As you grow older, you are going to notice some changes in your brain’s ability to remember things. You go to the kitchen and cannot remember why, or keep forgetting where you place your keys. Sometimes, you miss an important appointment or a loved one’s birthday because it just slipped your mind. Memory lapses can occur at any age. However, as you grow older, you will find that the memory lapses keep increasing which will invariably upset you. Most people tend to relate memory loss with conditions such as dementia.
In some cases, memory loss may indicate such chronic illnesses. However, in most cases, it just reflects regular shifts in the functioning of the brain. Age tends to slow certain cognitive processes thus making it harder for an individual to learn new things and to get rid of distractions that tend to interfere with memory. While these changes may be frustrating, there is hope. Years of research and studies have yielded fruits. There are now certain things you can do to help keep your mind sharp and protect yourself from memory loss.
Stimulate your brain continuously
Sure, you got your degree years ago, got your dream job, married the love of your life and your life is seemingly amazing, you still need to keep learning. According to researchers, advanced education helps to keep your brain active and thus allows you to have a sharper memory. By being active intellectually, you can stimulate the communication among your brain cells. Going to school is not the only way to stimulate your brain, jigsaw puzzles, traveling around the world and learning a new dance can help you keep your mind active. If you have no idea what you can do to achieve this, play a video game. Studies have shown that computer-based brain exercises have managed to promote brain function by increasing the attention span, improving problem-solving, knowledge retention, reasoning and information processing. These studies showed that areas such as an executive control that were not targeted in the exercises also improved meaning that general cognitive health also enhanced through brain exercises.
The doctor always mentions that a healthy diet and regular exercises are what you need to stay healthy and active. Well, they are right. According to a review done in 2008 of more than 50 studies by Kirk Erickson and Arthur Kramer, your brain functions can improve when you engage in regular aerobic exercises. Of course, some people will not work out even if they know that it is good for their body. If you are one of those people, then do it for the sake of your cognitive health. The studies found that regular workouts improved brain functions such as multi-tasking, problem-solving and planning. Even the slightest exercises like a brisk walk twice or thrice a week over a six-month period will reveal great results. One of the studies reviewed showed that patients with early signs of Alzheimer’s disease who exercised regularly had less brain atrophy.
How does it work? Well, the brain’s neuroplasticity is improved by exercises. This means that the brain can grow new neural and blood flow pathways as a response to stimulation by learning new things and exercises. The higher the number of neural pathway reserves in the brain, the better it will be at handling strokes, head traumas and Alzheimer’s disease which are more likely as you grow older.
Use all your senses
If you are learning a new dance, concentrate all your senses into it. The more senses you use, the more active your brain will be in preserving the memory. A study was conducted to find out how memory retention worked. One group was shown images without any emotional implications, and another was shown images with scents associated with them. The pictures with odor were remembered by most of the participants. Therefore, ensure you engage all your senses even when speaking to nurses and friends at the stroke rehab home. It will go a long way in boosting your memory.
It is now possible for you to remember experiences without having to take medication. Learning how to take care of your general health will help stabilize your mental health.
IRC’s interview with Chad Jukes. Chad lost his limb while serving in Iraq and now is a prolific mountain climber. Follow his upcoming climb in Ecuador with the Range of Motion Project (ROMP) in July on our social media. Dan Easton, our Social Media Director for IRC, will also be climbing with Chad and the elite ROMP team.
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.
Whether you enjoy the company of dogs, cats, or even iguanas, pets have been proven to benefit seniors in plenty of ways. For many, they have become an integral part of the family. In fact, assisted-living facilities have adopted a few animals from shelters to keep residents company and uplift their spirits. Pet ownership has helped so many seniors by keeping them physically active, providing emotional support, and even improving cardiovascular health.
However, keeping up with your pet’s needs may not be as easy as it was when you were younger. Elderly individuals may be at a disadvantage when matched with highly-energetic pets. The costs of pet care are also a big consideration in this situation, especially when you have your own care costs to contend with.
To keep all the hassles and stresses at bay, we have listed a few tips in living a happy life with your beloved pets.
- Care providers who include pets
Many care providers include pet care in their list of services. This may consist of dog walking, pet sitting, boarding, grooming, and even training. So check with your care providers if they can also accommodate your pets.
- Maintain a regular schedule for feeding and walking
Schedules and routines do not just benefit the animals; these also can help you maintain a good quality of life. Create a schedule for you and your pets to eliminate surprises and memory lapses that could possibly come with old age.
- Set a spending limit and sticking to it
Though pets undeniably cost money, these expenses can be cut down to affordable amounts. Many veterinarians offer senior discounts, so check if yours provides any for special rates.
There are also various pet-care support programs, like selected Meals on Wheels, which help seniors in providing food for their pets. Low-cost clinics are also a great option for individuals on a budget.
- Create an emergency plan
Individuals get affected by emergencies, which is why they plan and prepare for it. This is also true for our pets. As their caretakers, it is your duty to ensure their safety before, during, and after an unforeseen incident.
Using Ready.gov’s list of steps to take, you will be able to safeguard and care for your pets through pet and animal emergency planning. Through this, you get to rest soundly knowing that they are protected even when you are not present.
ALTCP.org provides free long term care information, resources, long term care insurance quotes and expert planning advice for seniors and adults. Our mission is to raise awareness and promote self-education on the need to plan for long term care and buy long term care insurance.
This type of cancer occurs mainly in older adults, with an average age at diagnosis of 73 years, with 9 out of 10 cases of bladder cancer diagnosed in persons over age 55. The American Cancer Society (ACS)(2012) reported that over 73,000 cases were diagnosed in 2012 and that this diagnosis rate has been relatively stable over the last 20 years. Men are three times as likely to get cancer of the bladder as women (American Foundation for Urologic Disease, 2008) and the incidence increases with age.
Risk factors include chronic bladder irritation and cigarette smoking, the latter contributing to over half of cases. Male gender and age are also risk factors.
The classic symptom of bladder cancer is painless hematuria (blood in the urine). Older adults may attribute the bleeding to hemorrhoids or other causes and feel that because there is no pain, it must not be serious.
Assessment begins with a thorough history and physical. Diagnosis may involve several tests including an intravenous pyelogram (IVP), urinalysis, and cystoscopy (in which the physician visualizes the bladder structures through a flexible fiber-optic scope). This is a highly treatable type of cancer when caught early. In fact, the ACS (2012a ) estimates that there were more than 500,000 survivors of this cancer in 2012.
Once diagnosed, treatment depends on the invasiveness of the cancer. Treatments for bladder cancer include surgery, radiation therapy, immunotherapy, and chemotherapy (ACS, 2012). Specifically, a transurethral resection (TUR) may involve burning superficial lesions through a scope. Bladder cancer may be slow to spread, and less invasive treatments may continue for years before the cancer becomes invasive or metastatic, if ever. Certainly chemotherapy, radiation, and immune (biological) therapy are other treatment options, depending on the extent of the cancer.
Immune/biological therapy includes Bacillus Calmette-Guérin (BCG) wash, an immune stimulant that triggers the body to inhibit tumor growth. BCG treatment can also be done after TUR to inhibit cancer cells from re-growing. Treatments are administered by a physician directly into the bladder through a catheter for 2 hours once per week for 6 or more weeks (Mayo Clinic, 2012a). The patient may be asked to lay on his/her stomach, back, and or sides throughout the procedure. The patient should drink plenty of fluids after the procedure and be sure to empty the bladder frequently. In addition, because the BCG contains live bacteria, the patient should be taught that any urine passed in the first six 6 hours after treatment needs to be treated with bleach: One cup of undiluted bleach should be placed into the toilet with the urine and allowed to sit for 15 minutes before flushing (Mayo Clinic, 2012a).
If the cancer begins to invade the bladder muscle, then removal of the bladder (cystectomy) is indicated to prevent the cancer from spreading. Additional diagnostic tests will be performed if this is suspected, including CT scan or MRI. Chemotherapy and/or radiation may be used in combination with surgery. When the cancerous bladder is removed, the person will have a urostomy, a stoma from which urine drains into a collection bag on the outside of the body, much like a colostomy does. Bleeding and infection are two major complications after surgery, regardless of type, whether a TUR or cystectomy is performed. Significant education of the patient related to intake/output, ostomy care, appliances, and the like is also indicated.
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.
Stroke, also known as cerebrovascular accident (CVA) or brain attack, is an interruption of the blood supply to the brain that may result in devastating neurological damage, disability, or death. Approximately 795,000 people in the United States have a new or recurrent stroke each year (American Stroke Association [ASA], 2012a). Stroke accounts for 1 in 18 deaths, making it the fourth leading cause of death in the United States. A death from stroke occurs every 4 minutes and the cost of stroke treatment and disability was over $73 billion dollars in 2010. Death from stroke is generally higher among females, with higher rates in Black males (67.7/100,000) and females (57.0/100,000) than in Caucasians (ASA, 2012a). In Canada, stroke is the fourth leading cause of death, affecting 50,000 people each year (Heart and Stroke Foundation of Canada, 20059).
There are two major types of stroke: ischemic and hemorrhagic. The vast majority of strokes are caused by ischemia (87%), usually from a thrombus or embolus (ASA, 2012a). The symptoms and damage seen depend on which vessels in the brain are blocked. Carotid artery occlusion is also a common cause of stroke related to stenosis
Some risk factors for stroke are controllable and others are not. The most significant risk factor for stroke is hypertension. Controlling high blood pressure is an important way to reduce stroke risk. Those with a blood pressure of less than 120/80 have half the lifetime risk of stroke as those with hypertension (ASA, 2012a). Smoking 40 or more cigarettes per day (heavy smoking) increases the stroke risk to twice that of light smokers. If a person quits smoking, their risk after 5 years mirrors that of a nonsmoker, so older adults should be particularly encouraged to stop smoking.
Several warning signs are common. These include:
SUDDEN numbness or weakness of face, arm or leg – especially on one side of the body.
SUDDEN confusion, trouble speaking or understanding.
SUDDEN trouble seeing in one or both eyes.
SUDDEN trouble walking, dizziness, loss of balance or coordination.
SUDDEN severe headache with no known cause (National Stroke Association, 2013)
There are several tools for assessing for signs and symptoms of stroke. One easy acronym is FAST:
F stands for facial droop. Ask the person to smile and see if drooping is present.
A stands for arm. Have the person lift both arms straight out in front of him. If one is arm is drifting lower than the other, it is a sign that weakness is present.
S stands for speech. Ask the person to say a short phrase such as “light, tight, dynamite” and check for slurring or other abnormal speech.
T stands for time. If the first F-A-S checks are not normal, then one is to remember F-A-S-T that Time is important and the emergency medical system should be activated (National Stroke Association, 2012).
Older adults experiencing the warning signs of stroke should note the time on the clock and seek immediate treatment by activating the emergency response system in their area calling 911 (American Stroke Association, 2012). Transport to an emergency medical facility for evaluation is essential for the best array of treatment options. A history and neurological exam, vital signs, as well as diagnostic tests including electrocardiogram (ECG), chest Xx-ray, platelets, prothrombin time (PT), partial thromboplastin time (PTT), electrolytes, and glucose are routinely ordered. Diagnostic testing imaging may include computed tomography (CT) without contrast, magnetic resonance imaging (MRI), arteriography, or ultrasonography to determine the type and location of the stroke. The CT or MRI should ideally be done within 90 minutes so that appropriate emergency measures may be initiated to prevent further brain damage.
The first step in treatment is to determine the cause or type of stroke. A CT scan or MRI must first be done to rule out hemorrhagic stroke. Hemorrhagic stroke treatment often requires surgery to evacuate blood and stop the bleeding.
The gold standard at present for treatment of ischemic stroke is t-PA (tissue plasminogen activator). At this time, t-PA must be given within 3 hours after the onset of stroke symptoms. This is why it is essential that older adults seek treatment immediately when symptoms begin. Only about 3 – 5% of people reach the hospital in time to be considered for this treatment (ASA, 2012d). t-PA may be effective for a select group of patients after the 3-hour window (up to 4.5 ½ hours), and this treatment window has been approved in Canada (Heart and Stroke Foundation of Canada, 2009). The major side effect of t-PA is bleeding. t-PA is not effective for all patients, but may reduce or eliminate symptoms in over 40% of those who receive it at the appropriate time (Higashida, 2005). Other, much less common procedures such as angioplasty, laser emulsification, and mechanical clot retrieval may be options for treatment of acute ischemic stroke.
To prevent recurrence of thromboembolic stroke, medications such as aspirin, ticlopidine (Ticlid), clopidogrel (Plavix), dipyridamole (Persantine), heparin, warfarin (Coumadin), and enoxaparin (Lovenox) may be used to prevent clot formation. Once the stroke survivor has stabilized, the long process of rehabilitation begins. Each stroke is different depending on location and severity, so persons may recover with little or no residual deficits or an entire array of devastating consequences.
The effects of stroke vary, and some persons may recover with no residual effects. But more often, stroke survivors may have problems that include hemiplegia or hemiparesis (paralysis or weakness on one side of the body), visual and perceptual deficits, language deficits, emotional changes, swallowing dysfunction, and bowel and bladder problems. Ninety percent of all dysphagia (swallowing problems) results from stroke (White, O’Rourke, Ong, Cordato, & Chan, 2008).
Rehabilitation after a stroke focuses on several key principles. These include maximizing functional ability, preventing complications, promoting quality of life, encouraging adaptation, and enhancing independence. Rehabilitation emphasizes the survivor’s abilities, not disabilities, and helps him or her to work with what he or she has while acknowledging what was lost.
Stroke survivors go through a unique recovery process. This model shows the process of stroke recovery where forward progress after stroke lead to acceptance and adaptation:
If significant functional impairments are present, evaluation for transfer to an intensive acute inpatient rehabilitation program is recommended. Inpatient rehabilitation units offer the survivor the best opportunity to maximize recovery, including functional return. An interdisciplinary team of experienced experts, including nurses, therapists, physicians, social workers, and psychologists, will help the survivor and the family to adapt to the changes resulting from the stroke. Outcomes for geriatric stroke survivors are enhanced by intensive rehabilitation programs, whether offered in rehabilitation units or in skilled nursing facilities (Duraski, Denby, Danzy & Sullivan, 2012; Jett, Warren, & Wirtalla, 2005).
A large amount of teaching is often done by stroke rehabilitation nurses who work with older survivors and their families. These include knowing the warning signs of stroke and how to activate the emergency response system in their neighborhood, managing high blood pressure, understanding what medications are ordered as well as how often to take them and why, the importance of regular doctor visits, preventing falls and making the home environment safe, available community education and support groups, and the necessity of maintaining a therapeutic regimen and lifestyle to decrease the risk of complications and recurrent stroke. All survivors will need assistance in re-integrating into the community. This is generally begun in the rehabilitation setting.