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Sleep’s Importance in Aging Well
Many think that as we get older, the need for sleep decreases but results from research are saying otherwise. While it is true that seniors’ sleep patterns change over the years, a full night’s sleep (7.5-9 hours), undisturbed, is as important as the emotional and physical state of their life.
Sleep helps the memory process, allows for cell regeneration and strengthens the immune system. According to the article “Sleeping Well as You Age”, many physicians use a senior’s ability to sleep as an indicator of his or her health status. With reduced sleep, there is a greater concern about the onset of depression, memory problems, excessive daytime sleepiness, weight problems, diabetes, cardiovascular disease and even breast cancer in women.
In the aging process, growth hormones and melatonin levels decrease. With the reduction of growth hormones there is less of a deep sleep or slow wave sleep, while the reduction of melatonin can cause a more broken sleep or faster sleep cycles. The circadian rhythm is the internal “clock” that tells you when it is time for sleep and when it is time to wake up. For seniors, as this “clock” is changing, bedtime and rising from sleep happens earlier and with the need to get up during the night, it may take more sleep time to satisfy the senior’s sleep requirement. Sometimes naps are required to satisfy a senior’s needs. It is normal for this to occur.
If seniors want to improve their quality of sleep, there are easy ways to help, such as participating in social interactions during the day, speaking with a trusted friend about worries and problems, regular exercise and time in the sunlight whether outside or keeping your home bright and sunny. Exposure to light can help regulate melatonin levels.
According to a LiveStrong.com article, another way of keeping melatonin levels up is by consuming trace amounts found in the following foods: olive oil, tomatoes, walnuts, beer and wines, tart cherries and grape skins. Before taking a melatonin supplement, in hopes of getting a sounder night’s sleep, it is recommended that a physician be consulted for directives.
The Better Sleep Council provides tips on getting better sleep – from checking the mattress to making sure not to exercise or eat too close to bedtime. The Council even recommends having no television, computer or work materials in the bedroom.
According to Timi Gustafson, RD, getting ample sleep is one of the greatest remedies for staying healthy and dealing with the stress of everyday challenges. Rested and relaxed seniors will have more energy and the ability to keep a positive outlook on life. When sleep is given high priority, the quality of life is better all the way around.
When is it Time to Share Control?
Wills, trusts, powers of attorney, advance health care directives: All are important and useful tools as people age and seek to protect assets, prepare for an unexpected event, or eventual death. When transitions occur, these documents, and documented decisions, are vitally important. They make life easier for the family members and concerned others of seniors, and they can mean the difference between controlling one’s life and being left at the hands of the system – medical, legal, and various levels of government.
Yet sometimes, the senior individual is so fearful of losing control that he or she does just that – loses control. Consider the man whose children know nothing about his wealth, insurance, wills, or any of the other documents the prudent person would possess. When they try to raise the subject they are brushed off. Moreover, as he ages and becomes less able to attend to a large swath of everyday living activities, he is unwilling to get or accept needed assistance. Is it because the person is unable to pay for services? Is it because the mental capacities are diminishing and he doesn’t recognize the peril?
The Grandfather: We’ll call him James. James was well known in the neighborhood as a lifelong resident, father, grandfather, and surrogate grandfather. Always happy for company, he kept sodas and ice cream bars at the ready for neighborhood kids. And he always had plenty of your favorite brand of beer in the refrigerator. Every Saturday he cooked up a feast, “in case someone should stop by.” Needless-to-say, lots of family, friends and neighbors did.
James had four living children, all adults, several with children of their own. Three of his children lived nearby. He also had health issues that prevented him from keeping up with household chores. His children and older grandchildren – as well as some neighbors – often helped with cleaning. And they always made sure the dishes were washed, put away, and the floor swept before leaving on a Saturday. His daughter lived 40 miles away, yet for years she would drop by after work to see how things were going and to provide caregiver assistance.
Over time, though, James’s health problems increased, even as his family became less and less able to meet his physical needs. One son and his family moved away through job relocation. James had to have his leg amputated due to complications of diabetes, and his needs increased.
After considerable discussion regarding their own commitments and time, and James’s increasing needs, the adult children decided to hire someone to assist their father on a regular basis. Although James could pay for services, the kids determined to take money out of the equation by jointly sharing the cost of cleaning and support services. However, James wanted none of it. Objections ranged from, “the kids can do it,” to “the house is fine,” “the person was hard to get along with,” “unreliable,” or “didn’t do a good job.” After a series of failures, the children finally gave up.
James eventually had to have his other leg amputated and at that point his children moved him to a nursing home. It is futile to dwell on what might have been if James had been more willing to accept homecare support. Still, there are lessons to be learned – in particular, for the aging senior. Namely, recognize that your adult children have other lives, priorities, families and commitments. Let them help in the ways that they can, because in most cases they want to help. And give them the tools to work with. Have the discussion about finances, wills and other important papers including banks, brokerages, legal advisers, and medical providers. Talk about other special concerns such as how you feel about certain medical interventions in an emergency. It is almost a given that, as we age, ailments and health complications will arise. But by being open with your loved ones, many of these problems can be minimized or avoided.
You Are Old Father William
In the spirit of the season and the many positive things that accompany aging – maturity, experience, wisdom and wit – we are posting this poem from Alice’s Adventures in Wonderland. It was originally published in 1865 by Charles Lutwidge Dodgson under the pseudonym of Louis Carroll.
Image via Wikipedia
“You are old, Father William,” the young man said,
“And your hair has become very white;
And yet you incessantly stand on your head –
Do you think, at your age, it is right?
“In my youth,” Father William replied to his son,
“I feared it might injure the brain;
But, now that I’m perfectly sure I have none,
Why, I do it again and again.”
“You are old,” said the youth, “as I mentioned before,
And you have grown most uncommonly fat;
Yet you turned a back-somersault in at the door –
Pray, what is the reason for that?”
“In my youth,” said the sage, as he shook his grey locks,
“I kept all my limbs very supple
By the use of this ointment — one shilling a box –
Allow me to sell you a couple?”
Image via Wikipedia
“You are old,” said the youth, “and your jaws are too weak
For anything tougher than suet;
Yet you finished the goose, with the bones and the beak –
Pray, how did you manage to do it?”
“In my youth,” said his father, “I took to the law,
And argued each case with my wife;
And the muscular strength, which it gave to my jaw,
Has lasted the rest of my life.”
“You are old,” said the youth, “one would hardly suppose
That your eye was as steady as ever;
Yet you balanced an eel on the end of your nose –
What made you so awfully clever?”
“I have answered three questions, and that is enough,”
Said his father, “Don’t give yourself airs!
Do you think I can listen all day to such stuff?
Be off, or I’ll kick you downstairs.
Studies on a Link Between Diabetes and Alzheimer’s Disease
Continuing research suggests that diabetes is linked to Alzheimer’s. The former can lead to strokes and heart attacks. But recent research has added to that list; Diabetics are at twice the risk of Alzheimer’s and are 1.75 times more likely to suffer from dementia of any form.
In an article at Health.com , Dr. David Geldmacher, M.D., professor of neurology at the University of Alabama at Birmingham, states that “having high glucose is a stressor to the nervous system and the blood vessels. The emerging information on Alzheimer’s disease and glucose shows us that we do need to remain vigilant on blood sugar levels as we grow older.”
Diabetes is broken down into two categories, Type 1 which is insulin dependent and Type 2 which is non-insulin dependent. People with Type 1 give themselves daily injections to manage their illness, while people with Type 2 make their own insulin, but their cells do not respond to it properly.
Type 2 diabetes is the more common of the two, affecting 85-90 percent of reported cases. These people can keep their blood sugar levels under control with managed weight, exercise and oral medications.
One thought among researchers is that having diabetes may block the body’s effectiveness in breaking down an amyloid or protein, therefore clumping and creating the plaque associated with Alzheimer’s disease. Joseph R. Burdo, Ph.D., assistant professor at Bridgewater State College in Bridgewater, Mass., reports that everyone’s blood contains a small amount of the protein, but for diabetics, “there may be a synergistic toxicity between the amyloid and high level of blood glucose that is leading to the problems with proper blood vessel formation.”
Science has come to understand how insulin works throughout the body, but with the brain it is not clear. Nor is it clear as to how the insulin gets into the brain. According to Brown Medical School neuroscientist, Suzanne M. de la Monte, brain cells create their own insulin. Neurologist, Jeffrey M. Burns, director of the Alzheimer and Memory Center at the University Of Kansas Medical Center, believes that a portion of the insulin comes from the pancreas.
Wherever this insulin comes from, there is agreement that it is crucial for the “growth and survival of the neurons” that create the brain’s synapses; important for memory and learning. Lower brain insulin levels decreases one’s abilities in these areas.
After many studies and research, Ms. de le Monte stands on the premise that Alzheimer’s and diabetes come from the same disease – and refers to Alzheimer’s as Type 3 diabetes. Until further research is done, she supports exercising as a way to rev up blood flow to the brain and build insulin responsiveness throughout the body as a whole. “It won’t prevent Alzheimer’s…You’re making the brain work harder and delivering more nutrients to the brain.”
Medical Orders for Life-Sustaining Treatment
In June we posted an article about a couple who found themselves in the difficult situation of being unprepared for a medical emergency. Our friend, a senior in his sixties, suffered a stroke that paralyzed his right side. Initially unable to speak, walk or use his right hand, he was still legally bound to pay his bills. A widower, he had met another and they now lived together. He paid all of the household expenses and the checking account was in his name only. Moreover, had the stroke been more severe, questions of his preferences for life-sustaining treatments would have gone unanswered. He had neither advance medical directive nor financial power of attorney documents.
Now, Maryland and some other states have come out with a simple two-page form that begins to address this problem. Known by its acronym MOLST, this document gives the medical community information about patients’ wishes regarding whether and which life-sustaining treatments should be administered in the event of a medical emergency or end of life care.
“Maryland MOLST is a portable and enduring medical order form covering options for cardiopulmonary resuscitation and other life-sustaining treatments. The medical orders are based on a patient’s wishes about medical treatments. Effective October 1, 2011, a Maryland MOLST form must be completed for all individuals admitted to nursing homes, assisted living facilities, hospices, home health agencies, and dialysis centers. All hospital patients that are being discharged or transferred to one of these facilities above or another hospital must have a MOLST form completed.”
We stated above that the form begins to address the void of medical personnel not having information about patients’ wishes. However, it is only a beginning, because it is not required for admission to a hospital. Yet the hospital is one of the places where this information is most needed. In the event of a cardiac arrest, would you want cardiopulmonary resuscitation for example? What about having fluids and nutrition administered – indefinitely?
If you want to increase your likelihood that your wishes regarding life-sustaining treatment will be known and followed, the MOLST form is a good place to start. Together with a medical advanced directive and financial power of attorney documents, your medical community will be better equipped to address your medical needs.
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