Living Longer

Things you need to know about talking to your ageing parents

February 17, 2016/in 5 Things you should know about dementia, Aging Myths, Aging Population, Alzheimer's & Dementia Care, Dollars and Sense, Funeral Services, Having the talk with Parents, Living Longer, Personal Safety, Technology /by inourcare@gmail.com

Having the Talk? Here’s a few tips.

If you have not had “the talk” with your ageing parent/s, don’t put it off any longer. While mom and dad are cognitively intact the process is pretty straight forward… albeit, it can be somewhat uncomfortable for both parties. It needs to be approached from the same angle as if the conversation was to be had with you by your own grown children.

IOC The talk1 Talking about the future can be hard. Such discussion will invoke anxiety in even the most calm of us when we start to think about all the unknowns in our futures and those of our loved ones. These discussions can get even harder when it’s not our future we’re talking about, but rather someone else’s. However, as difficult as it may be, there are some questions that we need to have answers to when it comes to our ageing parents and it is wise to have these conversations sooner rather than later. On that note, here are 7 basic questions that you should include in the “talk” with your ageing parent/s… as soon as you can.

1. How do they feel about getting older or having to get help to sustain their independence?

A parent/s can have all the legal stuff taken care of, but that doesn’t tell you how they feel. To really understand your ageing parents, it’s important to talk about how they feel about the situations that might happen. Allow them to talk about their fears, their wishes, how they envision things unfolding in the event of a medical situation, and so on. This is the type of conversation that will tell you if they have made decisions based on what they think will be easiest for others or what they really want. This is the type of conversation that will allow you to make sure that the legal documents accurately represent your loved one’s wishes. Most importantly, it is the type of conversation that will allow your ageing parent/s to know how much you support and love them and want what is best for them.

2. Do they have a will? Is the Will is safe keeping and up-to-date?

Bringing up a will can seem like you only care about what you’re getting, but a will contains so much more than just ‘who gets what’ and is essential to the process of handling matters when a loved one passes. This is your parent’s opportunity to dictate how they would like their affairs to be handled and who they want to handle things. It is equally important for our parent/s to ensure their will is up-to-date so that loved ones don’t end up in bureaucratic chaos trying to simply execute the wishes of a loved one while simultaneously trying to mourn. Importantly, the same questions pertain to life insurance, which is separate from a will and requires the beneficiaries to be named to the life insurance company directly.

3. Do they have a living will?

Although many people plan for their deaths, many forget to also plan for any situation that might render them incapable of making their own decisions while still living. Your parent/s may assume that the “right” decision will be made for them, by those in charge. This is not always how it plays out. Taking the time to decide what they want and making sure those wishes are legally noted is the only way to ensure your parents will be cared for in that way.

4. Do they have a Power of Attorney?

This can be one of the trickier topics to discuss if there are multiple children or individuals who might expect to be “chosen”. Parents sometimes put this off because they simply don’t want to be seen as picking favourites, but it’s an essential document to have. For this reason it is important that children (and any other interested individual) are respectful of whatever decision the elder makes. No offense should be noted to the parent/s and if there are concerns about a selection, it would be wise to make sure all parties are involved in discussing this instead of trying to quietly bring it up to the parent. By involving everyone, the right decision for your aging parent can be made.

5. Do you have long-term care insurance?

Not all people have invested in long-term care insurance and with the costs of long-term care. This is something your parents may want to consider if it’s not too late to invest. If they have invested, being aware of what is covered, who to contact to initiate the insurance claim, and what services your parent will want to take advantage of is important to know ahead of time and can save money and hassles if/when the time comes.

6. What kind of care situation do you want?

Does your parent have a retirement or assisted living home in mind? Do they want to stay at home as long as possible, focusing on ageing in-place (Home Care)? What nursing homes are they comfortable with if the situation were to become necessary? Having these discussions before a decision needs to be made ensures that people can look for the right care, make any needed arrangements, and not scramble at the last minute and have to take whatever is available.

7. What are your wishes for a funeral/memorial?

IOC-The talk2 Sometimes there’s a lot of pressure to do things in a “traditional” way when it comes to how we remember our loved ones, but that’s not always what they want. Although funerals/memorials need to reflect both the person that is gone and those who are left behind, having a discussion ahead of time can mean that all sides get their voices heard. When a decision is reached beforehand, our loved ones know their wishes will be respected and those of us left behind can know we’re memorializing our parents in a way that they accept as well. This means no guilt for anyone and that’s a much-needed relief at a time of sorrow.

However hard it may be, please take the time to talk to your loved ones about these issues. It’s also not too late to start thinking about them for yourself as well. The more prepared you are, the easier it is for those around us and the more open we are, the more likely we are to respect everyone’s wishes and know that ours will be respected too.

Myths & Facts About Aging

May 5, 2015/in Aging Myths, Aging Population, Alzheimer's, Alzheimer's & Dementia Care, Common Age Related Issues, Dementia, Depression, Healthier & Happier, Incontinence, Living Longer, Oral Health, Personal Safety /by inourcare@gmail.com

elderly-woman This article delves into ageist stereotypes dressed-up in the garb of myth that biases perceptions and experiences of being old. The article argues current ”mythmaking” about aging perpetuates that which it intends to dispel: ageism. It considers how traditional myths and folklore explained personal experience, shapes social life, and offers meaning for the unexplainable. The current myths of aging perform these same functions in our culture; however, they are based on half-truths, false knowledge, and stated as ageist stereotypes about that which is known. Recent studies in the cognitive sciences are reviewed to provide insight about the mind’s inherent ability to construct categories, concepts, and stereotypes as it responds to experience. These normal processes need to be better understood, particularly regarding how social stereotypes are constructed. Finally, the article argues that ageist stereotypes when labeled as ”myth” even in the pursuit of the realities of aging, neither educate the public about the opportunities and challenges of aging nor inform social and health practitioners about the aged.

Think you know the facts about growing older? Think again.

Take a brief quiz to determine your knowledge on myth versus fact as it relates to aging:

Myths of Aging Quiz – Answer true or false to each statement.

Polypharmacy (administration of many drugs together) can lead to a change in mental status.
Aging is a universal phenomenon.
Older adults may present with atypical symptoms that complicate diagnosis.
The body’s reaction to changes in medications remains constant with advancing age.
If the rehabilitation nurse observes a sudden change in mental status in an older adult, medication side effects should be investigated as a likely cause.
Primary causes of delirium in older adults include medications, dehydration, and infection.
Dehydration is not common in older adults.
Older adults experiencing a decline in daily function will show no benefit from early rehabilitation.
A decline in functional ability for a person residing in a long-term care facility may indicate the onset of a new illness.
Urinary incontinence is so common in older adults that it is considered a nor- mal part of aging.

Answers: 1. True; 2. True; 3. True; 4. False; 5. True; 6. True; 7. False; 8. False; 9. True; 10. False

In no particular order… what are the common 20 myths that are often associate with Aging

Myth: Dementia is an inevitable part of aging
“Dementia should be seen as a modifiable health condition and, if it occurs, should be followed as a medical condition, not a normal part of aging. In other words, if you or your loved one becomes forgetful, it could be related to medication, nutrition or modifiable medical issues, she said. Don’t assume Alzheimer’s.

Just consider that when doctors examined the brain of a 115-year-old woman who, when she died, was the world’s oldest woman, they found essentially normal brain tissue, with no evidence of Alzheimer’s or other dementia-causing conditions. Testing in the years before she died showed no loss in brain function.

Not only is dementia not inevitable with age, but you actually have some control over whether or not you develop it. “We’re only now starting to understand the linkages between health in your 40s, 50s and 60s and cognitive function later in life. Studies find that many of the same risk factors that contribute to heart disease—high blood pressure, high cholesterol, diabetes and obesity… may also contribute to Alzheimer’s and other dementias.

For instance, studies on the brains of elderly people with and without dementia find significant blood vessel damage in those with hypertension. Such damage shrinks the amount of healthy brain tissue you have in reserve, reducing the amount available if a disease like Alzheimer’s. That’s important, because we’re starting to understand that the more brain function you have to begin with, the more you can afford to lose before your core functions are affected.

Myth: Creaky, Achy Joints are Unavoidable
Not exercising is what makes achy joints inevitable. When Australian researchers at the Monash University Medical School looked at women ages 40 to 67, they found that those who exercised at least once every two weeks for 20 minutes or more had more cartilage in their knees. It suggests that being physically active made them less likely to develop arthritis.

In Fact – You may actually dodge the dementia bullet… Exercise your body and your brain. Physical activity plays a role in reducing the risk of diseases that cause Alzheimer’s. It also builds up that brain reserve. One study found just six months of regular physical activity increased brain volume in 59 healthy but couch-potato individuals ages 60 to 79. Other research finds people who exercised twice a week over an average of 21 years slashed their risk of Alzheimer’s in half.

Then there’s intellectual exercise. It doesn’t matter what kind, just that you break out of your comfort zone. Even writing letters twice a week instead of sending e-mail can have brain-strengthening benefits. That’s because such novel activities stimulate more regions of the brain, increasing blood flow and helping to not only build brain connections, but improve the health of existing tissue.

Myth: If you didn’t exercise in your 30s & 40s, it’s too late to start in your 50s, 60s or 70s
It’s’s never too late! In an oft-cited study, 50 men and women with an average age of 87 worked out with weights for 10 weeks and increased their muscle strength 113 percent. Even more important, they also increased their walking speed, a marker of overall physical health in the elderly.

Myth: Your Bones Become Fragile And Your Posture Bends
Remember, only death is certain when it comes to aging. Osteoporosis is definitely more common in older people, but it’s also very preventable.   A study of females over 100 years of age found that only 56 percent had osteoporosis, and their average age at diagnosis was 87. Not bad, given these women grew up before the benefits of diet and exercise on bone were understood. Thankfully, you know better.

Myth: Old Age Kills Your Libido
Impotence and reduced libido are related to normally preventable medical conditions like high blood pressure, heart disease, diabetes, and depression. The solution is keeping yourself in shape. Something as simple as lifting weights a couple times a week can improve your sex life. Sexual desire might decline a bit as you age, but that doesn’t typically occur until age 75A survey of 3,005 people ages 57 to 85 found the chance of being sexually active depended as much if not more on their health and their partner’s health than on their age. Women who rated their health as “very good” or “excellent” were 79 percent more likely to be sexually active than women who rated their health as “poor” or “fair.” And while fewer people ages 75 to 85 had sex than those 57 to 74, more than half (54 percent) of those who were sexually active had intercourse two or three times a month. emember – Sexually transmitted diseases do not discriminate based on age. If you’re not in a monogamous relationship, you or your partner should use a condom.

Myth: Getting older is depressing so expect to be depressed
No way! “Depression is highly treatable. If older people could just admit to it and get help, they could probably live a much more active and healthy life.” That’s because studies find that older people who are depressed are more likely to develop memory and learning problems, while other research links depression to an increased risk of death from numerous age-related diseases, including Parkinson’s disease, stroke and pneumonia.

Myth: Genes Play The Biggest Role In How You’ll Age
Even if you’re born with the healthiest set of genes, how you live your life determines how they behave over your lifespan. Your genes can be changed by what you eat, how much physical activity you get, and even your exposure to chemicals.

Myth: Women fear aging more so than men
Not so! A survey conducted on behalf of the National Women’s Health Resource Center found that women tend to have a positive outlook on aging and to be inspired by others who also have positive attitudes and who stay active as they grow older. Women surveyed were most likely to view aging as “an adventure and opportunity” and less likely to view it as depressing or a struggle.

Myth: You Lose Your Creativity As You Age
Creativity actually offers huge benefits for older people. A study found that older adults who joined a choir were in better health, used less medication, and had fewer falls after a year than a similar group that didn’t join. The singers also said they were less lonely, had a better outlook on life, and participated in more activities overall than the non-singing group, who actually reduced the number of activities they participated in during the year.

Myth: The pain and disability caused by arthritis is inevitable, as you get older
While arthritis is more common as you age, thanks to the impact of time on the cushiony cartilage that prevents joints and bone from rubbing against one another, age itself doesn’t cause arthritis. There are steps you can take in your youth to prevent it, such as losing weight, wearing comfortable, supportive shoes (as opposed to three-inch spikes), and taking it easy with joint-debilitating exercise like running and basketball. One study found women who exercised at least once every two weeks for at least 20 minutes were much less likely to develop arthritis of the knee (the most common location for the disease) than women who exercised less.

Myth: Your Brain Stops Developing After Age 3
This developmental myth was overturned in the 1990s, and ever since, researchers no longer look at the older brain as a static thing. Instead, studies show your brain continues to send out new connections and to strengthen existing ones throughout your life — as long as you continue to challenge it. It really is your body’s ultimate muscle.

Myth: Your Brain Shrinks With Age
This myth began with studies in 2002 showing that the hippocampus, the part of the brain that controls memory, was significantly smaller in older people than in younger people. This never sounded right to Dr. Lupien, particularly after she conducted groundbreaking research in the late 1990s showing that chronic stress shrinks the hippocampus.   Was it age or stress that was responsible for the shrinking brains of older people? Probably stress. When she examined brain scans of 177 people ages 18 to 85, she found that 25 percent of the 18- to 24-year-olds had hippocampus volumes as small as those of adults ages 60 to 75.

Myth: Seniors Are Always Cranky And Unhappy
When researchers from Heidelberg, Germany, interviewed 40 centenarians, they found that despite significant physical and mental problems, 71 percent said they were happy, and more than half said they were as happy as they’d been at younger ages. Plus, when the researchers compared them to a group of middle-age people, they found that both groups were just as happy. Most important: Nearly 70 percent of the centenarians said they laughed often. What does it all mean? It means there is no universal definition of aging. How you’ll age is entirely up to you – and the time to begin writing that definition is today.

Myth: When you get older, you don’t need as much sleep
You may need as much sleep as when you were younger, but you may have more trouble getting a good night’s sleep. “It is not so much that there is a decline in the number of hours needed, but rather that sleep patterns may change with a tendency to more naps and shorter nighttime periods of deep sleep.

Myth: If you live long enough, you’re going to be senile
The odds are against it. “The probability of senility at age 65 is only about five percent. It rises to about 20 percent by age 85.

The term “senility” is no longer used to describe dementia. Alzheimer’s disease is the most common type of primary progressive dementia. Alzheimer’s is linked to age, Dr. Gorbien says, and older people worried about it should seek an assessment with a geriatrician, neurologist or psychiatrist.
“Early detection of Alzheimer’s disease is so important,” he says. New medications may slow the progression of the disease and help keep people independent.

Myth: Older adults are always alone and lonely
In proportion the number of older people living alone are greater than their younger counterparts, but they are not necessarily lonely. Relationships may grow more intense in old age, Dr. Schaie says. More people live alone as the population ages, Dr. Gorbien says. And Dr. Schaie says gender differences in average life spans leave many more women than men widowed. Widowed men are more likely than women to remarry, Dr. Schaie says, “because of the availability of a larger pool of eligible partners.”

“Most seniors are active,” adds AARP spokesman Tom Otwell. Many have paying jobs, regularly volunteer, garden or help care for grandchildren, for instance.

Myth: Old age means losing all my teeth
If you’re not worried about losing your mind when you’re old, you might fret about losing your teeth. Periodontitis, or late stage gum disease, is the primary cause of tooth loss in adults. This condition commonly begins as gingivitis where gums turn red and begin to swell and bleed, a situation experienced by too many people. Fortunately healthy gums and avoiding false teeth are both reasonable goals.

The elderly of today are much more likely to keep their teeth than previous generations. Even so, dental disease is prevalent. The New England Elders Dental Study found the beginnings of periodontal disease in over 3/4 of the 1150 persons examined. Part of the problem, said these investigators, was that education and dental care for this population are overlooked by both dentists and the patients themselves. The sad part of this situation is that proper dental hygiene and regular cleanings by the dentist are usually enough to stave off infection. Healthy people should replace their toothbrushes every two weeks; those with a systemic or oral illness more often. Everyone should use a new toothbrush when they get sick, when they feel better and again when they completely recover.

Myth: The older I get, the sicker I’ll get
It’s true that as we age, our physiology changes. These changes can lead to poor health if not addressed. But old age doesn’t have to mean feeling sick and tired. An important part of staying well into the older years is keeping your immune system operating at its peak. Aging is generally associated with lagging immunity and consequently more infections especially of the respiratory system. However, John Hopkins’ Professor Chandra discovered that when independent, apparently healthy, elderly people were fed nutritional supplements for a year, their immunity improved. Immunological responses were so marked that those who were supplemented (versus the placebo group) were plagued with less infections and took antibiotics for less days. Besides taking care of your immunity with supplementation, diet, exercise and other measures, you can prevent many age-related diseases with specific health precautions. For example, there is evidence that smoking and low plasma levels of vitamins C and E, and beta-carotene contribute to cataracts.

Calcium and magnesium supplementation helps some individuals with hypertension. Most are helped by high potassium foods (fruits and vegetables), salt restriction and weight maintenance. Keeping blood pressure under control can also decrease the risk of a stroke.

Adult-onset diabetes is usually treated best with dietary measures such as reducing simple sugars, consuming a lot of fiber and taking chromium supplements. It’s estimated that half of all types of cancer are linked to diet. This explains why less fat, lots of fruits, vegetables and fiber, vitamins A, B6, C and E and zinc and selenium all appear to play a role in cancer prevention.

Myth: Urinary incontinence is considered a normal part of aging
Although urinary incontinence (UI) occurs more frequently among older adults (10%–42% of hospitalized elders), it is not considered a normal part of aging and is highly treatable. A new onset of UI can signal problems such as urinary tract infection, electrolyte imbalances, mobility limitations, or medication side effects. Before beginning any rehabilitative interventions for incontinence, all possible causes should be investigated to rule out reversible factors. Bladder retraining for those with urge or stress incontinence is still highly effective for older adults. Behavioural management is the first line of treatment for incontinence.

Myth: Growing older means accepting the loss of independence and a Home for the Aged
There is absolutely no evidence to support that as we age we accept loss of independence or going into a nursing home as part of the aging process. In fact today’s older adults enjoy a more vibrant and vigorous lifestyle. Remaining active, engaged and enjoying a more robust social life. An ever-increasing number of older adults are adopting home care in order to preserve the very things that the myth depicts. However, older adults do share common fears… in fact the 5 greatest noted fears among older adults are:

Loss of independence
Loss of loved ones
Loss of friends
Going into a Nursing Home
Death

In Our Care supports the aging process so effectively that you never have to ever see the inside of Nursing Home, unless you’re visiting friends and family. We are fully equipped to handle all your care needs – Effectively, Efficiently & Affordably.

Please contact us today, to discuss any challenges you may be facing and how our services can help you remain independent, protected, safe, and in you home / community.

You got questions, we have answers: (905) 785-2341 or email us at homecare@inourcareservices.com

A Summary of Canada’s Aging Population

December 25, 2014/in Aging Population, Alzheimer's, Alzheimer's & Dementia Care, Common Age Related Issues, Dementia, Depression, Dollars and Sense, Elder Abuse, Eye Care, frauds and scams against Seniors, Living Longer, Personal Safety /by inourcare@gmail.com

A Summary of Canada’s Aging Population

An aging Canadian population is expected to present significant social, economic and political challenges over the next decades. Understanding the needs of seniors and addressing the barriers they face can promote successful aging and ensure that Canadian society benefits from the numerous contributions seniors can provide as engaged citizens and voters.

This research note is the first in a two-part series on seniors, defined as those aged 65 and older. This note provides a demographic profile of this age group, including information about their geographical distribution, lifestyles and socio-economic status. It also addresses some of the challenges that they face in various areas of life. The second note will focus on the electoral participation of seniors, including turnout in federal elections, barriers to voting and initiatives that can be put forward to reduce these barriers.

The qualifying age for seniors is generally 65 in developed countries. However, seniors do not represent a homogenous group, and there is significant variation in the circumstances of those aged 65 to 74, 75 to 84, and 85 and older. Therefore, each one of these three age categories will be treated as distinct where possible.

The Aging Population
A sustained decline in mortality and fertility rates during the twentieth century has resulted in a shift towards older populations worldwide. Canada, while somewhat younger than the average among developed countries, still has an all-time high proportion of seniors. According to Statistics Canada, between 1981 and 2011, the number of Canadians increased significantly amongst the three age groups:

For those aged 65 to 74, from 1.5 million (6% of the total population) to 2 million (8%)
For those between 75 and 84, from 695,000 (2.8%) to 1.6 million (4.9%)
For those aged 85 and older, from 196,000 (0.8%) to 492,000 (2%)

The number of seniors in all age groups is expected to continue to rise, and by 2041, seniors are projected to comprise nearly a quarter (24.5%) of the Canadian population, as compared to 14.8% today. Those aged 85 and over are expected to nearly triple to 5.8% of the total population by 2041.

The chart below illustrates the growth of the older population since 1921.

Aging Population Chart-Canada Geography
Canada’s senior population is distributed unevenly across the provinces, with the highest concentration in the Atlantic provinces. Nova Scotia has the highest proportion of seniors, at 16.6% of its population, followed by New Brunswick (16.5%) and Prince Edward Island (16.3%). Alberta has the lowest proportion of seniors at 11.1% of the population, while Nunavut has the youngest population overall, with only 3.3% over 65. Some regions are aging more rapidly than others. The Atlantic Provinces are expected to see the highest increase in their proportion of seniors by 2026, while Ontario has the lowest projected increase. Most older seniors (61%) live in metropolitan areas, reflecting the overall trend towards urbanization in Canada, while 23% reside in rural areas.

Gender and Ethnicity
Since women have a longer life expectancy, the majority of seniors are women, with the gender discrepancy increasing with age. In 2011, women made up 52% of seniors aged 65 to 74, 56% of seniors aged 75 to 84, and 68% aged 85 or older. This gap is narrowing, however, and the next decades are expected to see a relative increase in the number of older men as they catch up in terms of life expectancy.

Approximately 28% of seniors are immigrants, the majority of whom were born in Western Europe and Asia. Most immigrant seniors moved at a relatively young age and have been living in Canada for several decades. The proportion of Aboriginal seniors is low, with only 5% of the Aboriginal population over 65, and 1% over 75.

Living Arrangements
As shown in table 1: Most people over 65 reside at home, either with a spouse or alone. According to a study released in 2002 by Health Canada, three quarters of seniors enjoyed housing considered to be affordable, adequately sized and in good condition.

A small percentage of seniors live in institutions, including long-term care facilities and hospitals, though rates of institutionalization rise sharply with age. Reasons cited for institutionalization include increasing frailty and care needs that exceed the capacity of family or friends. In many cases, family and friends continue to provide care even after institutionalization.

Table 1: Where Seniors Live

Living Arrangements	% Of Seniors Aged 65–74	% Of Seniors Aged 74–85	% Of Seniors Aged 85+
Institution	2.2	8.2	31.6
With Spouse	54.4	39.9	16.2
With Children or Grandchildren	18.9	16.0	15.8
Alone	21.5	33.0	33.7
Other	2.9	2.8	2.6

Employment and Income
As of 2006, nearly 15% of men and 5% of women over 65 were participating in the workforce. A smaller percentage of seniors in the 75+ age group were still working, with labour force participation rates of 7.5% for men and 2.4% for women. Self-employment and higher levels of education are associated with a higher likelihood that a person will continue to work after 65.

Post-retirement sources of income among retired seniors include transfers (such as CPP/QPP, OAS, EI, GIS), pensions, RSP withdrawals and investment income. Older seniors are often mischaracterized as impoverished. While they generally have only half the income of working-age households, they are often able to support a similar standard of living. This is likely due to lower expenses (for example, no mortgage or expenses related to child provision) and higher savings from which to draw.

Consumption and spending remain steady through the working years up to age 70, and then begin to decline. It is likely that this decline is voluntary, as gift giving and savings remain unchanged. Older seniors may be less willing or able to spend money; they may be saving for anticipated health care costs or to leave money behind for relatives.

Income aside, work is also important in defining personal identity. The loss of full-time employment, therefore, may present challenges to retired seniors, including lowered confidence, loss of perceived prestige and loss of purpose. Participation in various groups or organizations can ease the transition, and new challenges like volunteer activities may restore a sense of purpose.

Health and Quality of Life
Improved medical technology and public health measures have provided Canadians with a longer life expectancy and quality of life than in the past. Nonetheless, chronic health conditions are widespread among seniors, with four out of five seniors residing at home having a chronic health condition of some kind. The most common of these conditions are arthritis or rheumatism, hypertension, (non-arthritic) back pain, heart disease and cataracts. Alzheimer’s disease and other forms of dementia also affect significant numbers of older seniors and are expected to present a major social and public health problem as the population ages. In 2008, 480,600 people, or 1.5% of Canada’s population, suffered from some form of dementia. This number is expected to rise to 1.13 million (or 2.8% of the Canadian population) by 2038. Most dementia sufferers are 75 years of age or older.

Many seniors also have a disability or activity restriction that requires them to seek assistance with various activities. One quarter of older seniors require help with housework, while one in ten need help with personal care activities, such as washing, dressing or eating. Most assistance is provided by immediate family members, although friends and professional caregivers may help as well. Limitations increase sharply after 85, with mobility, sight, hearing and cognition becoming more restricted.

Despite the prevalence of chronic conditions and activity limitations, seniors generally perceive themselves to be in good health. As of 2011, 46% of men and women over 65 rated their own health as very good or excellent. Higher levels of educational attainment are strongly related to better self-reported health, as are greater independence, the absence of pain or barriers to communication, and the presence of strong social networks. Even seniors residing in long-term care facilities generally rate their health fairly highly, suggesting that they adjust their expectations for health relative to their circumstances and those of their peers.

Victimization, Abuse and Ageism
Elder abuse is gaining increasing recognition as an important issue. Abuse can be physical, psychological/emotional, sexual or financial in nature, or involve intentional or unintentional neglect. A random survey of seniors in Canada found that 4% reported experiencing maltreatment since turning 65. Older women and sponsored immigrant seniors are particularly vulnerable to elder abuse. This could be due to increased financial dependency, social isolation, cultural norms, familial status, disadvantage or disability.

Fraud against older people is also common. Seniors may be particularly vulnerable due to isolation and, in some cases, cognitive decline. Types of scams may include mail or telephone fraud, charity or lottery scams, or fake business opportunities.

Older seniors may also experience a type of discrimination referred to as ageism, defined as a “process of systematic stereotyping or discrimination against people because they are old, just as racism and sexism accomplish with skin colour and gender.” Ageism may be positive (for example, the belief that all seniors are wise or caring) or negative (one study shows that younger Canadians overwhelmingly assume that most seniors reside in an institution, suffer from dementia and are responsible for a large proportion of traffic accidents). Ageism can have implications for individuals whose competencies and merits are not acknowledged, and for society as a whole, which, operating under the assumption that everyone is young, fails to meet the varied needs of all of its citizens.

What Older Seniors Fear The Most
A recent study looked at some of the fears that seniors experience as they age. Losing their personal independence and going into a Nursing Home were among the their greatest fears… more so than death. What Seniors Fear Most

Social and Civic Participation
It is important for seniors to remain active in social networks, as this fosters a sense of belonging and connectedness, and is associated with better health and quality of life outcomes. Seniors who are socially involved are less isolated and tend to have more close friends.

As of 2003, 54% of seniors were involved in groups or organizations, such as social clubs, service clubs, sports leagues and religious organizations. This proportion is similar to that of adults under 65. For seniors over 75, the rate of group involvement dropped to 46%. Seniors with higher levels of education and those with a previous history of involvement are more likely to participate in a group or organization.

Many seniors also volunteer for charities or non-profit organizations. While they are somewhat less likely to volunteer than younger retirees or working people, they tend to contribute more hours when they do volunteer. In 2004, 39% of seniors between 65 and 74 volunteered, contributing an average of 250 hours of volunteer work – 100 hours more than the average for adults between 25 and 54. Volunteering decreases somewhat after age 75, health being the most widely reported reason for non-volunteering seniors.

Conclusion
The role of seniors in society warrants increased consideration as their share of the population grows. Currently, seniors have a good quality of life in Canada. Most enjoy good living conditions, adequate financial resources, and generally rate their health highly. While the majority of seniors are retired, many remain socially involved through participation in organizations or volunteer work. Nonetheless, seniors continue to face certain challenges and barriers. These include physical and cognitive health conditions, a lack of independence and negative attitudes.

Understanding the needs of seniors and addressing the barriers they face can promote successful aging and bring benefit to Canadian society from the numerous contributions older people can provide, including their participation in the electoral process.

Please contact us today, to discuss any challenges you may be facing and how our services can help you remain independent, protected, safe, and in you home / community.

You got questions, we have answers: (905) 785-2341 or email us at homecare@inourcareservices.com

Alzheimer’s & Dementia Care… The road ahead

December 10, 2014/in Alzheimer's, Alzheimer's & Dementia Care, Common Age Related Issues, Dementia, Depression, Dollars and Sense, Institutional Infections, Living Longer, Mental health, Personal Safety /by inourcare@gmail.com

Alzheimer’s and Dementia Care… The road ahead

Caring for a loved one with Alzheimer’s disease and other types of dementia can be a challenge, not only for the person diagnosed but also for their spouses and family members. Although caring for someone with Alzheimer’s or dementia can seem overwhelming at times, the more information & support you have, the better you will handle the demands and determine the long-term care options that are best suited to you and your loved one.

THIS ARTICLE WILL DEAL WITH:

Preparing yourself for the care
Developing routines
Engaging your loved one in activities
Planning activities with your loved one
Handling challenges as they present themselves
Considering long term care
Assessing assisted living or nursing homes

Preparing yourself for Alzheimer’s & dementia care

You may be dealing with a whole range of emotions and concerns, as you come to grips with an Alzheimer’s or other dementia diagnosis. There’s no doubt you will be worried about how your loved one will change, how you will keep him or her safe & comfortable, and how much your life will change in order to sustain it. Emotions such as anger, grief, and shock will be likely to be experienced. Adjusting to this new reality is neither, easy or immediate. It is critically important to give yourself some time, process the road ahead and reach out for help and support from a number of resources available. The more support you have, the better you will be able to help and manage your loved one, care.

While some of these tips are aimed specifically for people with Alzheimer’s, they can equally apply to persons suffering with other types of dementia.

Early-stage Alzheimer’s care preparations

Some Alzheimer’s & Dementia care preparations that are best done sooner rather than later. It’s hard to consider these questions at first, as it means thinking about a time when you or your loved one is already well down the road of his or her Alzheimer’s journey. However, putting such preparations in place early helps a smoother transition for everyone later on. Depending on the stage of diagnosis, include the person with Alzheimer’s & Dementia in the decision-making process as much as possible. If the person is at a more advanced stage of dementia, at least try to act on what their wishes would be.

Questions to consider in preparing for Alzheimer’s and dementia care:

▪ Who will make healthcare and financial decisions when the person is no longer able to do so?

While this is difficult topic to raise, if your loved one is still lucid enough, getting their wishes down on paper means they’ll be preserved and respected by all members of the family. Consider having a family meeting involving the person and those who may be impacted with the decisions being made (all children, and or grandchildren who may have to ultimately step up and take on a role in their care). In most cases such family meetings can go smoothly as it pertains to respecting the affected person’s wish. However, do not hesitate to involve an elder law attorney to best understand your options. You’ll need to consider power of attorney, both for finances and for healthcare. If the person has already lost capacity, you may need to apply for guardianship/conservatorship. Last but not least, their Personal Will if one is not in place already.

▪ How will care needs be met?

It is not uncommon that some family members assume that a spouse or nearest family member can take on the role of caregiver, but this assumption is not always the case or even possible. Caregiving is a rather a large commitment, and one that becomes greater over time. The person with Alzheimer’s and or advanced Dementia will eventually need round-the-clock personal care. Although family members are more than willing to take this challenge on, many family members may have their own health issues, jobs, and other roles & responsibilities. Communication is essential to ensure that the needs of the affected person are known & met, and that the caregiver has all the support in place to meet those needs.

▪ Where will the person live?

Knowing their wishes ahead of time will certainly ease the process in making this decision. Their own home will more than likely be their first wish. However, before concluding that home care is the final decision, consider a home assessment to determine the appropriateness of the home to meet their care needs. An assessment can be performed free of cost and determine the care needs and client’s challenges for today and moving forward. This way you will know if perhaps the home is fine for now, but difficult to access or make safe for later. On the other hand, the home could be fully suitable for their care… now and to meet future challenges. This is the type of information that will be invaluable to make informed decisions. If the person is currently living alone, for example, or far from any family, it may be necessary to relocate or consider care options that best suits their need, care, wishes… or a facility with more support.

Find out what assistance your medical team can provide in these areas. In some countries, you can also hire a care manager privately. Geriatric care managers can provide an initial assessment as well as assistance with managing your case, including crisis management, interviewing in-home help, or assisting with placement in an assisted living facility or nursing home.

Developing day-to-day routines

Having a daily routine in Alzheimer’s & Dementia care helps caregiving run smoothly. These routines won’t be set in stone, but they give a sense of consistency, which is beneficial to the Alzheimer’s patient even if they can’t communicate it.

While every family will have their own unique routine, you can get some great ideas from your medical team or Alzheimer’s support group, especially regarding establishing routines to handle the most challenging times of day, such as evenings.

Keep a sense of structure and familiarity. Try to keep consistent daily times for activities such as waking up, mealtimes, bathing, dressing, receiving visitors, and bedtime. Keeping these things at the same time and place can help orientate the person.
Let the person know what to expect even if you are not sure that he or she completely understands. You can use cues to establish the different times of day. For example, in the morning you can open the curtains to let sunlight in. In the evening, you can put on quiet music to indicate it’s bedtime.
Involve the person in daily activities as much as they are able. For example, a person may not be able to tie their shoes, but may be able to put clothes in the hamper. Clipping plants outside may not be safe, but the person may be able to weed, plant, or water. Use your best judgment as to what is safe and what the person can handle.

Communication tips

As your loved one’s Alzheimer’s progresses, you will notice changes in communication. Trouble finding words, increased hand gestures, easy confusion, even inappropriate outbursts are all normal. Here are some tips, do’s and don’ts on communicating:

Communication Do’s and Don’ts?

Avoid becoming frustrated by empathizing and remembering the person can’t help their condition. Making the person feel safe rather than stressed will make communication easier. Take a short break if you feel your fuse getting short.

Keep communication short, simple and clear. Give one direction or ask one question at a time.

Tell the person who you are if there appears to be any doubt.

Call the person by name.

Speak slowly. The person may take longer to process what’s being said.

Use closed-ended questions, which can be answered as “yes” or “no.” For example, ask, “Did you enjoy the beef at dinner?” instead of “What did you have for dinner?”

Find a different way to say the same thing if it wasn’t understood.Try a simpler statement with fewer words.

Use distraction or fibs if telling the whole truth will upset the person with dementia. For example, to answer the question, “Where is my mother?” it may be better to say, “She’s not here right now” instead of “She died 20 years ago.”

Use repetition as much as necessary. We prepared to say the same things over and over as the person can’t recall them for more than a few minutes at a time.

Use techniques to attract and maintain the person’s attention. Smile, and make eye contact, use gestures, touch, and other body language.

Don’t

Ever say things like: “Do you remember?” “Try to remember!” “Did you forget?” “How could you not know that?!”

Ask questions that challenge short-term memory, such as “Do you remember what we did last night?” The answer will likely be “no,” which may be humiliating for the person with dementia.

Talk in paragraphs. Instead, offer one idea at a time.

Point out the person’s memory difficulty. Avoid remarks such as “I just told you that.” Instead, just repeat it over and over.

Talk in front of the person as if he or she were not present. Always include the person in any conversation when they are physically present.

Use lots of pronouns such as “there, that, those, him, her, it.” Use nouns instead. For example, instead of “sit there” say “sit in the blue chair.”

Use slang or unfamiliar words. The person may not understand the latest terms or phrases.

Use patronizing language or “baby talk”. A person with dementia will feel angry or hurt at being talked down to.

Use sarcasm or irony, even if meant humorously. Again, it can cause hurt or confusion.

Planning activities and visitors

As you develop daily routines, it’s important to include activities and visitors into their life. You want to make sure that the Alzheimer’s patient is getting sensory experiences and socialization, but not to the point of getting over-stimulated and stressed. Here are some suggestions for activities:

Start with the person’s interests.
Ask family and friends for memories of interests the person used to have. You’ll want to tailor the interests to the current level of ability so the person doesn’t get frustrated.
Vary activities to stimulate different senses of sight, smell, hearing, and touch. For example, you can try singing songs, telling stories, movement such as dance, walking, or swimming, tactile activities such as painting, working with clay, gardening, or interacting with pets.
Planning time outdoors can be very therapeutic. You can go for a drive, visit a park, or take a short walk. Even sitting on a balcony or in the backyard can be relaxing.
Consider outside group activities designed for those with Alzheimer’s. Senior centers or community centers may host these types of activities. You can also look into adult day care programs, which are partial or full days at a facility catering to older adults and/or dementia patients.

Visitors and social events

Visitors can be a rich part of the day for a person with Alzheimer’s disease. It can also provide an opportunity for you as the caregiver to socialize or take a break. Plan visitors at a time of day when your loved one can best handle them. Brief visitors on communication tips if they are uncertain and suggest they bring memorabilia your loved one may like, such as a favorite old song or book. Family and social events may also be appropriate, as long as the Alzheimer’s patient is comfortable. Focus on events that won’t overwhelm the person; excessive activity or stimulation at the wrong time of day might be too much to handle.

Handling challenges in Alzheimer’s and dementia care

One of the painful parts of Alzheimer’s disease is watching your loved one, display behaviours you never would have thought possible. Alzheimer’s can cause substantial changes in how a person acts. This can range from the embarrassing, such as inappropriate outbursts, to wandering, hallucinations, and even violent behaviour. Everyday tasks like eating, bathing, and dressing can become major challenges.

As painful as some behaviours are, it’s critical not to blame yourself or try to handle all the changes in behaviour alone. As the challenging behaviour progresses, you may find yourself too embarrassed to go out, for example, or to seek respite care. Unfortunately, difficult behaviour is part and parcel of Alzheimer’s disease. Don’t isolate yourself. Ask for help from the medical team and reach out to caregiver groups for support. There are ways to modify or better accommodate problem behaviours. Both the environment you create at home and the way you communicate with your loved one can make a substantial difference.

Considering long-term Alzheimer’s and dementia care

It’s the nature of Alzheimer’s disease to progressively get worse as memory deteriorates. In the advanced stages of Alzheimer’s, your loved one will likely need round-the-clock care. Thinking ahead to these possibilities can help make decisions easier.

Care at home

There are several options for extending care at home:

In-home help refers to caregivers that you can hire to provide assistance for your loved one. In-home help ranges from a few hours a week of assistance to live-in help, depending on your needs. You’ll want to evaluate what sort of tasks you’d like help with, how much you can afford to spend, and what hours you need. Getting help with basic tasks like housekeeping, shopping, or other errands can also help you provide more focused care for your loved one. Be sure to look for a service provider who has extensive Geriatric Care experience.
Day programs, also called adult day care, are programs that typically operate weekdays and offer a variety of activities and socialization opportunities. They also provide the chance for you as the caregiver to continue working or attend to other needs. There are some programs that specialize in dementia care. Alternatively, you can hire a caregiver for the days you need it for without any time commitment. This may alleviate some stress on the part of the patient, as they do not have to leave their familiar surroundings.
Respite care. Respite care is short-term care where your loved one stays in a facility temporarily. This gives you a block of time to rest, travel, or attend to other things. Of course, you can hire a caregiver for the block of time desired. This may alleviate some stress on the part of the patient, as they do not have to leave their familiar surroundings.

Is it time to move?

As Alzheimer’s progresses, the physical and mental demands on you as caregiver can gradually become overwhelming. Each day can bring new additional challenges. The patient may require total assistance with physical tasks like bathing, dressing, and toileting, as well as greater overall supervision. At some point, you won’t be able to leave your loved one alone. Nighttime behaviours may not allow you to sleep, and with some patients, belligerent or aggressive behaviours may exceed your ability to cope or feel safe. Every situation is different. Sometimes, you can bridge the gap by bringing in additional assistance, such as in-home help or other family members to share the caregiving burden. However, it is not a sign of weakness if moving to your loved one to a facility seems like the best plan of care. It’s never an easy decision to make, but when you’re overwhelmed by stress and fatigue, it’s difficult to maintain your caregiving standards. If the person with Alzheimer’s is living alone, or you as the primary caregiver have health problems, this option may need to be considered sooner rather than later.

When considering your caregiving options, it’s important to consider whether you are able to balance your other obligations, either financial or to other family members. Will you be able to afford appropriate in-home coverage if you can’t continue caregiving? Talk to your loved one’s medical care team for their perspective as well.

Evaluating an assisted living facility or nursing home

If the best choice is to move the Alzheimer’s patient to a facility, it doesn’t mean you will no longer be involved in their care. You can still visit regularly and ensure your loved one gets the care he or she needs. Even if you are not yet ready to make that step, doing some initial legwork might save a lot of heartache in the case of a crisis where you have to move quickly. The first step is finding the right place for your loved one.

Choosing a facility

There are two main types of facilities that you will most likely have to evaluate for a loved one with Alzheimer’s: an assisted living facility or a nursing home.

Assisted Living

Assisted living is an option for those who need help with some activities of daily living. Some facilities provide minor help with medications as well. Staff are available twenty-four hours a day, but you will want to make sure they have experience handling residents with Alzheimer’s disease. Also be clear about what stage your loved one is at, as he / she may need to move to a higher level of care.

Nursing Home

Nursing homes provide assistance in both activities of daily living and a high level of medical care. A licensed physician supervises each resident’s care and a nurse or other medical professional is almost always on the premises. Skilled nursing care providers and medical professionals such as occupational or physical therapists are also available.

How do I choose a facility?

Once you’ve determined the appropriate level of care, you’ll want to visit the facility announced and unannounced—to meet with the staff and otherwise evaluate the home. You will also want to evaluate the facility based on their experience with Alzheimer’s residents. Facilities that cater specifically for Alzheimer’s patients should have a designated area, for residents with dementia.

Questions to ask such a facility include:

Policy and procedures – Does the unit mix Alzheimer’s patients with those with mental illness, which can be dangerous? Does the program require the family to supply a detailed social history of the resident (a good sign)?
Environment – Is the unit clean? Is the dining area large enough for all residents to use it comfortably? Are the doors alarmed or on a delayed opening system to prevent wandering? Is the unit too noisy?
Staffing – What is the ratio of residents to staff? (5 to 1 during the day, 9 to 1 at night is normal). What is staff turnover like? How do they handle meals and ensure adequate hydration, since the person can often forget to eat or drink? How do they assess unexpressed pain—if the Alzheimer’s resident has pain but cannot communicate it?
Staff training – What training for Alzheimer’s care do they have? Does the facility provide staff with monthly in-service training on Alzheimer’s care?
Activities – Is there an activity plan for each resident based on the person’s interests and remaining cognitive strengths? Are residents escorted outside on a daily basis? Are regular outings planned for residents?
Services – Does the unit provide hospice services? What were the findings in the most recent Ministry conducted inspection? What are the rates of infectious outbreaks? What is the resident rate of injury incidences?

What to expect during a transition

Moving is a big adjustment both for the person with Alzheimer’s and you as their caregiver. Your loved one is moving to a new home environment with new faces and places. You are adjusting from being the person providing hands-on care to being an advocate. Remember to give yourself and the Alzheimer’s patient time to adjust. If you’re expecting to move, try to have essentials packed and ready to go, and as many administrative details taken care of as possible, as sometimes beds can come up quickly. Work closely with staff regarding your loved one’s needs and preferences. An extra familiar face during moving day, such as another relative or close friend, can also help.

Each person adjusts differently to this transition. Depending on your loved one’s needs, you may either need to visit more frequently or give your loved one their own space to adjust. As the adjustment period eases, you can settle into the visiting pattern that is best for both of you.

Please contact us today, to discuss any challenges you may be facing and how our services can help you remain independent, protected, safe, and in you home / community.

You got questions, we have answers: (905) 785-2341 or email us at

Dollars & Sense

August 5, 2014/in Dollars and Sense, frauds and scams against Seniors, Living Longer, Uncategorized /by inourcare@gmail.com

Personal Finances – An Overview:

This is never an easy topic, but one that has to be embraced at some time in our lives… sometimes twice or three times.

Planning for our own retirement
Engaging our ageing parents financial plan into action
Engaging our own retirement financial plan

The article is powerful in part because it deals with an issue that — if we’re lucky — most of us will face. Despite the fact that the experience is almost universally shared, too few of us are prepared to deal with the financial challenges that tend to arise as our parents reach old age, it is now more important than ever to prepare for this stage of life.

Dealing with aging parents can clearly be trying — emotionally and financially — but you can make the process much easier if you begin to prepare before your parents face serious health problems. To get you started, here’s a look at six basic steps you’ll need to take.

Have a financial plan of your own

The first thing an adult child needs to do is protect his own financial security, to avoid serious financial difficulties while caring for their parents. Of course children want to be there for mom and dad, but it’s important to know your own financial capacity to help. If you have your own plan in place — one that takes into account the likelihood that you’ll live longer than your parents — you’ll better know those boundaries.

Unfortunately, most seniors today haven’t purchased long-term care insurance, and by the time they know they’ll need it, such policies are prohibitively expensive. But if you have aging parents, buying long-term care insurance for yourself may provide you with the certainty needed to be able to spend income and assets on your parents’ care.

Open up the conversation… gently

Getting your parents to be forthright with you about their financial situation can be very difficult. For decades, they have been the ones caring for you, and the ones dispensing advice. Reversing those roles can be trying for both you and your parents. That’s why framing the conversation effectively is important, broaching the subject in such a way that comes across as asking for help rather than offering it. Like, ‘Hey, Dad/Mom, I’ve been thinking about my long-term financial stability and it looks like you’re doing well. How did you plan for this?’” This way you can gauge if you’re parents are struggling, and if they’re not. It can also be great way to learn some planning strategies for yourself as well.

Get help

Dealing with ageing parents can be a source of acrimony between siblings. If you’re the adult child taking the lead, it’s important to involve your siblings early in the process – both to avoid resentment, and to avoid having the burden placed entirely on your shoulders. It is also a good idea to bring professionals into the conversation – a doctor, lawyer and financial adviser that your parents already trust. This will add outside authority to your discussions and help mitigate any qualms your parents have with being told what to do by their children.

Make it legal

In case your parent’s health deteriorates quickly, you or a trusted ally will need to be given the legal authority to make financial and health decisions for them. Documents like a durable power of attorney will allow a proxy to make financial decisions for your parents in case they become incapacitated. A living trust will allow a proxy to manage your parent’s estate under similar circumstances, and a will is necessary to dictate how your parents’ estate will be disposed of after they pass.

Simplify their financial life

Many seniors are resistant to online banking, but showing your folks the ropes will allow them to set up automatic bill pay, which will help them stay up on their financial responsibilities. It will also allow you to monitor their finances and make sure everything’s okay. Many individuals have their financial assets spread among a range of financial institutions; you’ll want to consolidate those assets to some extent.

Take over gradually

As you begin to take a larger role in your parents’ medical care and finances, it’s important to make the transition slowly if possible. Give them autonomy where they can handle it, as this will reduce tension between you and your parents. For health reasons, it’s also important for your parents to maintain a sense of autonomy and self-reliance.

As you move forward in the process of taking responsibility from your parents, the most important thing you can do for yourself is learn from your pa
rents’ experiences. Today, people are living a third longer than they thought they would, and that trend is likely to continue. Doing things like buying long-term care insurance and setting up your own legal directives while you’re still young will make the process that much smoother when you and your children face it.

Planning for the discussion:

If you are working with your elderly parents, choose a quiet moment to introduce a conversation about the five wishes concept. It is a good idea to document the answers. These points can formalize the five wishes as part of their legal documents, including their Power of Attorney and will documents. Five Wishes allows a person to spell out exactly how he or she wants to be treated should he or she become seriously ill. Note that specific funeral instructions, memorial services, and burial requests may be included in this document. Give your parent time to think about the following questions.

Wish 1: Whom do you wish to make health-care decisions for you, when you can’t make them for yourself?

Choose someone who knows you very well, cares about you, and who is able to make difficult decisions. Family members or your spouse may not be the best choice as they are too emotionally involved. Choose someone who is able to stand up for your wishes and lives close enough to help whenever needed. Be sure to discuss your wishes with this person; first ask if he or she is willing and able to take on this responsibility. You will need to fully discuss your wishes with this person. Ask if he or she is prepared to act on your wishes.

Wish 2: What is your wish for the type of medical treatment you want?

Traditionally this wish begins with the following statement: I believe that my life is precious and I deserve to be treated with dignity. When the time comes that I am very sick and I am not able to speak for myself, I want the following wishes and any other directions I have given to my health-care agent, to be respected and followed.

Describe your wishes for pain management, comfort issues, life support or extraordinary measures and what to do in specific situations (e.g., close to death, in a coma, or having permanent and severe brain injury with no expectation of recovery).

Wish 3: How comfortable do you wish to be?

This wish may contain specific requests; for example, music to be played, poems or favourite passages read out loud, or photos to be kept nearby. This may also include information about your grooming needs and cleanliness of bed and towel linens.

Wish 4: How do you wish people to treat you?

This wish may include requests for who you will want to be by your side in your dying days such as whom you would like to see (e.g., family, friends, clergy) and whether or not you want someone by your side to comfort you. You can also specify that you want to die in your own home (if possible) or to be in a facility with professional caregivers while family and friends visit as guests (as opposed to being caregivers).

Wish 5: What do you wish your loved ones to know?

This wish may contain statements that you want the family to know; for example, that you love them, or you may ask for forgiveness for times you have hurt family, friends, or others. It may also show forgiveness for hurts you have experienced from others. It is a wish that can evoke a need to make peace with yourself, your family, and your community; or to remind loved ones to celebrate your life with memories of joy, not sorrow. When you die, your debts must be paid first – before any money or property you leave behind is passed on to your loved ones. There may also be funeral costs, legal fees and other administrative expenses in settling your estate. There may be other estate costs, such as probate fees and taxes on investments that you may not have considered.

Common Estate Costs

Probate fees
When you die, your executor often needs proof (requested by financial institutions, government agencies and others) that they are the person authorized to represent your estate. Probate is the process that provides court certification of this fact. There can be a cost to this – and probate fees to settle your estate can be high depending on the province you live in. In Ontario, the fees (officially called an estate administration tax) equal almost 1.5% of your estate’s value.

Tax on capital gains
You’re deemed to dispose of all capital property at death. Your estate must cover the tax on any capital gains.

Tax on tax-sheltered savings plans
Registered plans such as RRSPs and RRIFs can be transferred tax-free to your spouse’s plan. If you don’t have a spouse, these savings are fully taxable at your death.

Ways to manage estate costs

Leave a valid will
If you die without a valid will, your estate gets settled according to the laws of your province, rather than according to your personal wishes. This can be a more complic
ated process, with higher legal fees and the potential for costly disputes.

Name beneficiaries for insurance and registered plans
When you buy life insurance or open an RRSP or other registered plan account, you can name a beneficiary to receive the money when you die. This means the money bypasses the estate process and is paid directly to that person. Because it does not form part of your estate, the money is not subject to probate fees and there is no delay in your beneficiaries receiving the money.

Jointly own property
Holding assets – such as a home or cottage – with another person is another strategy for reducing probate fees. Joint assets pass automatically to the surviving joint owner – and are generally not considered part of your estate and subject to probate fees. However, there can be complications to joint ownership, especially if you co-own an asset with someone other than your spouse.

For example:

If you transfer half-ownership of an asset to an adult child – and they have a spouse who they later separate from – the spouse could have a claim on your child’s half of the asset.
If your child has financial problems or declares bankruptcy, their ownership in the asset could be subject to claims by creditors.
If the asset has increased in value, you may have to pay tax on any capital gains when you transfer your half ownership. This is because a transfer is considered a sale for tax purposes.
You can no longer deal freely with the asset and must make joint decisions in managing or selling it.

Professional advice is essential: Joint ownership arrangements can be complicated. Get expert legal and tax advice before entering into one of these arrangements.

Preplan and prepay your funeral
Preplanning and prepaying your funeral doesn’t necessarily save you money, but it does remove a key expense that your family or estate must cover upon your death. When you prepay, the money goes into a trust account or insurance fund until your funeral. You gain certainty over costs because you choose the type of funeral you want in advance. And your family is saved the difficult job of making decisions during a time of grief.

Buy permanent life insurance
Life insurance proceeds can be paid to your estate to cover estate costs or left directly to a beneficiary to provide additional amounts to a particular person. The proceeds are always paid tax-free. Consider a permanent insurance policy for estate planning purposes. Permanent insurance covers you for life, no matter how long you might live. Term insurance does not.

Probate fees and life insurance
When you name a beneficiary for your insurance proceeds, the money is paid directly to your beneficiary. It does not form part of your estate and is not subject to probate fees.

You can also use insurance to cover estate costs. To do this, name your estate as the beneficiary. Your estate will pay probate fees on the insurance proceeds, but it gives your estate the cash to pay debts, taxes or other obligations. This can avoid the sale of estate assets – such as a home or cottage – that beneficiaries may want to keep in the family.

Life insurance can help cover estate costs: Taking out a life insurance policy can help cover the cost of capital gains taxes.

I know this a lot to cover in one sitting, but should really be broken down and discussed over a course of time… that allows for both parties to really have time to form questions and seek answers.

So what’s next?

Your mom and dad paid taxes all their life. Let the government take care of him/her? He/she should get rid of their assets so they’ll qualify. While some financial planners considered this to be good advice others consider it to be terrible advice.

What the financial advisor is tellingyou or your aging parent with this suggestion is that it is a good idea for your aging parent to give away his assets or otherwise impoverish himself so he can qualify for Medical Aide. Medical Aide is a state, county and federally funded health insurance program for the indigent. The benefits are quite limited

An impoverished elder may have only one option for care when care is needed for the basics, such as bathing, dressing, and walking. That option is a nursing home.

Some counties have programs, such as In Home Supportive Services, which will provide limited home care services through paid caregivers or sometimes through a relative. The care provided can enable a low income elder to remain at home rather than go into a nursing home. However, with the severe budget cuts going on in most states and provinces, these kinds of programs are either being cut back severely, or eliminated entirely.

If mom/dad needs help only with bathing, dressing, eating or meal preparation, walking, getting out of the chair or bed, or using the bathroom, Medical Aide will not cover care in a nursing home. Help with this so called “custodial care” is not a covered service under Medical Aide, or other health insurance. (Long term care insurance is the only exception).

Ask your parent what he or she wants for the long run.

“I want to stay at home as long as possible” may be in direct conflict with “I want to leave my assets to you kids and grandkids”. Some people simply do not have sufficient assets to do both, should they live long enough to need care.

Figure out the cost of caregiving at home.

There are many services that enable an older person to remain at home with additional care and services such as meals-on-wheels, adult day services, and home modifications. You will want to understand all the options in your community and calculate the costs.

Compare the cost of home care services with your parent’s income and assets. If there is no way their assets can match what they will need at home, and no other resources are available from you, or anyone else, by all means get legal advice about qualification for Medical aide. However, if they can take care of themselves with what they own, put their needs first and “your inheritance” second. Sorry, it’s their money. They deserve to stay at home with services if they want to.

Be realistic about expectations concerning inheritance.

Any competent estate attorney will advise adult children that no one is “entitled” to an inheritance. An aging parent can do whatever he or she wishes with assets. When parents lose competence and need daily supervision or have physical decline and need paid caregiving, they can burn through their assets rapidly. If your parents don’t have long term care insurance, they are likely to be paying out of pocket for the care they may need with advanced age. If that care lasts long enough, there may be nothing left when they pass.

As a person who makes a living giving advice and caring for seniors, I learn a lot from my clients. One thing I have learned based on not only my own experience but also on research is that our parents are likely to want to stay in their own homes. Most are happier if care can be brought to them, rather than expecting them to go to where the care is delivered in a facility. With that in mind, I hope you’ll carefully rethink any advice about relying on government benefits for your aging parent. Considering how to provide the best quality of life for them as they age needs to be the priority. Caring can take many forms. Helping parents plan ahead is one way to show you care.

Look down the road. Learn from what your parents did or didn’t do to plan for this phase of life. One day, it will be you and I.

Please contact us today, to discuss any challenges you may be facing and how our services can help you remain independent, protected, safe, and in you home / community.

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Osteoporosis

July 15, 2014/in Common Age Related Issues, Common Age Retaled Issues, Living Longer, Osteoporosis, Sleep Disorders, Test, Uncategorized /by inourcare@gmail.com

What is Osteoporosis?

Osteoporosis is a disease characterized by low bone mass and deterioration of bone tissue. This leads to increased bone fragility and risk of fractures, particularly of the hip, spine, wrist and shoulder. Osteoporosis is often known as “the silent thief” because bone loss occurs without symptoms.

Osteoporosis is sometimes confused with osteoarthritis, because the names are similar. Osteoporosis is a bone disease; osteoarthritis is a disease of the joints and surrounding tissue.

PREVALENCE Fractures from osteoporosis are more common than heart attack, stroke and breast cancer combined.

At least one in three women and one in five men will suffer from an osteoporotic fracture during their lifetime.

COSTS The overall yearly cost to the Canadian healthcare system of treating osteoporosis and the fractures it causes was over $2.3 billion as of 2010. This cost includes acute care costs, outpatient care, prescription drugs and indirect costs. This cost rises to $3.9 billion if a proportion of Canadians were assumed to be living in long-term care facilities because of osteoporosis. The reduced quality of life for those with osteoporosis is enormous.

Osteoporosis can result in disfigurement, lowered self-esteem, reduction or loss of mobility, and decreased independence. The statistics related to hip fractures are particularly disturbing. There were approximately 25,000 hip fractures in Canada in 1993. Twenty-eight per cent of women and 37% of men who suffer a hip fracture will die within the following year. Over 80% of all fractures in people 50+ are caused by osteoporosis.

ABOUT OSTEOPOROSIS Osteoporosis is a condition that causes bones to become thin and porous, decreasing bone strength and leading to increased risk of breaking a bone. As previously mentioned, the most common sites of osteoporotic fractures are the wrist, spine, shoulder and hip.

No single cause for osteoporosis has been identified.
Osteoporosis can strike at any age.
Osteoporosis affects both men and women.
Osteoporosis is often called the ‘silent thief’ because bone loss occurs without symptoms unless one has fractured.
Osteoporosis can result in disfigurement, lowered self-esteem, reduction or loss of mobility, and decreased independence.
Osteoporosis has been called a paediatric disease with geriatric consequences.

Building strong bones during childhood and adolescence can be the best defence against developing osteoporosis later. Peak bone mass is achieved at an early age, age 16-20 in girls and age 20-25 in young men. Women and men alike begin to lose bone in their mid-30s; as they approach menopause, women lose bone at a greater rate, from 2-3 per cent per year.

Risk factors include age, sex, vertebral compression fracture, fragility fracture after age 40, either parent has had a hip fracture, >3 months use of glucocorticoid drugs, medical conditions that inhibit absorption of nutrients and other medical conditions or medications that contribute to bone loss. Loss of 2cm (3/4″) as measured by one’s healthcare provider or 6cm (2 1/2″) overall from when one was younger may be an indicator of spinal fracture.

FACTS AND FIGURES

Each hip fracture costs the system $21,285 in the 1st year after hospitalization, and $44,156 if the patient is institutionalized. Osteoporotic hip fractures consume more hospital bed days than stroke, diabetes, or heart attack.

Fewer than 20% of fracture patients in Canada currently undergo diagnosis or adequate treatment for osteoporosis. Without BMD testing, 80% of patients with a history of fractures are not given osteoporosis therapies. Hundreds of thousands of Canadians needlessly fracture each year because their osteoporosis goes undiagnosed and untreated.

A study recently reported that only 44% of people discharged from hospital for a hip fracture return home; of the rest, 10% go to another hospital, 27% go to rehabilitation care, and 17% go to long-term care facilities. Persons with a wrist fracture (14%) suffered a repeat fracture within 3 years. One in three hip fracture patients re-fracture at one year and over 1 in 2 will suffer another fracture within 5 years. The risk of suffering a second spine fracture within the first 12 months following an initial vertebral fracture is 20%.

How strong are your bones? Assessing your risk and testing for bone loss are the keys to diagnosing osteoporosis. Osteoporosis is a potentially crippling disease characterized by low bone mass (density) and deterioration of bone tissue. Osteoporosis does not develop overnight. You can lose bone mass steadily for many years without experiencing any symptoms or signs of the disease until a bone fractures.

For this reason, osteoporosis is often called “the silent thief” – literally stealing our bone mass without giving us any indication whatsoever. If osteoporosis is first diagnosed at the time a fracture occurs, it is already fairly advanced. Early detection of bone loss, therefore, is critical in preventing osteoporotic fractures. This section is designed to help you assess your risk of osteoporosis so that you may take preventive action.

Osteoporosis and Osteoarthritis Despite the fact that osteoporosis, arthritis and osteoarthritis (a form of arthritis) are completely different conditions, they are frequently confused, in particular osteoporosis and osteoarthritis, because both names start with “osteo.”

	*Osteoporosis*	*Osteoarthritis*
Definition	Osteoporosis is a bone disease. The word “osteoporosis” literally means porous bones. It is a bone disorder characterized by decreased bone strength as a result of reduced bone quantity and quality. A person with osteoporosis has an increased risk of breaking a bone (fracturing) easily.	Osteoarthritis is the most common form of arthritis. It is a degenerative joint disease that involves thinning or destruction of the smooth cartilage that covers the ends of bones, as well as changes to the bone underlying the joint cartilage. Osteoarthritis produces pain, stiffness and reduced movement of the affected joint, which ultimately affects ones ability to do physical activities, reducing quality of life.
Symptoms	Osteoporosis is called “the silent thief” because it can progress without symptoms until a broken bone occurs. When bones become severely weakened by osteoporosis, simple movements – such as bending over to pick up a heavy bag of groceries or sneezing forcefully – can lead to broken bones. Hip, spine and wrist fractures are the most common fractures associated with osteoporosis.	Osteoarthritis most often affects the hips, knees, fingers (i.e., base of the thumb, tips and middle joints of the fingers), feet or spine. It affects each joint differently, and symptoms are easy to overlook. It can be painful – the pain may result from overuse of a joint, prolonged immobility or painful bony growth in finger joints.
Diagnosis	Osteoporosis is diagnosed through a bone mineral density test, a simple, painless test that measures the amount of bone in the spine and hip.	Osteoarthritis is diagnosed based on medical history, physical examination and x-rays of the affected joints. activities, reducing quality of life.
Risk Factors	The risk of osteoporosis may be reduced by becoming aware of these risk factors and taking action to slow down bone loss. Low bone mineral density is a major risk factor for fracture, the main consequence of osteoporosis. Other key risk factors include older age, prior low-trauma fracture, a history of falls and use of certain medications, such as corticosteroids (for example, prednisone). Family history of a fragility fracture is often a contributing factor.	Some factors that can contribute to the development of osteoarthritis include family history, physical inactivity, excess weight and overuse or injury of joints.
Treatment	Osteoporosis can be treated with lifestyle changes and, often, the use of prescription medication. Paying attention to diet (adequate calcium and vitamin D intake) and getting regular physical activity are important lifestyle changes. Weight-bearing and strength training exercises can help to manage pain and improve the strength of bones and muscles, which helps to prevent falls. Broken hips caused by osteoporosis usually need to be repaired surgically. This can include the use of specialized “pins and plates,” but can also involve hip replacement surgery. This is determined by the surgeon based on the exact type of hip fracture that has occurred. If you have osteoporosis, there are effective medications that can reduce your risk of fracture.	Osteoarthritis can be managed with the use of joint protection (decreasing the amount of work the joint has to do), exercise, pain relief medication, heat and cold treatments, and weight control. Severe arthritis may be treated with an operation, where damaged joints are replaced with an artificial implant. Knee and hip joint replacements are commonly performed.

A few basic facts:

Osteoporosis is a bone disease in which the amount and quality of the bone is reduced, leading to fractures (broken bones). Osteoporosis produces no pain or other symptoms unless a fracture has occurred. Arthritis (arth = joint; itis = inflammation) is a disease of the joints and surrounding tissue. Osteoarthritis and rheumatoid arthritis are the most common forms of arthritis. A joint is the location at which two or more bones make contact and allows for movement of the bones. A person can have osteoporosis and osteoarthritis at the same time.

Both diseases may cause pain and limit mobility, but the cause of this pain and the way it is treated are quite different. An accurate diagnosis of your pain is very important. With an accurate diagnosis, you will be better able to develop a pain management program that works for you. The prefix “osteo” (which means “bone”) is the only thing that osteoporosis and osteoarthritis have in common.

IF YOU HAVE BOTH DISEASES

Individuals who suffer from osteoarthritis and osteoporosis should seek help planning a program to manage both conditions and pay special attention to advice about exercise. Regular weight-bearing exercise is usually recommended for individuals with osteoporosis, but may be difficult to follow in the presence of significant hip or knee arthritis. Keeping joints mobile requires a special approach to exercise and movement. A specially trained physiotherapist can help ensure exercises are safe and beneficial for both conditions.

WHERE TO GET HELP

Arthritis: The Arthritis Society (TAS) is the leading source of information on arthritis, including osteoarthritis. For more information about arthritis, contact:

The Arthritis Society : 1-800-321-1433  www.arthritis.ca.

Osteoporosis: Osteoporosis Canada (OC) is the leading source of information on osteoporosis in Canada. OC provides individuals concerned about their risk of developing this disease and those who have been diagnosed with up-to-date information on all aspects of bone health. Information counsellors oare available at a toll-free line (1-800-463-6842).

Men and Osteoporosis

Osteoporosis is not just a woman’s disease. It is also a serious health issue for men. During their lifetime, at least one in three women and one in five men will suffer a broken bone from osteoporosis. Approximately 30,000 hip fractures occur in Canada each year, and over one quarter of these occur in men.

Proportionately more men than women die as a result of a hip fracture – 37% of men who suffer a hip fracture will die within the year following that fractured hip. Men are also more likely than women to require care in a long-term facility after a hip fracture. Yet despite the fact that hip fractures can be more devastating for men than for women, men are less likely to be assessed for osteoporosis or to receive treatment for osteoporosis after they break a bone.

Secondary Osteoporosis

Drugs and Diseases that can Cause Bone Loss, Falls and/or Fractures

There are several well known risk factors for osteoporosis and osteoporotic fractures such as age, sex, low body weight, a low bone mineral density, a past fragility fracture, having a parent who had a hip fracture and a past history of fall(s). Less well known are which medications and medical conditions can increase the risk of osteoporosis and osteoporotic fractures either by causing more thinning of bones, by increasing the risk of falls or both.

Osteoporosis that results from having another disease or condition or from the treatment of another condition is called secondary osteoporosis. This fact sheet will present a brief summary of the commoner causes of secondary osteoporosis.

How to Minimize the Harmful Effects

Talk to Your Doctor

This fact sheet may not include all medications or all medical conditions that can contribute to fractures. If you are taking any medications or suffer from any medical conditions that may increase bone loss or the risk of falls, talk to your doctor and request a fracture risk assessment, which is a more in-depth assessment of your bone health. To do this your doctor may suggest you have a bone mineral density (BMD) test. This is a painless test that can help to predict your likelihood of fracture. Your doctor will also need to consider other risk factors including your age, sex, fracture history, parental history of hip fracture and glucocorticoid use.

Calcium, Protein and Vitamin D

The Osteoporosis Canada (OC) fact sheet Nutrition: Healthy Eating for Healthy Bones can help you determine if you are getting enough calcium and vitamin D. OC recommends that as much as possible, calcium intake should be from food, and supplements should only be taken if one cannot consume sufficient calcium from the diet. On the other hand, there are few food sources of vitamin D and sun is an unreliable source, so OC recommends daily vitamin D supplementation all year round for all Canadian adults. A balanced diet, following Canada’s Food Guide, will ensure that you get sufficient protein and other nutrients essential for bone health.

Regular Exercise

Exercise helps build and maintain strong muscles and bones. The OC fact sheet Exercise for Healthy Bones provides good general guidelines for choosing the exercise that is right for you.

Smoking and Alcohol

Any type and amount of smoking contributes to bone loss and increases the risk of osteoporosis in both men and women. Drinking an average of three or more alcoholic beverages per day may also increase bone loss and fracture risk. OC recommends no smoking and no more than an average of two alcoholic drinks daily.

Checklist for Risk of Broken Bones and Osteoporosis

Part A:
□ Am I 65 or older?
□ Have I broken a bone from a simple fall or bump since age 40?
□ Has either my mother or father had a hip fracture?
□ Do I smoke?
□ Do I regularly drink three or more alcoholic drinks per day?
□ Do I have a condition that requires me to use a glucocorticoid medication such as prednisone?
□ Do I take any other medication that can cause osteoporosis such as an aromatase inhibitor for breast cancer or hormonal treatment (androgen deprivation therapy) for prostate cancer?
□ Do I have a medical condition that can cause bone loss or fractures? Examples include rheumatoid arthritis, celiac disease, gastric bypass surgery, COPD (chronic obstructive pulmonary disease) or chronic liver disease.
□ Did I have an early menopause, i.e. before age 45?
□ Have my periods ever stopped for several months or more (other than for pregnancy or menopause)?
□ Have I ever suffered from impotence, lack of sexual desire or other symptoms related to low levels of testosterone (male sex hormone)?
□ Do I currently weigh less than 60 kg or 132 lbs?
□ Have I lost more than 10% of my body weight since age 25?
□ Have I recently had an X-ray that showed a spinal fracture?
□ Have I had an X-ray that showed low bone mineral density?
If you are over 50 and have checked one or more of the above, Osteoporosis Canada recommends that you talk to your doctor to see if you need a bone mineral density test and about doing a comprehensive fracture risk assessment with FRAX or CAROC.

If you are under 50, it is very unlikely that you need a bone mineral density test unless you have a chronic medical condition or medication that puts you at high risk for fractures. If you are unsure, speak to your doctor.

Part B:
□ Have I lost 2 cm (3/4″) in height as measured by my healthcare provider, or 6 cm (2 1/2″) overall from when I was younger?
□ Do I have kyphosis (a forward curvature of the back)?

If you are over 50 and have checked one or more of the above, Osteoporosis Canada recommends that you talk to your doctor about getting checked for the possibility of a spine fracture. This is done with a regular back X-ray.

Part C: Frequent falls can lead to broken bones.
□ Have I fallen two or more times in the past year?
□ Do I have an unsteady walk and poor balance? □ Do I need to push with my arms to get up from a chair?
□ Do I need an assistive device such as a cane, walker or wheelchair? If you have checked one or more of the above, you are at risk of falling and you need to take steps to prevent falls.

Nutrition – Healthy eating for healthy bones

As we get older, we often pay less attention to our diet. We may live alone and not always bother cooking a meal. We may become less active as we age, which can also reduce our appetite. Grocery shopping may become more difficult so we do less of it. The result is that we soon run out of items like milk, yogurt and fresh fruit and vegetables. The next thing you know, some tea and toast is all we really have left, or care to prepare. It is important to plan your diet and your grocery shopping so that your bones will stay as healthy and strong as possible. You have no doubt heard that calcium and vitamin D are good for your bones.

They are, but they are not the only important nutrients. A well balanced diet, made up of all the four food groups in Canada’s Food Guide, is the secret to healthy bones.

MEAT AND ALTERNATIVES

In addition to calcium and other minerals, bone is made up of protein, a nutrient that is necessary for building and repairing body tissues including bones. Protein gives bone its strength and flexibility. Protein is also the big component of muscles, which are, of course, crucial for mobility and in preventing falls. The “Meat and Alternatives” food group provides your body with protein. Meat and alternatives also contain other vitamins and minerals that are essential for overall good health.

How do you know how much protein you need? Canada’s Food Guide recommends 2 – 3 servings of meat or alternatives each day for those over 50. A serving size is about the size and thickness of your palm (excluding the thumb and fingers). This means that you should eat a palm size portion of protein with at least two of your three meals. The “Meats” include beef, pork, poultry and fish. The “Alternatives” include beans, lentils, tofu, egg whites, peanut (or other nut) butters, shelled nuts and seeds. Dairy products are also a good source of protein and have the added advantage of being good sources of calcium.

Too many seniors don’t eat enough protein or other important nutrients. Less protein means more fragile bones. Less protein also means weaker muscles. Weaker muscles lead to poorer balance and more falls, and falls can lead to fractures. It is not unusual to find that people who break a bone also had a deficiency of protein in their diet over a period of several months just before their fracture. So, put ham or peanut butter on your morning toast; have boiled eggs or a salmon sandwich with your lunch, a chicken breast or hamburger patty with your supper. Eat well and eat regularly. Exercise for Healthy Bones

WHY SHOULD I EXERCISE?

Regular exercise improves health in many ways. People who engage in regular exercise have lower rates of depression, heart disease, dementia, cancer, diabetes and many other chronic diseases. Exercise can improve physical fitness, strength, energy levels, stamina and mental health. In children and teens, frequent and vigorous exercise helps to increase bone strength. In older adults, certain types of exercise help to prevent bone loss.

Exercise also improves balance and coordination, which helps prevent falls and this in turn may reduce fractures. Exercise is very important for all, but especially for those with osteoporosis and those who are at risk of a broken bone (fracture) caused by osteoporosis. Because everyone is different, it is impossible to develop a “one size fits all” program for exercise.

WHAT EXERCISES ARE SAFE AND APPROPRIATE FOR ME?

The first step is to consult your doctor before you start a new exercise program. Any exercise may carry with it a certain amount of risk. If you have osteoporosis or low bone mass, or have broken a bone from a minor event such falling from a standing height or doing a simple task, you must be aware of yourfracture risk to determine the specific types of exercises that you can perform safely and those you should avoid.

A comprehensive fracture risk assessment will tell you if you are at low, medium or high risk of fracture. This in turn will assist your doctor and your physiotherapist in designing an exercise program that is safe and most beneficial for you, and identifies the precautions you need to take. A comprehensive fracture risk assessment does not rely solely on the results of a bone mineral density (BMD) test. The assessment begins with your doctor asking you questions about your past medical history, including whether or not you broke any bones and how those fractures happened, as well as questions about your family’s medical history. He/she may also examine you and send you for tests that may include blood tests and/or a bone mineral density test.

Your doctor may also order an X-ray of your spine to make sure you don’t have any spine fractures because two-thirds of spine fractures are “silent,” meaning they do not cause any pain. If you have a spine fracture from osteoporosis, this means that your risk for another fracture is high. It also means that you should avoid high impact exercises or sports that require forward bending, heavy lifting, reaching overhead, twisting, jumping, bouncing or jerky movements.

What Types of Exercise Should I Do?  A comprehensive exercise program includes all of the following:

weight-bearing exercise
strength training exercise
posture training
balance training and
stretching

Although most individuals can perform all five types of exercise, some exercises may need to be modified for those who have a moderate or high risk of fracture, including those with spine fractures

WHY IS WEIGHT-BEARING EXERCISE IMPORTANT?

In weight-bearing exercise, bones and muscles of the legs and trunk work against the force of gravity while they bear the weight of the body. Activities like walking, jogging, step aerobics, dancing and stair climbing are all examples of weight-bearing exercise, as are sports that involve running and jumping such as soccer, basketball, volleyball, racquet sports and others. Weight-bearing exercises are the most effective forms of exercise for maintaining strong bones, especially the bones of the hip and spine. Everyone should participate in weight-bearing exercise, not only to maintain strong bones, but to maintain heart health.

Individuals who are in good general health and are trying to reduce their risk of osteoporosis will be able to do much more vigorous and frequent exercise than those who have more complicated health issues or have a greater risk of fracture. Individuals whose fracture risk is moderate or high may need to participate in lower impact weight-bearing exercises.

Choose exercises that are appropriate for your fitness level, abilities and health status. When in doubt, start low and go slow! Swimming and cycling are not weight-bearing as water buoys or lifts the body and cycling is done in the seated position, which means the legs are not bearing the person’s weight.

WHAT IS STRENGTH TRAINING AND HOW CAN IT HELP PREVENT FRACTURES?

Strength training refers to exercise wherefree weights (dumbbells), weight machines or exercise bands are used to make the bones and muscles work by lifting, pushing or pulling a “load.” Strength training improves muscle mass and strength, and it can increase spine and hip bone density and strengthen bone.

HOW DO I GET RID OF THE HUMP ON MY BACK OR PREVENT ONE FROM DEVELOPING? –

POSTURE TRAINING

Some kyphosis (a forward curvature of the spine) can be normal, but weak back muscles or spine fractures can produce more rounding of the back called an exaggerated kyphosis. The more an individual bends or slouches forward, the more pressure he or she is putting on the front of the vertebrae, which puts the vertebrae at even greater risk for breaking (fracturing). Posture training exercises emphasize good neck, back and shoulder positioning. Proper alignment of the spine by sitting or standing up straight with the shoulders back can strengthen the back muscles, improve general comfort and help maintain good balance.

HOW DOES EXERCISE HELP TO PREVENT FALLS AND FRACTURES? – BALANCE TRAINING

Exercises that improve balance and coordination can also reduce falls and fractures. Balance exercises help us maintain balance when unexpected or unbalanced movements in daily life occur. However, when balance is challenged, there is an increased risk of falling. For this reason, it is important to observe safety precautions while doing balance training, such as having a table, wall or chair nearby to hold onto, or by having someone “spotting” you. Tai chi is a very safe and effective low impact form of exercise that improves balance and reduces the risk of falls.

WHAT ABOUT STRETCHING – IS IT BENEFICIAL?

As we age, we lose flexibility from inactivity and poor habits, which can contribute to pain and stiffness. Pain and stiffness can result in a vicious cycle. The more pain and stiffness we experience, the less likely we are to exercise, and so we lose bone and muscle strength as a result. This in turn increases the risk for falls and broken bones, which will just add more pain and stiffness. Stretching exercises help to break this vicious cycle by improving flexibility and range of motion.

Sweeteners – Natural and Artificial

July 7, 2014/in Healthier & Happier, Living Longer, Sweeteners - Natural and Artificial /by inourcare@gmail.com

This is a sensitive topic – Sweeteners (Natural and Artificial)

Lets start with the primary question.

Is it possible to eat sweets when you have diabetes?
The answer is “yes.” But when you’re trying to satisfy your sweet tooth, it can be hard to know what to reach for at the grocery store (sugar-free this or low-calorie that). So, use this primer to help you choose wisely.

The Sweet Facts

When you’re comparing sweeteners, keep these things in mind:

Sugars are naturally occurring carbohydrates. These include brown sugar, cane sugar, confectioners’ sugar, fructose, honey, and molasses. They have calories and raise your blood glucose levels (the level of sugar in your blood).
Reduced-calorie sweeteners are sugar alcohols. You might know these by names like isomalt, maltitol, mannitol, sorbitol, and xylitol. You’ll often find them in sugar-free candy and gum. They have about half the calories of sugars and can raise your blood sugar levels, although not as much as other carbohydrates.
Artificial sweeteners are considered “free foods.” They were designed in a lab, have no calories, and do not raise your blood sugar levels.

Types of Artificial Sweeteners

Artificial low-calorie sweeteners include:

Saccharin (Sweet’N Low, Sugar Twin). You can use it in both hot and cold foods. Avoid this sweetener if you are pregnant or breastfeeding.
Aspartame (NutraSweet, Equal). You can use it in both cold and warm foods. It may lose some sweetness at high temperatures. People who have a condition called phenylketonuria should avoid this sweetener.
Acesulfame potassium or ace-K (Sweet One, Swiss Sweet, Sunett). You can use it in both cold and hot foods, including in baking and cooking.
Sucralose (Splenda). You can use it in hot and cold foods, including in baking and cooking. Processed foods often contain it.
Advantame can be used in baked goods, soft drinks and other non-alcoholic beverages, chewing gum, candies, frostings, frozen desserts, gelatins and puddings, jams and jellies, processed fruits and fruit juices, toppings and syrups.

Read Between the Lines

Use this “cheat sheet” to identify which products are sweetened the way you want them.

No sugar or sugar-free. The product does not contain sugar at all, though it may contain sugar alcohols or artificial sweeteners.
No added sugar. During processing, no extra sugar was added. However, the original source might have contained sugar, such as fructose in fruit juice. Additional sweeteners such as sugar alcohols or artificial sweeteners also might have been added.
Dietetic. The product may have reduced calories, but this word can mean a lot of things.

When in Doubt, Read the Nutrition Label

To know for sure what kind of sweetener a food product contains, check the Nutrition Facts label. In the Carbohydrate section, you can see how many carbohydrates the product has, and how much of these carbohydrates are in the form of sugar or sugar alcohol.

For even more nutrition information, read the Ingredients list. It should show any added sweeteners, whether they are sugars, sugar alcohols, or artificial.

By understanding more about artificial sweeteners and diabetes, you will be able to make better food choices as you balance sweetness with good blood sugar control.

What are artificial sweeteners? Comparison

Artificial sweeteners can be used instead of sugar to sweeten foods and drinks. You can add them to drinks like coffee or iced tea, and they are found in many foods sold in grocery stores. These sweeteners, also called sugar substitutes, are made from chemicals and natural substances.

Sugar substitutes have very few calories compared to sugar. Some have no calories. Many people use sugar substitutes as a way to limit how much sugar they eat, whether it’s to lose weight, control blood sugar, or avoid getting cavities in their teeth.

If your goal is to lose weight, keep in mind that even though a food is sugar-free, it can still have carbohydrates, fats, and calories. It’s a good idea to read the nutrition label to check for calories and carbohydrate. Sugar alcohols are also used to sweeten diet foods and drinks. These plant-based products include mannitol, sorbitol, and xylitol. If you eat too much of them, sugar alcohols can cause diarrhea, bloating, and weight gain.

Are sugar substitutes safe?

Yes. The FDA regulates the use of artificial sweeteners. At one time, saccharin was thought to increase the risk of bladder cancer in test animals. Studies reviewed by the FDA have found no clear evidence of a link between saccharin and cancer in humans.

People who have phenylketonuria (PKU) should avoid foods and drinks that have aspartame, which contains phenylalanine.

Do artificial sweeteners raise blood sugar?

No. Artificial sweeteners provide no energy, so they won’t affect your blood sugar. If you have diabetes, these substitutes are safe to use. But that’s not true of sugar alcohols. They don’t cause sudden spikes in blood sugar, but the carbohydrate in them can affect your blood sugar.

If you have diabetes, read food labels carefully to find out the amount of carbohydrate in each serving of food containing sugar alcohol. It’s also a good idea to test your blood sugar after you eat foods with sugar alcohols or artificial sweeteners to find out how they affect your blood sugar.

How do sugar substitutes compare?

Sweetener name	Can be used for cooking and baking
Aspartame (NutraSweet, Equal)	No, because it breaks down during cooking
Saccharin (Sweet’N Low)	Yes
Sucralose (Splenda)	Yes
Acesulfame K (Sunett)	Yes
Stevia (Truvia, PureVia, SweetLeaf)	Yes

Diet foods and drinks are promoted to help you lose weight but compelling evidence shows that artificial sweeteners like aspartame cause weight gain rather than weight loss. That’s right, aspartame―which was once hailed as a wonder chemical because it tastes like sugar without the calories―actually makes you fatter, and adversely affects your blood glucose levels and insulin sensitivity.

So far so good – right? – Well, there are controversies & for the sake of information, read on. Studies Repeatedly Find Aspartame Causes Weight Gain

The fact that aspartame is NOT a dieter’s best friend has been known by scientists for some time. The problem is this news has not received the necessary traction in the media. For example, a study from 19861, which included nearly 80,000 women, found that those who used artificial sweeteners were significantly more likely than non-users to gain weight over time, regardless of initial weight. According to the authors, the results “were not explicable by differences in food consumption patterns,” and concluded that:“ The data do not support the hypothesis that long-term artificial sweetener use either helps weight loss or prevents weight gain.”

Another more recent study with the telling title of Gain Weight by “Going Diet?” Artificial Sweeteners and the Neurobiology of Sugar Cravings, published in 2010, found that epidemiologic data suggest artificially sweetened foods and beverages do not reduce weight.

Quite the contrary: “Several large scale prospective cohort studies found positive correlation between artificial sweetener use and weight gain. The San Antonio Heart Study examined 3,682 adults over a seven- to eight-year period in the 1980s. When matched for initial body mass index (BMI), gender, ethnicity, and diet, drinkers of artificially sweetened beverages consistently had higher BMIs at the follow-up, with dose dependence on the amount of consumption… Saccharin use was also associated with eight-year weight gain in 31,940 women from the Nurses’ Health Study conducted in the 1970s.

Similar observations have been reported in children. A two-year prospective study involving 166 school children found that increased diet soda consumption was associated with higher BMI Z-scores at follow-up, indicating weight gain. The Growing Up Today Study, involving 11,654 children aged 9 to 14, also reported positive association between diet soda and weight gain for boys. For each daily serving of diet beverage, BMI increased by 0.16 kg/m2… A cross-sectional study looking at 3,111 children and youth found diet soda drinkers had significantly elevated BMI.”

Study Finds Aspartame Worsens Insulin Sensitivity

A recent study published in PLoS One found that chronic lifetime exposure to aspartame, commencing in utero, produces changes in blood glucose parameters and adversely impacts spatial learning and memory in mice. The study, which was published, was a blow against claims that aspartame is an ideal sugar substitute for diabetics.

The researchers used a dosage of aspartame that approximates the ADI for aspartame in the US (approx. 50 mg/kg body weight), and not only was aspartame found to decrease insulin sensitivity compared to controls, it also wrought havoc on brain function.As mentioned on countless occasions, optimizing your insulin sensitivity is key for optimal health, as insulin resistance is a hallmark of virtually every chronic disease you can think of, but especially type 2 diabetes.

Now, contrary to popular belief, aspartame is being revealed as a substance that actually decreases or worsens insulin sensitivity, which is the complete opposite of what you want—especially if you’re already pre-diabetic or diabetic!

According to the authors:“At 17 weeks of age, male aspartame-fed mice exhibited weight gain, elevated fasting glucose levels and decreased insulin sensitivity compared to controls. Females were less affected, but had significantly raised fasting glucose levels.During spatial learning trials in the MWM (acquisition training), the escape latencies of male aspartame-fed mice were consistently higher than controls, indicative of learning impairment… Interestingly, the extent of visceral fat deposition correlated positively with non-spatial search strategies such as floating and thigmotaxis, and negatively with time spent in the target quadrant and swimming across the location of the escape platform.

These data suggest that lifetime exposure to aspartame, commencing in utero, may affect spatial cognition and glucose homeostasis in C57BL/6J mice, particularly in males.”

Male mice fed aspartame experienced significantly higher weight gain compared to the control group, whereas female weight gain was unaffected by the aspartame diet compared to controls. However, deposits of visceral fat—those dangerous fat deposits around internal organs, which are associated with an increased risk of heart disease in humans—increased in aspartame-fed mice of both sexes. Aspartame-fed mice of both sexes also had elevated fasting blood glucose levels compared to non-consumers of aspartame, although the male mice experienced higher elevations than the females.According to the authors:

Surprise: Aspartame raises insulin levels as much as sugar

Another study published in 2007 in the journal Diabetes Care found similar results. Here, the researchers investigated the effect of different macronutrient compositions on plasma glucose and insulin levels during an acute bout of exercise in men with type 2 diabetes. They compared the subjects in five different conditions:

high–glycemic index sucrose meal (455 kcal)
low–glycemic index fructose meal (455 kcal)
aspartame meal (358 kcal)
high-fat/low-carbohydrate meal (455 kcal)
fasting

They hypothesized that using fructose or aspartame would have a lower impact on insulin release and glucose response than a sucrose-sweetened meal. However, experts on sugar and fructose like Dr. Richard Johnson and Dr. Robert Lustig will immediately recognize this as a fatally flawed hypothesis. And indeed, that is what they discovered as well.

According to the authors:“Contrary to all expectation, the aspartame breakfast induced a similar rise in glucose and insulin levels at baseline than the sucrose meal, even if the aspartame meal had the same taste, and was 22 percent lower in calories and 10 percent lower in carbohydrates, with an inferior glycemic index.… Considering the lack of evidence on the aspartame utilization in patients with type 2 diabetes, we consider that these clinical observations, in an exercise setting, raise important concerns regarding the safety of aspartame as suggested by international guidelines.”

European Food Safety Authority to Re-Evaluate Aspartame

In related news, the European Commission (EC) has asked the European Food Safety Authority (EFSA) to speed up the full re-evaluation of aspartame (approved in Europe under the designation E951). Previously planned to be re-evaluated by 2020, the EC is now asking for the review of aspartame to be initiated this year.

According to a notice by EFSA:“In the course of its scientific deliberations, the Panel found that there were too little data available on 5-benzyl-3, 6-dioxo-2-piperazine acetic acid (DKP) and other potential degradation products that can be formed from aspartame in food and beverages when stored under certain conditions. EFSA is therefore launching an additional call for data on DKP and other degradation products of aspartame.”

Aspartame’s three components are phenylalanine (50 percent), aspartic acid (40 percent), and methanol (10 percent). When aspartame is exposed to heat or prolonged storage, it breaks down into metabolites. One of these breakdown products is Diketopiperazine (DKP), a toxic metabolite that is not usually found in our diet. The effects of these different metabolites are unknown. It will be interesting to see what, if anything, the EFSA re-evaluation will find out about these metabolites, but regardless, it stands to reason that anything not normally found in actual food is probably not suitable to eat if you’re interested in maintaining optimal health… After all, the human body is designed to run on nutrients, not foreign chemicals.

Retraining Your Taste Buds is Necessary if You Want Good Health

The idea that you can have your sweets without paying the price of excess weight and related health problems is a persistent one, but it’s not one we’re likely to solve anytime soon. Still, beverage manufacturers like PepsiCo and Coca-Cola are hard at work searching for the magic ingredient that will quench your thirst for sugary sweetness without the extra calories.

As reported by SeattlePi.com, increasing awareness of the harmful effects of both high fructose corn syrup and artificial sweeteners has soda makers searching high and low for new naturally occurring sweeteners. Some extracts currently under consideration include stevia, monk fruit, and miracle fruit.

Whether or not any of them will actually be able to let you have your soda without suffering negative consequences remains to be seen. But one thing is for certain, and that is that artificial sweeteners have completely failed in this regard. The evidence showing that artificial sweeteners actually worsen the conditions it’s supposed to ameliorate—primarily obesity and diabetes—is quite overwhelming, and since its approval aspartame has been linked to all sorts of health problems.

The following chronic illnesses can be triggered or worsened by ingesting of aspartame:

Brain tumors
Multiple Sclerosis
Epilepsy
Chronic Fatigue Syndrome
Parkinson’s Disease
Alzheimer’s
Lymphoma
Diabetes

Aspartame and MSG Implicated in Worsening Fibromyalgia and Irritable Bowel Symptoms

Another recent study published in the journal Clinical and Experimental Rheumatologyreveals a potential link between aspartame and conditions such as fibromyalgia and irritable bowel syndrome (IBS).

Both monosodium glutamate (MSG) and aspartate—one of the main ingredients in aspartame—are considered “excitotoxic,” meaning they can excite brain neurons to the point of death.According to the authors:“Fifty-seven fibromyalgia patients who also had irritable bowel syndrome (IBS) were placed on a 4-week diet that excluded dietary additive excitotoxins including MSG and aspartame. Thirty-seven people completed the diet and 84 percent of those reported that >30% of their symptoms resolved, thus making them eligible to proceed to challenges.

Subjects who improved on the diet were then randomised to a 2-week double-blind placebo-controlled crossover challenge with MSG or placebo for 3 consecutive days each week.… The MSG challenge, as compared to placebo, resulted in a significant return of symptoms; a worsening of fibromyalgia severity… decreased quality of life in regards to IBS symptoms… and a non-significant trend toward worsening fibromyalgia pain based on visual analogue scale.

These findings suggest that dietary glutamate may be contributing to fibromyalgia symptoms in some patients. Future research on the role of dietary excitotoxins in fibromyalgia is warranted.”

Are Your Health Problems Related to Artificial Sweeteners?

Many people belatedly realize they’ve been suffering reactions to one artificial sweetener or another. If you suspect an artificial sweetener might be to blame for a symptom you’re having, a good way to help you weed out the culprit is to do an elimination challenge. It’s easy to do, but you must read the ingredient labels for everything you put in your mouth to make sure you’re avoiding ALL artificial sweeteners. To determine if you’re having a reaction to artificial sweeteners, take the following steps:

Eliminate all artificial sweeteners from your diet for two weeks.
After two weeks of being artificial sweetener-free, reintroduce your artificial sweetener of choice in a significant quantity (about three servings daily). Avoid other artificial sweeteners during this period.
Do this for one to three days and notice how you feel, especially as compared to when you were consuming no artificial sweeteners.
If you don’t notice a difference in how you feel after re-introducing your primary artificial sweetener for a few days, it’s a safe bet you’re able to tolerate it acutely, meaning your body doesn’t have an immediate, adverse response. However, this doesn’t mean your health won’t be damaged in the long run.
If you’ve been consuming more than one type of artificial sweetener, you can repeat steps 2 through 4 with the next one on your list.

Lets make it abundantly clear that even though you may not show immediate signs of any noticeable reaction after consuming artificial sweeteners, please don’t make the mistake of telling yourself “they must be OK for me”. Experts strongly urge you to avoid them at all costs. They are toxic to all humans and will not help you in any way, shape, or form.

Are there ANY Safe and Healthy Alternatives to Sugar?

The best strategy is to lower your use of sugar and eat right for your nutritional type and use the right fuel for your genetics and biochemistry making sure you have enough high quality fats. Once your body has the proper fuel, your sweet cravings will radically diminish and you will be satisfied without them. If you still have cravings it is a strong suggestion you need to further refine your attempt to identify the right fuel for your body. If you need a sweetener you could use stevia or Lo Han, both of which are safe natural sweeteners.

Remember, if you struggle with high blood pressure, high cholesterol, diabetes or extra weight, then you have insulin sensitivity issues and would benefit from avoiding ALL sweeteners. As for sodas and other high sugary content or artificially sweetened… wean yourself off of them and go with water instead.

Could artificial sweetener CAUSE diabetes?

Splenda modifies the way the body handles sugar’, increasing insulin production by 20%

Study found sugar substitute sucralose had an effect on blood sugar levels
Also discovered that insulin production increased by 20% when consumed
Scientists aren’t sure what implications are, but said that regularly elevated insulin levels could eventually cause insulin resistance and even diabetes

Splenda is made of sucralose, which has been found to affect blood glucose and insulin levels. Scientists found that consuming the sugar alternative made of sucralose caused a person’s sugar levels to peak at a higher level and in turn increase the amount of insulin a person produced. Researchers also said that while they did not fully understand the implications of the findings, they might suggest that Splenda could raise the risk of diabetes. This is because regularly elevated insulin levels can lead to insulin resistance, which is a known path to type 2 diabetes.

“Our results indicate that this artificial sweetener is not inert – it does have an effect,” said Yanina Pepino, research assistant professor of medicine at the Washington School of Medicine in St. Louis, who led the study. “And we need to do more studies to determine whether this observation means long-term use could be harmful.”Sucralose is made from sugar, but once processed its chemical make up is very different. Gram for gram it is 600 times sweeter than table sugar.

The scientists analysed the effects of Splenda in 17 severely obese people who did not have diabetes and did not use artificial sweeteners regularly. Participants had an average body mass index of just over 42. A person is considered obese when their BMI reaches 30.

Scientists gave subjects either water or dissolved sucralose to drink before they consumed glucose (sugar). They wanted to understand whether the combination of sucralose and glucose would affect insulin and blood sugar levels. Every participant was tested twice. Those who drank water followed by glucose in one visit drank sucralose followed by glucose in the next. In this way, each person served as his or her own control group.“We wanted to study [overweight people] because these sweeteners frequently are recommended to them as a way to make their diets healthier by limiting calorie intake,” Pepino said.They found that when study participants drank sucralose, their blood sugar peaked at a higher level than when they drank only water before consuming glucose. Insulin levels also rose about 20 percent higher.

So despite no extra sugar being consumed, the artificial sweetener was related to an enhanced blood insulin and glucose response. Professor Yanina explained that they do not fully understand the implications that these rises could have.She said: “The elevated insulin response could be a good thing because it shows the person is able to make enough insulin to deal with spiking glucose levels. But it also might be bad because when people routinely secrete more insulin, they can become resistant to its effects, a path that leads to type 2 diabetes.”

It has been thought that artificial sweeteners, such as sucralose, don’t have an effect on metabolism.

They are used in such small quantities that they don’t increase calorie intake. Rather, the sweeteners react with receptors on the tongue to give people the sensation of tasting something sweet without the calories associated with natural sweeteners, such as table sugar.

But recent findings in animal studies suggest that some sweeteners may be doing more than just making foods and drinks taste sweeter. One finding indicates that the gastrointestinal tract and the pancreas can detect sweet foods and drinks with receptors that are virtually identical to those in the mouth.That causes an increased release of hormones, such as insulin. Some animal studies also have found that when receptors in the gut, are activated by artificial sweeteners, the absorption of glucose also increases. But in real life, people rarely consume a sweetener by itself. They use it in their coffee or on breakfast cereal or when they want to sweeten some other food they are eating or drinking.

Just how sucralose influences glucose and insulin levels in people who are obese is still somewhat of a mystery. “Although we found that sucralose affects the glucose and insulin response to glucose ingestion, we don’t know the mechanism responsible,” said Pepino. “We have shown that sucralose is having an effect. In obese people without diabetes we have shown sucralose is more than just something sweet that you put into your mouth with no other consequences. Further studies are needed to learn more about the mechanism through which sucralose may influence glucose and insulin levels, as well as whether those changes are harmful.” The study was published in the journal Diabetes Care.

In a statement, Splenda said: “Numerous clinical studies in people with Type 1 and Type 2 diabetes and non-diabetic people have shown that Splenda Brand Sweetener (sucralose) does not affect blood glucose levels, insulin, or HbA1c.’FDA and other important safety and regulatory agencies from around the world have concluded that sucralose does not adversely affect glucose control, including in people with diabetes.

It has become increasingly harder for the general population to make sound decisions when there is so much contradiction around what is optimal for human consumption.

As far as sweetening agents go Natural versus Artificial, there are as many questions as there are answers. Studies and debates are as controversial as the products themselves depending on who’s conducting them, funding the studies, how the data is perceived / interpreted and reported.

One thing is for certain, a healthy life style, proper diet and exercise will certainly allow you to partake in everything you enjoy… in moderation. Just know the basic facts on your intakes and how it could be adversely affecting you.

My objective is simply provide you with information, to ensure you make the right choices in life, age well and promote positive well-being – Mentally, Physically and Emotionally.

Please read the many other articles posted on our website and should you be in a position where you can benefit from our services