Another Sleepless Night

 I know plenty of you have the same problem as I, waking up in the middle of the night and unable to go back to sleep.  I know this because hardly a night goes by that I don't get an e-mail or text at 2pm.  According to Johns Hopkins, waking up multiple times during the night is normal.  (on average, 2-3 times per night).  We stare at the clock, flip from side to side, or watch TV.  For me, I can lie there for hours.  Here are some tips on how to get back to sleep from the experts.

1.  Don't watch the clock.  This only increases stress and anxiety,

2.  Get comfortable.  Go to the bathroom, make sure your room is cool and dark.

3.  Relax.  Easier said than done.  Start at your feet, and contract and release each part of the body.  Take slow, deep breaths in between muscle groups.

4.  If you haven't fallen asleep in about 20 minutes, get up, sit in a comfortable chair in another room.  Read a boo, or listen to quiet music. Do not stay in bed.  Don't do anything stressful.  Go back to bed when you feel drowsy.

5.  Adhere to your normal schedule tomorrow.  Don't sleep in because of your disrupted sleep the night before.  Go to bed at your normal time the next night.  You want to keep to the same schedule.  

I always thought counting sheep or counting backwards was the thing to do, but no one seems to do that anymore.  It didn't work for me.  I have always stayed in bed, but after reading this information, I may get up and try to read.  At least it's worth a try.

Hydration For Seniors Isn't An Option: It's Mandatory

 I know, you've heard it a million times, especially when the weather is hot.  Stay hydrated.  Well, I will tell you here that hydration is a foundation for cardiovascular stability, skin integrity and mental clarity.  It's one of the simplest yet most powerful health habits for maintaining independence and vitality.  Even mild hydration can cause fatigue, confusion and balance problems that increase fall risk.

As you age, your thirst sensitivity is reduced.  You may not feel thirsty, and by the time you actually do, you may already be dehydrated.

Changes in body composition as you age may cause dehydration.  Muscle holds water.  As muscle mass decreases and fat increases, total body water may drop, leaving less reserve during illness or heat.

Medications and chronic conditions may disrupt fluid regulation.  Diuretics, laxatives and some antidepressants promote fluid loss.

As you age, kidney efficiency declines.  Aging kidney cannot concentrate urine as effectively, so the body loses more water.  Dehydration puts you at risk of urinary tract infections and confusion.

Signs and risks of dehydration in seniors:  Early dehydration may include dry mouth, fatigue, irritability and constipation.  Later on, confusion, dizziness, rapid pulse or decreased urine output my present.  It's not unusual for a senior to initially be diagnosed as dementia because of confusion may actually turn out to be dehydration.  

6-8 cups of fluid is still the recommendation for adults, but contrary to common myths, coffee, tea, and hydrating food like soups and fruit, also sustain fluid balance.

Stay hydrated.  It's one of the easiest, and most important things you can do for your general well being.

Why Do Some Seniors Resist Help?

If you have cared for a senior parent, spouse, or friend, then you have probably discovered that some seniors are resistant to change and help.   I was recently told about a neighbor of mine, living alone, on a walker, very private and in need of help, but she won't accept it.  She has not been out of her house in years, except to go to medical appointments.  How do you get help to these seniors that refuse?

First a quick list of the reasons they may not want to accept help.  

1.  Fear of independence.  This is at the top of the list because in several studies it was found that seniors fear losing independence more than they fear death!

2.  Pride and self-esteem.  Most of these seniors are part of the Silent Generation.  They lived through the great depression, and want to continue to be self sufficient.  Asking for help is not part of their vocabulary.

Other reasons for not accepting help include privacy concerns, financial worries, not becoming a burden, mistrust of caregivers, fear of institutionalization. 

In order to avoid the senior from feeling like you are taking away their independence and having them feel they are being told what to do, you must shift the conversation.  Instead of saying "You Need help," reframe the statement to make it sound like it's a collaborative effort to make everyone's life easier.  "You need help keeping the house clean," can easily be changed to "Let's hire someone to do the vacuuming so that you have more energy to enjoy your hobbies."

Asking questions and listening are key to identifying why the senior resists help.  Ask open ended questions like "What worries you most about having someone in the house?"  Finally, start with small changes, like having a care worker twice a week and see how it goes.  My experience is that seniors enjoy having the help once they experience it.

Caring for a senior is a daunting task.  Seeing neighbors in need of help that won't ask or accept help is equally difficult.  We are community, and that means helping those that can't help themselves, whatever it takes.

Are You Smarter Than A Fifth Grader?

 For anyone reading this blog who is over 30 (that's probably all of you), the bad news is that your brain is already on the decline.  The brain's peak performance is in our mid- 20's.  Decline is gradual, and the effects of healthy aging on cognitive functions are actually quite subtle.  

For example, a middle-aged adult can remember a sequence of seven numbers, while a person in their 60's without dementia can hold on to six digits.  When asked to list as many animals as they can in a certain time frame (verbal fluency), adults over 55 can list about 4% fewer animals than a person in mid life.

What causes lapses in memory as we age?  Alzheimer's disease and dementia affect us more than most anything else, but there are other reasons for memory lapse.  Medications, anxiety, depression and lack of sleep can all affect memory.  Normal changes occur in our brain, and processing speed may slow.  The amount of content in our working memory may diminish.  The short list of items you can keep in your head when going to the grocery store might get shorter, but it should not drop to zero.

Memory loss is part of the general atrophy and slowing down that happens to all parts of our bodies with age.  We know there's a slight atrophy of the brain with age, which could change processing speed. THIS IS NORMAL.  We were all at our maximum brain function in our mid 20's, and it's all downhill after that.  Just keep exercising, eating well, socializing, and learning and you will keep a well functioning brain into your 100's.  Slower to process, but non the less well functioning.

When dealing with very old people, recognize they may not answer questions or respond to information as quickly as you.  Give them a chance to recall and formulate what they want to say.  Most of the time the information is there.  It just takes them longer to retrieve.

How Remarkable Friendships Transform our Lives: Friends of the Good

This is a new book by Demond Martin, who rose from poverty in the south, with a drug addicted step father, to a Harvard Business School graduate and CEO of a large corporation.  The idea of a self made man really doesn't exist.  Demond Martin had lots of help along the way, and friendships that transformed his life.

In the book, he reflects on the people that made his journey possible.  Achievement is communal, someone is always offering you a ladder.  Martin speaks about a teacher that told he could be anything, do anything.  A church leader guided him for many years, sort of as a second father.  Aristotle wrote that there are three types of companionship:  convenience, pleasure and virtue.  Personally, I have many groups of friends and they help me enjoy life in different ways.  I've got intellectual friends, that challenge me and make me think.  I've also got fun friends, that love to have fun, and they keep me from being too serious.

There is an epidemic of loneliness and disconnection, especially among young people.  This is partly created by social media, but whatever the reason, it's not good.  We all need to connect.  We are social beings.

I have not read this book by Demond Martin, but the reviews sound good.  He describes how he got from poverty to success, who helped him along the way, and why we need friends.

The World Is Getting Smaller...Not

 Remember the days when it took days, if not weeks, to get news from around the globe?  Obviously that has all changed, and now, wherever you are in the world, news is available almost instantly.  As we age, we still have news and social media all the time.  In spite of all this, our world gets smaller as we grow older.

Many of the things you were able to do at 50 or 60 years of age are no longer so easy at 70, 80, and 90.  Driving and walking are two skills that when you lose them,  shrink your world.  You can no longer get up and go shopping whenever you want, or take a walk, or walk around a mall.  Plans have to be made in advance, and that's not always easy.  

Everything becomes harder as you age, and the things you do for yourself take longer.  Bathing, dressing, buttoning clothes, tying shoes all take more time.  So you resort to slip on shoes, blouses or shirts without buttons, quick showers (hopefully you've got handrails) instead of long, luxurious baths.  Sometimes you say "It's just too  much trouble to get dressed and go out for dinner.  I'll stay in and eat leftovers or call Uber Eats."

Traveling becomes difficult too, in fact so difficult, that many people I know over 70 don't want to travel or go near an airport anymore.  

For all these reasons, despite the instant access to shopping on line, ordering food on line, watching interesting travel films on line, and getting our news on line, the world is shrinking for many seniors.  Some rarely go out of their homes, others wander a bit in their neighborhood, but since they might not drive or probably don't drive at night anymore, they miss out on much of their community activity.  They may not travel anymore, go to theatre or concerts, so they are spectators rather than participants.

I know it's hard.  I lived with someone in declining health for 6 years, yet we cruised, flew, went to ball games and the movies.  Oh, and we ate out every week!  It was hard for me, and so hard for Ron, but it was worth it.  He participated in life until the very end.  That's what I intend to do, even as things get a little bit harder everyday.