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.

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.

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“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.

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.”

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.

“Maryland drivers can now add three emergency contacts to their driver’s license so police will know who to call if an accident occurs. The emergency contact information is stored electronically on an individual’s driver’s license and will be available only to authorized law enforcement personnel. You can go to MVA’s website at www.mva.maryland.gov <http://www.mva.maryland.gov/>  and add your three emergency contacts in just a few minutes. Go to the website, click “On-line Transactions, then click “More” and then click “Emergency Contacts” to add your emergency contacts.”

This information is only available to police and medical personnel

This new information benefits everyone, young and old alike. The MVA is to be commended for its intelligent use of available technology.  The process is similar in many respects to Silver and Amber Alert laws, except in this case the data is collected in advance of the actual need.

The Silver Alert program is patterned after the Amber Alert legislation for tracking missing children, but is focused on seniors with Alzheimer’s disease and other forms of dementia. Upon notification of a missing older adult, the state police are notified, given a description of the person, vehicle, license number, and area where the person was last known to be. This information, along with a contact number is then posted on highway signs throughout the area. To date, 38 states have passed legislation specifically titled Silver Alert, other legislation substantially the same as silver alert, or broader legislation that encompasses this age group. In most of the remaining states, legislation is in process. A similar bill is pending at the federal level.

Writers and philosophers have debated the topic for years. In his book, The Waterworks, E. L. Doctorow, in a fictional story set in the late 1800s, tells of a group of wealthy men who use nefarious means to promote their own longevity.

The writer, Jonathan Swift, in Gulliver’s Travels, has Gulliver visit the nation of Luggnagg where certain of its citizens are born immortal. They are known as struldbrugs. But lest he get too excited, Gulliver learns that being born a strudbrug is a curse. After about 30 years old, “They grew melancholy and dejected.” By 80, they had become, “not only opinionative, peevish, covetous, morose, vain, talkative, but incapable of friendship, and dead to all natural affection..”.

The tenor of these writings clearly argues against artificially extending our ‘natural’ life.

Yet as we shift away from storytelling, significant and exciting progress is taking place in genetic, stem cell and other medical research. Scientists are investigating aging from many different directions and coming up with ways to slow the process. Looked at another way, one could say they are researching ways to enhance our life quality, and in the process, extend our lives. And it’s not just for the elderly among us.

One exciting example comes from The Wake Forest Institute for Regenerative Medicine. Researchers there have successfully grown bladders in a lab and implanted them in children with spina bifida. Spina bifida is a condition that causes incomplete closure of the spine and, among other complications, subsequent bladder problems. The basic structures of the bladders were created using biodegradable material. The bladders were then filled with the patients’ stem cells. Once a bladder was grown, it was implanted into the patient. There was no problem with organ rejection since the bladder was made from the patient’s own cells. First performed in 1999, the researchers waited until 2006 to announce their achievement as they wanted to first satisfy themselves that the experiment had worked.

Organ printing is another innovative and exciting development underway. Think of a highly sophisticated printer but instead of being filled with ink, it is filled with cells. Then imagine that instead of paper, the printer is printing onto biodegradable material. The printer prints ‘pages’ of cells on top of one another to make a three dimensional shape. The company, Organovo, announced in 2010 that it had successfully created human blood vessels, and is now working on more complex and larger organs.

These examples are but a narrow glimpse of the diverse approaches to improving our life quality, and, in the process, allowing us to live longer. A Wall Street Journal article, Living to 100 and Beyond, from the August 27-28, 2011 Review, states, “gerontologist and scientific provocateur Aubrey de Grey claims that the first humans to live for 1,000 years may have already been born.”  Whether true or not, the astonishing developments in growing replacement organs suggests that far more of us will live to be 100 plus than we ever would have imagined.

Elders want to travel – to vacation, visit family and friends, fulfill a dream, go again to a place in memory. This may seem impossible or difficult at best. He’s blind. She has dementia. He has Alzheimer’s. She can’t go down the street without getting lost, how is she going to make it to the wedding 2,000 miles away?

Given, elder travel is different from the backpacking days of our youth, but it doesn’t have to be gone. Accompanied senior travel makes the world safer, larger, brighter, and a lot more fun for the individual.

A woman we’ll call Michelle contacted our office. Her husband Al had Alzheimer’s Disease and she needed someone with him so he would be safe while she was away at work. His car keys had been taken away, but Al was not one to sit around; he liked to go out and about. And he had one passionate desire: to see Pearl Harbor.

Born in 1925, Al’s father woke him the morning of December 7, 1941. Pearl Harbor had been bombed! “Boy,” he said, “you best go down to the post office and sign up to go fight.” Only 16, Al had to wait a couple of years before serving four years in the army. He later graduated from the University of Maryland, married and raised a family. He was involved in the Boy Scouts, sharing his pride in the “Great U.S. of A.” And someday, he said, he’d see Pearl Harbor.

When our Companion, Gary, met Al, they hit it off immediately. When Gary wasn’t available, his wife and fellow employee Bonnie filled in. (There has to be consistency of care givers or the Alzheimer’s victim gets confused.) Al knew one of them would be there if Michelle couldn’t be.

Al knew he’d never get to Pearl Harbor. Michelle knew differently. She knew she couldn’t handle Al alone, and that she needed a little ‘down-time’ herself. She and Al asked Gary and Bonnie if they would accompany them on a trip to Hawaii.  Four months later the four of them left for the two-week cruise. Unexpectedly, Al noticed a gravelly-voice singer on the beach, with a box in front that read, “If inquisitive to hear, put some $ in the box.” Al put money in and sat mesmerized as the singer sang.

Al passed away three years later. But for three years, he had pictures to look at and talk about – from a place in history, a place he always wanted to go to but feared he wouldn’t be able to – with family and friends.

What Gary and Bonnie did with Al and Michelle was a continuation of what they were already doing with their clients, accompanying them wherever they wanted to go. And why not? This trip was just a little longer.

Ella Wheeler Wilcox had it figured out when her poem, “Solitude”, was published in 1883. Here is the first stanza:

Laugh, and the world laughs with you:
Weep, and you weep alone;
For the sad old earth
Must borrow its mirth,
It has trouble enough of its own.

Especially as we age, it’s easy to get caught up in life’s daily stresses. Physical ailments, retirement worries, illness of a friend or elderly neighbor down the street –  the list goes on. Yet research has shown that people who laugh live longer. According to Sven Svebak of the medical school at Norwegian University of Science and Technology, adults who have a sense of humor outlive those who don’t find life funny, and the survival edge is particularly large for people with cancer.

He released his study of about 54,000 Norwegians, tracked for seven years, at the 2007 American Psychosomatic Society meeting in Budapest, Hungary. The greater a role humor played in their lives, the greater their chances of surviving the seven years. Adults who scored in the top quarter for humor appreciation were 35 percent more likely to be alive than those in the bottom quarter, he says.

In a subgroup of 2,015 who had a cancer diagnosis at the start, a great sense of humor cut someone’s chances of death by about 70 percent compared with adults with a poor sense of humor.

Like your muscles, your brain needs regular workouts to stay healthy and fit as you age. Because just as we lose some muscle as we get older, so can our brains atrophy The brain’s “cognitive reserve”— its ability to withstand neurological damage due to aging and other factors without showing visible signs of slowing or memory loss — diminishes through the years. That can make it more difficult to perform mental tasks. But, just as weight workouts add lean muscle to your body and help you retain more muscle in your later years, researchers now believe that following a brain-healthy lifestyle and performing regular, targeted brain exercises can also increase your brain’s cognitive reserve.

So, as Gerry Hopman says, “Keep learning: computer, languages, skills, crafts, whatever. Never let the brain be idle. An idle mind is the devil’s workshop, and the devil’s name is Alzheimer’s.”

And why shouldn’t we laugh? The way they’re playing with our social security we’re going to have to live longer just to get our money back!

You may ask: What is a caregiver? What does a caregiver do?

According to the Area Agency on Aging of Pasco-Pinellas, Inc., if you are you providing unpaid assistance to a spouse, relative, or friend who is ill, disabled, or needs help with basic activities of daily living you are a caregiver. If you help with rides to the doctor, shopping, meals, bill paying, bathing, grooming, dressing, walking or transferring to a wheelchair, housekeeping, managing medications, or arranging services to be provided by others, you are a caregiver.

Talk to your immediate family about you being the caregiver. Make sure they understand that you will not be able to spend a lot of time with them and let them be involved in your decision. Then reach out to the extended family.

Stage Two – Finding Help

If you have been a caregiver for months – or longer – on a regular basis, you are the primary caregiver. It has become clear that this is not going to be a short-term illness with a quick recovery. If you also hold a full-time job, caregiving may be exhausting you already. What is your loved one’s prognosis? How many more years of caregiving lie ahead?

Now is the time when you must find relief for you, the caregiver. Clearly, the loved one needs to have continuity of care, but if you do not find support for the person needing care there will soon be two people in need. As the flight attendants instruct, “put your mask on first.” If you don’t take care of your health you will not be able to provide the support your loved one needs.  Look to family, friends, faith communities, and caregiving agencies for additional assistance.

Stage Three: Heavy Care

You may have been providing care for years to someone whose mental or physical health is deteriorating – now at a more rapid rate. If the person for whom you are caring has Alzheimer’s disease or another degenerative disease, wandering at night may become a risk. But you cannot work ‘around the clock’. Your first responsibility must be to care for yourself. Caregiver burnout helps no one. Your second responsibility is to protect your care recipient, maintaining a safe and loving environment.

Stage Four: Letting Go

Letting go focuses on the meaningful and positive experiences you shared with your loved one.  It also acknowledges the grief that comes with loss of a loved one – whether through death, placement in a nursing home or mental deterioration. In this final stage, you have come to an end of the cycle of caregiving as you have known it. You will be experiencing grief in your loss, both of the care recipient and of your own role as caregiver. Still, your life must go forward as you reconnect with the world around you. No doubt, your caregiving experience will have given you new perspectives as you resume former activities and, quite possibly, pursue new directions as well.