When you think about your sleep, you typically think about a period of restoration and rejuvenation. Your sleep is supposed to be the time your mind and body have an opportunity to rest and repair for the next day.
What most people don’t know is that you could be sleeping incorrectly and making your pain worse instead of better.
How you could be sleeping incorrectly
You may not realize there’s a specific technique to the way you sleep. Besides, you’ve been sleeping all of your life. How could you possibly be doing it wrong?
One of the most important factors to your sleep, especially when you’re dealing with aches and pains, is your sleeping posture. Most sleepers sleep on their sides, and this can cause a lot of complications. For one thing, half of your body is crushed under the weight of the other half of your body. This can specifically target your pain points, so you’ll wake up with soreness in your shoulders, hips, and knees.
It’s not only sleeping on your side that can amplify your pain. Stomach sleepers are in an even worse position, putting undue stress on their lower backs all throughout the night, especially with thicker pillows that raise your neck up even higher.
You probably knew your sitting posture was important for your neck and back pain, but keeping proper posture while unconscious is a little more challenging to account for. Here’s how you can work on it.
What you can do to correct your sleep
If you’re a stomach sleeper, you should probably work on trying to get comfortable in other positions. It takes some time to adjust to sleeping in a new position, but it is possible to make a change. If possible, try to adjust to becoming a back sleeper. This is the best position for maintaining spinal alignment and decreasing your chances of waking up in pain.
If you’re absolutely committed to stomach or side sleeping, there are ways you can fix your technique. As a stomach sleeper, sleep with less, or no, pillows to eliminate the arching up that causes lower back pain. As a side sleeper, try to keep your body elongated rather than curled into the fetal position. This can help reduce morning pains (and snoring, too).
Author’s bio: Laurie Larson is a writer based in NC who writes on health topics.
Commonly known as shingles, herpes zoster is the reactivation of the varicella virus that causes chicken pox. Older persons may be infected with this latent virus after initial exposure to it in the form of chicken pox. The virus then lays dormant in the neurons until it is reactivated, often due to immunosuppression, when it appears in the form of painful vesicles or blisters along the sensory nerves. This reactivation tends to occur once in a lifetime, with repeat attacks occurring about 5% of the time (Flossos & Kostakou, 2006). Herpes zoster occurs in both men and women equally, with no specific ethnic variations, but is more common in the elderly.
Risk factors for developing shingles are age over 55 years, stress, and a suppressed immune system. For many older women particularly, emotional or psychological stress can trigger recurrence.
Signs and symptoms of herpes zoster include painful lesions that erupt on the sensory nerve path, usually beginning on the chest or face. They may appear as initially as a rash, looking much like chicken pox, often wrapping around the chest area in a band-like cluster. These weepy vesicles get pustular and crusty over several days, with healing occurring in 2-5 weeks (Kennedy-Malone et al., 2004; NINDS, 2013).
Diagnosis is usually made by viewing the appearance of the lesions and a history of onset. A scraping will confirm some type of herpes virus. The most common complaint of those with herpes zoster is the painful blisters that usually subside in 3–5 weeks (NINDS, 2013). Postherpetic neuralgia, a complication of herpes zoster, may last 6–12 months after the lesions disappear and may involve the dermatome, thermal sensory deficits, allodynia (the perception of pain where pain should not be), and/or severe sensory loss, all of which can be very distressing for the patient (Flossos & Kostakou, 2006).
Zostavax, a vaccine for shingles, has become available, and it is recommended for all persons age 60 or older who have already had the chicken pox. A person can still get shingles even after having the vaccine, but the symptoms and complications would be less severe. The vaccine has also been approved for persons age 50 – 59, and research has shown that receiving the vaccine significantly decreases the rate of shingles in the population (NINDS, 2013; PubMed Health 2012).
Antiviral medications (such as Acyclovir) are used to treat shingles, but must be given within 48 hours of the eruption of the lesions. Topical ointments may help with pain and itching. Pain medications, particularly acetaminophen (Tylenol), are appropriate for pain management in older adults. If a fever is present, rest and drinking plenty of fluids is suggested. Persons with pain that lasts past 6 weeks after the skin lesions are gone and that is described as sharp, burning, or constant require re-evaluation by a physician. Postherpetic neuralgia may be a long-term complication lasting years (PubMed Health, 2012).
The person should be advised to seek medical attention as soon as he or she suspects shingles, in order to receive the best results from Acyclovir. The virus will run its course, but the person is contagious while vesicles are weepy. Persons should not have direct contact (even clothing) with pregnant women, people who have not had chicken pox, other elderly persons, or those with suppressed immune systems. The older person with shingles may experience concerns with pain management and feel a sense of isolation, particularly if they live alone. Arranging for a family member or friend who does not have a high risk of infection to check on the older person at home is advisable.
Adapted from Mauk, K. L., Hanson, P., & Hain, D. (2014). Review of the management of common illnesses, diseases, or health conditions. In K. L. Mauk’s (Ed.) Gerontological Nursing: Competencies for Care. Sudbury, MA: Jones and Bartlett Publishers. Used with permission.
Most of us have New Year’s resolutions. One of my new goals for 2019 is to age better. Andrew Weil, MD, in his bestseller Healthy Aging: A Lifelong Guide to Your Well-Being (2005) said, “to age gracefully requires that we stop denying the fact of aging and learn and practice what we have to do to keep our bodies and minds in good working order through all the phases of life” (p. 7). You may well ask, “how does one do that”? For me, it means actually practicing what I preach. We are fortunate today to have so much research and information on aging that we can pinpoint some specific areas that are common to successful aging. I have taught these to numerous students and groups of older adults, but it wasn’t until I joined the over 50 age group that this knowledge seemed more personally applicable. So, let me share with you five keys that both scientists and the oldest old persons in our society have found contribute to healthy aging.
Have a positive attitude towards life. This includes having good coping skills and being able to deal with grief and loss appropriately. Most centenarians will say that you should always having something to look forward to. Make a list of places you want to travel this year, vacations to take, people you need to visit, or things that need to be fixed around the house. Then start to cross them out as you do them, and bask in your accomplishments.
Maintain key relationships. These include having a stable marriage and/or being involved in a religious or social community. In George Vaillant’s book Aging Well (2002), he reported the results of the Harvard Study of Adult Development. Generativity, or selfless investment in others (including the next generation), was found to be the best predictor of a long and happy marriage. Likewise, studies show that older persons who affiliate with a religious organization, such as attending church regularly, report better health and better social support systems, and tend to remain independent longer.
Maintain a healthy weight through proper nutrition. Eat a diet with plenty of fiber, fruits, vegetables and water. Limit saturated fats, salt, processed foods, and less useful calories from alcohol or sugary drinks.
Stay active. Physically, do some moderate exercise on most days of the week. For persons who are older and unable to do strenuous activity, remember that regular daily chores that include continuous motion such as doing laundry, gardening, or cleaning house can count as exercise and can also be spread throughout the day to accumulate the recommended 30 minutes of activity. If able, brisk walking is highly recommended. Keep your mind active as well. Resolve to take up a new hobby such as a craft, learning to play an instrument, or studying a foreign language. Working puzzles, playing cards, and reading are also good ways to stimulate your brain function and keep your memory sharp.
Avoid negative behaviors such as overeating or drinking too much alcohol. Adopt an attitude of “everything in moderation”. Don’t smoke, and if you do smoke, stop. Sadie Delany (1994) at over 100 years of age wrote in her book Having Our Say, “so you want to live to be 100. Well, start with this: No smoking, no drinking, no chewing” (p. 11).
Resolve with me to age more gracefully during 2019 and let’s see how we do. Do you have any secrets of healthy aging that have worked for you or your parents/grandparents? Please share them with us.
Alzheimer’s disease (AD) is the most common type of dementia seen in older adults. An estimated 5.4 million Americans of all ages had Alzheimer’s disease in 2012. Nearly half (45%) of people over the age of 85 have AD. By 2050, the number of individuals age 65 and over with Alzheimer’s could range from 11 million to 16 million unless science finds a way to prevent or effectively treat the disease. One in eight older adults has AD, and it is the sixth leading cause of death in the United States (Alzheimer’s Association, 2012). Those affected with AD may live from 3–20 years or more after diagnosis, making the life span with this disease highly variable.
Advanced age is the single most significant risk factor for AD (Alzheimer’s Association, 2012). More women than men have AD, but this is because women live longer than men, not because gender is a risk factor. Family history and heredity are also identified risk factors for AD, as are head trauma and poor cardiac health.
Alzheimer’s disease is characterized by progressive memory loss. The person affected by AD is gradually less able to remember new information and memory lapses begin to affect daily function. It is a terminal disease that over its course will eventually leave a person completely dependent upon others for care.
Initially, the clinical progression of the disease is slow with mild decline; however, deterioration increases the longer the person lives, with an average life span of 8 years after diagnosis (Cotter, 2002; Fletcher, Rapp, & Reichman, 2007). The underlying pathology is not clear, but a growth of plaques and fibrillary tangles, loss of synapses, and neuronal cell loss are key hallmarks of AD that interfere with normal cell growth and the ability of the brain to function. Absolutely definitive diagnosis is still through autopsy, although clinical guidelines make diagnosis easier than decades ago when less was known about the disease. Primary care physicians generally make the diagnosis through a thorough history, physical exam, cognitive testing, and labs. New criteria for diagnosis include staging the disorder and biomarkers (beta amyloid and tau in the cerebrospinal fluid and blood) (Alzheimer’s Association, 2012b). An MRI of the brain may be ordered to rule out other causes of symptoms.
The clinical course of AD is divided into several stages, depending on the source consulted. In the early course of AD, the person may demonstrate a loss of short-term memory. This involves more than common memory loss, such as where the keys were put, and may involve safety concerns such as forgetting where one is going while driving. The inability to perform math calculations and to think abstractly may also be evident. In the middle or moderate phase, many bodily systems begin to decline. The person may become confused as to date, time, and place. Communication skills become impaired and personality changes may occur. As cognitive decline worsens, the person may forget the names of loved ones, even their spouse. Wandering behavior as well as emotional changes, screaming, delusions, hallucinations, suspiciousness, and depression are common. The person with AD is less able to care for her- or himself and personal hygiene suffers. In the most severe and final phase, the person becomes completely dependent upon others, experiences a severe decline in physical and functional health, loses communication skills, and is unable to control voluntary functions. Death eventually results from body systems shutting down and may be accompanied by an infectious process. Although there is no single test, and the diagnosis may be one of exclusion, early diagnosis is important to maximize function and quality of life for as long as possible. Persons experiencing recurring and progressing memory problems or difficulties with daily activities should seek professional assistance from their physician.
Treatment for AD is difficult. There are several medications (such as Aricept, Namenda, Razadyne, and Exelon) that may help symptoms (such as memory), but they do not slow the course of the disease. There is currently no cure; however, research continues to occur in pharmacology, nonpharmacology, and the use of stem cells to manage symptoms and perhaps one day eradicate the disease.
Treatment will focus on symptom management, particularly in the areas of behavior, safety, nutrition, and hygiene. Behavioral issues such as wandering and outbursts pose a constant challenge. Many long-term care facilities have special “memory care” units to care for Alzheimer’s patients from the early to late stages of the disease. These units provide great benefits such as consistent and educated caregivers with whom the patient or resident will be familiar, a safe and controlled environment, modified surroundings to accommodate wandering behaviors, and nursing care 24 hours a day. Additionally, nurses are present to manage medications and document outcomes of therapies. However, many family members wish to care for their loved ones at home for as long as possible.
Thus, another important aspect of care in AD is care for the caregivers. Howcroft (2004) suggested that “support from carers is a key factor in the community care of people with dementia, but the role of the caregiver can be detrimental to the physical, mental, and financial health of a carer” (p. 31). She goes on to say that the caregivers of persons with AD would benefit from training in how to cope with behaviors that arise in these patients and how to cope with practical and legal issues that may occur.
Research has shown that ongoing skills are needed by family caregivers to deal with the progressive decline caused by AD. In fact, “a 63% greater risk of mortality was found among unpaid caregivers who characterized themselves as being emotionally or mentally strained by their role versus noncaregivers” (National Conference of Gerontological Nursing Practitioners & National Gerontological Nursing Association, 2008b, p. 4). Adapting to stress, working on time management, maximizing resources, and managing changing behavior were all skills caregivers needed to develop in order to successfully manage home care of their loved ones. When interventions and resources were not used by caregivers in the early stages of the care recipient’s AD, the risk of a healthy patient being institutionalized due to caregiver burden was higher (Miller, Rosenheck & Schneider, 2012). Caregivers needed not only to acquire knowledge and skills, but also to make emotional adjustments themselves to the ever-changing situation.
Such findings suggest that nurses should focus a good deal of time on educating caregivers of persons with AD to cope with, as Nancy Reagan put it, “the long good-bye.” Scientists continue to explore the causes of AD and hope in the near future to be able to isolate the gene that causes it. In the meantime, results from a fascinating longitudinal study (called the Nun study) on aging and AD, which used a group of nuns who donated their brains to be examined and autopsied after death, has suggested that there is a connection between early “idea density” and the emergence of AD in later life. That is, essays the nuns wrote upon entry to the convent were analyzed and correlated with those who developed AD. It was found that those with lower idea density (verbal and linguistic skills) in early life had a significantly greater chance of developing AD (Grossi, Buscema, Snowdon, & Antuono, 2007; Snowdon, 2004). The nun study has allowed researchers to examine hundreds of brains so far in nuns who died between 75 and 107 years of age and discover other important facts such as a relationship between stroke and the development of AD in certain individuals, and the role of folic acid in protecting against development of AD (Snowdon, 2004). Scientists from a number of fields continue to research the causes and possible treatments for AD and the Nun study project is continuing at the University of Minnesota. Snowdon’s research suggests that early education, particularly in verbal and cognitive skills, may protect persons from AD in later life.
Adapted from Mauk, K. L., Hanson, P., & Hain, D. (2014). Review of the management of common illnesses, diseases, or health conditions. In K. L.
Mauk’s (Ed.) Gerontological Nursing: Competencies for Care. Sudbury, MA: Jones and Bartlett Publishers. Used with permission.
Sometimes the holidays bring with them conundrums, and figuring out good gifts is usually one of them. Finding a present that expresses how much you value the caregiver in your life can be particularly challenging. We’ve pulled together a list of ideas that go the extra mile for that special someone who always serves above and beyond for you or your loved one.
Rest and relaxation
It’s no secret that caregivers bear a heavy burden. Selecting a gift that provides relaxation and comfort can bring meaningful restoration to those in the role of caregiver. Consider an aromatherapy diffuser with essential oils in soothing scents, such as lavender, sandalwood, or vanilla. Along those same lines, you could assemble a gift basket for an indulgent bath. Choose oils, lotions, and bath salts in a favorite scent, and add a luxurious towel and some herbal teas.
If you really want to wow your caregiver, consider splurging on a new mattress. Some of the bed-in-a-box options are particularly outstanding, and it can be delivered straight to the recipient’s door. Look for a top-rated mattress that can fit any sleep style. For example, the Leesa is one great option. It’s a highly-rated foam mattress that’s optimal for all sleeping styles and is perfectly poised between soft and firm.
Connection and caring
Sometimes a break is the best gift you can give someone who is in the role of caregiving. Consider a gift certificate to a local restaurant or movie theater, and include a handwritten note on pretty paper or a card saying you will cover care during the meal.
If your time is tight or the duties are too complex, offer to perform a task for the caregiver instead. Pick up groceries, take her car for an oil change, then get it washed and waxed, or do some yard work or housekeeping. If the caregiver can’t break away, consider reaching out with an offer to bring a meal over. You can prepare lunch and sit down together, which is a chance for companionship and conversation – a gift often beyond immeasurable value.
For an ongoing gift, a meal delivery service can be a boon to caregivers, making nutritious food easy and convenient, or consider a coffee club subscription. If you’re good friends, considering having a movie night together. Popcorn, a dvd, and a few hours of friendship can provide much needed respite, and choosing a comedy offers the bonus of allowing you both to laugh off stress.
Happiness and hobbies
Certain kinds of activities tend to fall by the wayside for caregivers. With that in mind, consider ways to help your caregiver pursue a hobby interest. You can assemble a gift tote of supplies, such as for crafting, baking, or woodworking. Add a note explaining that once a week you’ll cover care, or you could hire an aide to cover that time periodically.
If your special caregiver loves events, tickets to a tour, concert or play can be ideal. Another idea is to purchase participation in a class your caregiver would enjoy, such as in culinary arts, yoga, or music lessons.
For booklovers, a new e-reader could be just the ticket, along with a gift card to download some books. Journaling is a popular stress-reliever for caregivers, allowing them to sort through emotions and process events of the day. Consider purchasing a handmade journal and selecting an especially beautiful pen to go with it.
For caregivers who are primarily housebound, a bird feeder which mounts to the window or could hang from a nearby tree can provide hours of peaceful entertainment and stress relief. Add a pair of binoculars, seed, and a bird identification guide to make your gift complete.
Caregiving is a challenging burden, and those who take on the responsibility are worthy of special gifts. Consider options which show how much you appreciate their self-less, loving assistance. The holidays are the perfect season for demonstrating how grateful you are to the caregiver in your life.