Archive for the ‘Senior Health Management’ Category

FIVE BODY PARTS NO-ONE TELLS YOU TO EXERCISE:

Friday, November 20th, 2015

By Elise Adler

No matter how much you walk, work your core and lift weights, you might not be doing enough to avoid some of the issues we can start to experience as we age – issues like hunched shoulders, shuffling feet and weak hands.

Working large muscle groups and performing cardiorespiratory exercise doesn’t get at the small muscles we need for performing everyday activities. Generally there’s a lot of emphasis on walking and lifting weights, while very little attention is paid to functional stretches and exercise.

Five neglected body parts in particular are crucial to how happily and safely we age: the neck, the shoulders, the shins, the hands and the hips.M They’re all easy to work on. Try some simple stretches and strength moves to keep your whole body fit and functioning well.

Shoulders
Seniors hunch over for many reasons, among them osteoporosis or arthritis. Sometimes, though, it’s simply because of a combination of strong pectoral (chest) muscles and weak rhomboids (the muscles in between the shoulder blades). This imbalance pulls the shoulders forward in a hunch, also called “pronation,” which in turn shortens the muscles connecting the pectorals to the shoulder joint. How to avoid or correct it? Try two things: strengthen the rhomboids – the muscles primarily responsible for good posture – and stretch those connecting muscles.

Hip Flexors
Most people will experience low back pain in their lifetime. Sometimes this problem is serious and needs medical attention, while at other times the problem is simply tight hip flexors. Your hip flexor muscles are a group that keep your leg in the hip joint, among other functions. The largest one, the psoas, attaches to the lowest vertebrae and low back muscles on the opposite side (right psoas attaches to left low back muscles, and vice versa). So if the psoas is tight, it pulls on the lower back, causing pain. Tight hip flexors can also result in poor posture by tilting the pelvis back, forcing the upper body to lean forward. If you are exercising often, your hip flexors need extra attention.

Neck
As we age, driving becomes more dangerous due to weakening eyesight and slower reaction times. But there’s another reason that most of us fail to factor in: decreased neck mobility. Over time, our joints become less flexible due to bone thinning and cartilage loss, making turning the head more difficult. Even walking along a busy sidewalk requires looking to your right and left.

Shins
Once you start to sense that you’re not picking up your feet the way you used to, you know your body is aging. Shuffling the feet is a health hazard – shuffling makes you more likely to trip and fall. Exercising your shins can help you stop the shuffle from developing down the road. We mostly focus on the large muscles of the legs when we work out (e.g.: glutes, quads and hamstrings) and neglect the small muscles, like the tibialis anterior. This muscle is located at the front exterior of the shin and makes possible what’s known as “dorsiflexion of the ankle,” or lifting the toes up toward the leg. When you’re walking, this action clears your toes as you swing your leg and encourages you to put your heel down first. Keep this muscle strong and flexible to balance out the calf, and you’ll be able to walk with confidence.

Hands
Is it getting hard to open pickle jars? That’s not the only problem you’ll run into if you lack hand and forearm strength. Turning door handles, using a can opener and holding a toothbrush require strength in the upper extremities. You might think you can just squeeze a squishy ball and have it covered – but that only strengthens the muscles on the underside of the forearm. You need to keep the top of the hand and forearm strong as well.

The Sun

Tuesday, June 2nd, 2015

 

That luminous circle of light that ascends into the sky every morning can be just as good for your health as it is damaging. In fact, some experts now believe that the sun’s rays provide more benefit than harm—provided you get the right dose.

Even dermatologists, who worry about the sun’s ravaging effects on the skin in the form of cancer, age spots, and wrinkles, acknowledge that we could all use a little sun exposure. “Being out in the sun boosts our mood, improves sleep, and promotes vitamin D production,” says James Spencer, associate clinical professor of dermatology at Mt. Sinai School of Medicine in New York. “There’s no controversy about that.” Still, he emphasizes, the operative word is little when it comes to exposure. “The majority of people aren’t putting on sunscreen every time they step outside, and that 5 or 10 minutes a day of casual exposure is probably all you need.” Much attention has been paid to the benefits of vitamin D, which is manufactured when the sun’s UV-B rays hit the skin and which protects against cancer, bone brittleness, heart disease, and a host of other ills. But there are other payoffs to a small daily dose of sunlight, including:

  • Better sleep. Natural daylight helps shut off your body’s production of melatonin, a hormone produced at night that makes you drowsy. This can help you maintain a normal circadian rhythm, so you’re more likely to feel tired at bedtime when it’s dark outside. Going outside for 15 minutes at the same time each day, preferably in the morning, gives your body a clear signal that it’s no longer night. Also, forgo the sunglasses if possible, since this will enable sunlight to pass unhindered through your eyes to the brain’s pineal gland, triggering the gland to stop releasing melatonin.
  • Happier outlook. A type of depression called seasonal affective disorder affects some people during the winter when they don’t get enough sunlight. Experts now believe that sunlight has widespread mood-elevating effects, possibly because the “happy” hormone serotonin increases when nights are short and days are long. In fact, psychiatrists often recommend that depressed individuals go outside in the sun for 30 minutes a day. Bonus: You can slather on all the sunscreen you want and still reap the mood benefit.
  • Protection from autoimmune diseases. Exposure to UV radiation appears to suppress an overactive immune system, according to an April report published in Environmental Health Perspectives. This could explain why exposure to UV rays may help with autoimmune diseases like psoriasis and lupus; one recent study also suggests it might help alleviate asthma.
  • Lessening of Alzheimer’s symptoms. Elderly Alzheimer’s patients exposed to bright lighting during the day—from 9 a.m. to 6 p.m.—got better scores on a mental exam, had fewer symptoms of depression, and lost less function than did those exposed to dim daytime lighting, according to a study published this month in the Journal of the American Medical Association. The researchers attributed the improvement to more-regular circadian rhythms, which are thrown out of whack when advanced dementia sets in.

AHRQ Safety Program for Long-Term Care: CAUTI

Wednesday, August 20th, 2014

By Diane Orzechowski, NHA

LifeQuest Nursing Center is pleased to be able to participate in a program that is being led by the Health Research & Educational Trust (HRET). HRET and its partners are developing and implementing an infection prevention and safety program to support long-term care facilities in adopting evidence-based infection prevention practices. Participating facilities will also learn how to use teamwork and communication tools to improve safety culture in their facilities.

The Agency for Healthcare Research and Quality (AHRQ) is funding this national long-term care (LTC) safety program to reduce catheter-associated urinary tract infections (CAUTIs) and other hospital acquired infections (HAIs) in Long Term Care Facilities across the country.

According to the Patient Safety Authority this program is important because research tells us that the rate of hospital-acquired infections in long-term care facility (LTCF) residents is between one and three million annually in the US.,  contributing to  400,000 deaths per year. In addition, re-hospitalizations from LTCFs are increasing, with urinary tract infections (UTIs) being the second most common reason. This program emphasizes evidence-based infection prevention practices and antibiotic stewardship to help eliminate (CAUTIs) and improve resident safety culture overall, which is  believed to  lead to improvements in other areas such as, C. difficile and multiple-drug resistant organisms (MDROs).

Anticipated benefits to the facility and residents include:

* Reduced morbidity and mortality from CAUTIs through improved infection prevention practices

* Reduced morbidity and mortality from C. difficile and other MDROs through appropriate antibiotic prescribing

* Reduced staff burden of admitting, readmitting and caring for residents with infection

* Improved safety culture through enhanced teamwork and communication

The project kickoff is scheduled for August 25 – September 5, 2014

Partner with Your Physician to Manage Your Medications

Tuesday, February 4th, 2014

Should seniors that are taking multiple medications actively manage those medications or depend on their health care provider(s) to keep track of the medications and possible interactions when adding new ones? A reader recently asked Dr. K. on AskDoctorK.com that question and we’ve included the full post for your reference below.

Dear Doctor K: I’m in my 70s. Like many women my age, I’m on several medications. Should I be actively managing them? Or can I leave that to my doctor?

Dear Reader:
Many older adults are on a number of medications, prescribed to treat different health conditions. Yet each medication you take has the potential to interact — sometimes dangerously — with another. And if you see specialists for various health conditions, your medications may be prescribed by several different doctors.

If that’s the case, work with your primary care physician (PCP) to manage your medications. That means reviewing all of them with your PCP at every visit. Make sure to tell him or her about pills prescribed by specialists as well as over-the-counter drugs and supplements. Your doctor can make sure each drug is appropriate for you, and check that your medications don’t interact with one another.

At any medical visit, your doctor may suggest starting a new medication or changing the dose of one you already take. But time constraints may prevent your doctor from providing a detailed explanation of why, and what to expect. So you need to take the initiative.

My colleague Dr. Anne Fabiny is chief of geriatrics at Harvard-affiliated Cambridge Health Alliance and editor in chief of Harvard Women’s Health Watch. She recommends asking lots of questions.

First, make sure you understand why the doctor is suggesting the medication, and what it is going to do. Ask what adverse effects the drug might have, and which ones warrant a call to your doctor. Find out how long you’ll be on the medicine. And check back in with your doctor after a few weeks to let him or her know how you’re doing.

Here is a list of 10 questions to ask your doctor every time you get a new prescription:

  • Why are you prescribing this drug?
  • How is it supposed to treat my condition?
  • Has it been tested and found to be safe and effective for people my age?
  • What side effects might it have, and what should I do if I have any of them?
  • At what dose are you starting me, and why?
  • Will you eventually increase or lower the dose?
  • Is there a lower-cost generic alternative to this drug available?
  • Can you put me on a drug regimen that will be easier for me to take (for example, once a day instead of several times a day)?
  • For how long do you want me to take this medicine?
  • What should I do when the medicine runs out? Will I need to refill the prescription, and if so, how can I get the new prescription from you?

If you’re thinking of stopping one of your medications, perhaps because of unpleasant side effects, let your doctor know first. You and your doctor can explore other options, such as lowering the dose or switching to a different drug.

When I was early in my training in internal medicine, I got my first lesson in how difficult it could be to make sure a patient was taking the right medicines. A patient of mine was getting medicines prescribed by several specialists — thirteen medications in all. At every visit I went over what I thought was the total list of her medicines, and she said I had it exactly right.

She was crippled by arthritis, so one day I made a home visit. She offered me some tea, and as we sat down at the dining room table I noticed a beautiful glass vase — full of pills. Her daughter told me that each morning she put her hand in the vase, grabbed a bunch of pills and swallowed them. She knew that she should take each pill as it was prescribed, but she felt “it would all work out OK in the end” the way she was doing it.

After she had gone into heart failure three times in three months, I (and her daughter) finally convinced her to take the medicines as prescribed. Her health improved.

Dr. Komaroff is a physician and professor at Harvard Medical School.

Music Can Promote Healing and Ease Stress

Saturday, February 1st, 2014

Not only can music be entertaining, but it can also promote healing and ease stress for people of all ages. A recent post (January 18, 2014) on AskDoctorK.com, shows just how music can affect our health. Here’s what Dr. K. had to say about the benefits…

Dear Doctor K: I believe music helped my mother recover after her stroke. Is there a connection between music and health?

Dear Reader:
The ancient Greeks certainly thought so: They put one god, Apollo, in charge of both healing and music. Recent medical studies seem to confirm what the Greeks thought. Music seems to slow heart rate, lower blood pressure and reduce levels of stress hormones. It can also provide some relief to heart attack and stroke victims and patients undergoing surgery.

How does music exert these benefits? Some research suggests that music may promote the brain’s ability to make new connections between nerve cells.

Another idea is that it works its magic through its rhythms. Humans are rhythmic beings: Our heartbeat, breathing and brain waves are all rhythmic. The human brain and nervous system are hard-wired to distinguish music from noise and to respond to rhythm and repetition, tones and tunes.

Not long ago I had a vivid example of that. I was late to attend a concert because of a noisy traffic jam with lots of honking. I parked the car and entered the theater. The concert had already started, and the music was louder by far than the sound of the traffic I had just left behind. But despite its volume, the sound of the music made me feel instantly at peace. I had left a world of disordered noise, and entered a world of ordered sound.

As you suspect may be true of your mother, there is some evidence that music can help with stroke recovery. One study enrolled 60 patients hospitalized for major strokes. All received standard stroke care. In addition, one-third of the patients listened to recorded music for at least one hour a day, another third listened to audiobooks, and the final group did not receive auditory stimulation.

After three months, verbal memory improved 60 percent in the music listeners, compared with 20-30 percent in the audiobook group and to the patients who did not receive auditory stimulation. In addition, the music listeners’ ability to perform and control certain mental operations improved by 17 percent. The patients in the other two groups did not improve at all.

Music therapy also is used to help patients with balance and coordination. A program designed to train older adults to walk and perform various movements in time to music helped improve their gait and balance when compared to their peers.

I introduced a friend with severe Parkinson’s disease to a friend who was a singing teacher. I thought singing might help him cope with his disease. When my friend with Parkinson’s disease would find himself “locked” and unable to walk or use his arms much, he would burst out singing a few notes of an aria — which unlocked his legs.

Finally, music can relieve stress. It can improve mood, even in people with depression. And it can lower heart rates, breathing rates and oxygen demands in patients who have recently suffered a heart attack.

Music not only “has charms to soothe the savage breast.” It also helps us to heal.

Dr. Komaroff is a physician and professor at Harvard Medical School.

Milford Village Receives Final Approval for First Phase of Building Project

Monday, December 23rd, 2013

On Tuesday night, December 17, 2013, Milford Township’s board of supervisors unanimously granted final approval to the first phase of Milford Village’s building project. The plans for a complex including senior housing, offices, stores and restaurants on our campus have been in the works for more than five years.

This spring, a 5,000 square foot kitchen will be added to the back of our skilled nursing facility, which will have the capacity to serve a much larger campus.

Overall, the plan on our 206 acre site calls for 576 congregate care units – apartments with shared dining and other common areas, 140 assisted living units, a memory care unit, 208 apartments, 41 townhouses and 33 cottages.

In the first phase of the project, only 73 assisted living units will be completed.

As part of the overall project, a traffic light and additional turning lanes will be added in front of the main entrance of LifeQuest on Route 663. The plan also calls for the realignment of Mill Hill Road.

The estimated timeline for the entire project is 12 years.