Dr. Mauk’s Boomer Blog
Each week, Dr. Mauk shares thoughts relevant to Baby Boomers that are aimed to educate and amuse.
According to the CDC, nearly 800,000 persons in the United States have a stroke each year. This is about one every 4 minutes, resulting in over 130,000 deaths annually. Stroke is simply defined as an interruption to the blood supply to the brain and is caused by a clot or hemorrhage. It can be a devastating problem for survivors, resulting in changes in mobility, cognition, speech, swallowing, bowel and bladder, self-care, and general functioning to varying degrees. Some people recover completely after a stroke, but others experience lifelong challenges.
The good news is that there is hope and quality of life after stroke. In my research with stroke survivors, I discovered 6 phases that survivors reported as they made the journey through rehabilitation towards recovery. These steps can be used to see where a person is in the recovery process, help us understand how they may be feeling, and help guide the way we interact with them.
Agonizing: In this first phase of the process, stroke survivors are in shock over what has happened to them. They can’t believe it, and may even deny the warning signs of stroke. The important task during this time is survival from the stroke itself. Call 911 if you see the warning signs of facial droop, arm weakness, or speech difficulties.
Fantasizing: In the second phase of the stroke process, the survivor may believe that the symptoms will all go away. Life will return to normal, and there is a sense of the problem being unreal. Time takes on a different meaning. The way to help is to gently help them recognize reality, and without taking away hope for recovery.
Realizing: This is the most important phase that signals a turn in the recovery process. This is when the survivor realizes that he/she may not fully recover from the effects of the stroke and that there is work to be done to rehabilitate and reclaim life. Common feelings during this phase of realizing are anger and depression. The way to help is to encourage the person to actively engage in rehabilitation. The real work of recovery is just beginning.
Blending: These last 3 phases in the process of stroke recovery may be occurring at much the same time. This is where the real work of adaptation to life after stroke begins. The survivor begins to blend his “old life” before stroke with his new life as a stroke survivor. He/she may start to engage in former activities even if it requires adaptations to be made. He/she will be actively engaged in therapy and finding new ways to do things. The way to help is to promote education. This is a time when survivors are most ready to learn how to adjust to life after stroke. Listen to your rehab nurses, therapists, and physician. Be active in the recovery process.
Framing: During this phase, the individual wants to know what caused the stroke. Whereas in the Agonizing phase they were asking “why me?”, now they need to the answer to “what was the cause?” Stroke can be a recurring disorder, so to stop a subsequent stroke, it is important to know the cause. Interestingly, if the physician has not given the survivor a cause for the first stroke, patients often make up a cause that may not be accurate. Help the survivor to learn from the health care provider what the cause of his/her own stroke was. Then steps can be taken to control those risk factors.
Owning: In this final phase of stroke recovery, the survivor has achieved positive adaptation to the stroke event and aftermath. The survivor has accomplished the needed grief work over the losses resulting from the stroke. He/she has realized that the effects may not go away and has made positive adjustments to his/her life in order to go on. Survivors in this phase have blended their old life with the new life after stroke and feel better about their quality of life. While they still may revisit the emotions of the prior phases at times, they have accepted life as a survivor of stroke and made good adjustments to any changes that resulted. They feel that they have a more positive outlook on life. At this point, survivors can use their experience to help others cope with life after stroke.
For more information about stroke recovery, visit www.seniorcarecentral.net and view Dr. Mauk’s model for stroke recovery.
Hearing loss is a disability that affects over 36 million American adults; 30 percent of those afflicted are 65-74 years old and 47 percent are 75 or older.
The Hearing Loss Association of America cites three types of hearing loss:
1. Conductive hearing loss is due to ear canal, ear drum, or middle ear problems. Most causes of conductive hearing loss can be treated with surgery or hearing aids, particularly bone conductive hearing aids.
2. Censorial hearing loss (nerve-related hearing loss) is due to inner ear problems. Depending upon the cause, treatments include medications or, in some cases, surgery.
3. Mixed hearing loss is when there is damage in the outer or middle ear as well as the inner ear or auditory nerve. The conductive hearing loss is usually treated first, then the censorial.
Hearing loss can have a profound impact on our work and social interactions. People with this disability may experience depression and as a result, anger at others or withdrawal from occasions where their hearing loss will be noticeable. Unfortunately, there is no cure to hearing loss, although, there are effective ways to manage it and be proactive. Learn about your disability and seek assistance to help cope.
- Hearing aids –Purchase your hearing aids from an auditory or medical professional who specializes in hearing, not someone who specializes in selling hearing aids. Hearing Denial suggests booking with ones that are able to offer evaluations and custom hearing aid fittings all within one supplier.
- Cochlear implants – You will need an evaluation by an audiologist and an implant-affiliated physician to determine if you are eligible for cochlear implants.
- Hearing Assistive Technology is available at most performing arts venues, including most movie theaters. Amplified and captioned phone systems, smoke detectors and doorbells are also available.
Responding to Others
Communication is still a two-way. There are ways you can help maintain your end of communication with others. Some suggestions include:
- Do your best to focus and concentrate.
- Admit it when you don’t understand.
- Watch for visual clues and ask for written clues if necessary.
- Maintain your sense of humor and positive attitude.
When caring for the elderly, it can be tempting to feel as though you’re always in charge, and this can lead to treating those in your care like children. This can make what is already a difficult time even more so, as the elderly in your care will gradually feel as though they are losing any of the agencies they once had. Rather than approach care as though you lead, and they follow, why not tries an alternative view – a strategy based on cooperation.
It can be difficult to foster cooperation whilst caring for the elderly – many people are resentful of having to rely on someone else for help, and can actively reject what little you aim to do for them. No matter where you work or where your elderly relatives may be in care – whether it’s somewhere like Forest Healthcare or a simple food run once a week – it can be difficult work. There are some strategies you can use to deal with this, however.
Take an Interest
Firstly, take an active interest in those in your care. Get to know them as people. Remembering a couple of small details – whether it’s that their son is on holiday, or that they’re writing a letter to a cousin – and making the effort to ask about them will go a long way towards creating a sense of cooperation. If you’re treating them as an equal to you, and taking an interest in their life, then you are no longer some aloof figure, but a potential confidante. It doesn’t have to be a friendship by any means – but getting to know them as more than just one of many older people you help on a daily basis can go a long way.
Never make them feel stupid, or as though something you’ve discussed is irrelevant. Whilst some things the elderly people in your care might think desire or discuss may seem strange, it’s important to remember the huge difference in life experiences you’ve had. For instance, if they bring up something that’s bothering them that you might consider minor, treat it with the respect they deserve. Allowing the people in your care to remain autonomous is a vital step towards a working partnership.
You will be resisted. This is just a fact, and the sooner you accept it, the easier it is to deal with. Rather than being surprised and allowing you to get annoyed about it, treat it as what it is – just one step in a larger process? Try to figure out the root causes of the resistance – is it coming from a place of fear, perhaps of medical intervention? Or perhaps it’s resentment at their inability to do something themselves. Each person will be different, and treating resistance on an individual basis will make it easier to deal with in the long run.
Use ‘Trial Runs’
Imposing a particular routine, or type of medical care, on an elderly person can lead to them feeling as though they have no control. Instead, try to make use of trial runs – set a length of time for them to try something, and then meet to discuss it. This way they can make active, informed decisions about their own care – and you’ll often find that, given this opportunity, they’ll be happy to go along with what you suggested in the first place!
In general, what caring for the elderly mostly comes down to is remembering how things are from their point of view. To them, a move into care – no matter how great the care! – is a move away from independence, towards a more constructive way of life. In order to work towards cooperation, the best methods involve validating these feelings, acknowledging the difficulties, and trying to work around them. Therefore, anything that increases the autonomy and agency of those in your care is a great place to start. If you’re based somewhere like Forest Healthcare, then those decisions will be in your hands most of the day, but even in smaller, less frequent contact based care, it’s worth employing. If anything, the sooner you start working towards a cooperative strategy, the easier it will be for both of you in the long run.
Fall is a time of beautiful colors and crisp, fresh air, especially in places like the Western slope in Colorado. There are many simple family activities you can do with children and grandchildren to take advantage of this time of year, from Halloween tricks and treats to Thanksgiving traditions. Here are some that our family enjoys.
There’s nothing like picking apples straight off the tree. Besides the amazement that a good fruit-bearing tree could actually feed a family all year with delicious fruit (provided you do the work of canning and freezing), you have the satisfaction of knowing right where the apples came from. No processing or waiting to see them in the grocery store. That is as healthy and fresh as it can get! Have the kids and grandkids help. Use laundry baskets to collect the apples, then take them home and wash thoroughly to remove any dirt or pesticides. Shine them up with a clean kitchen towel and store in the refrigerator to make them last longer. If you live in a cooperative climate, think about planting your own fruit trees. This year, one of our apple trees bore more than a thousand apples, and we picked them by hand, put them in cute bowls with scary spider rings and ribbons, then gave them to family members and friends. We had still plenty to eat, make pies and applesauce with, and experienced the joy of sharing with others.
Organize a costume exchange
A lovely tradition at some churches is the annual costume exchange. Throughout October, the church gathers donations of gently used costumes from willing donors. Flyers are distributed in the community to advertise free costumes on a Saturday at the church for any who needs one. The women of the church bake cookies and have special treats available for that day. People from the town who might not be able to afford costumes for their kids visit as a family and get costumes free of charge while enjoying a time of neighborly fellowship.
Whether you have small children, teens, or grandkids, visiting the pumpkin patch is a treat. Some local farms will offer hay rides out to the field for everyone to find their perfect pumpkin. Have apple cider and donuts afterwards. For older kids, try a challenging corn maze at night with flashlights and glow rings. At home, decorate pumpkins by carving (but be careful to supervise – those carving knives are sharp), coloring, painting, gluing with felt designs, or other age-appropriate items. Display your creations in the window or on the porch for others to enjoy.
Share homemade baked goods
Around Thanksgiving time, many communities offer a complete turkey dinner for the homeless or those in need. Other towns provide a lunch for anyone who wishes to come and be part of a larger feast on Thanksgiving day. In some cases, cookies are taken to those who are in prison to brighten their day. To make such ventures a success, the sponsors often ask community members to bake pies or other baked goods. This is an excellent opportunity for children to learn to give to others who may be less fortunate. The entire family can be involved in baking and sharing with others in the spirit of being thankful.
Visit a special place to look at the changing colors
Chances are, there is a special place near you that has especially vibrant Fall colors. Certain parts of Colorado attract people from miles around for picture-taking of our aspen and other trees at the peak of the season. A drive through the mountains or hills can be quality family time. Stop and take early senior-pictures of your graduates or a family portrait for a Thanksgiving or Christmas card. Post your pics on FaceBook for friends and family to enjoy or make a Fall scrapbook to preserve the memories.
There are many ways to celebrate our gratefulness for all that God has given us. No matter how you participate in the wonder of the Fall season, be sure to stop and take time to breathe in the beauty of our great country.
Pets Provide Significant Health Benefits By Rachel Blankmeyer, DVM
Some of our closest companions, especially as we age, are our four-legged friends. The human-animal bond provides many benefits to people who may otherwise be isolated due to emotional, behavioral, or physical problems. Research shows several health benefits of pet ownership for older adults, including lower blood pressure, triglycerides, and cholesterol levels. A study by Friedmann & Thomas in 1995 showed that pet ownership actually resulted in increased survival rates after a heart attack. Other studies have shown that pets may provide social support similar to that of a family member for older adults. Consider additional general health benefits such as weight control and stress reduction, and pet ownership seems like a win-win situation!
You may have heard of the Alzheimer’s patient study performed by Edwards & Beck in 2002, where persons with Alzheimer’s disease observed a facility fish tank and demonstrated improved relaxation, alertness, and eating habits. This is a huge deal for patients dealing with dementia because at least 50% experience weight loss, increasing the mortality rate and progression of disease. Stroke survivors may also specifically benefit from animal companionship through improved communication, dexterity, mobility and balance. As a veterinarian, I may be biased, but the facts don’t lie: animals help all of us have a more active daily life, and can enrich our lives emotionally! So, consider the cost-benefit ratio:
Hearing loss can have a profound effect on a person and their quality of life. Hearing loss can lead to a withdrawal from social situations, signs of depression and other effects on the health of an individual. Therefore, it is imperative that any loss in hearing be treated as soon as possible. In order for hearing loss to be treated, an individual must recognize that a loss of hearing has occurred. Some hearing loss can have a gradual onset, so the person with the hearing loss may not be fully aware that treatment is needed.
According to the National Academy on an Aging Society, millions of Americans suffer from hearing loss. Those suffering from hearing loss range in symptoms from very mild to severe or near total hearing loss. Of these, 43 percent are those individuals aged 65 and older. However, hearing loss can affect all ages with some 5 percent of children having some form of hearing loss. The causes of specific hearing loss are varied, with some created due to occupational stress, or life choices, or those brought about because of aging.
Audiologists and hearing aid specialists at Hearinglife.com lists the types of hearing loss as:
- Conductive Hearing Loss
- Sensorineural Hearing Loss
- Mixed Hearing Loss
Conductive hearing loss is a result of some form of obstruction in the ear. This type can be temporary and usually corrected via medical procedure and occasionally the application of a mechanical aid.
Sensorineural hearing loss is damage or some other issue affecting the auditory nerve or inner ear. This category encompasses hearing loss due to aging or disease. Correction usually involves the application of assisted hearing devices as this loss is usually permanent.
Mixed hearing loss is attributed to directed sound at excessive volume, such as that found in headphones and in occupational settings. Corrective measures also require the use of a mechanical or assisted hearing device. Based on statistics performed by the Centers for Disease Control and Prevention, mixed hearing loss is a widespread concern affecting over 22 million Americans each year. As suggested by the professionals for Kaiser Permanente Health System, they symptoms of hearing loss appear as:
- Muffled Hearing
- Requiring Higher Than Normal Volumes
- Frequently Misunderstanding Spoken Words
- Ringing or Pain in the Ear or Fluid Leakage
- Off Balance or Feeling of Spinning
Any of these, and potentially other symptoms, can occur with hearing loss. Even before hearing loss is suspected, it is generally accepted that hearing should be tested regularly in order to quickly diagnose and treat any hearing loss before it becomes significant to the detriment of the individual and their quality of life.