, and slows down loss of bone density in older people. Weight bearing exercise requires your muscles to move against gravity eg walking, jogging and playing sports (swimming, cycling and rowing are not weight bearing activities).  Sunshine Vitamin D is needed for calcium to be deposited into bones. Sunshine (ultraviolet light) is needed for the body to produce its own Vitamin D. If exposure to sunshine is limited during a NZ winter especially in the south island, food sources of Vitamin D are important. These include fish oils, sardines, tuna, eggs, butter and margarine and liver. Healthy diet A diet rich in calcium and a variety of foods from the four food groups - fruit and vegetables, breads and cereals, meat or meat alternatives, and milk and dairy products ensure good general health. How do I achieve a healthy calcium intake Adult men and premenopausal women need 800mg of calcium per day. Adult men and premenopausal women need 1000mg of calcium per day. Post menopausal women (over 51 years) and men over 70 years 1300mg per day. The table below shows how to achieve a healthy calcium intake.  Dietary Supplements
The preferred source of calcium is from food and the preferred sources of Vitamin D are sunlight and food. Food also contains other important nutrients such as phosphorus, zinc and magnesium, protein and other vitamins. Vitamin D If you are unable to get outside regularly you may need a Vitamin D supplement. Calcium If you don’t like, or can’t eat calcium rich foods, calcium supplements may be necessary. Discuss with your doctor whether dietary supplements are necessary, and which type is best for you. Therapy Professionals Ltd has dietitians available who are able to provide information to groups or individuals on many aspects of nutrition. Just contact us Phone: 03 3775280 Email: [email protected] References Arthritis Foundation of NZ and DAB ‘Your Bones, Your Future’ Arthritis Foundation of NZ and DAB ‘Look after dem bones’ Mann, J, Trusswell S, ‘Essentials of Human Nutrition’ Why getting moving is 'The Miracle Pill' - Peter Walker
It's estimated that 1.5 billion people around the world are so inactive that they are at greater risk of everything from heart disease to diabetes, cancer, arthritis, depression and even dementia. Daily activity used to be an integral part of daily life, but humans are now more static and sedentary than ever before. Peter Walker is the political correspondent for The Guardian in London, and a regular commentator and broadcaster on issues including active living and health. His new book is The Miracle Pill: Why a Sedentary World is Getting it all Wrong. Walker tells Kathryn Ryan that, after university, he got a secure but ‘incredibly boring’ desk job and, on a whim, gave it up to be a cycle courier. “From doing nothing, I went to cycling about 60 miles a day, five days a week and the transformation was completely amazing. I’d not been sporty, and I had asthma very badly when I was kid and I never thought of myself as being a physical person. “But, within a matter of months, it literally was a transformation in my life. I’ve always tried to be active ever since then, not in such an extreme way, but it’s something that’s stayed with me.” A recent study found that half of middle-aged English people don’t walk for ten minutes or more continuously in an average month. “It’s basically a global issue. Around the world, around 3 in 10 adults move so little that their long-term health is potentially at risk.” He says it’s even worse for children and teenagers who are supposed to get at least one hour exercise every day. “Schools in many countries are too inactive, the kids sit down a long time. It’s a product of all sorts of things, from the rise of screen-based entertainment to the fact that motor traffic makes parents feel scared to let their kids out cycling and walking. “It’s a big problem because this is a time of life when all sorts of things from your cardiovascular health to your bone density gets laid down.” Walker says that, if you’re in a job where you have to sit down for long periods, it’s important to get up and move around every 30 minutes or hour. “Our bodies are designed to move. From the moment homo sapiens emerged for the first time, we’ve been hunting and gathering, our bodies are designed to be in motion and they do shut down really quickly. “The positive other side of it is that the moment you do start to exert yourself, the benefits are instant.” He says that many of the things that have made us more sedentary are good changes, for instance washing machines rather than hand-washing clothes. Another big change that has made us less physically mobile is rising car use in the past few decades. “Even the micro movements people used to do like walking across an office to talk to a colleague is now replaced by emails or chat apps. Even going to the cinema or to the shops can be done from home. “It’s not that there’s been this outbreak of laziness around the world, it’s just that there are more and more opportunities to not do it.” Walker says that losing weight through exercise is very difficult to do, and there’s been a fetishization of fitness that is off-putting to some out-of-shape people, but even if we’re not losing weight through exercise, we’re improving our overall health and staving off serious diseases. Essentially, we can be both healthy and overweight. “A lot of this connects to the stigma of people who have a bit of excess weight and don’t like going to the gym. But studies have shown that it’s better for you overall to be a bit overweight or even quite overweight and active than it is to be a normal weight and to be inactive.” Ref: RNZ https://www.simonandschuster.com/books/The-Miracle-Pill/Peter-Walker/9781471192548 Falls and Eyesight Currently, one in seven New Zealanders are 65 and over. Around 30% to 60% of people in this age group have a fall each year. And 10% to 20% will end up in hospital with a fracture. Those over the age of 85 are 15 times more likely to fracture their hip in a fall than a 65-year-old. Hip fractures can have a huge impact, with 30% of those over 85 who suffer one requiring placement in aged residential care. Research shows there is a link between poor eyesight and falls in older people. As we age most of us will become longsighted (presbyopia), making it hard to focus on things close up and we’re slower to adjust to light. This is because the muscles of the eye lens harden. Eventually we will all need glasses. Other age related eye conditions that contribute to falls are cataracts, glaucoma, macular degeneration and diabetic retinopathy. Some tips to prevent falls associated with eyesight issues:
 Follow this advice and you will help to reduce the chances of falling. For other tips on falls prevention check out these links:
http://www.therapyprofessionals.co.nz/uploads/4/9/5/2/49523375/be_aware_of_your_feet.pdf http://www.therapyprofessionals.co.nz/uploads/4/9/5/2/49523375/getting_yourself_up_from_the_floor._.pdf http://www.therapyprofessionals.co.nz/uploads/4/9/5/2/49523375/footwear_matters__.pdf http://www.therapyprofessionals.co.nz/uploads/4/9/5/2/49523375/to__exercise_or_not_to_exercise_.pdf http://www.therapyprofessionals.co.nz/uploads/4/9/5/2/49523375/home_gym.pdf For more information and advice on preventing falls our friendly Physiotherapists can help just contact Therapy Professionals : Phone: 3877 5280 Fax: 03 377 5281 Email: [email protected] www.therapyprofessionals.co.nz Footwear Matters  Here at Therapy Professionals we know the value of comfortable feet. Good footwear is important throughout life, however, as we age it becomes even more important.
Poor footwear can cause foot, back and knee pain, and discomfort from corns, calluses and fungal infections. High heels and sloppy fitting shoes can affect our balance and walking, making us prone to falls. Any of these make us less inclined to walk affecting our health, wellbeing and independence. To avoid pain and discomfort caused by ill-fitting shoes and to maintain your fitness and independence as long as possible, just follow this advice from our friendly Physiotherapists. As we age our feet change shape and become larger so it’s important to get your feet re- sized when you are buying new shoes. Here are some tips on buying shoes: The essential components of good shoes are that they:
The shoe
If you need advice about the best type of footwear for you, Therapy Professionals friendly Physiotherapists can help, just contact us Phone No: (03) 377 5280 Email: [email protected] Website: www.therapyprofessionals.co.nz Are my elderly parents coping?  As our parents move in to Shakespeare’s ‘Sixth stage of man’ many of us in our middle age are busy with our careers and bringing up children. We often take our parents for granted and forget they are ageing. If we see them regularly, we may not notice subtle changes or if we live elsewhere and rarely see them, we may get a shock at their decline between visits. Compounding this, most parents don't want to be a 'bother' and aren't good at telling their adult children they need help. It can be a shock to see our parents slowing down and not coping. We may have no idea how to deal with their changing state. Some of us respond by ignoring or minimising the situation, while others will behave more like a bossy parent. More often than not, even with the best intentions, we don't know when and how to respond. In my experience with my own mother and observing others it's best to start talking with your parents early in their retirement, and keep talking about all the different scenarios that may happen as they age, good and bad. For each scenario, find out the options for care or help and discuss these with your parents. Most importantly, find out what they want to happen in each case.  It may help to start by arranging a power of attorney, and who will be responsible for their health, welfare and finances should they become incapable of making those decisions. A change in the ability to manage one’s affairs could happen suddenly after a health event, like a stroke, or slowly as a result of dementia. It’s best to be prepared. Become informed with your parents on how ageing may affect them and how they may look after themselves to extend their independence and enjoyment of life. There is plenty of information on the Internet to help with this. I suggest you look at local reputable resources. Regularly check in with your parents, and ask them if there is anything they are struggling with. If so, discuss alternative ways of managing the problem area. Be observant, and if you notice there has been a change in, say, the standard of house keeping, tactfully discuss this with them. Again, it is helpful if you've discussed at an earlier time how to manage these changes and how best to broach the subjects with them. Changes you may notice include, a drop in: • household cleanliness and tidiness • household and garden maintenance • personal hygiene and grooming • weight and lack of food in the fridge and cupboards • bills being paid on time • managing trades people and technology It is well worth having these hard conversations with your ageing parents as it helps take some of the stress out of their decline and allows you to more readily enjoy their final years. If your parents are struggling at home our friendly therapists may be able to help them maintain their independence. Just contact us at Therapy Professionals Ph: 03 3775280 Email: [email protected] ‘The sixth age shifts
Into the lean and slipper’d pantaloon, With spectacles on nose and pouch on side; His youthful hose, well sav’d, a world too wide For his shrunk shank; and his big manly voice, Turning again toward childish treble, pipes And whistles in his sound. Last scene of all, That ends this strange eventful history, Is second childishness and mere oblivion; Sans teeth, sans eyes, sans taste, sans everything.’ William Shakespeare – As you like it. “The seven stages of man.” An anatomy of pain: how the mind and body experiences pain Pain is a universal human experience, yet we understand very little about the mechanics of it.
As a result, our treatments are still fairly rudimentary, says pain medicine specialist Dr Abdul Lalkhen. His new book Pain: The Science of the Feeling Brain is for people who struggle to manage their own. The nature of an individual’s pain needs to be understood from the outset, Dr Lalkhen tells Kathryn Ryan. “The way to think about pain is, it’s an experience. We talk to one another and somebody says, 'Oh I’ve got pain' and there is an assumption we automatically know what that person means. "It is a unique experience and whilst the biology and bits of our body used to detect damage are pretty much the same, when those signals reach the brain they are interpreted through our unique cognitive and emotional framework to produce that experience of pain. Using pain merely as a guide to disease is often misleading because of the different way that it is expressed. “Pain and suffering are intimately linked, but they’re not necessarily the same. I think it’s also important to distinguish between the pain from damage – if you step on a drawing pin and damage the skin the brain needs to know about that problem because obviously if you didn’t attend to it then it could get infected and it would threaten the organism. That’s a simple kind of brain problem, which is usually resolved by removing that drawing pin. “But when things become more complicated and long-term – for example, if you have diabetes and your nerves are damaged as a consequence of diabetes, the body then reacts by producing abnormal sensations all of the time, rather than the drawing point, which is time-limited and that requires a different approach in terms of managing that pain alarm. “The same is true with conditions like arthritis and more widespread conditions like fibromyalgia and lower back pain, which we don’t fully understand, but we’re certain normal biological alarm systems malfunction. “We try to apply simple solutions to those complex problems, often with deleterious results to the person. We kind of throw a blanket over those signals by giving people opioids but that then leads to further changes in brain chemistry, which cause further problems." Some people experience a 'pain alarm system' going off all the time but not flagging actual damage to the body, Dr Lalkhen says. That alarm may seem a lot 'louder' when there is a stressor in their environment, such as a domestic row or a work-related dispute. Modern medicine’s approach to pain modulation has a place in treatment, but risks need to be weighed up against benefits, he says. “The reality is the alarm is pretty much the same all the time, but it is your response to it [that fluctuates]. Living well with chronic pain is really about learning to understand that process. And for a doctor to say, ‘I can perhaps reduce the volume of that alarm, the problem is the drugs I may use may also have side effects, and you, therefore, learning how to pace your activities or avoid stressful situations that make that alarm louder, that is another way of learning to help yourself cope with persistent pain.” Explaining the nature of pain to patients helps reduce the fight-or-flight state of worry about what it may be signalling, Dr Lalkhen says. This allows the person to relax and reinterpret their pain as something they can more easily cope with. Acute pain can be a huge challenge to treat, though, he says. “I completely understand there are times when the pain is intractable and severe but there should always be an attempt made to try and have the individual understand the problem. That’s not easy and sometimes patient’s push against it because they just want a simple solution. “But in my experience, unless you have that conversation and people are able to move to that point where they understand the problem, that is why they’re experiencing that severe and intractable pain and they’re expressing that degree of distress is simply an inability or not having had the issue had clear, or really struggling psychologically to come to terms with what they’re feeling. "And if you just respond to their distress - which is a perfectly normal human response - with medication, that’s where it tends to lead to the escalation of [opioid use] for example, with really quite disastrous effects long-term.” Support, empathy, caring and compassion play an important role in recovery from longer-term pain, Dr Lalkhen says. “All pain aspects require a holistic, biological, psychological and social approach if they are to be managed appropriately, and really that’s what the book is aimed at – to try and unpack all that and try and help people understand what it is they’re going through.” The basic physiological function of pain involves a signal to the brain that the body is in danger, and as such anything that threatens us will lead to an unpleasant physical experience, he says. When we stand on a drawing pin, a system of pain is triggered, first by localised inflammation releasing chemicals. "Those chemicals attached to nerve endings have specific receptors called non-receptors… so that mechanical damage of the drawing pin is converted into an electrical signal from your peripheral nerves to your spinal cord, which is a sort of junction box. "Those messages are then relayed, and if you imagine fireworks going off in the night sky different parts of the brain and they go to the parts of the brain that deal with the where, the what have I experienced before, how am I interpreting it in that context, and so the brain perceives that there’s a problem and the brain then decides how important this drawing pin is – this injury, what does it mean. It can then increase the number of signals to the brain or decrease it. So, the experience of pain is produced in the brain as a consequence of that system. "Now, usually once you take the drawing pin out and the foot heals, those chemicals are no longer present and the nerves are no longer stimulated so the signalling stops and in time the pain stops.” When that system goes wrong, people develop chronic pain which persists in the absence of ongoing tissue damage. In the case of a mechanical problem like a slipped disc compressing a nerve, the pain caused by the distortion of the nerve, as well as the inflammation produced as a result of the compression, may remain even after successful surgeries due to nerves being sensitised. Managing this kind of persistent pain can involve medications and a spinal cord stimulator, which can put a break on nerves that are hypersensitive. Treatment of conditions like fibromyalgia, where the body's pain alert system is constantly on, must take a holistic approach, Dr Lalkhen says. "It really starts with education. It starts with what chronic pain is and it doesn’t rely on ongoing damage. Most people get into a cycle where their understanding is that pain is due to damage, therefore if I did more, and I had more pain, I’m doing more damage they then stop moving, which makes muscles and joints stiff and when they do move they get pain and they end up getting caught in this cycle of distress and disability. “Breaking that cycle involves understanding the condition and then supporting [the person] to rehabilitate it by teaching them how to manage that pain.” Dr Abdul Lalkhen is a member of the Faculty of Pain Medicine at the Royal College of Anaesthetists in the UK and a visiting professor at Manchester Metropolitan University. Ref: RNZ https://www.rnz.co.nz/national/programmes/ninetonoon/audio/2018830916/an-anatomy-of-pain-how-the-mind-and-body-experiences-pain |
AuthorShonagh O'Hagan Archives
December 2025
|
RSS Feed