Senior
Lif l LIVING a blank slate media/litmor publications advertising section • march 23, 2018
34 SENIOR LIVING • Blank Slate Media Newspapers, Friday, March 23, 2018
Avoiding falls key to good health Tips to risk chance of a fall in the home, many of which are covered by insurance BY D AV I D J . SANDS, DPM
Every second of every day in the United States an older adult falls. This makes falls the number one cause of injuries and deaths from injury among older Americans. In 2014 alone, older Americans experienced 29 million falls causing seven million injuries and costing an estimated $31 billion in annual Medicare costs. Eighty-seven percent of all fractures in the elderly are due to falls. Two-thirds of those who fall will do so again within six months. When an older person falls, his or her hospital stays are almost twice as long as those of older patients who are admitted for any other reason.! Among people aged 65 to 69, one out of every 200 falls results in a hip fracture. That number increases to one out of every 10 for those
aged 85 and older.! Onefourth of seniors who fracture a hip from a fall will die within six months of the injury. Many falls do not result in injuries, yet 47 percent of noninjured seniors who fall cannot get up without assistance. Falls, with or without injury, also carry a heavy quality of life impact. A growing number of older adults fear falling and, as a result, limit their activities and social engagements. This can result in a further physical decline, depression, social isolation, and feelings of helplessness. The most profound effect of falling is the loss of independent living. Many older patients are resistant to using a cane, let alone a walker.! Trying to get them to agree to a home assessment is next to impossible. To get them to consider wearing an ankle brace is even harder.! Patients will take a myriad of medications prescribed by their internist with-
out question but will be so resistant to doing something that will clearly reduce their risk of falling. The analogy can be made that the prescription for your high blood pressure is a pill, and your prescription for your risk of falling is…” There are so many things that can be done for patients that are at risk of fall, most of which are covered by insurance/Medicare, why not take advantage?! The following are some things that can be done to reduce risk of fall. Home fall-risk assessment: many healthcare agencies will come in and assess ones home to make suggestions to reduce risk of fall in the home. Here are some great tips for reducing risk of fall in the home: Remove obstacles inside and outside of the house that could cause tripping. Install handrails and lights on staircases, with light switches at the top and bot-
tom of the stairs. Add nonslip treads for bare wooden steps. Install shower and tub grab bars in the bathroom, around the toilet and the tub. Place no-slip mats on the shower floor and bathtub. Secure loose rugs with double-faced tape, tacks, or slip-resistant backing. Store clothing, dishes, food and other necessities within easy reach. Make home lighting brighter. Have vision checked often and regularly. Have the senior wear sensible shoes. They should be properly fitting, sturdy shoes with nonskid soles. Consider a PERS (Personal Emergency Response System) unit that will alert others when help is needed. Physical Therapy: PT is a great tool for patients that are at risk of falling. Most therapy facilities will now come to the patient’s home which is a great conve-
nience.! There are many therapeutic modalities that can reduce one’s risk of fall, and a good therapist that has experience with balance therapy can be a great resource. Assistive Devices: canes, walkers, orthopedic shoes, braces; these words are often stigmatized in the older population. Using a cane or walker can make an older patient feel inferior.! It is seen as a sign of age and loss of function and independence. Many of my patients shun the use of an assistive device because they don’t want to give in to father time. In conclusion, an elderly patient’s risk of fall is the leading cause of mortality in this population.! There are so many things that can be done to limit such risk. Information provided by David J. Sands, DPM, www.sandspodiatry.com. !
Blank Slate Media Newspapers, Friday, March 23, 2018 • SENIOR LIVING
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36 SENIOR LIVING • Blank Slate Media Newspapers, Friday, March 23, 2018
How a P.T. can help you age well BY ROB ZIEGELBAUM, PT, DPT, TPI As we get older, our bodies undergo changes that play a role in how we go about our lives. Tasks that were previously commonplace may present more of a challenge. However, that is not to say that we can’t adapt. Physical therapy can play a crucial role in how we tackle the marathon of aging. Performing transfers like standing up from a chair, reaching into cabinets and walking in the community are things that the younger population may take for granted — in the rehab world we refer to these as activities of daily living. With the guidance of a physical therapist, increased independence during ADLs can be either re-attained or made sustainable for the long term. A very common complaint from elderly patients is difficulty standing up from a chair or sofa in their homes. While there are many reasons why the transfer can pres-
Y u
ent difficulty, several steps can be performed to increase efficiency. Strengthening your legs under the guidance of a physical therapist is a good place to start. In addition to strength, putting yourself in a position to succeed is crucial; patients are coached in the “nose over toes” method. The first instruction in the transfer is to slide to the edge of the chair and bring their feet back towards the seat. The next part lends itself to the name of the method – lean forward, such that a person’s nose is on top of their toes. This shift forward increases a person’s ability to stand up. Across all body parts, range of motion and strength are critical in increasing an individual’s level of function. Our shoulders are one of the most mobile joints in our bodies. The large range of motion that our shoulders are capable of allows us to do a wide variety of tasks. The muscles in our shoulders — such as the rotator cuff muscles—are critical in stabilizing our shoulders through motions in our day-to-day lives.
As we get older and perhaps slightly less active, muscle strength can diminish. The decrease in strength in the shoulders can then become a limiting factor in an individual’s ability to perform functional tasks such as lifting a carton of milk and placing it in the refrigerator. A physical therapist can instruct a patient in a proper strengthening regiment to address deficiencies a person may have in their strength. Isometric rotator cuff exercises are often the starting point in a strengthening program. Isometric exercises are safer initially in that the patient is in total control of the amount of force exerted without adding resistance. An added perk of these exercises is they don’t require equipment, so they can be done anywhere! A common problem people in the elderly population face is difficulty walking and balance issues. A fear of falling is a legitimate and real problem. Physical therapists can aid in reducing the risk of falls through a variety of methods. In order to
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maintain our balance, our bodies rely on three systems: vision, sensation and our vestibular system located in our inner ear. To remain upright, we need two of the three to be functioning properly. Physical therapists can assist with deficits in all three areas, but we will hone in on sensation. As people age, the nerves furthest away from our core become less efficient in transferring information to the brain. These nerves are called peripheral nerves. When peripheral nerves in the feet are affected, as often is the case in the elderly population, messages about where the feet are in space are lost and balance is affected. Physical therapist can’t stop this aging process, but can facilitate something known as neuroplasticity.## Neuroplasticity is an amazing phenomenon that our brains are capable of wherein the body subconsciously finds nerves that are functioning properly to pick up the slack for others that are lagging behind. One way to do this in terms of balance is
through exposure. A physical therapist will perform supervised weight shifting in all directions to allow the individual to feel their body move in space without the risk or fear of falling. Cues for mechanics during ambulation are also crucial to increase safety and independence when walking on all surfaces. A solid program for balance strategies coupled with leg strengthening and gait mechanics can greatly affect a person’s ability to walk or stand with confidence while performing ADLs. Getting older comes with a multitude of changes, but with the guidance of a PT the transition can be a smooth one. A supervised treatment plan and an appropriate home exercise program can be a huge asset in increasing independence. Aging is a privilege, and the human body is capable of incredible things – take advantage! Information provided by Rob Ziegelbaum PT, DPT, TPI, Clinical Director/Physical Therapist at Zelik Ziegelbaum Physical Therapy, www.ZZ-PT.COM
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Blank Slate Media Newspapers, Friday, March 23, 2018 • SENIOR LIVING
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38 SENIOR LIVING • Blank Slate Media Newspapers, Friday, March 23, 2018
Steps involved with estate planning
A
lthough inevitable, death is an emotional subject that’s difficult to discuss. While estate planning can make people uncomfortable, it is an essential part of securing assets for future generations and can make a death in the family easier for loved ones to handle. Estate planning is an umbrella term that refers to a host of things that must be done prior to a person’s death, including writing a will and even making funeral arrangements. Estate planning attempts to eliminate financial uncertainties and maximize the value of an estate, and allows men and women to state their wishes with regard to long-term healthcare and guardianship for their children. When done right, estate planning can prevent family feuds and ensure that the deceased’s estate stays in the hands of family rather than being relegated to the government. Estate planning can be a complex process, so men and women should seek help to ensure the process
Funeral arrangements
goes smoothly.
Getting started
Estate planning should begin early in a person’s life, especially for young parents. It’s easy to talk about saving for a home or retirement, but it’s not so simple to discuss who will care for your children should you die while they are still minors. Those who are not able to sort through these answers on their own should enlist the help of an attorney or a financial adviser, both of whom can take some of the emotion out of the discussion and put it in more practical terms.
The will
A will is an important component of estate planning. Without clearly and legally spelling out your wishes, there is no guarantee that those wishes will be honored. It will be up to a state or province to make potentially life-altering decisions that can impact your surviving family members, and the only way to ensure your
wishes will be carried out is to put them into a will. Although men and women can write their own wills, many people prefer to seek the assistance of an attorney, who can make sure all necessary details are included in the will.
Medical directives
In addition to a will, estate planning includes your wishes if you become incapacitated or
suffer from a serious medical condition that precludes you from making decisions about your care and finances. Spouses can be named to make important health decisions, but you may want to indicate other information, such as life support measures or organ donation, as well. If you have strong opinions on treatment, medical directives and living wills are a necessity.
Another aspect of estate planning concerns funeral arrangements. Many people prefer to make their own funeral and burial plans so that these heart-wrenching decisions do not fall on the shoulders of grieving family members. Funeral planning may include choosing a burial plot, selecting a casket, indicating cremation, and paying for everything in advance so there is no financial burden on surviving family members. According to the funeral planning website Efuneral.com, the average cost of a funeral in the United States in 2012 was more than $8,500 for a burial service and $3,700 for a cremation. That’s a considerable expense that you may not want surviving family members to pay. Estate planning is a process that is difficult to discuss, but one that is essential to maximize your assets and ensure your end-of-life wishes are honored.
The best countries for retirees M any couples look to downsize once they retire. Empty nest retirees may no longer need their large family homes, which can be expensive and difficult for seniors to maintain. While some retirees choose to move into senior living communities or condominiums, some opt to be a bit more adventurous and venture further from home.
A number of retirees choose to spend their golden years abroad. Doing so can equate to a more adventurous retirement, a lower cost of living and the ability to stretch retirement savings much further than if you decided to stay closer to home. Many of the more popular international retirement locations offer beautiful climates, culture and health care systems that are hospitable to retirees. Affordability is a key consideration for men and women mulling whether or not to retire internationally. According to U.S. News and World Report, retiring overseas may run the average person anywhere from $700 to $1500 USD per month. Those who can offer higher budgets may be able to retire to any location of their choosing. Before you make any drastic changes, first calculate your retirement budget. Add up retirement savings, Social Security income (if applicable), pensions, and any other investments or savings you may have. Have an estimate of the market value of your current home and any other property you may own. These figures will be your working numbers. Subtract your age from your estimated life expectancy and divide the retirement funds sum by that many years to see how much per month you will have to spend. Once you have established your budget, begin investigating where you
would like to live. Argentina, Ecuador, Belize, Costa Rica, and France are some of the more popular retirement locations among North Americans. Once you’ve selected a potential location, take a vacation there and explore. In addition to the climate, check out the infrastructure, shopping, medical services, amenities, and crime rates. Try the place on for size and figure out if this is an area where you can comfortably spend your retirement.
Once you have narrowed down your prospects, contact your native country’s embassy to determine what will be needed to legally live in a foreign country and obtain a visa. Some places are more accommodating than others with regard to residency visas. It also pays to contact an accountant or tax professional to see what, if any, taxes you will still be required to pay even if you move abroad. Your obligation may be less than if you chose to stay closer to home. Another consideration is health insurance. Government-sponsored plans may not cover services overseas, requiring you to find an alternative insurance source. The good news is that many international plans may be more affordable than ones found in the United States. Retiring abroad does not mean you have to cut all ties to home. Some couples choose to keep dual residency and fly back and forth when necessary. But the slower pace, affordability and other draws of international retirement spots could be challenging to leave behind. AARP, Forbes and International Living routinely rank the best international retirement destinations. Check with these sources for more information about retiring abroad.
Blank Slate Media Newspapers, Friday, March 23, 2018 • SENIOR LIVING
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Did You Know?
f you have psoriasis, an autoimmune skin condition marked by red, flaky patches on the body, you also could be at risk for a certain type of arthritis. Psoriatic arthritis, which causes stiffness, swelling and pain in and around the joints, affects up to 30 percent of people with psoriasis, says the National Psoriasis Foundation. While psoriatic arthritis can develop at any time, it is most common in people between the ages of 30 and 50. This type of arthritis can develop slowly or come on quickly and be severe. Just like psoriasis itself, psoriatic arthritis tends to go through periods of flare-up and remission. Typically, the skin condition precedes the joint disease in 85 percent of patients. Keep in mind that a severe case of psoriasis will not necessarily translate into a severe case of arthritis. Psoriatic arthritis may be treated like other forms of arthritis. Doctors may prescribe anti-inflammatory drugs,
antirheumatic drugs, exercise, and complementary therapies. Those who have psoriasis and have begun to experience joint pain and stiffness should talk to a doctor about potential therapies.
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40 SENIOR LIVING • Blank Slate Media Newspapers, Friday, March 23, 2018
3 money-saving Make vacations and travel tips travel a key component for retirees of your retirement T
W
hen the time comes to bid farewell to conference calls, meetings and daily commutes, retirees have open schedules to fill with whichever activities they choose. Travel is one exciting way to pass the time.
Traveling can be a rewarding prospect for active seniors, particularly those who successfully preplanned for retirement and have the income to fund various excursions. Many seniors, both in the United States and Canada, find that travel tops their to-do lists once they retire. According to Senior Travel magazine, new travel options are emerging for newly minted retirees looking for something a little different from the status quo. The list of destinations retirees have at their disposal is limitless. The following ideas are some of the more popular ways retirees choose to travel.
Road trips rule. Taking to the highways and byways is an excellent way to see the country. Seniors can customize their routes depending on which places they want to visit. RV travel can be as comfortable or as
rustic as travelers prefer. Many seniors spend months traveling in their campers, which offer many of the same amenities of home. Campsites and special RV hook-up sites offer the other necessities of traveling the open road.
Genealogical tourism is popular. People hoping to trace their ancestry and visit their ancestral homelands are one of the fastest-growing travel segments. Visiting an old church in Europe where ancestors were married or buying food from a market in which a great aunt or uncle once worked leads retirees on many international adventures. Such trips provide travelers with a unique opportunity to understand their roots up close and personal while enjoying some international travel along the way. Exotic tours can be exciting destinations. History buffs or adventure-seeking couples may be particularly attracted to exotic travel destinations that are slightly off of the beaten path. Travel tours may take vacationers to destinations such as excavation sites or backpacking through the rainforest. With passport in
hand, seniors can go just about anywhere their desires take them.
Enjoy a relaxing seaside trip. A seaside vacation can be the perfect trip for seniors who want to put their feet up and sip some cocktails while watching the waves lap the shores. Many beach resorts offer all-inclusive packages for different age groups. Meals, excursions and hotel rooms can be bundled into one affordable, confusion-free price. Go cruising. Speaking of allinclusive vacationing, cruising seems tailor-made for those ages 50 and older because it offers the convenience of accommodations, food, entertainment, and transportation all in one. The various activities offered on the ship mean travelers can find ways to spend their time how they see fit. Cruising couples can opt to spend all of their time on the ship enjoying carefully prepared meals and entertainment or disembark and explore the various ports of call along the way. Now that they have more free time, retirees can gear up for travel adventures to remember.
hough a transient lifestyle is something few people aspire to during much of their lives, come retirement, the idea of staying in a place for only a short time has more appeal.
According to a recent study from the Transamerica Center for Retirement Studies, 36 percent of baby boomers want to spend their retirements traveling. Many are succeeding in doing just that, as a study from the luxury travel network Virtuoso found that today’s seniors spent an average of just over $11,000 per year on travel. That was more than any other generation, highlighting just how much older adults like to get out and explore the world. Retirees who fear they cannot afford to travel can explore the various ways for seniors to cut costs and still satisfy their wanderlust during retirement.
1. Take advantage of age-related discounts.
Some adults prefer to hide their ages, but when it comes time to travel during retirement, honesty is the best policy. Many businesses that cater to travelers offer discounts to seniors. Car rental agencies, hotels, travel agencies, and cruise lines may offer direct discounts to customers 65 and older, while membership in organizations such as AAA and AARP may make seniors eligible for additional discounts. Discounts on lodging and airfare might net the biggest savings, but even discounts on various smaller expenses can add up to big savings.
2. Don’t overlook travel agencies.
While many prospective travelers’ first instincts are now to visit various travel websites in an effort to find the most affordable trips, it’s important that travelers not overlook travel agencies when planning trips. Travel websites, though a valuable resource, only list the hotels and airlines that agree to be included on their sites. While many participate, some do not, and those that do not may instead work independent of travel websites or partner with travel agencies. Travel agencies have access to the latest information, and many specialize in certain countries, knowing all the attractions visitors to their countries want to see. Travel agencies may offer packages that include admissions to popular attractions, which can be more affordable than planning a trip a la carte.
3. Travel as part of a group.
Group travel may not appeal to everyone, but it should appeal to older, budget-conscious travelers. Retirees who are uncomfortable driving at home will likely be even less comfortable driving in foreign countries where the rules of the road are not the same. Traveling in groups, whether it’s with a retirement community, religious organization or another program, can save travelers substantial amounts of money. Many hotels and tourist attractions offer steep discounts for group tours, which can even be arranged through travel agencies. A hidden benefit of signing up for a group tour is the chance to meet new people and develop new relationships with fellow globetrotters. Many working professionals hope to spend the bulk of their retirement traveling the globe. While such a goal is potentially costly, there are various ways to save and still see the world.