Time flies!

I can't believe the semester is almost over... it went by so quickly! I learned so much and I feel more comfortable with working in the geriatric field.
I was surprised to learn that there was primary and secondary aging. I figured it was all just clumped together into "aging." I also thought that some diseases, like arthritis, were a normal part of aging. I was wrong! Most of the normal signs of aging were not surprising to me (i.e wrinkles, grey/white hair, decrease in senses). However, I did not think of them from an OT perspective before; it surprised me how these normal aspects of aging can lead to so many other problems.

 
Examples:
Hearing- A loss of hearing could lead to social isolation, depression, and decreased safety.
Taste & Smell- A decrease in these senses can lead to decreased food intake and nutrition, decreased safety, and social participation (especially when cooking/eating involved).

Link to Article on Untreated Hearing Loss
Geriatric Nutrition
Making Sense of Sensory Loss

Most of the patients that I saw this semester had hearing loss. It is hard to know how loud or close to talk to them without looking like you are yelling at them. Also, it was hard to know how much of the conversation they were missing due to not wanting to keep asking, "What did you say?"

My grandma has not been able to smell anything for at least 5 years. One of her favorite things used to be candles... so we would always get her pretty scented candles for presents. Now that she can't smell anymore, we never buy them for her and she said she really misses being able to smell her candles.

A big thing that I have noticed with my grandma as well as the patients is the high amount of salt and sugar they put on their food. WOW!

I am looking forward to our summer break, then next semester! Oh my goodness, our last one before fieldwork 2...Scary and Exciting!

What's Your Favorite Food?

I can't believe that summer session is only two days from being completed. It seems like we just started talking about working with geriatrics yesterday. I know I've learned so much this summer even with such little time to do so. It's been hectic with everything going on, but I wouldn't really want it any other way. One of the biggest things I learned is that no matter how much you plan and attempt to think of everything, it always changes. Not one day went by as I "had planned." But as far as learning for test, reading our text book, doing field work at a skilled nursing home, and even while interviewing a few folks, one change that comes with "normal aging" that I think was the biggest surprise was the loss of ones senses, in particular, taste.
I've always known that as we age our body slowly breaks down and some things that worked one day wouldn't work the next. I knew hearing would lead to hearing aids and we would one day need glasses to read a book, or these days, watch our favorite shows. But I never really stopped to think about losing the ability to taste our favorite meal. That's always been a classic question one asks to get to know someone, "what is your favorite food, or meal?" And often some of our fondest memories are situated around events that involve food, such as Thanksgiving. For birthdays, special events, and holidays something is usually cooked up for a particular reason. I know one of the things that I miss most about my grandmother was her mashed potatoes, mhmmm, I've never had any quite like hers since she lost the ability to cook.
But one day, if someone were to tell me I might never like the taste of mashed potatoes again, I'd probably laugh at them as if they told had just told a joke. And if my favorite food was something like fried chicken to go with those potatoes, and someone told me I couldn't eat those at all anymore, I'm pretty sure I'd toss something across the room. What's the point of aging if we can't even enjoy what we like anymore? I can see how one might not be able to indulge in solid foods for their entire life, but the fact that our taste buds change?!  But, then again, when I think about myself now, my taste buds have already been changing. I know enjoy broccoli and salads, I'll choose an apple over a candy bar, and "chicken fingers" at fast food restaurants don't tempt me anymore. So, if my change tastes can change to this point, what's to keep them from changing again.
Also, not only could this affect how we enjoy food, but it could cause us serious problems. If I were to bite into an apple and it tastes bad, I would know the immediately spit it out. But as our tastes changes, we lose the ability to know if items are rotten (spoiled). Imagine enjoying your favorite cereal with lumpy milk! If we no longer want to eat our favorite foods, why on earth would we want to eat what we really don't want to. If salads were already difficult to eat, why bother when they taste even worse. The decline in our taste senses can even lead to malnutrition and health problems (health issues).

With all of the changes the body will go through as we age day-by-day, this is the most surprising to me. I still can't imagine a day I won't enjoy my favorite meals, even though I have seen it happen to those around me. Until then, I'll keep trying new foods and as many mashed potatoes as I can until I might one day either find the ones that taste like my grandmothers or I just don't want them anymore.

Does my diaper make my butt look big?

A lot of factors of normal aging are obvious when you know someone who is over 65. You can see the whitening of their hair, the loosening and bruising of their skin and perhaps notice they can't hear or see as clearly as you can. I wasn't surprised to learn about the decline in the five senses or in bone density, muscle mass, and organ systems. I was surprised to learn that incontinence was NOT a normal part of aging.

Since incontinence issues are so common among older adults I figured that it was the norm. At Rose Manor, there's not one patient in there that does not wear Depends, even if they are able to get up and go to the bathroom independently. My grandparents don't wear depends (that I know of) but I do know they have issues going to the bathroom sometimes. At night my grandma grabs herself a good book and says "I'm going to sit on the pot" and she'll be gone for 30 mins. I just figured that since the metabolism gets slower as you age, it is just harder to regulate and control the bowel and bladder.

To me, all of the other normal parts of aging were obvious. However, incontinence is prevalent among elders but it's not a normal part of aging. I'm relieved to hear that because wearing Depends and relying on someone to change you does not look appealing. I'm definitely going to be an advocate for strengthening the pelvic floor muscles and making sure that people are aware about what is NOT a normal part of aging.

This video helps explain more on how to prevent incontinence and educate people on ways to control bowel and bladder issues.

Geriatric Summer Reflections

                            
This summer has definitely been an interesting one!  We were able to experience and work with a number of different people who enhanced our classroom education.  The topic today is one factor of normal aging that surprised us.  There were a number of surprises but the biggest one to me was the 1% decrease after the age of 30!  It did however bring some consolation by way of explanation to the morning aches & pains that were never there before, having to look for my car keys for a half hour because I forgot where I put them and accidentally burning my boiled eggs!  It was also interesting when doing the interviews to hear the different levels of decline related to primary aging in the different individuals.  It definitely isn't all down hill at lighting speed but a slow and progressive process that is compensated for over time.

One of my interviewees used to play couples tennis until she nearly took out her partner because she wasn't in her line of sight.  Since, she has continued to play tennis to keep active but just one on one.  This person also confirmed the facts we went over in class do to aging; adding more salt to food, increased thirst, decreased vision, loss of sensation and decreased sense of smell as the years have gone on.  It was very enlightening to hear her positive attitude on getting older despite the decline in key areas.  She has continued to keep physically active in hopes of doing senior Olympics after retirement!  I've included a little video here of a team of senior volleyball Olympians, very inspiring! 

http://www.nsga.com/video/rallying-troups

So to wrap it up I depart this summers blogging by saying regardless of the inevitable physical changes, it is a positive perspective that will make the years ahead more enjoyable :-) Peace.

It Don't Mean a Thing if You Ain't Got That Swing

With your pharmacy store helper

   and my hormone patch

do you think we could possibly

   make a great match?

(submitted to the 10th International Longevity Light Verse Contest by Jane Moralice of Costa Mesa, FL)

     It's time for health professionals and caregivers to address sexuality in elders who live in the community and long-term care skilled nursing facilities.The Area Agency on Aging in Pasco-Pinellas, Fl,(http://www.agingcarefl.org/aging/normalAging) an area with a large number of seniors, has identified six characteristics besides heredity and genetics that are traits of people in areas with exceptionally long life expectancies. They are:

1. Following a diet low in animal fats and high in vegetables and whole grains
2. Moderate consumption of alcohol
3. Maintaining physical activity throughout life
4. social involvement in the community
5. Having an environment that is challenging and free from pollutants
6. Sexual activity that continues into later years--they are sexually active and free to express themselves in this way.

     According to a training module called Geriatrics, Palliative Care and Interporfessional Teamwork Curriculum, put out by the NY/NJ Veteran's Administration www.nynj.va.gov/docs/Module19.pdf,

elders do not mind discussing sex and in fact, are quite interested in the topic. However, current aging stigma enforces beliefs such as: elders don't want to be sexually active, they have a decreased interest, they are incapable of sexual relations, and it is dysfunctional for seniors to want to have sex.

     That is where our role as professionals comes in. We have to be willing to initiate the conversation. It will benefit the patient/OT relationship by building rapport and trust and help shatter myths about sexuality and aging. There is an increasing elder demographic and life-expectancies are increasing, making sexuality a significant subject for older adults.

     In our treatments, we must be respectful and nonjudgmental, take accurate sexual histories and assessments, ask direct questions, educate patients and caregivers about safe practices and adaptations, listen to patient concerns and be willing to refer them to specialists for assistance if necessary.

     This summer, I found out just how willing elders are to talk about this topic, which seems to be more uncomfortable from the professional side of the coin. I interviewed three elders of various ages and always asked their opinions of sex. One lady, who is 96, said she thinks sex is one of the most natural things in a person's life. She remained sexually active well into her 80s, when her husband's health declined. She assured me she always had a very active sex life. Afterall, she said, her husband was French and "you know how they are with lovemaking."

     Also, my mother and her friends, who are all widows, continue to talk and joke about sex. None are currently active, but one 84 year old joked that when she goes to the nursing home she will ride around in her wheelchair and interview the prospects.

     Following is a link to a Youtube video that challenges aging sexuality stigmas and encourages members of the Allied Health Professions to talk about the elderly and sexual behaviors. Because of restrictions, you must follow the link to youtube to view it. Please do. It will be worth your time.

<iframe width="560" height="315" src="http://www.youtube.com/embed/sw6UetyUuD0" frameborder="0" allowfullscreen></iframe>

 

Can you smell the roses?

I knew that your senses change as you age, but I didn’t realize the extent of the changes that could occur.

For example, even though I’m not a senior citizen, I’ve been wearing reading glasses for years.  And this week, when we had an activity at a nursing home, we were helping some residents work on crafts.  One resident had forgotten to bring her glasses to the activity room.  As a result, she wasn’t able to work on her craft.  It’s surprising how much a simple thing like forgetting your glasses can keep you from doing things that you want to do.

We’ve learned that as you age, you might have trouble tasting saltiness in foods.  Once, my father-in-law was having barbecue at our house.  He wanted to add more barbecue sauce.  When he reached into the refrigerator, he didn’t realize that he accidentally took chocolate sauce instead of barbecue sauce.  He put it on his barbecue, and even as he continued eating, he didn’t notice what he had done.

Smell can also be affected by aging.  Sometimes I’ll comment to my mother that I smell something, and she doesn’t smell it and isn’t aware of it at all.

Most people are aware of how common it is for senior citizens to have hearing loss.  Very often, when working at the nursing home, we need to stand in a certain position where the residents could hear us more easily, and we need to be sure to speak clearly.

The following Web site offers info about aging and sensory changes.

http://www.intelihealth.com/IH/ihtIH/WSIHW000/22030/23724/347117.html?d=dmtContent

Often, by the time we have time to stop and smell the roses, it’s hard to smell them!

Driving

Watch the video! It is Jerry Seinfeld talking about older people driving! It is so funny!

Driving has changed in the United States. The streets are much busier and congested and everyone just seems to be in a hurry! There should be new laws made to keep up with our fast growing society. People 70 years and up should need to take tests every two years to renew their license. The test should include an eye exam and a road test. This would decrease the number of accidents on the road. There should also be training for DMV staff on what to look for while doing the test. The staff could be trained with a program like CarFit. This is a program developed by the American Society on Aging with AAA, AARP and AOTA. The program looks at an older person's car to make sure that it is the right "fit" for them. Examples of what they are looking at are: Foot Positioning on gas/brake pedals, mirror adjustment to eliminate blind spots, seat belt positioning and position of the person with the steering wheel (should be 10 inches or greater). If the DMV staff knew what to look for, it would make the test much more effective. The staff would not need to do the entire CarFit program... this might be too time consuming. But if they were concerned, they could refer the driver to a CarFit program where they could do additional testing. They would need to make the CarFit program mandatory before receiving their license.Also, Doctors need to ask their patients about driving. Doctors see the patients the most often so they need to be responsible for talking to the patient about driving, giving information and doing a thorough eye exam including testing visual acuity and field of vision. The Doctors could also refer older drivers to programs such as CarFit. It would help if this was something that was done early (at 65) so that drivers are well educated and feel like the Doctor is trying to help, not take away there independence.More INFO:Click here for CarFit
Tips and Play a Driving Game 

What OT can do!