More Caregivers Are No Spring Chickens Themselves

by Paula Span

Gail Schwartz wants to keep her 85-year-old husband out of a nursing home as long as she can, but it isn’t easy.

Because David Schwartz, a retired lawyer, has vascular dementia and can no longer stay alone in their home in Chevy Chase, Md., she tends to his needs from 1 p.m. to 11 p.m. every Monday through Saturday and all of Sunday. When she dashes out for errands, exercise and volunteer work in the morning, she checks in by phone with the aides she has hired. “I’m always on alert,” she said. “At the grocery store, I’m thinking, ‘Is David O.K.?’ ”

An aide now stays overnight, too, because Mr. Schwartz awakened so frequently, disoriented and upset, that his wife began to suffer the ill effects of constantly disrupted sleep. She has moved into the bedroom across the hall. “I need my rest,” she said. “I’m no spring chicken myself.”

Indeed, Gail Schwartz is 78. While she thinks her husband does better at home — “he’s getting 24-hour attention, and you don’t get that in a nursing home,” she said — friends point out that the arrangement is much harder on her. She worries, too, about costs climbing as Mr. Schwartz’s health declines and his needs increase. For now, though, she manages, part of an apparently growing phenomenon: the old taking care of the old.

Every few years, the National Alliance for Caregiving and the AARP Public Policy Institute survey the state of American caregiving; their latest report, published last month, focused in part on caregivers over 75. They constitute 7 percent of those who provide unpaid care to a relative or friend, the survey found — more than three million seniors helping with the so-called activities of daily living (bathing, dressing, using a toilet), instrumental activities of daily living (shopping, transportation, dealing with the health care system) and a rising tide of medical and nursing tasks.

Almost half of them report caring for a spouse; the others assist siblings and other relatives, friends or neighbors, most also 75 or older. About 8 percent of these oldest caregivers still care for parents.

The aging of the population has thrust more seniors into this role, said Gail Hunt, president and chief executive of the National Alliance for Caregiving. “There didn’t use to be so many 95-year-olds,” she said, “and someone’s caring for those 95-year-olds.”

That’s challenging for anyone, though the extent of what’s called “caregiver burden” remains a subject of debate. For years, researchers have presented caregiving stress as a potential source of depression, compromised health, even premature death. Some of those findings are being reassessed; a recent study in The Gerontologist, for instance, argues that the picture is “overly dire” and that several studies find benefits for caregivers — the “healthy caregiver” hypothesis. (My own hypothesis: Both responses can be true, with caregiving providing purpose and activity in some situations but proving exhausting in others.)

People over 75, however, can find caregiving particularly taxing. They spend an average of 34 hours a week on caregiving tasks, the National Alliance for Caregiving report found, 10 hours more than caregivers over all, and they are less apt to have other unpaid help.

Because 46 percent take care of spouses, they are also more likely to be live-in caregivers, a known source of strain. “You’re responsible for their safety,” Ms. Hunt said. “You have to interact with the person all day long and maybe all night long, so your sleep is disturbed. It’s more stress than if you’re coming over periodically to help.”

The typical older caregiver in the study had been providing care for over five years. “Just the physical part of it, the lifting and bathing and all of that, can hurt you,” said Donna Wagner, dean of the College of Health and Social Services at New Mexico State University and a longtime researcher on family caregiving. Older caregivers, typically women, have their own health issues.

“My mother is a perfect example,” Dr. Wagner said, describing her as a 4-foot-10 woman who cared for her husband, an obese man with heart disease and diabetes, for seven or eight years. “I don’t even know how she managed,” Dr. Wagner said. After he died at 85, “it didn’t take her long to slide right into dementia. It’s as if she put it off while she had responsibility for him. There are a lot of mysteries.”


The Ultimate Anti-Inflammatory Foods List

Is an anti-inflammatory diet the answer to chronic health ailments? Researchers have found that natural anti-inflammatory foods are a critical part of a healthy diet.The Ultimate Anti-Inflammatory Foods List

One of the major dietary concerns is the specter of chronic inflammation. Regular inflammation is part of the immune system’s natural response, mobilizing the body’s resources to fight injury or infection. But when inflammation becomes chronic and persists over a long period of time, it can increase the risk of long-term illness. Diet is one piece of the complex puzzle that we can easily control – making the right nutritional choices can help us minimize inflammation and, with it, the risk of disease.

Why Choose an Anti-Inflammatory Diet?

Chronic inflammation has various potential causes, including long-term stress or illness, environmental toxins, lack of exercise, genetic predisposition – as well as too many processed foods or an otherwise poor diet. In fact, some foods are theorized to exacerbate inflammation in the body, like beef, fast food and foods that spike blood sugar, like refined flour or sugary drinks. Meanwhile, recent studies have shown that dieting and fasting may prompt an anti-inflammatory response.

Those who do not eat enough anti-inflammatory foods may be at risk for a number of chronic and long-term ailments, such as heart disease, Type 2 diabetes, Alzheimer’s disease, rheumatoid arthritis, and many cancers and autoimmune diseases. Luckily, simple dietary changes that include anti-inflammation foods can help prevent these conditions and boost overall wellness.

20 Best Foods for Fighting Inflammation

Incorporate more of these delicious, natural anti-inflammatory foods into your diet to promote healthy habits in yourself and your family:

1. Whole grains: Eat these to gain more fiber, which has been associated with fewer signs of inflammation. They also have a lower glycemic index, for those watching blood sugar levels.

2. Berries and tart cherries: Fruit in general is high in antioxidants, and berries in particular have anti-inflammatory properties because they contain healthy polyphenols and anthocyanins.

3. Olive oil: This plant-based fat is great for a heart-healthy diet and contains healthy oleic acid. It’s also delicious and fits in well with the Mediterranean diet.

4. Cruciferous vegetables: Vegetables in the cabbage family contain numerous nutrients, including antioxidants, which protect the body from the free radicals which can prompt inflammation.

5. Fatty fish: Cold-water fish like salmon and sardines contain omega-3 fatty acids, which have significant anti-inflammatory properties if eaten a few times a week. Those who don’t like fish may want to consider fish oil supplements instead.

6. Tomatoes: Tomatoes are rich in lycopene, an antioxidant that may reduce inflammation in the lungs and elsewhere in the body.

7. Peppers: These, too, contain antioxidants: in this case, vitamin C. They also contain capsaicin, a chemical which reduces inflammation. Those with rheumatoid arthritis may want to be careful, though, with peppers, tomatoes and other members of the nightshade family.

8. Leafy greens: Spinach, kale and other dark leafy greens contain an abundance of healthy compounds including vitamin E, calcium, iron, and phytochemicals that help reduce inflammation.

9. Apples: Apples, like most other fruits, contain healthy phytonutrients that help protect against age-related diseases.

10. Nuts: Walnuts contain omega-3s, almonds and macadamias contain oleic acid, and nearly all nuts contain antioxidants – key ingredients in helping the body fight inflammation. Many nuts and their oils are also considered healthy fats.

11. Garlic and onions: Besides being delicious, garlic and onions contain anti-inflammatory chemicals like the antioxidant quercetin, which naturally inhibits histamine.

12. Soy and soybeans: Soy-based foods contain a high amount of vegetable-based protein, as well as isoflavones, which may help reduce inflammation in women. Avoid highly processed soy that may contain additives, and go for tofu, soymilk, and edamame.

13. Ginger and turmeric: These two spices often found in Indian food have anti-inflammatory properties. Turmeric contains curcumin, a particularly potent anti-inflammatory compound. If these flavors don’t appeal to you, try supplements.

14. Carrots: Carrots are rich in the antioxidant beta-carotene, which helps reduce free radicals in the body.

15. Low-fat dairy: Dairy can prompt inflammation in certain sensitive people, but high-quality and low-fat dairy products like good cheese and yogurt are an excellent source of protein, probiotics, and calcium.

16. Beets: Beets are one of those colorful vegetables with ample fiber, vitamin C, and phytonutrients. If you hate canned beets, make sure you give fresh beets a try – they are completely different.

17. Orange winter squash: Like carrots, orange winter squashes like the sweet butternut squash contain plenty of the antioxidant beta carotene.

18. Beans: Particularly important for those who eat little or no animal protein, beans contain lots of vegetable protein as well as fiber.

19: Sweet Potatoes: Another healthy carbohydrate, sweet potatoes also contain fiber, antioxidants, and the phytonutrient beta carotene.

20: Tea: White, green, and oolong tea in particular contain phytonutrients and flavonoids which help reduce inflammation.

For those at risk of chronic conditions like heart disease, diabetes and Alzheimer’s – and for those of us who want to age as well as possible – a healthy diet rich in anti-inflammatory foods can help ward off illnesses related to chronic inflammation. Even if you aren’t worried about inflammation, a diet that contains enough anti-inflammatory nutrients will also generally be heart healthy and delicious. What more can we ask for as we get older?

by: Sarah Stevenson

What Are the Benefits of Tai Chi?

Tai chi chuan, a gentle form of martial arts combining deep, diaphragmatic breathing and flowing, dancelike poses, can be a remarkably potent workout for people of many ages. In various recent studies and reviews, tai chi has been found to improve practitioners’ balance, leg strength, cardiovascular endurance, pulse rate, muscular flexibility, immune system response, sleep habits, happiness, sense of self-worth, and ability to concentrate and multitask during cognitive tests.

In one especially impressive study from last year, the brains of older people who had been practicing tai chi for several years were compared with the brains of age-matched sedentary adults. The tai chi participants showed greater connectivity and other measures of health in portions of the brain known to be involved in decision-making and attention than the volunteers who had never done tai chi.

Overall, tai chi “can improve both physical and psychosocial health,” said Dr. Chenchen Wang, the director of the Center for Complementary and Integrative Medicine at Tufts Medical Center in Boston.

Scientists haven’t yet determined, though, whether tai chi is substantially better for you than other types of light-to-moderate exercise, such as walking, yoga or weight training, said Fuzhong Li, a principal investigator at the Oregon Research Institute, who has studied tai chi. Comparative effectiveness studies pitting the activities against one another have not been done.

But tai chi is definitely better than no or very light activity. “Our work does suggest that tai ji chuan”— another form of the activity’s name — “produces far better outcomes compared to low-impact activities such as stretching,” Dr. Li said.

Many community centers and Y.M.C.A.’s nationwide offer low-cost classes, Dr. Li said. You can find a program near you by visiting the American Tai Chi and Qigong Association’s website

Gretchen Reynolds

Medicare Toughens Standards on Nursing Homes

By Katie Thomas

The star ratings of nearly a third of the nation’s nursing homes were lowered on Friday, as federal officials readjusted quality standards in the face of criticism that the ratings were inaccurate and artificially inflated.

Federal officials said they hoped the changes would make it easier for consumers to differentiate between facilities, as well as spur nursing homes to make improvements.

The changes that took effect on Friday were mainly aimed at one of three major criteria used to rate the homes on the Nursing Home Comparewebsite, which ranks more than 15,000 nursing homes on a one- to- five-star scale. Officials essentially adjusted the curve for the quality-measures rating, which is based on information collected about every patient.

Representatives for the nursing home industry said that rather than helping consumers, the changes could frustrate them.

“Any time that nearly a third of an entire sector is impacted by a change of this magnitude, there will be confusion,” said Mark Parkinson, the chief executive of the American Health Care Association, the trade group for profit-making nursing homes. “We’re not helping patients and their families get the information they can trust when the star rankings don’t match the quality care being delivered.”

Advocates for nursing home residents, however, described the changes as long overdue.

“We think that rescaling the quality measures will result in improved reporting of the quality of care a nursing home may provide,” said Robyn Grant, director of public policy and advocacy at the group Consumer Voice.

Nursing Home Compare has become the gold standard for evaluating the nation’s nursing homes, even as it has been criticized for relying on self-reported, unverified data. The website receives 1.4 million visits a year, federal officials said.

In August, The New York Times reported that the rating system relied so heavily on unverified information that even homes with a documented history of quality problems were earning top ratings. Two of the three major criteria used to rate operations — staffing levels and quality measures statistics — were reported by the homes and not audited by the federal government.

In October, the federal government announced that it would start requiring nursing homes to report their staffing levels quarterly — using an electronic system that can be verified with payroll data — and that it would begin a nationwide auditing program aimed at checking whether a home’s quality statistic was accurate.

Before the change on Friday, about 80 percent of the nation’s nursing homes received a four- or five-star rating out of five on their quality measures score; afterward, nearly half did. The number of homes receiving one star in that area increased to 13 percent, from 8.5 percent, after the recalibration.

The changes led to declines in the quality-measures rating of 63 percent of homes. The staffing scores of about 13 percent of homes also fell because of other adjustments that took effect on Friday.

Federal officials said the higher bar reflected the fact that the industry had improved since December 2008, when the rating system was put into effect.

Falls and Older Adults

Risk Increases With Age

Many people have a friend or relative who has fallen. The person may have slipped while walking or felt dizzy when standing up from a chair and fallen. Maybe you’ve fallen yourself.

If you or an older person you know has fallen, you’re not alone. More than one in three people age 65 years or older falls each year. The risk of falling — and fall-related problems — rises with age.

Falls Lead to Fractures, Trauma

Each year, more than 1.6 million older U.S. adults go to emergency departments for fall-related injuries. Among older adults, falls are the number one cause of fractures, hospital admissions for trauma, loss of independence, and injury deaths.

Fractures caused by falls can lead to hospital stays and disability. Most often, fall-related fractures are in the person’s hip, pelvis, spine, arm, hand, or ankle.

Hip fractures are one of the most serious types of fall injury. They are a leading cause of injury and loss of independence, among older adults. Most healthy, independent older adults who are hospitalized for a broken hip are able to return home or live on their own after treatment and rehabilitation. Most of those who cannot return to independent living after such injuries had physical or mental disabilities before the fracture. Many of them will need long-term care.

Fear of Falling

Many older adults are afraid of falling. This fear becomes more common as people age, even among those who haven’t fallen. It may lead older people to avoid activities such as walking, shopping, or taking part in social activities.

If you’re worried about falling, talk with your doctor or another health care provider. Your doctor may refer you to a physical therapist. Physical therapy can help you improve your balance and walking and help build your walking confidence. Getting rid of your fear of falling can help you to stay active, maintain your physical health, and prevent future falls.

Tell Your Doctor If You Fall

If you fall, be sure to discuss the fall with your doctor, even if you aren’t hurt. Many underlying causes of falls can be treated or corrected. For example, falls can be a sign of a new medical problem that needs attention, such as diabetes or changes in blood pressure, particularly drops in blood pressure on standing up. They can also be a sign of problems with your medications or eyesight that can be corrected. After a fall, your doctor may suggest changes in your medication or your eyewear prescription. He or she may also suggest physical therapy, use of a walking aid, or other steps to help prevent future falls. These steps can also make you more confident in your abilities.

Ways to Prevent Falls

Exercise to improve your balance and strengthen your muscles helps to prevent falls. Not wearing bifocal or multifocal glasses when you walk, especially on stairs, will make you less likely to fall. You can also make your home safer by removing loose rugs, adding handrails to stairs and hallways, and making sure you have adequate lighting in dark areas.

Falls are not an inevitable part of life, even as a person gets older. You can take action to prevent falls. Your doctor or other health care providers can help you decide what changes will help.

Survey says you’re Happiest at 33

Hmm, that would make sense. You’re at the age where you can’t say you’re naïve and you would be having more spending money than ever before. A British website, Friends Reunited, claims that 70% of the 40 years old picked that age as their happiest. Interestingly enough, only 6% picked the college years and 16% chose their childhood years.

One in three surveyed that they found their happiness in having children while one in five related their happiness with their job.

Do you agree with this? What was your “happiest” age?

Read the original article here—courtesy of

Professional Medical

Myths about Living Alone

What’s wrong with being alone? A new article from breaks down some myths about why Americans choose to be alone and the potential emotional and health consequences that come with it (or lack of). The truth is: most Americans now are living alone and they are okay with it. For example, some people might think that people live alone as a last resort, but on the contrary, people tend to live alone whenever they can afford too. It turns out that the number of people living alone went up during our recent economic downturn.

Another myth is that most people who live alone are elderly. The truth is that the largest group of Americans that live alone are between the ages of 35-64 years old. The fastest group growing is between ages 18-34. There are about 5 million of them in the United States which is up from 500,000 in 1950.

Another myth is that older people who do live alone are usually lonely, unhappy, and feels isolated. However, according to a study of 3,000 Americans, those who live alone are more receptive to socialize with their friends and neighbors compared to those who were married.

Click here to read more myths – according to

What do you think of being alone?

Professional Medical