New York Home Health Care

(HealthDay News) — The shoes you wear can play a big part in how steady you are on your feet, which is a big concern for many seniors.

Here are guidelines for choosing safe shoes, and other ways to help reduce the risk of falls, courtesy of the American Academy of Orthopaedic Surgeons :

• Make sure your shoes fit correctly. Always measure your feet before you buy new footwear.
• Choose shoes that are comfortable and sturdy, avoiding those with very thick soles or high heels.
• Look for shoes with soles that won’t skid or slip.
• Keep laces tied tightly all the times. If you have trouble tying laces, look for shoes with Velcro.
• Always wear well-fitted, non-skid slippers at home. Throw away slippers that have become too stretched. Avoid walking barefoot or in your socks.
• Don’t let your toenails get too long.

If you are looking for a Fountain of Youth, forget pills and diet supplements. Adventurer Dan Buettner has visited four spots on the globe where people live into their 90s and 100s and outlines how they add years of good life in his new book, “The Blue Zones.”

The answer, Buettner says, includes smaller food portions, an active lifestyle and moderate drinking.

“If someone tells you they have a pill or hormone (that extends life), you’re about to lose money,” Buettner says.

Buettner identifies four hot spots of longevity: the mountainous Barbagia region of Sardinia, an island off the coast of Italy; the Japanese island of Okinawa; a community of Seventh-day Adventists in Loma Linda, Calif., about 60 miles east of Los Angeles; and the Nicoya Peninsula of Costa Rica, in Central America. (The term “Blue Zones” takes its name from the blue ink Belgian demographer Michel Poulain used to circle an area of long-living Sardinians on a map.)

What Buettner found in his seven years of research and travel were common denominators among the vigorous super-elderly — close family relationships, a sense of purpose, healthy eating habits. He distills them into what he calls the Power Nine that readers can use to create their own Blue Zone.

“Picking half a dozen things off of this al a carte menu, and sticking to it, is probably worth eight to 10 (extra) years for the average American. And you’ll look younger and feel younger on the way,” says Buettner, a tall and lean 48-year-old who says he hopes to live until at least 100.

Buettner turned to probing the secrets of the longest-living cultures after leading three long-distance bicycle expeditions — from the tip of North America to the tip of South America; across the United States, Europe and the Soviet Union; and across Africa — in the 1980s and 1990s. He also used the Internet to take classrooms on interactive quests to solve everything from the collapse of ancient Mayan civilization to human origins in Africa.

Buettner made his first expedition to Okinawa in 2000 and eventually wrote a National Geographic cover story, “The Secrets of Long Life,” in November 2005. That led to National Geographic publishing “The Blue Zones” this March. The book debuted at No. 15 on The New York Times‘ list of advice book best sellers but has since dropped off.

Living long — even forever — is a human desire throughout history, says Dr. Robert Butler, president and CEO of the International Longevity Center-USA in New York. But Butler says he’s skeptical of claims of places of long-living people.

“There’s always been these rumors but they’ve always turned out to be inaccurate,” said Butler, who appears in “The Blue Zones” but has not read it.

Buettner is aware of the skepticism, but says he and his team of demographers, which included Poulain, scrupulously checked birth and death records and vetted the ages of Blue Zone residents in his book.

“We have the numerical data that shows that these places (in ‘The Blue Zones’) are living longer. It’s not just anecdotal,” Buettner said.

While ranking populations by average life expectancy is nothing new, Buettner has “done a nice job putting faces to it and looking at some of the special characteristics — be it diet or happiness — that typify some of these regions,” said Dr. Thomas T. Perls, director of the New England Centenarian Study and an associate professor of medicine at the Boston University School of Medicine. Perls also appears in the book.

Because of obesity and smoking, Americans are living about 10 years less than they should be, said Perls, co-author of the book “Living to 100.” He said if Americans embraced the healthy habits advocated by Buettner, the impact on public health “would be huge.”

Buettner found long-lived people have a sense of purpose and a strong support network. In Okinawa, women gather in social networks known as moais.

“Even at age 100, they’re all getting together in their moai … at 5 o’clock every day. They sit around, they drink a couple glasses of sake, they gossip, they talk about sex. If one doesn’t show up to the afternoon gathering, the other four sort of hobble over to see if she’s fallen down or if she needs help,” Buettner said.

Women in Okinawa also tend to be spiritual leaders, which imbues them with a sense of purpose, or “ikigai,” Buettner said.

Regular attendance at religious services also is a factor, Buettner said. Seventh-day Adventists observe the Sabbath on Saturday, which gives them a weekly break from stress.

“There’s no question but having a spiritual sense — a sense of belonging, a sense of personal value — enhances a person’s ability to follow good health habits. Out of that arises the longevity,” said Dr. Richard Hart, president and CEO of Loma Linda University Adventist Health Sciences Center.

Limiting food intake and eating healthy also are key, Buettner said. Elderly Okinawans follow a maxim to eat only until their stomachs are 80 percent full, Buettner said. Centenarians in Sardinia, Okinawa and Nicoya rarely ate meat, and some Adventists stick only to a plant-based diet. Adventists frequently eat nuts while Okinawans eat tofu.

Drinking in moderation can help, Buettner said. Sardinians drink a dark red wine that’s loaded with antioxidants, he said.

Exposure to sun — a source of vitamin D — also is common in Blue Zones, where the residents are tan, Buettner said.

“We shouldn’t be burning ourselves, we shouldn’t be frying. But 20 minutes a day, in the climates or the latitudes that have quality sunshine, it’s probably a good takeaway,” he said.

Buettner also advocates low-intensity physical activity. After years of biking, Buettner has switched to yoga for his main exercise. He lives on Lake of the Isles in Minneapolis, where he can skate around the lake in the summer and cross-country ski across it in the winter.

“You identify what you like to do, and you do it, because you’re likely to do that over the long run,” Buettner said.

Buettner also recommends “de-conveniencing” your home — getting rid of the TV remote or the power lawnmower. Buettner moved up to the third floor of his spacious home “so every time I need a shirt I walk three flights of stairs.”

Modern life is threatening the Blue Zones’ reputation for longevity, Buettner said. Obesity rates have soared in Sardinia, where young people are eating chips and drinking soda pop, he said.

“The phenomena of longevity is disappearing in all places, except for maybe among the Adventists, and the purpose of this book was to capture it and observe it before it disappeared, and measure it,” Buettner said.

Article from Yahoo! News

May 13, 2008 - A low-vision rehabilitation program that includes a home visit, counseling, assistive devices such as magnifiers and assignments to practice using them appears to significantly improve vision in elderly veterans with diseases of the macula (the area of the retina with the sharpest vision), according to a report in the May issue of Archives of Ophthalmology, one of the JAMA/Archives journals.

“Low vision, chronic visual impairment that limits everyday function, is one of the 10 most prevalent causes of disability in America,” the authors write as background information in the article. In addition to affecting daily function, low vision increases the risk of depression, injury and an overall decline in health.

Most diseases that cause low vision are not curable.

“In most cases, impaired vision cannot be corrected and rehabilitation is the only option for regaining lost function for the patient with low vision. Low-vision rehabilitation aims to restore functional ability, the ability to perform tasks modulated by visual impairment.”

Joan A. Stelmack, O.D., M.P.H., of the Edward E. Hines Jr. VA Hospital, Hines, Ill., and the University of Illinois at Chicago College of Medicine, and colleagues studied 126 patients (average age 78.9, 98 percent male) with low vision and diseases affecting the macula who were eligible for Veterans Affairs (VA) services.

Between November 2004 and November 2006, participants were randomly assigned to one of two groups. In one, patients received a low-vision rehabilitation program incorporating a low-vision examination, counseling, assistive devices such as magnifiers and five weekly sessions provided by a low-vision therapist to teach use of the assistive devices and other adaptive strategies.

They were also assigned homework to ensure they used the devices outside of rehabilitation. The other group was placed on a wait list for the rehabilitation program and received no treatment for four months, an amount of time veterans might normally wait to receive such services.

After four months, the 64 patients in the treatment group received an average of 10.46 hours of face-to-face low-vision rehabilitation and experienced a significant improvement in all aspects of visual function, including reading ability. Among the 62 patients in the group that did not receive rehabilitation, vision and functional ability declined over the four-month follow-up.

“Significant improvements in functional ability for mobility, visual information processing, visual motor skills and overall ability also were seen in the treatment group; small losses in these functions were observed in the control group,” the authors write.

“At least 10 hours of low-vision therapy, including a home visit and assigned homework to encourage practice, is justified for patients with moderate and severe vision loss from macular diseases,” they conclude.

“Because the waiting-list control patients demonstrated a decline in functional ability, low-vision services should be offered as early as possible.”

Editor’s Note: Funding for this research was provided by a Department of Veterans Affairs Rehabilitation Research and Development grant. Funding for the low-vision devices prescribed and dispensed to veteran participants was provided by the Department of Veterans Affairs Prosthetics Service.

In a study involving 214 patients, researchers found that the patient-physician relationship is strengthened when patients see themselves as similar to their physicians in personal beliefs, values and communication style. Further analysis revealed that patients’ perception of similarity to their physician is a multidimensional construct that includes both personal and ethnic components, some of which are more strongly related to outcomes than others. Researchers found that of the two dimensions, personal similarity appears more strongly related to patient trust, satisfaction and intent to follow the doctor’s recommendations. Regardless of issues of race and gender, a doctor who is skilled in providing information, showing respect, and supporting patient involvement can establish a connection with the patient that contributes to greater patient satisfaction, trust, and commitment to treatment. The authors assert that these findings support the need for communication skills training as a foundational part of medical education at all levels.

Understanding Concordance in Patient-Physician Relationships : Personal and Ethnic Dimensions of Shared Identity By Richard L. Street, Jr., Ph.D., et al

Old age can keep us from doing things we once thought were easy. As we grow older, living on our own can become something of a struggle. However, home care and home health care services can provide the elderly or sick with the aid and activity they need on a daily basis, allowing them to continue living an independent life.

With over one million people making use of home health care, it has proven to be a successful alternative to long-term nursing facilities. A normal home care service consists of a nurse or aid visiting the patient’s home every day to help assist with whatever needs assisting. This can vary from simply cooking meals and housecleaning to providing the patient with physical therapy and medicine. No aspect of what a patient needs is overlooked, and every patient is treated differently according to his or her needs. While one patient might need help keeping maintenance of his or her home and minor physical therapy, another may require help in being bathed and fed. Nurses are trained to be attentive to any potential needs their patient may have.

The need for home health care isn’t always clearly determined. It is a good idea to consult with a doctor before deciding whether you or someone you know should seek the aid of home health care services.  Consulting with a doctor may also help you financially. If your doctor confirms the need for home services and orders it, financial burden can be lifted off your shoulders through Medicare. Research the agency you use to make sure they can do whatever needs to be done to aid you or a loved one. Check if the nurses are licensed and trained. This research can help prevent any problems along the way.

One important thing to remember is that home care services and home health care services are different. While home care may provide the elderly with daily check-ups and domestic services, home health care includes helping a patient recover from an ailment, such as a heart attack or stroke. Depending on what is required, you might want to make sure that those you’d be hiring are licensed therapists or nurses.

Home health care is a great way to provide yourself or a loved one with the aid and medical treatment that’s needed on a daily basis. It allows patients to live healthy lives without encroaching on their independence. If you or someone you know is not ready to go to a long-term nursing facility, home health care is a viable alternative that might just be worth looking into.