CareNotes: The Home Care Newsletter Vol 2 Issue 6
Since we unveiled our website last month, we have continued to enhance its features and build the most intuitive online experience possible. We have done more than make a visitor’s online experiences on our website natural, easy and informative.
We have also added helpful resources throughout the site. Additions include a new and improved comment section on our Home Care Blog and a section “For Elder Professionals” with useful and relevant information about our services. We hope that these new features will not only strengthen visitors’ online experiences, but also generate business growth for all our franchise owners in North America.
In the last issue of CareNotes, we unveiled the Balanced Care Method™, a caregiver training system based on a major study of Japanese centenarians. Last month’s article explained the Balanced Care Method’s low-calorie, plant-based, omega-3-rich, and flavonoid-laden diet. This month, we will highlight the “Physical Activity” portion of the Balanced Care Method™. Okinawans exercise often and are much more physically fit than their Western counterparts; this activity plays a major role in their longevity and longer lifespans.
Okinawan elders walk a great deal within their communities and tend their own gardens. They also lend a hand with difficult household tasks, allowing them not only the ability to live independently as they age, but also the opportunity to benefit from the moderate physical exercise that these activities provide. Okinawan elders also do tai chi, a practice that merges spirituality and physicality and consists of slow, controlled, flowing movements. Tai chi provides flexibility training, weight bearing exercise, and moderate cardiovascular fitness.
It is unlikely that most North American seniors will be interested in tai chi. Instead, the Balanced Care Method™ strives to keep every senior as active as possible. The first and most important step towards remaining active and maintaining levels of health and ability is to do things for oneself as much as possible.
Seniors who can still take walks, with companionship if necessary, should do so on a regular basis. Seniors interested in gardening or doing light housework are encouraged to do so, with help as needed. Those who have active hobbies or group activities in which they still wish to participate are facilitated in doing so by skilled caregivers. The value in all levels of physical activity – from folk dancing or aqua aerobics to simply walking across a room or getting dressed – is honored and encouraged.
This portion of the Balanced Care Method™ helps seniors avoid becoming dependent on caregivers and makes it easier for them to maintain social ties or beloved hobbies. The more that seniors keep up their preferred activities and social networks, the more active, healthier, and happier they can be.
The opposite of physical activity – sleep – is also of utmost importance to keep seniors healthy. Many seniors have one or more of these sleep problems: trouble falling and staying asleep, waking up extremely early, not feeling rested when waking up, falling asleep during the day, wanting to go to bed very early in the evening, or wanting to take multiple naps during the day. Lack of sleep can cause falls and other accidents due to drowsiness, poor concentration, and inability to focus. Worse still, undiagnosed sleep disorders such as breathing trouble and sleep apnea have been connected to hypertension, and general pulmo-cardiovascular and nervous system health. A 2005 Gallup poll of 1,000 adults over age 50, found that only 32 percent of respondents reported getting a good night's sleep every night of the week. Yet those surveyed ranked good sleep as more important even than interpersonal relationships.
And no wonder; proper sleep improves concentration, aids memory formation, allows the body to repair cell damage, and keeps the immune system functioning at its best. A full night's sleep also improves mood, reduces pain from chronic conditions, helps control anxiety, and leads to better sleep the next night.
Why Sleep Is Difficult for Seniors
Changes in sleep-regulating hormones as people age can lead to more rapid sleep cycles. These cycles in turn cause multiple night waking, fragmented sleep, and decreases in the amount of deep sleep. Those that suffer from this problem end up feeling unrested. This same hormone shift can cause seniors to want to go to bed and wake up very early. These shifts in sleep patterns alone are not necessarily disruptive and can often be addressed with a shift to an earlier bedtime and good sleep hygiene (see below). Too often, however, they snow-ball into other sleep problems – and other negative results such as anxiety, depression, and physical pain.
Senior sleep can be disrupted for a wide variety of reasons beyond physiological aging. Arthritis and other chronic conditions can cause sleep-disturbing pain. Seniors with cardiovascular issues are advised to sleep in an angled position, which many people find less than ideally comfortable for sleeping. Both bladder and prostrate problems can lead seniors to wake up for bathroom breaks during the night. Also, many medications can cause sleep problems. In all of these instances, the senior's medical care provider should be advised of the sleep problem, since medications may be able to be adjusted or changed to help improve sleep.
Another cause of sleep problems is, oddly enough, a lack of physical activity. A lack of exercise can either make people feel tired and unmotivated all the time, or make them never tired enough to sleep, no matter how late they stay up or early they wake up. Exercise, along with its many other benefits, releases chemicals that promote better sleep. Just a short daily walk, bit of gardening, or similar low-impact activity can greatly improve the quantity and quality of one's sleep.
Taking that exercise outside has the added benefit of being exposed to daylight, which can help regulate the body's natural circadian rhythms and further promote a restful sleep pattern. Making sure to spend even a bit of time outdoors at a regular time everyday, or even simply sit in a window with natural light, can help lead to healthier sleep.
Finally, stress, anxiety, and depression can all interfere with healthful sleep. It's a vicious cycle, since a lack of sleep can also cause stress, anxiety, and depression. Many seniors experience greater levels of anxiety as they age. Finding a way for them to express these worries and concerns – no matter how small they may seem or how many times they re-appear – can seriously impact the ability of the senior's ability to get a good night's sleep. Having friends, family, and caregivers they can talk to makes a difference in many seniors' anxiety levels. Serious emotional issues, such a grief from a departed spouse or dear friend or clinical depression, may necessitate the help of a trained medical or mental health professional.
How to Improve Senior Sleep
Naps and medication are two of the most frequently cited ways seniors and their caregivers try to solve their sleep problems. Either (or both) may be appropriate, but each carries its own ability to disrupt sleep further. Each must be used carefully and purposefully, and in conjunction with healthy sleep habits (a.k.a. "sleep hygiene") as outlined below.
Naps can be either the cause or the cure, depending on how and when they happen. For seniors who struggle to stay alert all day, a short nap may be the bridge they need to get them from a convenient waking time to a reasonable bedtime. Good, healthy, restorative naps are short – just 15 to 30 minutes – since longer naps can lead to drowiness and an inability to fall asleep at bedtime, relatively early in the afternoon so they don't conflict with bedtime, and physically comfortable in a quiet and dimly lit place.
Many seniors turn to the ever-growing numbers of sleep aids – both prescription and over-the-counter – that are available. One of the potential problems with this route is that sleep aids can interact negatively with a range of medications the senior may already be taking and/or they can cause drowsiness that itself leads to accidents and falls. Worse, many sleep aids can cause confusion and disorientation even in younger, healthier people. For seniors with any level of dementia, this potential side effect must be closely monitored and avoided since it can lead to night fears, heightened anxiety, and even worse: sleep problems.
For seniors having trouble getting to sleep and staying asleep long enough to feel rested and refreshed in the morning, these "sleep hygiene" tips and habits are the first steps to take:
1) Gradually eliminate caffeine from your diet, or at least limit caffeine intake to one caffeinated beverage in the morning. Avoid all caffeine after lunch.
2) Eat a big meal at lunchtime, and have a lighter dinner.
3) Avoid alcohol, or at least limit alcohol consumption to one drink, preferably with a meal and not right before bedtime.
4) Do some sort of physical activity every day, preferably outside where you can get direct daylight. Exercise early in the day since physical exertion too close to bedtime can be stimulating.
5) Establish and maintain a set bedtime and waking time. If you choose to take a nap (see guidelines above), do so at a regular, set time.
6) Establish a pre-bedtime calming routine. This may include a warm bath, reading, or listening to restful music.
7) Avoid television right before bed.
8) Write down or simply state aloud any fears, worries, or concerns that are on your mind as part of your bedtime routine – giving voice to such concerns can help reduce their ability to negatively impact sleep.
9) Use your bed (and preferably the whole bedroom) only for sleeping, do not read or watch television in bed.
10) If you don't fall asleep after 15 – 20 minutes, get out of bed and do something quiet and calm, read or listen to restful music or a book on tape.
Serious or long-term sleep disorders should always, of course, be brought to the attention of a health care provider.
Caregiver Spotlight: Alison Breshears
Alison Breshears is a Certified Nurses Assistant and has been a caregiver with Home Care Assistance of Arkansas since the opening of our branch in Hot Springs, AR in October of 2008. She always has a positive attitude and puts 100% into every hour of every day that she is caring for her clients. Alison's genuine passion for providing exceptional care has always shone through and all of the clients who know her rave over her personality and attention to detail. Alison is one of the most dependable employees working for Home Care Assistance. It is always apparent that she takes great pride in her work and she is not satisfied unless the client is satisfied. Even in difficult situations, she has demonstrated a wonderful ability to stay calm and focused on the task at hand. Alison is a prime example of what a Home Care Assistance employee should be and she is always appreciated. Keep up the great work!