New York Home Health Care

Do you feel as good now as you did at 40 years of age? At 50?

If the answer is no, read on. You might be able to feel as good as you used to (or even better) by picking up a few new good health habits. It may seem like more trouble than it’s worth to start doing something new. However, even small changes can improve your health. One small change you can make is to add some activity to your daily life. Another is to eat more fiber or to make sure you get plenty of fruits and vegetables in your diet.

What if I’ve never been very active? Will starting now really make a difference?

Yes! Physical activity is good for people at any age. Among older adults, falls are a common cause of injury and disability. Physical activity makes your bones and muscles stronger. When your muscles are strong, you’re less likely to fall. If you do fall, strong bones are less likely to break.

Regular physical activity is good for your brain too. Recent studies have shown that people who do simple exercises (for example, walking briskly) on a regular basis are better able to make decisions than people who aren’t physically active.

I haven’t been physically active in a long time. I’m afraid I’ll get hurt when I start.

From diabetes to heart disease, many chronic (ongoing) health problems are improved by even moderate amounts of physical activity. For people who have these conditions, a lack of exercise is a bigger risk than an exercise-related injury.

Talk with your doctor about your plans before you get started. Your muscles will very likely be sore when you first increase your physical activity, but don’t consider that a reason to stop. Mild soreness will go away in a few days as you become more used to the physical activity.

What’s the best way to get physically active now?

For most people, walking is one of the easiest activities to do. Experts recommend at least 30 minutes of physical activity on most days of the week, but you don’t have to do all 30 minutes at once. Try walking for 15 minutes twice each day or for 10 minutes 3 times each day.

People who have started being physically active later in life say that exercising with a partner is the best motivation to stick with it. Some suggest starting or joining a walking group with friends or neighbors. Others suggest getting a dog that needs to be walked.

If walking isn’t your idea of a good time, try gardening or dancing. Go fishing or swimming. The activity can be both enjoyable and good for you.

What about strength training?

When your muscles are strong, activities like getting out of a chair or holding a door open are much easier. If you decide to lift weights, start with a 1-pound or 5-pound weight. If you don’t have weights, you can use a can of soup, a book or a full water bottle. Keep your weights in the same room as your television and do a few exercises while you watch.

Another way to build muscle is to use a resistance band (also called an exercise band). Resistance bands are flexible and come in different lengths. They are commonly used to strengthen upper arm and leg muscles.

Why should I eat more fiber?

Fiber can improve your health in 3 ways:

Men over 50 years of age should get 30 grams of fiber per day; women over 50 should get 21 grams per day.

I don’t want to start eating healthy food. How can I get more fiber without changing my diet completely?

You don’t have to change your diet all at once. Try making 1 small change at a time. For example, if you eat 2 slices of white toast for breakfast, replace 1 of them with a slice of whole grain bread. If you drink orange juice every day, eat an orange instead for 3 days of the week. If you prefer salty snacks, try low-fat popcorn instead of potato chips.

Some people find it helpful to focus on adding a single high-fiber food (see the box below) at each meal or snack time.

Foods rich in fiber

Fruits and vegetables are a great healthy addition to your diet. Not only are they high in fiber, but they are also high in other vitamins and minerals.

I often have a hard time sticking with something, even when I know it’s a good thing to do.

How active you are and what you eat are habits. Picking up healthy habits can be tough at first. But by starting small and rewarding yourself for each step you take, you can make a difference in how good you feel. You may find it easier to be more physically active and eat more fiber if you think of every day and every meal as a chance to do something good for yourself.

(Written by familydoctor.org editorial staff)

(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

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