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Information and Handy Hints

June 29th, 2021

29/6/2021

 
How to Stay Fit and Active as You Grow Older 
Fitness is not just for the young

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  • ​Do you want to keep fit, as you grow older?  
​
  •  Are your joints stiff?
 
  • Has your co-ordination declined?
 
  • Have you had a recent illness, operation or accident and not regained your previous level of fitness and confidence?
 
  • Do you trip more than you used to?
 
  • Have you fallen once or more in the past year?
 
  • Do you fear falling more than you used to?
 
  • Do you feel less confident 
          -  walking at night? 
          -  walking on uneven surfaces?
          -  climbing up stairs? 
          -  getting out of a chair  

Why Strength and Balance Matters
 
There are many reasons why we can lose strength and balance - the most common is lack of use.
 
As we get older we are less vigorous, less adventurous and less active, so we don’t challenge our sense of balance as we did when we were young.  
 
Therefore we:
 
  • lose muscle strength
  • develop stiff joints
  • are slower to react 
  • are more likely to trip and fall
We need to avoid the disuse cycle​
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Your sense of balance can be influenced by:

  • poor eyesight or bad lighting
  • badly fitting shoes
  • hazards at home or in public places
  • side effects of some drugs
 
Be sure you stay on your feet.  Remember if we don’t use it – we lose it
 
As you grow older you need:

  • to keep your joints well-oiled
  • to maintain strong muscles 
  • to maintain or re- train your sense of balance       
 
Consider seriously increasing your level of fitness or activity even if your strength and balance and general fitness is still good.
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Exercise Classes                                                

Find an exercise class that suits you, something that:

  • has a ‘Live Stronger Live Longer’ tick  
  • you will enjoy
  • strengthens and stretches ALL muscles and joints
  • allows you to progress at your own pace
  • provides professional support 
  • challenges your balance
  • is friendly and fun
  • is supportive and instructive
  • conducted to carefully chosen music
  • has others with similar needs
  • is led by someone experienced in exercise for older people
  • is suitable for all levels of fitness
  • challenges those who want to do more, and if you want to do less, that’s ok
  • has chairs available at all time

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If you join an exercise class and:
  • you can’t hear, ask for the music to be turned down or ask the instructor to speak up and speak slower
  • you have difficulty seeing tell the leader 

Other recreational or sporting activities you may enjoy:
 
  • walking with a friend or group
  • swimming
  • bowls
  • dancing
  • gardening
  • attending the gym
 
Visit ‘Active Canterbury’ and ‘Sport Canterbury’ websites for a list of activities in your area.
 
Some general tips on exercise:
 
  • wear comfortable clothes that allow you to stretch freely and footwear with a broad low heel.
  • go at your own pace and build up your fitness gradually
  • remember it’s good to get a little breathless – it means you are working your heart and lungs.  If you can still talk while feeling a little breathless, this is ok.
  • It’s also ok for your muscles to feel a bit stiff after exercising.
 
Physical activity is the best medicine for our bodies so keep it up as you age and enjoy it.
 
If you need some advice about what exercise is best for you our friendly physiotherapist can help, just contact us on:
 Phone:        03 377 5280             Email:   [email protected]
​
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June 24th, 2021

24/6/2021

 
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How fit am I?

As we grow older our strength, balance and general fitness is in danger of declining so much so that we put ourselves at risk of falls, something we all wish to avoid.
 
If you want to know how fit you are and to test your balance here a few tests you can do yourself.

Walking distance – are you able to comfortably walk:

  • across the road
  • around the house
  • in your garden
  • one block in the street
  • more than four blocks
 
Not being able to walk round the block from your home is one indicator for increased risk of falling.
 
 
Get up and go test – start by sitting down on a dining type chair.  Record how long it takes you to:
 
     rise to standing
    walk three metres (10 feet) 
    turn
    walk back 
    sit down
 
 
Try it again in a month’s time.  A change of result by more than four seconds can indicate a change in the level of mobility.
 
eg    
  six seconds slower -       weaker/less confident mobility
  six seconds faster   -      stronger/more confident mobility which is what you want                          

Balance test
 
This test has four levels of increasing difficulty and should be done without assistance.  We advise you have someone with you while you do the test.
 
  • Wear flat shoes
  • Stand next to a chair but do not hold on to it, unless you lose your balance
  • Position feet as shown (4 different levels)
  • Try standing without support for 10 seconds starting at Level 1 moving through the levels.
  • If unable to assume the foot position or hold a level for 10 seconds – do not progress to the next level as your balance is not good enough and you may fall, put zero as the score for the next level/s.
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Scoring - Note down how long you hold each position
 
                                                                                                        Your score                                                                                                                                                                                                                                         
Level 1    Feet together stand                                                    / 10 seconds                                                                           
Level 2    Semi-tandem stand                                                    / 10 seconds                                                                                                                                                                     
 Level 3    Tandem stand                                                             / 10 seconds                                                                                                                                                     
 Level 4     One leg stand                                                             / 10 seconds                                                                                                                                       
 
                                                Total                                              / 40  seconds
                                                                                                                                                                                                             
 
 
Score of:                     under 20 seconds               very poor balance
                                     20 – 30 seconds                 poor balance
                                     30 – 35 seconds                 moderately good balance
                                      35 - 40 seconds                 good balance
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 Leg strength test
 
Level 1                stand up with arms crossed if possible
                            or use a hand to push up
                            or use two hands to push up
 
Level 2              stand up taking 5 seconds from when your bottom is off the seat
 
Level 3              sit down taking 10 seconds until your bottom  touches the seat                                                                               
 
Level 4              sit down, stopping half way down, hold 5 seconds, then continue to sit
 
Level 5              sit down stopping about 5 cm from the seat, hold 5 seconds, then continue to sit                                                         

Scoring
                                                                                                        Your score                                                                                                                                                                                                                                                                                
Level 1
Stand and sit       arms crossed 5 points                                               / 5                                                                                                
                               one hand to push up 3 points                                   / 5               
                               two hands to push up 1 point                                   / 5
Level 2
Stand taking 5 seconds (score number of seconds held)                    / 5
 
Level 3
Sit taking 5 seconds (score number of seconds held)                         / 5                                                                                      
 
Level 4
Sit and stop half way down – hold 5 seconds
(score number of seconds held)                                                                 / 5                                                                                                                                                              
 
Level 5
Sit and Stop when about 10 cms from the seat – hold 5 seconds       / 5
Then continue to sit (score number of seconds held)
 
                                                                                                                                                                                                                         Total                                                                                                              / 25
 
Score of:                     under 10 seconds                 very poor leg strength
                                    15 seconds                             poor leg strength
                                     20 seconds                            moderate leg strength
                                     25 seconds                            good leg strengths
                                     40 seconds                            good balance

​If you scored poorly on any of these tests, it’s time to take action!!
See our How to Stay Fit and Active as You Grown Older information page.
 
Our friendly physiotherapist can help just contact Therapy Professionals Ltd on
Phone:  03 377 5280              Email:  [email protected]

June 16th, 2021

16/6/2021

 
Financial support for those caring for
a disabled person

(from Ministry of Health Website) 
If you have an elderly family member or disabled child you care for at home and you need some time off the Ministry of Health can help fund some support (Carer support) for you.
 
You may be able to use this support to fund some allied health services.  Talk with your local DHB Needs Assessment and Service Coordination (NASC) services or Ministry of Health NASC Lifelinks in Christchurch.
 
Carer Support
 
Carer support provides reimbursement of some of the costs of using a support person to care and support a disabled person.  This means their carer can take some time out for themselves.
 
What Carer Support is
 
Carer support is a subsidy that helps you take some time out for yourself.  It provides reimbursement of some of the costs of care and support for a disabled person while you have a break.
 
Who can get Carer Support
 
Carer support is available for full time carers - a full time carer is the person who provides more than four hours per day unpaid care to a disabled person, for example, the parent of a disabled child.
 
The number of hours or days that Carer Support is funded for depends on your needs and those of the person you are care for.
 
Who funds Carer Support
 
Carer support for people with age-related support needs, mental health and long-term medical conditions is funded by district health boards.
 
Carer Support for people with disabilities is funded by the Ministry of Health.

Getting Carer Support
 
You can be assessed by a Needs Assessment Service Coordination (NASC) organisation, or, undertake a review with you, usually after a year.
 
You can find out more about claiming at Carer Support Claims or by talking to your local NASC.
 
 
Tax Issues
 
Carer Support payments may be subject to income tax. This will depend on your individual circumstances. You may wish to seek advice regarding tax issues from the Inland Revenue Department or, if you receive a benefit, from Work and Income New Zealand.
 
 
Carer Support – funded by the Ministry of Health
 
The following information applies if you receive Carer Support from the Ministry of Health. Carer Support from DHB’s is not affected.
 
You must work within your current funding allocation.
 
You can continue to spend your Carer Support on any disability support/service/item that:
 
  • helps you live your life or makes your life better, and
  • gives you a break from caring for your family member with a disability, or to provide a break for the disabled person, and 
  • use of funding is reasonable and cost-effective, and
  • not funded through other funding options such as Disability Allowance.  You can find out about what is reasonable for you to buy and you can find out more information below.
 
 
You cannot use your Carer Support for the following:
 
  • paying family carers who are either a family member living with a disabled person or a parent or spouse
  • illegal activities, gambling or alcohol, or
  • to pay for things that are not disability supports like rent/mortgage, food, personal debt, gifts, power, regular household items etc
 What people can buy with Disability Funding: Ministry of Health Purchasing Guidelines
 
Published online 17 April 2018
 
This document describes what government disability support funding (funding) can be used to buy. It is for people using:

  • Enhanced Individualised Funding (EIF)
  • Individualised Funding (IF)
  • Choice in Community Living (CiCL)
  • Enabling Good Lives (EGL) hosted personal budgets
  • Flexible Respite Budgets (IF Respite and Carer Support)
  • Flexible Disability Supports (FDS).
 
Disabled people who can make choices about how they use their funding are more likely to buy goods and services that make their lives easier and/or better. This purchasing policy aims to give disabled people as much flexibility as possible over what they can buy with government funding.
 
A disability support (support) is a good or a service that helps a person overcome barriers that come with having an impairment within a disabling society.
 
Criteria
 
There are four criteria that must be met to be able to use funding to help buy a disability support.
 
1.   It helps people live their life or make their life better 
​
     The support should help people live a good life.
     Each person has a different idea about what a good life is. The person’s goals and aspirations
     for a good life should be written out in a personal plan. This can be done with help from their
     Needs Assessment and Service Coordination (NASC) organisation or Independent Facilitator.

    Personal plans should include goals such as:
  • having good relationships
  • maintaining or improving skills
  • being able to do everyday activities at home or in the community
  • the person’s family/whānau being supported to continue their caring roles
  • being able to live in a home of the person’s own choice.

2.  It is a disability support

     The support:
  • is only needed because the person is disabled and/or
  • costs more than would be the case if the person weren’t disabled and/or
  • is in addition to, or complements, the goods and/or services the person would need if they didn’t experience disability.

3.  It is reasonable and cost-effective

      Generally, the support should be ‘reasonable’. Here it means that the support should cost about
      the same as (or less than) the market price for comparable things. 

     ‘Cost-effective’ here means the best available outcome for the money spent.
 
    It might cost more than another type of support but will help the person more, it will last longer
   or mean that less is spent on some other support now or in the future.

4.  It is not subject to a limit or exclusion

    A person should explore other funding options to help get a support. Examples of other options
   include:
  • the Disability Allowance (from Work and Income)
  • grants, charitable donations
  • equipment funding (either by the Ministry of Education or the Ministry of Health)
  • specialist services, (eg, the Ministry of Health’s Behaviour Support Services and Child Development Services)
  • district health board funded therapies
  • transport allowances (eg, the Total Mobility transport scheme).

   In some cases, people can buy a support when funding for that support has been turned down by  
   (or on behalf of) the responsible government agency or if waiting times are too long and the  
   proposed support is expected to:

  • achieve a person’s life goal that would not otherwise be achievable and/or
  • reduce disability support costs over time and/or
  • reduce the risk that disability support costs will increase in the future.
 
The funding cannot be used for:

  • paying family carers who are either a family member living with the disabled person or a parent or a spouse unless they are delivering Home and Community Support services and the disabled person has been assessed by a NASC as having high or very high needs.
  • illegal activities, gambling or alcohol
  • things that are not disability supports, such as health services provided by a hospital or income support.
 
Further help
 
For more help in understanding this policy, people can talk to their NASC organisation or their provider to work out if a support they want to buy meetings the criteria.
 
See Ministry of Health Purchasing Guidelines Processes 
Ministry of Health Purchasing Guidelines notes 
 
 
A Guide for Carers - He Aratohu mā ngā Kaitiaki
Has a good summary of financial support available to carers
 
 
https://www.msd.govt.nz/what-we-can-do/community/carers/guide-for-carers/index.html
 
 
 
 
Reference:
 
See Ministry of Health Carer Support
 
https://www.health.govt.nz/your-health/services-and-support/disability-services/types-disability-support/respite/carer-support

June 08th, 2021

8/6/2021

 
What is Dementia?
(By Dementia NZ 2017)
Dementia is a progressive disorder where there is a decline in a variety of mental functions. The declining functions are primarily cognitive, that is, the person has a change in thinking abilities. The word dementia is a term which covers a group of disorders of cognition. Different types of dementia have different underlying disease processes and usually present with a different pattern of cognitive symptoms.  However, all forms of dementia are associated with a decline in the ability to function day to day, emotional distress or behaviour changes.  This will discuss: 
 
  • The common types of dementia
  • Who is likely to develop dementia
  • How to get help including diagnosis
  • Treatment of dementia
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Types of Dementia

Alzheimers Disease

This is the most common form of dementia. It usually begins with a decline in memory and the ability to learn new things.  Later, in the course of a steady, gradual deterioration, there are problems in other areas (for example speech, planning or reasoning, recognising objects, changes in emotions and behaviour).  The cause of Alzheimers Disease is unknown though old age and certain genes appear to make people more prone to it.  In the brain, there are microscopic changes, “plaques” of a substance known as amyloid and “tangles” within dying nerve cells.

Vascular dementia:
 
This occurs when there is insufficient blood supply to the brain. The symptoms are variable depending on which part of the brain is affected, though changes in the ability to pay attention, slowing of thought and frontal-lobe changes (see below) are common. The progression may be steady if the blood supply is gradually reduced by the narrowing of small arteries.  Alternatively sudden or, “stepwise” progression occurs if the blood supply suddenly closes off to an area of the brain, often because a blood clot has formed or been carried from another location. The diagnosis is made from the history and evidence of blood vessel damage e.g. previous stroke seen on a brain scan or heart attack.

It is quite common especially in the very elderly to have “mixed dementia”, that is, both Alzheimers and vascular changes. 
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 Lewy Body Dementia (LBD):
 
This condition is the third commonest cause of dementia, perhaps 20% of dementia cases. LBD is on a spectrum that includes Parkinson’s disease and the dementia associated with that condition. People with LBD have symptoms similar to those of Parkinson’s disease, such as stiffness, shaking and changes in gait. Cognitive changes include poor attention, changing levels of alertness and visual hallucinations (that is, seeing things that are not there). 
Sometimes those with LBD fall, faint or thrash about in their sleep as if acting out their dreams. Memory is typically not too impaired early on, but as the condition progresses all aspects of thinking are more widely affected. It is important to make the diagnosis to distinguish it from delirium, a potentially treatable medical condition, and to ensure the person is not given antipsychotic medication which can have severe side-effects in LBD. In this condition we see large spherical protein deposits in the brain – these are Lewy Bodies. The cause is unknown. 

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Frontotemporal dementia:
 
In this group of conditions the frontal and /or temporal lobes of the brain are affected. Memory loss and learning problems are less obvious early on and the main symptoms are changes in behaviour and / or personality and / or language. The sorts of behavioural changes seen are: disinhibition (e.g. unrestrained or antisocial speech or behaviour), apathy (not initiating or doing anything), loss of empathy (understanding of others thoughts or feelings) repeated behaviours or rituals, changes in eating and loss of ability to plan or make judgements. Language changes include slow or hesitant speech, word-finding, naming, grammar and word comprehension. Frontotemporal dementia is a common cause of early onset dementia (beginning before the age of 65) and about 40% of people with frontotemporal dementia have a family history, suggesting there is a genetic cause. 

Who gets dementia?

The likelihood of getting dementia increases as a person ages. This doesn’t however, mean that younger people – people aged less than 65 – don’t also get dementia. Some people may be predisposed to dementia by pre-existing intellectual disability, head injury or family history. 
 
Dementia is very common and as our population ages it is likely that everyone will have contact with someone with dementia. So the answer to “who gets dementia?” is really, “Anyone, though it is much more likely in older people”. 

How do you recognise dementia and get assistance? 
 
The important thing to note is that a person developing dementia has a change in how they function. For example, if someone has always had trouble reading maps or finding their way around and still can’t do this, there is no cause for alarm. On the other hand, if someone normally good at navigating, starts getting lost, you might worry. Sometimes the change is subtle: the usually reliable person is not paying the bills or the meticulous dresser goes out with stains on her clothing. 
 
This might not mean dementia. Other conditions like depression or physical illness can cause these changes, hence it is important to get to the doctor and / or encourage someone with alterations in their thinking ability, behaviour or emotions to attend the GP. In New Zealand the GP has access to a “cognitive impairment pathway” which is a series of steps and tests to go through to rule out other problems and decide whether this is dementia. Sometimes it is hard to tell and the person might be referred to a specialist (usually based in a hospital) or a memory clinic. 

Treatment
 
While there are no cures, yet, for any of the common forms of dementia, there is a lot that can be done to help and possibly slow the progression of symptoms. There is evidence that if people get an early diagnosis and thus know what is happening, they and their family / whanau cope better in the long term.  Knowing what to expect also allows people to plan for the future. 
 
If you require some help managing a family member with dementia our friendly therpaists ca help.  Just contact:
 
                        Therapy Professionals Ltd 
                        Phone:  03 377 5280
                        Email:  [email protected]
 
 
 
Reference:
Dementia NZ 
 
https://dementia.nz/wpcontent/uploads/2020/02/about_dementia_1_what_is_dementia_nz.pdf

June 01st, 2021

1/6/2021

 
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Understanding Autism – Autism NZ

 
Definition 
 
Autism is a neurodevelopmental condition that affects cognitive, sensory, and social processing, changing the way people see the world and interact with others.
 
Autism is currently estimated to be present in 1 in 54 people. It is not a mental illness, but a neurological difference - one of many variations of neurodiversity.

​Every autistic person is unique, with a wide range of skills, qualities, interests, and personality styles.  As the saying goes, "if you have met one person with autism, you have met one person with autism."  The level of support required is also highly individual.  This heterogeneity is due to the fact that autism is not a single condition but a cluster of underlying neurological differences that are present in varying combinations in each person. The behaviour and needs related to these differences share common themes but manifest in different ways for each individual.
 
Autism is considered an invisible disability since challenges and difficulties are often not immediately apparent. There are no visible physical markers. The cognitive differences associated with autism may also contribute to specific skills such as superior visual memory, attention to detail, and pattern recognition.

Traits and characteristics
An autistic person may experience challenges with social communication and interaction, have intense interests and a strong need for routines and predictability, and be hyper or hyporeactive to sensory input.

No two autistic people are alike, but can often experience difficulty with social skills and executive functions, and have sensory needs that are different from those of the neurotypical population.

Within these areas of challenge, autism will be expressed in different ways for each person, e.g. difficulty making small talk or having a balanced conversation, sensitivity to certain sounds or textures, and the need to stick to a daily routine. The traits experienced may change during the lifetime of a person as coping mechanisms or compensation strategies are learned and appropriate support is provided. However, this does not mean that the person has grown out of their autism.  It would be more accurate to say that they have 'grown into' their autism, a process that is never finished and requires a phenomenal amount of energy to maintain.
 
Many of the challenges autistic people face are not self-perceived as 'symptoms' of their autism but as difficulties created by their environment: a society that largely refuses to make accommodations for people with cognitive/invisible disabilities
 
 
 
Reference Autism NZ 
https://www.autismnz.org.nz/what-is-autism/


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    Shonagh O'Hagan
    and Therapists at Therapy Professionals

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Phone: (03) 377 5280
Email:   [email protected]
Hours:  8:30am-4pm, Monday-Friday
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Therapy Professionals makes every effort to ensure that the information provided on its web pages is accurate and up-to-date. Website content is subject to regular review and no warranty can be provided regarding the accuracy of it. © Therapy Professionals Ltd 2015. All rights reserved.