Ageism is prejudice or discrimination on the grounds of a person’s age…
While I hesitate to discuss politics, as an aging physical therapist, I feel that it is incumbent upon me to speak out against ageism, especially with so much attention being paid to the age of the candidates in the upcoming US presidential election. Interestingly enough, age seems to be of more concern for President Biden (age 81), than his opponent, former President Trump (age 78), even though there is only 4 years between them. By the way, “Corporate Sages,” Warren Buffett, CEO of Berkshire Hathaway is 93 years old and Rupert Murdock, CEO of News Corp is 86 years old and their stock holders seem very satisfied! Two local examples of aging with an “A Game” are my 92 year old mentor, Dr. Gino Mori, founder of Delta Medix, who took college classes for enrichment until the age of 90 and Fr. Bernard Mcllhenny, SJ, retired dean of admissions at the University of Scranton, who plays golf (competitively) at least once a week at the age of 98.
It is low hanging fruit to list all the problems associated with age; muscle and bone loss, balance deficits, delayed mental processing, and memory loss to name a few. However, the purpose of this column is to present the positive qualities of the “golden years!”
There are no shortcuts for the assimilation and accumulation of knowledge and wisdom that one acquires over a lifetime and it cannot be taught…only experienced! Not only do older adults know what they know, more importantly, they know what they DON’T know! Moreover, they know how to use this knowledge efficiently and effectively. This is referred to as “crystallized intelligence” and it keeps improving with age…even at 65-75 and more.
While the term “Grumpy Old Men/Women” makes for good TV, the reality is that most of us get more agreeable, likable and consistent with age. Older people are less volatile, control their emotions and tend to focus more on the important things in life.
With age, people tend to be less egocentric and more in tune with the feelings and emotions of others. Using this acquired insight, one can foster a more cooperative and productive solution to problems with friends, family and coworkers.
Quality over quantity with age! Studies show that women over 40 and much older have improved sexual satisfaction when compared to their youth. Moreover, women over 80 were more satisfied with sex than those between 55 and 75! Go figure!
Whether you like it or not, there is a good chance that you will become a “morning person” with age. As sleeping patterns change, including sleep interruptions, we tend to go to bed earlier and rise and shine with the sun. The good news is that you can start your day early to “suck the marrow” out of the day.
Most migraine sufferers report little to no headaches after age 70. And, for older adults who experience headaches, they tend to be less painful and debilitating.
Studies show that early retirement may not be good for your health. The Longevity Project that people who continue to be productive, have purpose, and enjoy their work, live the longest. So maybe, Biden and Trump want the POTUS job in order to stay healthy!
While older adults may fear falling and breaking a bone, they don’t have the same fears and concerns that distract many younger people. With age, self-esteem and confidence improves and with wealth, education, good health and a sense of purpose, these qualities increase exponentially. According to the American Psychological Association, while more young people report high stress levels, older Americans report less. And, even when encountering a stressful situation, older people have learned coping methods to manage it better than younger people.
We can waste our time debating the potential problems with an aging POTUS, however, we must decide between two candidates that will be octogenarians while in office. With that in mind, we must focus on the potential for solid, honest, dedicated, effective and productive leadership to guide us through the next four years. Research has shown that the workforce is aging worldwide and older workers are a critical component to overall productivity in an age of worker shortages. A thorough assessment of the literature related to the productivity of an aging workforce shows that older workers are at least as productive and in some cases (that does not require heavy labor), are more productive than their younger coworkers. In great part, this is attributed to the aforementioned positive aspects of aging such as “crystallized intelligence”. In view of this, ageism has no place in the workplace because older workers can and do keep up.
SOURCES: National Institutes of Health; Mayo Clinic, WebMD
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This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
Summer heat and humidity are here and the risk of heat related illnesses are particularly high for those over 65, especially dehydration. Age, diet, illness and medications are some of the many reasons why elders suffer from dehydration not only in the summer heat, but year round. Furthermore, age related changes in 50-60 year olds can also make one vulnerable to dehydration if they are active and exercise in the heat. Recently, a local medical professional and his brother were hospitalized for several days due to dehydration and associated illness. They are active, fit, healthy 63and 64 year olds who continued running daily for exercise, even during the heat wave.
It is often forgotten that, next to oxygen, water is the nutrient most needed for life. A person can live without food for a month, but most can survive only three to four days without water. Even though proper hydration is essential for health, water gets overlooked as one of the six basic nutrients. Dehydration occurs when the amount of water taken into the body is less than the amount that is being lost. Dehydration can happen very rapidly (i.e. in less than eight hours); the consequences can be life threatening and the symptoms can be alarmingly swift.
In the body, water is needed to regulate body temperature, carry nutrients, remove toxins and waste materials, and provide the medium in which all cellular chemical reactions take place. Fluid balance is vital for body functions. A significant decrease in the total amount of body fluids leads to dehydration. Fluids can be lost through the urine, skin, or lungs. Along with fluids, essential electrolytes, such as sodium and potassium, are also perilously depleted in a dehydrated individual.
Dehydration is the most common fluid and electrolyte disorder of frail elders, both in long term care facilities and in the community! Elders aged 85 to 99 years are six times more likely to be hospitalized for dehydration than those aged 65 to 69 years. More than 18% of those hospitalized for dehydration will die within 30 days, and associated mortality increases with age. Men appear to dehydrate more often than women and dehydration is often masked by other conditions.
Elderly individuals are at heightened risk for dehydration for several reasons. Compared to younger individuals, their regulatory system (i.e. kidneys and hormones) does not work as well and their bodies have lower water contents. The elderly often have a depressed thirst drive due to a decrease in a particular hormone. They do not feel thirsty when they are dehydrated. This is especially true in hot, humid weather, when they have a fever, are taking medications, or have vomiting or diarrhea. They have decreased taste, smell, and appetite which contribute to the muted perception of thirst. Because of dementia, depression, visual deficits, or motor impairments, elderly persons may have difficulty getting fluids for themselves. Many elderly individuals limit their fluid intake in the belief that they will prevent incontinence and decrease the number of trips to the bathroom. The medications that they are taking (e.g. diuretics, laxatives, hypnotics) contribute to dehydration.
Elders may suffer headaches, fainting, disorientation, nausea, a seizure, a stroke, or a heart attack as a result of dehydration. The minimum daily requirement to avoid dehydration is between 1,500 (6.34 cups) and 2,000 ml of fluid intake per day. Six to eight good-sized glasses of water a day should provide this amount. Better hydration improves well-being and medications work more effectively when an individual is properly hydrated.
Those who care for the elderly whether at home or in a health care facility need to be alert to the following symptoms:
Plain old tap water is a good way to replenish fluid loss. Some energy drinks not only have excess and unneeded calories but also contain sugar that slows down the rate at which water can be absorbed form the stomach. Consuming alcoholic and caffeinated beverages actually has an opposite, diuretic effect!
Visit your doctor regularly and listen to your body.
Keep moving, eat healthy foods, exercise regularly, and live long and well!
Contributor: Janet M. Caputo, DPT, OCS
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
For all or Dr. Mackarey's articles visit: http://www.mackareyphysicaltherapy.com/forum
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
I have a vested interest in this column…I just had a big birthday! It is a BIG birthday because it is the one before I get health care insurance from Uncle Sam! Consequently, the “aging process” is very much on my mind!
In the book, “Being Mortal,” Atul Gawande discusses the role of medical care placing emphasis on “well-being” rather than survival, especially as it relates to end-of-life care. It is a “must read” for health care providers as well as the general public. The book also describes, in great detail, the process of aging; the physiology of bone and muscle mass loss, factors affecting balance and coordination, changes in mental acuity, memory, and mood. As depressing as it sounds (many of the changes begin as early as mid to late thirties), it is also a “call to arms!”
To prepare for the inevitable aging process one must be proactive, not reactive. From an early age, challenge yourself mentally by taking classes and learning things for which you may not have an interest. Try new physical activities and sports even if you feel unable to excel. Find balance in your diet by trying to eat fruits and vegetables that you don’t find appealing. Engage in daily exercise and physical activities even if you would rather be indoors playing video games. Lastly, get professional advice on matters beyond your scope. See your physician regularly for routine care and diagnostic tests, find a mental health professional if you are not at peace, consult with a physical therapist to help you design an exercise routine appropriate for your individual needs.
While it is never too late, remember, slowing down the aging process should not begin at 60, it begins at 30!
While aching joints are expected with age, inactivity is not the cure. Controlled movement, exercise and sport modification, supportive devices, and non-prescription supplements and medicines can go a long way.
Controlled movement may include lifting lighter weights or doing squats at ½ or ¾ through your available range of motion. Sport modification includes playing pickle ball instead of tennis or brisk walking or biking instead of running. Supportive devices can be wrist or knee supports or enlarging your racket or golf club grips to lessen the impact on your hands. Over-the-counter treatments include; hot and cold packs, paraffin wax, topical ointments or medications, and nonsteroidal anti-inflammatory drugs (NSAIDs). When all else fails, see a physical therapist for professional advice and treatment and discuss other more aggressive options with your family physician.
Unfortunately, your skin also suffers from the aging process by getting thinner, drier, and less elastic. Avoid the things that can make them worse such as; smoking and ultraviolet rays from the sun or a tanning bed. Protect your skin from the sun, and if you smoke, quit. Consider skin products like moisturizers or prescription retinoids that might make wrinkles less noticeable over time. However, if it is really an issue for you, see a dermatologist.
Aging also makes your skin more vulnerable to drying but there are some things you can do. Use sun screen and wear sun resistant clothing and quitting smoking will go a long way. Drink alcohol in moderation because it can dehydrate you. Also, keep showers or baths to less than 10 minutes and use warm water instead of hot followed by applying oil-based moisturizer.
Loss of strength and endurance is common in seniors. The loss of bone density in women (and men) is also expected. The aging process is only partially responsible. Lack of exercise and activity can also contribute to the problem. Make time to exercise daily (or every other day). Weight training for your arms and legs can be easily performed using light to medium dumbbells or resistance bands. Aerobic exercise can include biking, walking, or swimming, gardening, or swimming for at least 30 minutes a day (or 15-minutes twice a day).
The loss of balance and coordination with age is a serious matter because it can lead to falls that impact long term health and independence. Studies show that those who continue to challenge themselves by riding a bike, dancing, or engage in traditional exercise are much less likely to suffer from early balance problems and are less likely to fall…so get to it! If you can’t do these activities safely, try holding onto your countertop and walk forwards, backwards and sideways, preferably when someone is home with you. See your doctor to be sure that you don’t have a medical condition or taking a medication that contributes to this problem.
Sleep problems are part of aging in many ways; difficulty falling asleep, staying asleep, lack of deep sleep, waking up and not being able to return to sleep, etc. Sleep deprivation can have a negative impact on physical and mental performance. There are some things you can do to improve your sleep such as avoiding coffee and alcohol. Also, try to avoid napping during the day. Talk to your doctor to keep problems that can impact sleeping like high blood pressure or GERD, under control and ask about melatonin supplements.
SOURCES: National Institutes of Health; Mayo Clinic, WebMD
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week: Part 2 of 2 on Slowing the Aging Process. This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician.
For further inquires related to this topic email: drpmackarey@msn.com
For all of Dr. Mackarey's articles visit: http://www.mackareyphysicaltherapy.com/forum
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
Parkinson’s disease (PD) is a chronic, degenerative disease that leads to slowness of movement, balance disorders, tremors, and difficulty walking. PD results from the loss of dopamine-producing nerve cells in the brain. Dopamine is critical to stimulate the nerves of the muscular system in the body. PD affects approximately 1.5 million people in the USA with 60,000 new cases each year according to the National Parkinson Foundation. Most people know someone affected by PD. PD typically affects those over 65 years of age and only 15% are under 50. However, actor, Michael J. Fox brought national attention to the disease in 1991 when he was only 30 years old. Juvenile Parkinson’s, those diagnosed under the age of 40, is rare and only represents 7% of all those with PD.
While there is no current cure for PD, exercise can relieve some of its symptoms. Although PD affects an individual’s ability to move, exercise can help keep muscles strong, joints mobile, and tissues flexible. Exercise will not stop PD from progressing, but it will improve balance, enhance walking ability, reduce muscle weakness, and minimize joint stiffness. In 2007, a study published in the Journal of Neuroscience revealed that exercise will benefit individuals with PD because exercise encourages the remaining dopamine cells to work harder to produce more dopamine. Also, the researchers discovered that exercise decreases the rate at which dopamine is removed from the brain.
Depending on the stage of the disease and the level of assistance required, exercise to improve strength, balance, flexibility and ambulation for those with PD, can be performed independently at home or supervised at a rehab or fitness facility. Supervised exercise can include physical therapy, recreational therapy, water therapy, yoga, and Tai Chi… AND DANCE! Physical therapy can improve walking ability, enhance balance, reduce fatigue, increase strength, promote flexibility and minimize pain. Physical therapy uses movement techniques and strategies as well as various pieces of equipment to enhance an individual’s level of independence and improve his quality of life. Recreational therapy incorporates leisure activities (e.g. golfing and ballroom dancing) to reduce the symptoms and associated limitations of PD. Recreational therapy adapts these activities to meet the specific needs of the person with PD. The modified activities are taught by professionals who have significant knowledge and experience in this area. Water therapy is especially helpful to people with PD because the water provides enough buoyancy to lessen the amount of balance required to perform essential exercises. The cushioning effect of the water allows for freedom of movement while providing the appropriate level of resistance necessary to achieve the desired results. Using a combination of physical and mental exercises, yoga promotes flexibility, reduces stress levels, and increases stamina and strength in individuals with PD. Tai Chi, a total mind and body workout, and is a series of individual dance-like movements linked together in a continuous flowing sequence. Particular benefits for people with PD include reduced stress, increased energy, improved concentration and focus, better circulation and muscle tone, and significant improvements in balance.
If you choose the convenience of a home exercise program, consult your physician or physical therapist for recommendations regarding: (1) the types of exercise best suited for you and those which you should avoid, (2) the intensity of the workout, (3) the duration of your workout, and (4) any physical limitations you may have.
The type of exercise that works best for you depends on your symptoms, fitness level, and overall health. Your exercise program should address not only strength but also flexibility and endurance and should include all body parts: face, mouth, neck, torso, arms, legs, hands, and feet. Some general exercise suggestions include:
Since individuals with PD are at risk for falling and freezing (becoming rigid), work out in a safe environment and, if possible, when someone is present. Avoid slippery floors, poor lighting, throw rugs, and other potential dangers (e.g., watch out for the pooch because he might want to join in the fun). If you have difficulty balancing, exercise sitting down, lying on the bed or within reach of a grab bar or securely installed rail. Stop and rest if you feel tired during your exercise program since overexertion can make your PD symptoms worse.
Contributions: Janet Caputo, DPT, OCS,
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week: Part II of II: Dance for Parkinson ’s Disease.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.comPaul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
For all of Dr. Mackarey's articles visit: http://www.mackareyphysicaltherapy.com/forum
When an older loved one sustains a serious injury it is traumatic for the entire family and mine is no exception. My grandmother and father enjoyed 90 wonderfully active years; however, their independence was lost the same way more than one-third of a million people lose their independence each year… hip fractures! As a doctor of orthopedic physical therapy, I feel remise that I could not prevent this from happening. What most of us fail to realize is that his fracture, like many, was more than just an orthopedic problem …it involves age, gender, diet, exercise, vision, leg strength, medications, environmental risks, and vestibular problems (inner ear problems effecting balance).
Injuries due to falling are a very common problem in the elderly. Hip fractures are the most common injury due to falling in the seniors. According to the American Academy of Orthopaedic Surgeons, each year more than 300,000 people are hospitalized for hip fractures in the United States. These fractures represent 72% of all fracture costs, totaling more than 12 billion dollars in 2005 and, not surprisingly, 90% occurred in those 65 and older. Most hip fracture patients who previously lived independently will require family assistance, home or long term care and 50% will require a cane or walker.
Several risk factors for hip fractures have been identified. While some factors are somewhat controllable and may improve bone quality, (diet, exercise, smoking, alcohol) others are not.
Vestibular or inner ear problems
Preventing a fall can not only save your independence but also your life! Preventing injuries from falls reduces the need for nursing home placement.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Hip Fractures - Part II of II
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
For all of Dr. Mackarey's Articles visit: www.mackareyphysicaltherapy.com/forum
You are never too old to exercise! This is the second of two columns dedicated to appropriate exercise for the elderly. Last week I discussed basic strengthening exercises. This column will address three additional components necessary for independence in the elderly: flexibility, balance and endurance. While it may not be as valuable for those fortunate to be over 75 years of age and capable of running, skiing and playing tennis, you may still find a noteworthy pearl of wisdom.
Why would someone 75 or 80 be interested in a basic exercise program? Well, one must maintain adequate flexibility, strength, balance and endurance to safely function in daily activities around the house. For example, the most common goals of elderly patients are: climbing stairs, getting in and out of a shower, putting on shoes and socks, tucking in a shirt or fastening a bra, cooking, cleaning, and carrying groceries or laundry.
Remember, for most people it is more harmful not to exercise, so contact you physician to discuss whether independent exercise is appropriate for you. You may need to consult with a physical therapist to get started.
Flexibility Exercises involve moving the arms, legs and trunk through comfortable range of motion to give you more mobility in order to improve your ability to perform daily activities such as tucking in a shirt, tying shoes or fastening a bra. Best if performed after strength exercises because the muscles and joints will be warm and limber. Always perform slowly with slight stretch sensation and no pain. No bouncing or over stretching!
These exercises are to be performed while sitting in a chair with a backrest, slowly, 5 repetitions, 3-5 times per week.
Balance Exercises involve strengthening muscles that keep the body upright and stable in standing in order to improve your ability to perform daily activities without falling. According to the NIH, 300,000 US hospital admissions for broken hips occur each year due to falls. Check with your physician if you have a history of dizziness before performing these exercises on your own. Best if performed with someone at home or some assistance. Always use a countertop or back of chair to hold onto for support.
Endurance Exercises involve any activity such as walking, swimming, biking or raking leaves that elevates your heart rate and breathing for an extended period of time. Check with your physician if you have a history of heart problems or dizziness before performing these exercises on your own. Best if performed with someone at home or some assistance. Start off slowly for only 5 minutes and add 1-2 minutes each week or 2. Wear good and comfortable shoes – no heels!
While not all of these endurance exercises may be appropriate for you, one or two of these may offer a good starting point.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate profession of clinical medicine at Geisinger Commonwealth School of Medicine.
For all of Dr. Mackarey's articles visit mackareyphysicaltherapy.com
You are never too old to exercise! A reader who described herself as “elderly” asked me if she was too old to exercise. Without knowing her age, I replied that she was not. I did qualify my response with the fact that exercise must be adjusted to meet the individual needs of a person based on age, health status and goals. Her question, however, led me to think of the many “elderly” who may be apprehensive to begin an exercise program for a variety of reasons. Fear of injury and lack of information may be two reasons. Another reason, according to this inquiry, is the fact that so many exercise programs featured in the media are geared to the young and healthy or baby boomers and few focuses on the needs of those over 75, home bound and weakened by age and inactivity. Those running, biking, skiing, golfing at 75 and over and do not fall into this category, please do not be offended, you are the exception. God bless you!
Why would someone 75 or 80 be interested in an exercise program? Well, one must maintain adequate flexibility, strength, balance and endurance to safely function in daily activities around the house. For example, the most common goals of elderly patients are: climbing stairs, getting in and out of a shower, putting on shoes and socks, walking safely for functional distances, tucking in a shirt or fastening a bra, cooking, cleaning, and carrying groceries or laundry.
The National Institute of Health (NIH) recommends four areas of concentration for elderly persons to concentrate on in order to maintain safety and independence: strength, flexibility, balance and endurance. It will be the purpose of this column to recommend safe, practical and easy exercises that focus on each of these categories.
Remember, for most people it is more harmful not to exercise, so contact your physician to discuss whether independent exercise is appropriate for you. You may need to consult with a physical therapist to get started.
Strength Exercises involve using the muscles to move the arms and legs against resistance such as a weighted object, dumbbells, resistance bands, and body weight against gravity. Strength is necessary to perform daily activities such as walking, lifting a ½ gallon of milk, transferring to a shower or chair safely.
These exercises are performed while sitting in a chair with backrest, slowly, 5 -10 repetitions, and 3-5 times per week. No weight is used in the beginning, only the weight of the arm against gravity. In 1-2 weeks a light 1-2 pound weight and light resistance band may be added.
Once you have mastered these exercises against gravity, then advance to using light weights or light resistance bands. Ankle weights are very inexpensive and can be purchased in 1 pound increments. Light resistance bands are available in yellow and red in colors.
Visit your doctor regularly and listen to your body.
Keep moving, eat healthy foods, exercise regularly, and live long and well!
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week: Never To Old To Exercise – Part II of II
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate profession of clinical medicine at Geisinger Commonwealth School of Medicine.
For all of Dr. Mackarey's articles visit http://mackareyphysicaltherapy.com/forum
According to the United States Environmental Protection Agency, NEPA and all of Pennsylvania is experiencing a change in climate as indicated by a half a degree (F) in temperature, more frequent and heavy rainstorms and the tidal portion of the Delaware River is rising one inch every eight years. Last summer was one of our hottest on record and this summer has produced a several heat waves with more expected. For those without air conditioning or access to a lake or pool, it will also be remembered as record setting warm temperatures. A local reader who cares for her elderly mother wrote to express her concern about dehydration in the elderly. Age, diet, illness and medications are some of the many reasons why elders suffer from dehydration not only in the summer heat, but year-round.
Next to oxygen, water is the nutrient most needed for life. A person can live without food for a month, but most can survive only three to four days without water. Even though proper hydration is essential for health, water gets overlooked as one of the six basic nutrients. Dehydration occurs when the amount of water taken into the body is less than the amount that is being lost. Dehydration can happen very rapidly (i.e. in less than eight hours); the consequences can be life threatening and the symptoms can be alarmingly swift.
In the body, water is needed to regulate body temperature, carry nutrients, remove toxins and waste materials, and provide the medium in which all cellular chemical reactions take place. Fluid balance is vital for body functions. A significant decrease in the total amount of body fluids leads to dehydration. Fluids can be lost through the urine, skin, or lungs. Along with fluids, essential electrolytes, such as sodium and potassium, are also perilously depleted in a dehydrated individual.
Dehydration is the most common fluid and electrolyte disorder of frail elders, both in long term care facilities and in the community! Elders aged 85 to 99 years are six times more likely to be hospitalized for dehydration than those aged 65 to 69 years. More than 18% of those hospitalized for dehydration will die within 30 days, and associated mortality increases with age. Men appear to dehydrate more often than women and dehydration is often masked by other conditions.
Elderly individuals are at heightened risk for dehydration for several reasons. Compared to younger individuals, their regulatory system (i.e. kidneys and hormones) does not work as well and their bodies have lower water contents. Older adults often have a depressed thirst drive due to a decrease in a particular hormone. They do not feel thirsty when they are dehydrated. This is especially true in hot, humid weather, when they have a fever, are taking medications, or have vomiting or diarrhea. They have decreased taste, smell, and appetite which contribute to the muted perception of thirst. Because of dementia, depression, visual deficits, or motor impairments, elderly persons may have difficulty getting fluids for themselves. Many elderly individuals limit their fluid intake in the belief that they will prevent incontinence and decrease the number of trips to the bathroom. The medications that they are taking (e.g. diuretics, laxatives, hypnotics) contribute to dehydration.
Elders may suffer headaches, fainting, disorientation, nausea, a seizure, a stroke, or a heart attack as a result of dehydration. The minimum daily requirement to avoid dehydration is between 1,500 (6.34 cups) and 2,000 ml of fluid intake per day. Six to eight good-sized glasses of water a day should provide this amount. Better hydration improves well-being and medications work more effectively when an individual is properly hydrated.
By the way, plain old tap water is a good way to replenish fluid loss. Keep in mind that some energy drinks not only have excess and unneeded calories but also contain sugar that slows down the rate at which water can be absorbed form the stomach. Consuming alcoholic and caffeinated beverages actually have an opposite, diuretic effect!
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician.
For further inquires related to this topic email: drpmackarey@msn.com Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
For all of Dr. Mackarey's articles visit: https://mackareyphysicaltherapy.com/forum/
It is difficult to take care of a senior with many needs. The demands of care-giving can create situations in which abuse is more likely to occur. Even though many non-professional care-givers consider their role to be satisfying and enriching, the responsibilities can be extremely stressful. This stress can escalate, especially as the elder’s condition deteriorates, and can lead to mental and physical health problems causing caregivers to burn out, become impatient, and unable to restrain their frustration.
Even caregivers in institutional settings can experience stress at levels that can lead to elder abuse. Nursing home staff may be prone to elder abuse if they lack training, have too many responsibilities, are unsuited for care-giving, or work under poor conditions.
In many cases, elder abuse, though real, is unintentional. Caregivers may be pushed beyond their capabilities or psychological resources.
Elder abuse help-lines offer help for caregivers as well. Call a helpline if you think there is a possibility that you might cross the line into elder abuse. (REPORT ELDER ABUSE: PA Dept of Aging 24 Hotline 1-800-490-8505)
If you suspect elder abuse, report it. Look at the elder’s medications to see if the amount left in the bottle is consistent with the dosing schedule and date of the prescription. Watch for possible financial abuse by asking the elder if you may scan financial documents for unauthorized transactions. Call and visit the elderly person as often as you can. Offer to stay with the elder so that the caregiver can have a break.
Many seniors do not report abuse. Many are ashamed, feel responsible or fear retaliation from the abuser. Others believe that if they turn on their abusers, no one else will take care of them. If you are an elder who is being abused, neglected, or exploited, tell at least one person: your doctor, a friend, or a family member whom you can trust. Every state has at least one toll-free elder abuse hotline or helpline for reporting elder abuse in the home, in the community, or in nursing homes and other long term care facilities. You can also call Eldercare Locator at 1-800-677-1116. For those over the age of 60, help is available through local Area Agencies on Aging (AAA).
One in seven senior citizens nationwide falls victim to some type of elder abuse, usually at the hands of a family member. The abuse can be financial, physical, or psychological and the consequences can be deadly. Statistics suggest that abused and exploited seniors die sooner than other seniors their age. Despite such devastating consequences, most elder abuse goes unreported because of fear or lack of knowledge. If you have been abused, you may be afraid of what might happen if you tell someone. If you suspect that an elderly neighbor or friend is being abused, you may not know where to turn for assistance.
(REPORT ELDER ABUSE: PA Dept of Aging 24 Hotline 1-800-490-8505)
Elder abuse is the use of power or control to affect the well-being and status of an older individual. The World Health Organization considers elder abuse as a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person. The core feature of this definition focuses on harm which includes mistreatment by people the older person knows or with whom they have a relationship, such as spouse, partner, or family member, a friend or neighbor, or people that the older person relies on for services.
There are several types of elder abuse that are universally recognized:
Each different type of elder abuse has specific signs. Below are some indicators that you need to be aware of and may recognize when involved personally or professionally with an elderly person:
Read “Health & Exercise Forum” next week to discuss the risk factors and interventions for elder abuse.
Read “Health and Exercise Forum” by Dr. Paul J. Mackarey every Monday in The Scranton Times-Tribune.
Read all of Dr. Mackarey's articles at: https://mackareyphysicaltherapy.com/forum
Dr. Mackarey is a doctor of orthopedic and sports physical therapy with offices in downtown Scranton. He is an associate professor of clinical medicine at GCSOM.
