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The number of falls continue to rise in the aging population and some of these falls have serious consequences. Each year, millions of older adults experience a fall. And, according to the CDC, more than one out of every four older adults fall each year, but less than half tell their doctor about it. Skilled Nursing Facilities, Assisted, and Independent Living Communities all struggle to balance safety and the independence of their residents. Seniors value maintaining their freedom of movement around their communities and are frequently adverse to many safety measures that might be put into place to prevent a fall. 

How can you build safety into your life while still maintaining your independence?

Incorporate Exercise into your Daily Routine: Try adding just twenty minutes of progressive strengthening and balance activity into your daily routine. Kirby Pines offers several classes and equipment to stay active. Consider adding a balance and strength class at least two to three times per week to help prevent falls.

Mind Medications: There are many medications that can impact a person’s risk for a fall. Make sure you are aware of what medications you may be taking and how it could impact your balance. For example, sleeping pills and sedatives can cause dizziness, while hypertension medications can cause postural hypotension.

Modify Environment: Look at ways to make the environment you live in as safe as possible. Eliminate area rugs, reduce clutter, ensure clear paths to restroom, use grab bars, and ensure your furniture will not topple over if used to hold on to. 

Use Proper Lighting: Falls commonly occur in the middle of the night when someone gets up to use the restroom and falls because it is dark, and they cannot see properly. An easy solution is to Illuminate the path to the restroom. This can be done with nightlights, toilet lights, or even motion sensor lights.

Select Footwear: Proper footwear is essential in fall prevention. Shoes with a back on them, like tennis shoes, and shoes or socks with tread are recommended. Avoid shoes that you slip into, like clogs or slides, and make sure you shoe fits properly.

Use Recommended Walker or Cane: Assistive devices can be great aids for balance and fall prevention, but it is important that the device is fitted for you, as well as educating yourself on proper form and technique.

Try Our Yoga Class: Yoga can help prevent the onset of osteoporosis, which causes bones to become brittle or weak. It reduces stress and enhances balance, flexibility, mobility and strength. It may also help you get a good nights sleep along with alleviating aches and pains.

Functional Pathways’ Wellness Program and Skilled Therapy services has trained professionals and programs designed for helping Senior Living Communities reduce falls while maintaining seniors’ highest level of independence. 

A growing body of research shows massage therapy can be an effective part of pain relief and management. This research data, and the experience of physicians, massage therapists, and patients should encourage pain specialists to consider incorporating massage therapy into their pain management programs. Some base findings about the value of massage therapy for pain relief have included the following:

1. According to Cherkin, Eisenberg, et. al. in the April 2001 issue of the Archives of Internal Medicine, massage is effective for providing long-lasting relief for patients suffering from chronic low back pain.
2. Data collected nearly 10 years ago indicates that therapeutic massage promotes relaxation and alleviates the perception of pain and anxiety in hospitalized cancer patients. Recent studies have confirmed the findings and others indicate positive effects for massage in decreasing pain intensity among cancer patients.
3. In 1990, Jensen et al. published data indicating that massage was better than cold pack treatment of post-traumatic headaches. The October 2002 issue of the American Journal of Public Health reports that new research by Quinn, Chandler and Moraska showed muscle-specific massage therapy is effective for reducing the incidence of chronic tension headaches.
4. A pilot study in 2000, conducted by Gregory P. Fontana, MD at Cedars-Sinai Medical Center in Los Angeles, found that massage reduces pain and muscle spasms in patients who have multiple incisions. When surveyed, 95 percent of patients felt that massage therapy was a crucial part of their hospital experience, while need for medications dropped on the days, they received a massage.

The effectiveness of massage lies in a simple and direct strategy: working from the external, outer mechanisms of pain to the primary, root cause. Massage therapists utilize a holistic approach, focusing on the entire body system and its relationship to soft tissue — their care is not focused pain site specific.

Another benefit of massage therapy — from a patient perspective — is that it helps patients become more aware of their bodies and better familiarize them with the pain they experience. The massage therapist not only helps relieve muscle and other soft tissue pain, but also has an impact on the patient by virtue of human touch. This is especially pronounced for women facing mastectomies and dealing with the outcomes of that surgery. While women directly benefit from various forms of massage that focus on lymph drainage and muscle pain, massage also helps them feel comfortable once again with their bodies, improves their confidence and allows them to better deal with pain.

Although more research is needed to confirm the optimal uses of massage, the potential for a positive impact on patients with acute or chronic pain is clear. As it stands, enough research exists to encourage pain management specialists and massage therapists to forge professional relationships. These pain management relationships should exist in the hospital, in clinics, in private practice offices and in-home care. 

Are you over the age of 65 and have been diagnosed with diabetes or pre-diabetes? If yes, you should implement modifications to your diet daily to decrease its effect on your body. Even minor dietary changes can help in reducing your diabetes risk.

The first step in the prevention is to understand how today’s food choices can impact your blood sugar and metabolism. Foods should not be classified as ‘good’ or ‘bad,’ but on the types and amount of food you are consuming. Sometimes we take in certain foods in excess, foods that should only be thought of as “sometimes” foods. “Sometimes” foods and beverages are highly processed, refined, and sugary. You should limit these types of foods and only consume them for occasional enjoyment. Eating foods such as vegetables and fruits, whole grains, and lean proteins with the occasional splurge of “sometimes” foods can help you understand how foods affect blood sugar levels

The Facts

• Almost 1/3 of adults over the age of 65 in the U.S. have diabetes, with 50% of that 1/3 being undiagnosed.
• An additional 1/3 of adults have pre-diabetes.
• Aging adults are especially at risk for poor nutrition caused by bad eating habits, loss of appetite, and decreased access to healthy foods because of time, money, or limited mobility.
• The best way to manage diabetes is to self-manage.

Diabetes To Do List

• Start by having a conversation with your physician to learn everything you can about diabetes and preparing a diet that will control your blood sugar.
• Talk with your community Dietitian to review your current dietary choices and set-up a meal planning process.
• Plan every meal the day or two before.
• Ensure that your planned meal fits into your nutritional goals.
• Try not to make last-minute meal choices that do not include the goals you have set for yourself.
• Make one or two dietary modifications and set obtainable goals for yourself. An example might be to stop eating cookies or cake unless it’s a special occasion.
• Review your goals regularly with your physician and community Dietitian and add new goals as you attain the ones you have set.
• Ensure you are taking care of your feet and skin:
• Inspect your feet every day. Look for cuts, blisters, calluses, red spots, swelling, or any other abnormal issues. Use a mirror to see the bottoms of your feet. If you have difficulty seeing all areas of your feet, ask for assistance from staff or family.

1. Protect your feet by washing them every day. Use a mild soap with warm water and thoroughly dry. Use lotion instead of powder to keep the skin smooth and moisturized to prevent cracks or fissures. Avoid the use of lotions between toes; It can create a moist breeding ground for bacteria and lead to wounds that are difficult to heal.
2. Prevent elevated blood sugars, which can lead to a loss of sensation to your feet, leading to uncared for wounds. Report any findings of abnormalities immediately to your health care provider.

Healthy Foods to Control Your Blood Sugar

According to the Centers for Disease Control and Prevention, each year one out of every three adults aged 65 and older experiences a fall. Falling once doubles your chances of falling again. Older adults who have fallen typically report moderate to severe injuries, including deep bruises, head trauma and hip fractures. Fall related injuries may alter mobility and limit independent living, requiring both formal and informal caregiving. Many of these injuries, such as hip fractures, increase the risk of premature death. These facts of falling put into perspective the importance of reducing your risk of falls. Many falls can be prevented by making simple changes in your daily life. This month’s Healthy Living Series will focus on tips to decrease your chances of falling.

How Can You Prevent Falls? First, it is important to take care of your health. Have your eyes and hearing checked frequently for changes. See a healthcare provider if you have foot pain, or if you can’t trim your toenails. Also, consult a healthcare provider right away if you feel weak or unsteady on your feet, if you feel confused, or if you fall. Let a healthcare provider know if a medicine is making you feel dizzy or making you lose your balance. If your healthcare provider wants you to use a cane or a walker, learn how to use it – and then use it consistently. It is also important to get regular exercise, especially walking.

Six out of every 10 falls happen at home, where older adults spend much of their time. Older adults should be encouraged to take steps to “fall proof” their living areas, both inside and outdoors including:

• Wear shoes with nonskid soles
• Be sure your home is well lit so that you can see things you might trip over
• Remove throw rugs or fasten them to the floor with carpet tape
• Don’t put electrical cords across pathways
• Have grab bars put in your bathtub, shower and toilet area
• Have handrails put on both sides of stairways
• Don’t climb on stools and stepladders

How can therapy help? By participating in a balance/fall management program, you will develop and learn skills necessary for safe, functional mobility with reduced risk for falls. You may also reduce the risk for falls and other complications resulting from balance problems, low vision, cognitive changes and decreased sensation. In order to ensure success of an individualized balance/fall management program, therapists work closely with the multi-disciplinary team.

Join Functional Pathways, your NEW Rehab Provider, for a Welcome Reception July 28th at 2:00 pm in the PAC.

Did you know that each year more people die from excessive heat waves than from hurricanes, lightning, tornadoes, floods, and earthquakes combined? Summer weather can be erratic, especially during the spring and summer months. Even with a degree of unpredictability, it`s almost certain that we will see high temperatures climb into the upper 80s, 90s and even 100 degrees. Older adults are at high risk from excessive heat. As we age, the body’s cooling mechanisms may become impaired. Living alone or being confined to a bed and unable to care for one’s self further increases risk to heat related illness. Existing health conditions such as chronic illness, mental impairment, and obesity can also heighten an individual’s vulnerability. In addition, individuals taking certain medications are also susceptible to heat related illness. 

You can follow these prevention tips to protect yourself from heat-related stress: 

• Drink plenty of fluids but avoid alcohol, caffeine and sugary drinks 
• Rest 
• Take a cool shower, bath, or sponge bath 
• If possible, remain indoors in the heat of the day 
• If you don’t have air conditioning in your home, open windows and shades on the shady side and close them on the sunny side to try to cool it down 
• Avoid strenuous activity during the hottest part of the day (between 11 a.m. and 4 p.m.) 
• Wear loose, lightweight, light-colored clothing 
• Wear sunscreen and a ventilated hat (e.g., straw or mesh) when in the sun, even if it is cloudy 
• Never leave children, pets or those with special needs in a parked car, even briefly. Temperatures in the car can become dangerous within a few minutes 
• Check on your neighbors, family and friends, especially those who have special needs 

How can therapy help prevent heat related stress during the warmer months? 

By seeking professional advice to analyze your unique situation, the rehabilitation team can offer assistance and guidance to increase your safety during summer. Your rehabilitation team can offer assistance in creating a plan for summer safety that includes: 

• Identifying lifestyle changes that can facilitate staying physically and mentally healthy during the summer months. 
• Facilitating ease of movement throughout the home and outdoor spaces. 
• Recommending home modifications to keep you safe during the warmer months. 

For additional information, please contact your Select Rehabilitation Physical, Occupational and Speech therapists. 

Join us for “Fun in the Sun: Outdoor Safety Tips for Older Adults” in the PAC June 9th at 11:00 am

80% of US population will experience one or more episodes of low back pain during their lifetime. By 2050, 40 percent of the population will be older than 50. This growing age group will have a substantial impact on healthcare in the coming decades. As older adults have a greater susceptibility to chronic low back pain, the physical and psychological impact of this pain on society will be considerable. Improper body mechanics (such as improperly lifting heavy items) can put increased pressure on your spine. This may lead to the degeneration of discs, back pain, and other spinal problems. These statistics put into perspective the importance of protecting the spine and reducing the incidences of low back pain in older adults. Many back injuries could be prevented by using appropriate body mechanics during daily activities.

As an example, when lifting objects, you should set your trunk muscles to immobilize your spine, and then the arms and legs can do the lifting. It is important to keep a straight back with the pelvis as this will keep your center of gravity over your base of support. When lifting an object, keep your feet apart for a wide base of support. This broadens your base of support making it easier to maintain your balance while lifting. You should also lift with your knees. This lowers your center of gravity and helps you to use your quadriceps (leg muscles), which are much stronger than your back muscles, to do the lifting. While lifting an object, you should avoid holding your breath. Finally, once the object is lifted, hold the load close to your body. By doing this, the load will be lighter than holding it away from the body because of the effects of gravity and the increased lever length of the arms.

By seeking professional advice to analyze your unique situation, the rehabilitation team can offer assistance and guidance to help protect your spine and prevent back injury and pain. In addition, your rehabilitation team can offer assistance in creating a plan for protecting your lumbar spine. For example:

• Your rehab team can suggest product selection, placement and training to help you maintain good body mechanics;
• Your rehab team can recommend home modifications which identify the fit between the person and the environment;
• Your rehab team can look at what tasks the individual needs and wants to perform each day to ensure comfort, safety and enjoyment in their living environment;
• Your rehab team will be able to evaluate your body posture, mechanics, and strength.

The Rehabilitation Team assists each person in staying safe in their living environment. The Rehabilitation Team is there to support them through both their challenges and successes. For additional information, please contact your Select Rehabilitation Physical, Occupational and Speech Therapists.

Measures taken to reduce the spread of COVID-19 have changed our everyday schedules and disrupted exercise routines for many individuals. Although it might be tempting to skip your exercise during these challenging times, exercise is essential to your physical health and mental well-being during the COVID-19 pandemic. Regular physical activity can help give our days structure and be a way to stay connected with family and friends. Growing evidence shows that physical exercise does not have to be strenuous or even require a major time commitment. It is most effective when done regularly, and in combination with a healthy diet and mental wellness activity.

There are significant health benefits that can be gained with a moderate amount of daily physical activity. As metabolism naturally slows with age, maintaining a healthy weight is a challenge. Exercise helps increase metabolism and builds muscle mass, helping to burn more calories. Regular physical activity may reduce high blood pressure, help manage weight and reduce the risk of heart disease, stroke, type 2 diabetes, and various cancers – all conditions that can increase susceptibility to COVID-19. It also improves bone and muscle strength and increases balance, flexibility and fitness. Strength training may also alleviate the symptoms of chronic conditions such as arthritis.

There are also cognitive benefits of exercise for older adults. Physical Activity benefits regular brain functions and can help keep the brain active, which can prevent memory loss, cognitive decline, and dementia. Also, exercise improves your sleep. Poor sleep is not an inevitable consequence of aging. Quality sleep is important for your overall health. Physical activity often improves sleep by helping you fall asleep more quickly and sleep more deeply. Furthermore, exercise boosts mood and self-confidence. Endorphins produced by physical activity can actually help you feel better and reduce feelings of sadness or depression. Being active and feeling strong naturally helps you feel more self-confident.

How Can Therapy Help?

The Rehabilitation Team assists each person to progress towards their individualized fitness goals and is there to support them through both their challenges and successes. Your rehab team is specially trained to help adults with a broad range of conditions that affect their ability to participate in physical activity and exercise. Your therapists can identify lifestyle changes that can facilitate improved physical fitness levels. Therapy can offer assistance and guidance by creating a plan of care that includes:

• Resistive weight bearing exercises
• Correcting body mechanics & posture while exercising
• Balance & stability interventions
• Treatment of mechanical pain & dysfunction that limit exercise participation
• Home modifications & functional safety assessments
• Energy conservation with physical activity.

Consult your rehab team today if you are interested in increasing your Physical Activity during the COVID-19 pandemic. For additional information, please contact your Select Rehabilitation Physical, Occupational and Speech therapists.

Research has shown that proper nutrition can extend your lifespan and improve a person’s quality of life. An optimal diet may lead to less heart disease, obesity, high blood pressure, diabetes, and some forms of cancer. Good eating habits throughout life can help to promote physical and mental well-being. For older adults, eating right can help to minimize the symptoms of age-related changes that may cause discomfort. Although the aging process affects some people differently than others, everyone can benefit from eating a well-planned nutritious diet.

Are Nutritional Needs Different for Older Adults?

• Physiological changes occur slowly over time in all body systems and are influenced by life events, illnesses, genetic traits and socioeconomic factors.
• Generally, older adults take in less calories, than younger people. This may be due, in part, to a natural decline in the rate of metabolism as people age. It may also reflect a decrease in physical activity. If calorie intake is too low, then intakes of necessary nutrients may also be low.
• As people age, problems such as high blood pressure or diabetes become more common, necessitating certain dietary modifications.
• As people age, digestive system problems become more common, and some people may have trouble chewing or swallowing.
• For everyone, it is beneficial to eat well and understand some nutrition basics.

What is Malnutrition and how do I avoid it?

• Malnutrition is a critical health issue among older adults caused by eating too little food, too few nutrients, and by digestive problems related to aging.
• Malnutrition causes fatigue, depression, weak immune system, anemia, weakness, digestive, lung, and heart problems.
• To prevent malnutrition as you age: Eat nutrient-packed food, have flavorful food available, snack between meals, eat with other people as much as possible, get help with food preparation.

What are Current Dietary Recommendations for Older Adults?

Fruit: Choose color-rich choices like berries or melons. Aim for 2-3 servings a day.

Veggies: Choose antioxidant-rich dark, leafy greens, such as kale, spinach, and broccoli as well as colorful vegetables such as carrots and squash. Try for 2-3 cups every day.

Calcium: Maintaining bone health as you age depends on adequate calcium intake to prevent osteoporosis and bone fractures. Older adults need 1,200 mg of calcium a day through servings of milk, yogurt, or cheese. Non-dairy sources include broccoli, almonds, and kale.

Grains: Be smart with your carbs and choose whole grains over processed white flour for more nutrients and more fiber. Healthy fats: Because fat is so dense in calories, a little can go a long way in making you feel full and keeping you feeling fuller for longer.

Healthy fats include:

1. Monounsaturated fats are found in foods such as olive oil, avocados, nuts (like almonds, hazelnuts, and pecans), and seeds (such as pumpkin, sesame).
2. Polyunsaturated fats include Omega-3 fatty acids, found in fatty fish such as salmon, herring, mackerel, anchovies, and sardines. Other sources include flaxseed and walnuts.
3. Avoid Trans fats which are found in commercially baked goods, packaged snack foods, fried food, and anything with
   “partially hydrogenated” oil in the ingredients.

Protein: Adults over 50 without kidney disease or diabetes need about 1 to 1.5 grams per kilogram (2.2lbs) of body weight (0.5 g of protein per lb. of body weight is close enough).

Water: Drinking water regularly may help us to avoid urinary tract infections, constipation, etc.

Vitamin B: After the age of 50, your stomach produces less gastric acid making it difficult to absorb vitamin B-12—needed to help keep blood and nerves healthy. Get the recommended daily intake (2.4 mcg) of B12 from fortified foods or a vitamin supplement.

Vitamin D: With age, our skin is less efficient at synthesizing vitamin D, so consult your doctor about supplementing your diet with fortified foods or a multivitamin, especially if you’re obese or have limited sun exposure.

Cut down on sugar and refined carbs: Unlike complex carbs that are rich in fiber, refined or simple carbs (such as white rice, white flour, refined sugar) can lead to a dramatic spike in blood sugar, followed by a rapid crash which leaves you feeling hungry and prone to overeating.

Eat more fiber: Women over 50 should aim to eat at least 21 grams of fiber per day, men over 50 at least 30 grams a day. Good sources of fiber include whole grains, wheat cereals, barley, oatmeal, beans, nuts, vegetables such as carrots, celery, and tomatoes, and fruit.

Mental Health & Mental Illness Defined 

Mental Health: “A state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to his or her community.” 

Mental Illness: “Health conditions that are characterized by alterations in thinking, mood or behavior (or some combination thereof) associated with distress and/or dysfunction.” 

Most Common Mental Health Issues 

• Depression 
• Anxiety 
• Stress 

How Poor Mental Health Affects Your Body 

• Changes in your brain chemistry can also have a big effect on your body. 
• Mental health issues contribute to a wide array of physical  problems that affect everything from your heart to your immune system 
• Changes in the brain have an effect on many of the body’s system; i.e. low levels of neurotransmitters such as serotonin can alter your pain threshold 
• Mental health issues increase your risk of illness because of increasing levels of stress hormones such as cortisol and adrenaline 
• Mental health issues can affect the immune system making it harder for the body to fight infection. 

How Exercise Improves Mental Health

• Help reduce anxiety symptoms and improve mood
• Help keep anxiety from coming back once you’re feeling better
• Release feel-good brain chemicals (neurotransmitters, endorphins)
• Reduces immune system chemicals that can worsen depression
• Increase body temperature which may have calming effects
• Help you gain confidence
• Take your mind off of worries
• Get more social interaction
• Cope with anxiety/depression symptoms in a healthy way

How Much Exercise/What Types Are Best for Mental Health

• 30 minutes or more of exercise a day for 3-5 days a week—Even just 10-15 minutes at a time
• Do what type of exercise you like best: walking, NuStep, gardening, exercise bicycle, aerobics, yoga, etc.—Anything that gets you off the couch and moving is the exercise that can help improve your mood

Getting Started and Staying Motivated

• Identify what you like doing: find out what type of exercise you like doing and you will be more likely to do it
• Set reasonable goals: think realistically and set small goals in the beginning
• Don’t think of exercise as a chore: view your exercise time as your time to yourself
• Address your barriers: find out things that get in your way of exercising and find alternatives and ways around these barriers
• Prepare for setbacks and obstacles: give yourself credit for every step in the right direction. If you miss exercise one day, don’t be hard on yourself. Tomorrow is a new day

How Therapy Can Help

• Therapists can help you find the right exercise for you to manage physical and mental signs and symptoms
• Define an adequate and specialized program to fulfill your needs
• Help you perform exercise safely and correctly
• Help you improve your independence and quality of life

When people hear “wellness”, physical activity and exercise is what usually comes to mind first. Wellness is much more than that. Wellness has four main components- exercise, nutrition, spiritual practice, and rest and relaxation. Wellness is about making lifestyle choices that can minimize the risks for chronic disease and maximize the quality of life. Keeping wellness in your daily routine can get tough. Sometimes there are not enough hours in the day to get what you want done. Wellness should be a top priority for everyone. There are some simple tips to keep wellness in your daily routine and to keep you motivated in doing so.

When introducing wellness into your daily routine you want to start with little bits. You don’t want to start with too much and get overwhelmed. The little bits add up, and that’s what’s most important and most sustainable. You want to actually identify your wellness goals and priorities. It’s hard to work towards something that is undefined, so you want to set a goal. The key is to make your goals become real, rather than theoretical. When making your goals keep “starting with little bits” in mind. Track what you are doing and acknowledge your results. The act of tracking your wellness goals and efforts, and seeing the work pay off, does improve your chances of being successful. With a tracking system you will be able to see what the results are, and affirm the benefit of your efforts. Schedule it- scheduling your wellness time for the week helps reserve the time so you can turn your intention into action. If you know that a block of time is set aside for wellness, you won’t be as inclined to fill it will something else. Having a support system is important to have. Surrounding yourself with people and environments that are health-promoting is important for making wellness an accessible part of your life. You need to be able to understand your inspiration. In order to prioritize wellness you must see the value in it. Have your reasons for wanting to achieve your wellness goals visible to you. This will remind you of why you value wellness, what you want out of it, and what you are willing to do for it.

It is important to keep all four components of wellness in your daily routine. With these helpful motivation tips it should be easier for you to do so. Remember your goals should be something that is achievable. Exercise should not be a huge obstacle for someone, try to find something that you enjoy doing. Nutrition does not mean that you need to be on a diet. The most important thing about nutrition is moderation, so do not try to cut something out completely. You want to slowly work in healthier options as you shift your diet into one that is more nutritious and life giving. Spiritual practice is something that can be different for everyone. You do not have to be a spiritual person to take part in this. Spiritual practice can be anything from prayer, meditation, journaling, singing, drawing, etc. These activities can lead one to have more peace of mind and a greater ability to handle life’s challenges. One’s spiritual practice can be very relaxing which brings us to our last component, rest and relaxation. Sleep deprivation has been linked to many problems, for example, stress and depression. Everyone needs their rest to have a better quality of life.