Top Medical Issues Facing Seniors Run Gamut

©iStockphoto.com/vm

©iStockphoto.com/vm

The advent of humans living longer — sometimes into triple digits — has brought on a plethora of health problems that seniors must cope with. While some issues are remnants of past health choices, there are measures that seniors, and soon-to-be seniors, can take to mitigate future health concerns.

Dr. Steven Gambert is a professor of medicine and director of geriatrics at the University of Maryland Medical Center. He classified geriatric health problems into three categories: normal age-relatedchanges, age-prevalent diseases and diseases that present themselves in an atypical way.

“It’s usually the latter that causes most problems in older people who don’t even know they have a problem until later in the course of their illness,” said Gambert. “Any change in their usual state of health or function needs to be taken seriously. Older people should not dismiss [small problems] like it’s just a part of old age.”

He used the example that a heart attack can present itself as a shortness of breath or chest pain.

For age-prevalent diseases, Gambert emphasized that everyone — not just seniors — should be aware of osteoporosis.

“Any change in their usual state of health or function needs to be taken seriously. Older people should not dismiss small problems like it’s just a part of old age.”

— Dr. Steven Gambert, professor of medicine and director of geriatrics at the University of Maryland Medical Center

Dr. Steven Gambert (Provided)

Dr. Steven Gambert (Provided)

“Osteoporosis is a disease of the bones that happens when you lose too much bone, make too little bone or both,” according to the National Osteoporosis Foundation’s website. “As a result, your bones become weak and may break from a minor fall or, in serious cases, even from sneezing or bumping into furniture.”

According to the NOF, 54 million Americans have low bone density. One in two women and one in four men will break a bone due to osteoporosis, causing an estimated two million broken bones every year.

Gambert added that, if left untreated, the disease can cause respiratory failure due to the spine compressing and stopping the lungs from taking in enough oxygen. To prevent this, he recommended that people ensure they are getting enough calcium and vitamin D in their diets as well as speak to a doctor about bone density testing.

Dr. Robert Graw Jr. is the medical director at Righttime Medical Care, and he spoke to concussions, an issue that has received more attention in recent years.

Dr. Robert G. Graw Jr. (Provided)

Dr. Robert G. Graw Jr. (Provided)

“[We knew] people could hit their heads and could have problems but as far as jostling the brain around a bit, we didn’t attribute [many problems] to that,” said Graw. “[During] the last 10 years, researchers are finding the brain does not tolerate that well.”

He explained that when people age, they have less new cells being formed and the brain membranes are put under tension. Additionally, a concussion is defined by creating microscopic injuries that can’t be seen on an MRI or CT scan, meaning the damage may not be obvious to a physician. This damage can manifest itself in many ways, some of which are subtle such as not sleeping well or irritability.

Graw emphasized that the treatment for seniors who have fallen or tripped has become prescribed and that doctors “know what to do if [a senior] gets a head injury and how bad it can be, but the focus should be on preventing it.”

Another disease that has come to the forefront is cancer, but Dr. Martin Edelman, professor of medicine and director of solid tumor oncology at the University of Maryland Marlene and Stewart Greenebaum Cancer Center, believes seniors should be particularly vigilant.

Dr. Martin Edelman (Provided)

Dr. Martin Edelman (Provided)

“Cancer is the disease of aging,” said Edelman. “The older you get, the greater your chances are that you will develop a cancer somewhere.”

He said the most common cancers in the country are breast, prostate and colorectal. However, the cancer with the highest mortality rate, which is also his specialty, is lung cancer. The average age of lung cancer patients is 70.

In terms of prevention, Edelman said, “It’s never too late to stop smoking. That is the best thing anyone can do for their health.” However, he added, between 10 and 15 percent of lung cancer patients have never smoked.

According to the American Cancer Society, there are approximately 250,000 cases of lung cancer each year. (This means between 25,000 to 37,500 lung cancer patients are nonsmokers.)

The symptoms of lung cancer can be more difficult to detect as they are issues that often come and go such as aches and pains or coughing. Edelman said a persistent cough or coughing up blood isn’t inherently a sign of cancer, but when these common issues persist for an extended period of time then that is a signal to seek medical attention.

Gambert added that beyond understanding their own medical issues, one of the most important things seniors can do is share their medical histories with their family.

Said Gambert, “Tell [your] children and grandchildren; [people should] learn from [their] elders. Not just stories and knowledge, but also their medical history”

jkatz@midatlanticmedia.com

Until 120: A Mixed Blessing?

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©iStockphoto.com/freemixer

In Genesis 6:3, after creating people and watching them multiply, God promptly put a limit on humans’ lifespans, setting the maximum number of years at 120.

If that’s the number we’re shooting for as a species, we haven’t quite reached our full potential yet. But would we want to?

“Depressive disorders are much more common” in people who have had strokes, heart attacks or other ailments associated with aging, says Marc Zisselman, director of geriatric psychiatry at Einstein Medical Center in Philadelphia.

“Functional impairment, cognitive impairment, uncontrolled pain, insomnia, isolation — they’re all strongly associated with depression. Individuals in nursing homes have a very high prevalence.”

Depression affects more than 6 million Americans over age 65, according to the Geriatric Mental Health Foundation. The American Psychological Association says there is evidence to suggest some of the natural physical changes associated with aging may in fact increase the risk. (Zisselman does point out that depression, however common, is not considered a “normal” part of aging. Grief and sadness in response to life events, on the other hand, are.)

Rather than looking at osteoporosis or heart disease or stroke as something that just happens when you get old, they’re now seen as avoidable — or at least delayable.

One hundred years ago, there were fewer than 4 million Americans 65 and older. In 2010, there were more than 40 million, according to the Census Bureau, which predicts that by 2050 that figure will have more than doubled.

The fastest-growing subgroup in that population is the 85- to 94-year-olds.

Living longer means, of course, being healthier for longer, at least relatively — but there’s a huge discrepancy among the older set, Zisselman says. “If you take a bunch of 25- or 30-year-olds, they’re much more alike than dissimilar. If you take a bunch of 75-year-olds, they run the gamut from people who are CEOs of Fortune 500 companies to people in a vegetative state or suffering from Alzheimer’s disease.

“Most baby boomers, in the scheme of things, are interested in living longer, but they’re more interested in maintaining a high quality of life,” he adds.

Medical research is working on maintaining that high quality of life by trying to prevent the diseases of aging before they occur. Scientists are identifying the biomarkers — the biological molecules found in the body that indicate risk for certain ailments — and coming up with treatments that can be started well in advance of a disease appearing.

Low bone mineral density, for example, can be a biomarker of osteoporosis. High blood pressure might be another biomarker and “an argument to intervene,” says Jason Karlawish, a professor of medicine, medical ethics and health policy and a fellow of the Institute on Aging at the University of Pennsylvania. His research focuses on dementia.

“There’s no question a variety of common events seen as people age are, more and more, being regarded as discrete diseases that are amenable to diagnosis and intervention,” Karlawish says.

In other words, rather than looking at osteoporosis or heart disease or stroke as something that just happens when you get old, they’re now seen as avoidable — or at least delayable.

Like Zisselman, Karlawish points out the “tremendous variability among older adults” but adds that some diseases are common enough that “packaging the phenomena of aging as discrete diseases” and focusing research on preventing each one individually makes sense.

Many times prevention comes in pill form, but there are other ways to stay healthy longer. Karlawish compares seniors in the U.S. with those in Italy, who are generally more functional, he says, because “for much of their lives, Italians were walking around, climbing hills, carrying groceries — they have a regular chronic exercise habit. Habits and physical activity absolutely influence what we call aging.”

On a public health level, Karlawish suggests revamping cities and towns as a way to encourage habitual exercise and a healthier, more independent old age. He also thinks it’s time to change the conversation about aging entirely.

“We need to explore new opportunities for thinking about what it means to grow old in America. Instead of seeing the end as retirement for many, many years, people should go through different phases of working,” he says.

Rachel Vigoda is an award-winning writer and editor. This article originally appeared in The Jewish Chronicle.

Changing Priorities as You Age

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©iStockphoto.com/AleksandarNakic

Aging requires resiliency, creativity and adaptability, and it can lead to great self-discovery. Why are we sometimes surprised when someone in their 60s, 70s, 80s or 90s becomes more creative, starts a new meaningful relationship, offers sound advice or begins a new endeavor or interest? Since growing older is an inevitable part of life, why not look at these questions, focus on challenging negative stereotypes and reinforce positive contributions that occur as we age?

Over the past decade, society has begun to change its views about aging. Older politicians, rock-and-rollers and actors, such as Sen. Harry Reid, Betty White and The Who, now appeal to younger audiences. This is the beginning of a transformation of how we view the senior years with a focus on redefining one’s purpose and an emphasis on creativity, resilience and respect for experience. So, let’s work together to create a new image of the senior years.

First, envision and define what you want your purpose to be. It is important to challenge previous beliefs that one’s purpose in life is finished when one retires, ages or reaches a specific birthday. A 2015 study on healthy aging by the Rush University Medical Center in Chicago showed that having a sense of purpose in life during one’s senior years can provide a shield against the development of Alzheimer’s disease.

The ability to take risks that were previously not considered because of family and career obligations may contribute to greater  creativity.

According to Gene Cohen, a pioneer in recognizing the creative aspects of aging, developing one’s purpose is crucial as positive changes lead to new opportunities for creative expression as we age. The ability to take risks that were previously not considered because of family and career obligations may contribute to greater creativity.

According to author Jeffrey Kluger, it may be no coincidence that so many creative types live long lives, since they are doing what they love. According to Cohen, “the greater freedom and courage that many older adults exhibit helps explain why, throughout history, many older adults beyond the age of 70 have assumed the role of shapers or shakers of society.”

Major contributors include Socrates, Copernicus, Gandhi, Golda Meir, Frank Lloyd Wright and Benjamin Franklin. Wright died at 91 — just before his Guggenheim Museum opened — and Benjamin Franklin negotiated the Treaty of Paris at 77 and signed the Constitution at 81. Today, Wayne Thiebaud, 95, and Alex Katz, 88, are nationally recognized artists, and Edith Pearlman, 79, debuted her short stories in 2011 and won the National Book Critics Circle Award for fiction in 2012.

Now is the time to start thinking about your own senior years with purpose and appreciation. This new thinking should include teaching our children the positive aspects of aging. Of course, every senior doesn’t need to be famous or create a masterpiece. Designing one’s life during the senior years takes strength, resilience, respect and reinvention. Your senior years should be a blank canvas with new possibilities. No invention, artistic piece, creation or life is perfect. All lives have challenges and roadblocks.

The senior years are a balancing act between physical changes, evolving roles and creating a new purpose and examining new potentials. It is not a period of life where you should feel you need to stop learning or growing. On your blank canvas, it is important to recognize that there will be rough edges, challenges, roadblocks, bumps and bruises, but at the same time it can include brightness, spirit, possibilities and hope. According to Benjamin Zander, conductor, motivational speaker and writer, it is the time to “live the rest of your life in possibility.”

Jill Krystkiewicz is communications assistant at the Madlyn and Leonard Abramson Center for Jewish Life in North Wales, Pa. This article originally appeared in The Jewish Exponent.

Aging in Place with Practical Options Help your senior family member make the best choice for the next phase

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©iStockphoto.com/Bitter

Imagine: Mom is home alone and slips in the kitchen. Or Dad is out in the yard when he loses his bearings. The worst time to have the “how can we best support mom and dad?” conversation with your family is when you absolutely have to.

“I can’t stress enough that the most important thing is to make a move before you need it,” says Diane Stinchcomb, director of sales at Edenwald, a continuing care retirement community in Towson. “Don’t wait for a crisis to happen.”

Edenwald offers three core levels of care: independent living, assisted living and skilled nursing.

“I think that it’s important that residents consider communities that have all three levels [because] it’s just a lot easier of a transition,” says Stinchcomb. “If at some point they need to transition into assisted living, it’s still right here in the same community.”

“Skilled nursing has the old stigma,” says Troy Kirk, vice president of customer transitions at Lorien Health Systems. “Say 20 years ago, that’s all we had. So a lot of people thought that [these communities were] where people go to die.” Today, the picture is somewhat brighter — many people opt to move into adult living centers so they can function more efficiently day to day and make more time for friends, family visits and, yes, fun. “I really try to get people to understand that it’s the next phase of retirement.”

Lorien Health Systems, located in Ellicott City and Columbia, offers the three core levels — and rehabilitation services as well for those that need them. In some cases, health impediments can be successfully rehabbed and the patients returned home.

After you’ve found the right place for Mom or Dad — with their blessing, if at all possible of course — there are simple things you can do to help your aging parents adjust to their new environment. When they make the move, downsizing is usually a difficult reality — but new residents can choose to keep the items that they hold dear, such as old tables or special collections. Bear in mind: While you may think something is dated or outmoded, Mom and Dad know better.

“You know Dad will want to bring an old ratty recliner and the kids will say, ‘You can’t take that there’,” Stinchcomb says. Let Dad choose.

“We try to have a lot of empathy for our clients,” says Kristy Kruger, vice president of sales and marketing at Broadmead’s continuing care retirement community in Cockeysville — it offers short-term rehabilitation as well. “Clients are moving from houses or condos that they may have lived in for over 20, 30 or even 40 years. It’s an emotional change.”

Springwell, a retirement community in Mount Washington, features 136 units making it a smaller, more intimate facility. They offer the three core levels and specialize in memory care.

“Some will adjust right away, but on average it can take four to six weeks,” explains Phil Golden , director and principal at Springwell. He suggests getting the apartment or room ready for your family member ahead of time. “That way, it’s familiar for them.”

“We also encourage families to check our site for activities and encourage their loved one to participate,” adds Stinchcomb. Your impulse may be to visit often — on a daily or weekly basis — but excessive visitation could prevent your family member from fully socializing. “You want them to make friends on their own.”

Choosing — or helping to choose  —  the right senior living facility for your parent or other loved one can be overwhelming. Each facility or community is going to be nuanced in their approach. Health concerns, aesthetic, lifestyle, geography, pet policies, social needs … there’s so much to consider. Through it all, keep your senior family member’s needs the center of the conversation, and you can’t go wrong.

“Ask them what they want,” says Kirk. “Ask them what they would like to see happen.”