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Aging & Elder Care

Coping with age - Lessons in elder care

January 12, 2014
By GLYNIS VALENTI - Staff Writer ( , Times Leader

This is the first of a series of articles on aging and elder care, based on the writer's experience of taking care of her elderly parents. Each family's circumstances are different, but the series will provide some information on how to prepare, as well as programs and options for care and final arrangements.

"Life would be infinitely happier if we could only be born at the age of 80 and gradually approach 18." - Mark Twain

There is no getting around it. Everyone is aging at this very minute. There are ways to slow its progress, but there is no stopping the inevitable end, death. The body goes through certain processes beginning as early as age 30 of steady, sometimes imperceptible, decline.

Aging can be manageable, though, with preparation, and the more thorough preparation and planning, the easier it will be for yourself and loved ones. There is paperwork; there are procedures and steps and choices for various scenarios, whether it be an illness or accident, assisted living or home care, wills or trusts. First, a look at how the human body ages.

"Normal" aging can manifest differently from person to person, but there are certain indicators that nearly everyone experiences, right down to cell production, which diminishes, causing tissues to shrink and become less efficient. The skin becomes thinner, drier and less elastic, especially with a decrease of natural oils. This will help create wrinkles, and skin will bruise more easily.

Bone density and mass decreases, which makes bones weak, smaller and more fragile. Post-menopausal women may notice this. Seniors often become shorter because the fluid between the disks in the vertebrae is lost, shortening the spine. Deterioration of joints in the fingers, hips and knees will cause stiffness and can increase the risk of injury.

Men begin losing muscle mass in their 20s, and women start losing it in their 40s. Muscle fibers shrink and lose elasticity. Eventually they become rigid and coordination and balance can be affected. Compounding this is neurodegeneration (brain cell decline) which can also affect motor skills and movement, as well as memory.

An adult's brain weighs about 10 percent less at the end of life due to natural neuron die-off and the shrinkage of remaining cells. This contributes to cognitive difficulties that many people call "senior moments:" misplacing items, losing one's train of thought, having trouble learning or retaining new information. The process actually begins sometime in the 30s, but it becomes noticeable by age 60.

Most people's vision and other senses decline with age, and if someone is over age 55, he or she is most likely using eyeglasses at least part of the time. Again, difficulty seeing contributes to falling. Presbyopia (trouble focusing on close objects) is common as are dry eyes, changes in peripheral vision, sensitivity to glare and adjusting to varying light conditions.

Fifty percent of people between the ages of 65 and 74 develop cataracts, a clouding of the eye's lens, and an estimated 70 percent of those over age 75 have them. They are usually easily treated with prescription eyeglasses or minor surgery. Other age-related ailments include glaucoma, which is treatable, and macular degeneration, which can be slowed to a certain extent.

Significant hearing loss occurs in about one-third of the over-65 population. Beginning around age 30 and progressing into the 40s and 50s, hearing higher frequencies or distinguishing certain consonants becomes difficult, and eventually conducting a conversation in a crowded room is trying.

The senses of smell, touch and taste are also affected by age, especially for smokers. As the sense of smell diminishes, seniors may not be able to detect body odor, heavy perfumes or, more dangerously, smoke. Smell and taste are linked, also. The ability to distinguish flavors can reduce a senior's appetite, and many develop a "sweet tooth" because those taste buds are stronger. This can present an issue for diabetic seniors, but many seniors lose interest in eating and make other health problems worse by not taking in the proper nourishment.

Touch and sensitivity change with the changes in skin and with poorer circulation. Seniors can injure themselves if they can't feel extreme hot or cold temperatures. Because of muscular decline and possibly other diseases like arthritis, strength and motor skill tasks like opening jars, writing or turning faucet handles become more challenging.

The heart is a muscle and is susceptible to the same aging process as the rest of the body's muscles. Its pace slows a bit with age, and arteries and blood vessels lose their flexibility, too. The heart has to pump harder to get the blood throughout the body, which may cause hypertension or put a strain on the heart.

It is even normal for sleep habits to change as the body ages. Thirty-three percent of people over 65 suffer interrupted sleep on a regular basis. Beginning around age 40, most people don't sleep as deeply and wake up more easily and often. Hormones, stress and medications interfere with sleep as well, as do diseases like dementia and Alzheimer's.

This is what happens to everyone's body. Some people may experience more difficulty with some areas than others - for instance, muscle stiffness than hearing loss - but for the most part, the body's systems are linked together. That isn't to say that one should give up. There are common sense ways to slow aging and make the senior years more comfortable: 1. don't smoke; 2. eat a balanced diet; 3. do some physical exercise every day.

Aging weakens the body's cell structure as it is. Research at Weill Cornell Medical Center has confirmed that smoking changes the genetic makeup of respiratory cells to a primitive, un-programmed state. Genetic codes in each cell tell it what specific task it is to perform. The combination of chemicals in cigarettes alters that code, rendering the cell "out of control." Without the programming, they can adapt to become cancerous cells and take genetic direction from them, i.e. multiplying. As cells from the lungs travel with the blood, the damaged cells can set up in the brain or other organs.

Eating a variety of healthy foods and doing as little as 150 minutes of mall walking or other light exercise per week will help the body slow or counter the effects of aging and common diseases like cardiovascular disease, diabetes and hypertension. This is nothing new, and rewards from this investment will appear fairly quickly. Moving and providing proper nourishment will enhance all of the body's systems - cell production, skin, vision, muscular, circulation, brain and coordination -- and even help reduce the risk of falling.

Falling is a major concern for seniors and their loved ones as sight, joints and muscles age. The Mayo Clinic offers some precautions to take that may minimize the risks. First, talk to a doctor about medications and health issues that may affect balance or vision. Let the doctor know any details of a previous fall.

Second, even doing light exercise is better than none. The doctor may even be able to assign a physical therapist if you are worried about falling on your own. Buy shoes that fit and are sensible for your lifestyle.

Next, remove any hazards from walkways or traffic areas. This means loose rugs, magazines or newspapers on the floor, low tables or carpets and floorboards that are sticking up. Make sure areas are well-lit, and have a lamp by the bed and nightlights in hallways and other high traffic areas.

Install non-slip treads on steps and handrails on both sides of stairways and in the bathroom. A doctor can prescribe a walker or cane for further assistance.

After age 50, certain standard tests can indicate how the body is aging and if any problems are on the horizon. These include blood pressure, bone density, vision and hearing, cholesterol, blood glucose, prostate, mammogram, PAP test, colon and thyroid.

This information isn't meant as a dismal outlook of things to come. This is how aging happens. Understanding what is "normal" is the first step in identifying or preparing for health issues that may come up. The next article will look at preparations for illness.



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