Retirement and Senior Caregiving

When we hit retirement age, for some it’s 50’s others it may be well into their 70’s,  
if we haven’t already, we should begin thinking where we want to live out our golden years.  For some, being near family and friends are an important factor, for others it’s the cost of living as finances for some are limited.  

I recently found the article “The 10 Best States to Grow Old In” by Laura Dixon, on www. Caring.com that pulled together some great insights as well as details about the best locations for retirement and senior caregiving as follows: 

Whatever the case may be, it doesn’t hurt to do a little research in finding the appropriate place for you.  Make sure to take into account states that include a higher quality of senior care at lower cost, as well as one with an excellent quality of life.  According to Sara Zeff Geber, PH. D, an author and retirement planning expert,  “We really need to start thinking about someplace that’s stable, someplace that’s safe and someplace that we can afford.”

In Caring.com’s research, they were able to assemble ratings that offered the best mix of quality healthcare, long-term care, support for seniors and family caregivers, affordability of senior care and more than 100,000 ratings of senior care providers in each state. Below are the following top 10 states:  

Sources include Genworth’s 2015 Cost of Care Survey, the Gallup-Healthways Well-Being Index, the Long-term Scorecard, a joint effort by AARP, the Commonwealth Fund and The SCAN foundation.

1. South Dakota

Seniors in South Dakota have access to high-quality healthcare and senior care, with costs of care hovering around the national average (about $36,000 yearly for an assisted living community, and around $52,000 for a home health aide).

In addition to financial considerations, our survey incorporated The Gallup-Healthways Well-Being Index, which measures purpose, social, financial, community and physical well-being. As of 2015, the Mount Rushmore State boasted one of the highest combined rankings in these categories for residents 55 and older.

2. Iowa

Also like South Dakota, senior care costs here are around the national average.

But the state ranked among the top 10 in the nation for quality of life and healthcare for residents over 55.

3. Minnesota

Compared to the first two states on the list, senior care in Minnesota is pricier (an assisted living facility costs roughly $42,000 per year on average, while a home health aide runs about $57,000).

Still, the state ranked especially high (#3) in quality of health care and overall quality of life for seniors.

4. Alaska

Of all 50 states, Alaska topped the list for quality of life and health care, and also ranked very high for quality and access to long-term care services and supports for seniors.

At the same time, the state is also home to the most expensive senior care in the nation (a year in a nursing home costs a whopping $281,000 on average and assisted living runs more than $68,000 yearly), dragging its overall ranking down to the fourth spot. 

 

5. Oregon

The state ranked fourth in the quality of life and healthcare studies and also very high in long-term care and supports for seniors.

The ranking dipped somewhat due to pricier cost of senior care here– a year in an assisted living community runs about $50,000 on average and a home health aide costs over $51,000.

6. Colorado

For those 55 and older, the Centennial State ranks seventh in overall quality of life, well-being and healthcare quality.

Its relatively high senior care rates (roughly $50,000 on average for either assisted living or a home health aide) pulled down the state’s ranking slightly.

7. Hawaii

In addition to being one of the world’s most popular vacation destinations, beautiful Hawaii boasts a great mix of quality of life, health care and support for people 55 and over.

The state scored the highest marks in the nation on support for family caregivers, and among the highest for quality of long-term care and supports for seniors.

But with senior care costs here among the highest in the nation (home health aides cost around $56,000 per year on average, while a year in an assisted living community runs about $48,000), not everyone can afford to spend their later years in the Aloha State.

8. South Carolina

South Carolina not only draws plenty of tourists to its beachfront vacation towns, pastel-colored houses and Civil War monuments, it’s also a smart choice for seniors looking for affordable long-term care.

The only southern state to make the top 10, South Carolina boasts the nation’s fifth-cheapest elder care. A year in an assisted living community costs $37,500 on average, while a home health aide costs roughly $42,000 per year.

Meanwhile, the state’s overall quality of life and healthcare rankings for seniors are around the national average.

9. Nebraska

The Cornhusker State also ranks high in the quality of life, healthcare and well-being indexes, and scores high marks for its quality of senior care and support for seniors and family caregivers.

As far as affordability of senior care, Nebraska’s costs are around the national average (roughly $53,000 annually for a home health aide and about $43,500 a year for assisted living expenses).

10. Wisconsin

While senior care here is relatively expensive ($48,000 per year on average for an assisted living community and about $50,000 yearly for a home health aide), the state ranks eighth in the nation for quality of life and health care.

Wisconsin’s long-term care options and support for seniors and family caregivers also scored some of the highest marks in the country, cementing its place among the top 10.

Ideally, picking a great place to retire might change the proximity to the grand kids, family and friends as well as decent climate. But if you are among the Americans who may someday need long-term care or will be in the position for providing or paying for such care for a family member, the list of best spots may look somewhat different. For those of us with family, it becomes a group decision, for others it just may be the cost of living that matters.  Whatever the situation or location, make sure you live out your golden years to the fullest.  

As Mark Twain once said “Age is an issue of mind over matter.  If you don’t mind, it doesn’t matter.

Healthy Eating as We Age

Eating healthy is important at any age, but even more so as older adults, after the age of 50.  It’s imperative as we age to make better choices for our health in general. Healthier food choices affect our blood pressure, heart, bones, mood and all around well-being.

The National Institute on Aging suggests the following tips to get you started:

• Eat many different colors and types of vegetables and fruits.
• Make sure at least half of your grains are whole grains.
• East only small amounts of solid fats and foods with added sugars.  Limit saturated fat (found mostly in foods that come from animals) and Trans fats (found in foods like store-bought baked goods and some margarines).
• Eat ”good” (poly-and mono-saturated) fats, like those found in seeds, nuts, avocados, and fatty fish like salmon.  Any fats added in cooking should come from olive, canola, corn, or vegetable oil.
• Eat seafood twice a week.  Small fish, like sardines or trout, or farm-raised fish contain less mercury than large fish, like tuna.   Mercury can be harmful.

Eating foods from each food group will help you get the nutrients you need.  The 2015-2020 Dietary Guidelines for Americans from the U.S. Department of Agriculture (USDA) and Department of Health and Human Services (HHS) explains healthy eating patterns.

The Dietary Guidelines suggest that people 50 or older choose foods every day from the following:

• Fruits:    1(1/2) to 2(1/2) Cups
• Vegetables:  2-3(1/2) Cups
• Grains:    5-10 Ounces
• Protein Foods: 5-7 Ounces
• Dairy Food: 3 Cups of fat-free or low-fat milk
• Oils:  5-8 teaspoons
• Solid fats and added sugars and salt:  Small amounts

Here are a few examples of healthy, nutritious recipes for seniors from Aplaceformom.com.

Breakfast:    Banana Split Oatmeal (Single Serving)

• 1/3 Cup Oatmeal
• 1/8 Tsp. salt
• ¾ Cup water (very hot)
• ½ banana (sliced)
• ½ Cup frozen yogurt, non-fat

Preparation:      In Microwave safe bowl mix together oatmeal and sale. Stir in water.

Microwave on high power for 1 minute. Stir. Microwave on high power for another minute. Stir again.

Top with banana slices and frozen yogurt.

Lunch:        Spring Vegetable Soup (Serves 4)

• 1 Tbsp. extra-virgin olive oil
• ¼ red cabbage (medium head, about 2 cups, finely shredded).
• 2 ripe tomatoes (medium, seeded and chopped)
• 1 Cup canned artichoke hearts (drained and chopped)
• 1 Cup green peas (frozen or fresh)
• 2-1/2 Cups vegetable juice (low-sodium tomato)
• 1 Cup water
• 2 Tsp. dried basil
• Salt and freshly ground black pepper, to taste

Preparation:    In large soup pot, heat oil over medium heat. Saute cabbage, tomatoes,

        Artichoke hearts and peas for 10 minutes.

        Add tomato juice and water.  Bring to boil.  Reduce heat, add basil and simmer

        For 10 minutes, or until all vegetables are tender and soup is piping hot.

            Serve in individual serving bowls.  Season to taste with salt and pepper.

Dinner:        “So Easy” Crock Pot Recipe

• 1.5 lb. bag frozen skinless, boneless chicken tenders (no breading)
• 1-16oz. can of organic, low-sodium chicken broth
• 10-15 baby red potatoes
• 2 carrots cut into 1-inch pieces
• 3 stalks of celery cut into 1-inch pieces
• 1 small onion, sliced
• 1 packet of McCormick’s Gourmet Seasoning (Chicken and Potatoes or any other flavor you fancy).

Preparation:    Spray Crock Pot with olive oil spray

Add cut vegetables, potatoes, broth, frozen chicken tenders, packet of seasoning.  Mix all together.

Cook on low for 6-8 hours.  Use leftovers for lunch the following day or make into a stew.

Eating healthy is one of many lifestyle changes we make as we get into our senior years.  It doesn’t have to be the same meal or foods every day, there are many options and creative recipes out there that meet your restricted diet needs you just have to look.  Meeting with your doctor or a certified dietitian, can assist you in customizing meal plans, or suggesting certain foods to avoid due to special diets, allergies or interaction with medications.  As always, it’s very important to check with your doctor first.

Staying Hydrated is Important as We Age

Why is staying hydrated so important to healthy ageing?  Staying hydrated is important at all ages, but our bodies nutritional needs change as our bodies lack of sufficient sustainable nutrients are less absorbed.  What I’m trying to say is as we age our bodies need a little more help in adjusting to each phase of life and the ageing process.  The truth is our body absorbs less than before and we begin to feel the effects of ageing, something we have no control over, but living a healthier lifestyle can actually slow down and delay what is inevitable, growing old.

Now when I say staying hydrated I’m not talking about your daily allowance of sodas, lemonades, fruity cocktails etc.  I’m talking about drinking water, yes, plenty of plain water or water with lemon just to add a little something.  Water, is what I truly believe is the key to the fountain of youth.

According to https://www.nestlenutrition-institute.org/Education/practical-tools/Documents/Waters_Senior_light_pages.pdf

Gradual ageing of the body is accompanied by several changes, both physical and physiological.  The decline in lean body mass is accompanied by a decrease over time in the percentage of water in the body.  So, the percentage of body weight made up of water falls from about 60% in adults to about 50% in the elderly.

Age reduces the sensation of thirst:

Seniors are more at risk of dehydration as the sensation of thirst decreases with age, and their kidneys have decreased ability to concentrate urine.  The sensation of thirst allows the body to realize that it lacks water.  Thus, when we feel thirsty, our body is already slightly dehydrated.  In seniors, the sensation of thirst is decreasing, and therefore they are more at risk of becoming dehydrated.

Age and impairment of kidney function:

With age, the kidneys do not function as well and renal ability to concentrate urine decreases.  In fact, between the ages of 30 and 80, there is often a 20 to 25% loss of renal mass, the most of which is from the cortex.  Other changes explain the difficulty which kidneys have adapting urine concentration. When seniors are slightly dehydrated, they can feel the onset of some physical signs: thirst of course, but also a dry and sticky mouth, muscle weakness, headache, sleepiness or tiredness. So it’s important to drink water regularly throughout the day, and to drink before becoming thirsty.

Intestinal Comfort:

It is common knowledge that elderly people are affected by problems with bowel movements and constipation. From Suares study, constipation affects between 11% and 18% of the people according to geographical region. And the prevalence of this disorder is even higher and older people.  Constipation in the elderly has many potential causes, including a reduced fluid intake, malnutrition, reduced fiber intake, lack of physical activity, impaired mobility, side effect of medication, an acute or chronic illness. Therefore, it is important to practice regular exercise, healthy eating including fruits, vegetable, and whole grain foods as sources of fiber, and maintaining an adequate fluid intake with fiber consumption.  The bulking effect of fibers consists in retaining water.  Drinking enough water is a good habit.

Urinary Incontinence:

(Urinary incontinence is a symptom or sign of any involuntary loss of urine.  Continence (storage of urine) is maintained when the urethral pressure is greater than the pressure inside the bladder itself (intravesical pressure).  Urinary incontinence causes include structural changes in vesical muscle as well as impaired neural control and age-related changes of the lower urinary tract.).

Urinary incontinence is a rather sensitive issue for women and especially for senior women.  In fact, urinary incontinence affects about 19% of women aged 19 to 44 years, 25% of those aged 45 to 64 years, and 30% of those aged 65 year and older.

Adopting healthy habits can bring a real relief:

*Drinking enough water throughout the day is important for seniors to be well hydrated.  A decrease in fluid intakes may lead to urinary tract infections, constipation, or dehydration.

*Maintaining normal weight though adulthood may be an important factor in preventing the development of urinary incontinence especially in women, because overweight increases the pressure on the bladder and surrounding muscles.

*Prescribing some physical rehabilitation therapies with a physiotherapist including musculation of the pelvic floor can also be useful for initial management of urinary incontinence.

*It is also a good idea to go to the toilet regularly.

Drinking water helps to maintain water balance.  Every day, water loss must be compensated by sufficient intake of water.  That is why it is important to remain properly hydrated.  A healthy sedentary adult living in a temperate climate loses 2lto 3l of water a day, mainly from urine.  But other vectors are also responsible for the body water loss: the skin, the respiratory tract and, at a low lever, the digestive system.  It is important to compensate those losses by a sufficient water intake. 

Our body produces water by metabolism and gets water from food but this is not sufficient to fulfill the body needs.  So an adult should drink on average, 1.5l of water a day.  With ageing, all parameters of water metabolism undergo changes and so, the water balance evolves.  Elderly people show lower non-renal water losses (mainly due to lower sweat losses); at the same time renal concentration capacity becomes impaired, resulting in an increased obligatory urine volume.  Because eating habits are changing, the volume of water obtained from food increases slightly with age whereas the metabolic water decreases.  So the water balance remains nearly the same and the water intake recommendations can be maintained.  But water input can be reduced due to the diminution of the thirst sensation and appetite.  Therefore it is important to keep a healthy habit of drinking 1.5l the equivalent of 8 glasses of water regularly throughout the day.  The daily needs are even higher when the outside temperature increases or when the inside temperature is overheated.

Observing the color of urine is an easy and rapid way to assess whether someone is properly hydrated.  If urine is dark-colord rather than pale yellow, it might mean you are not drinking enough.  One thing to keep in mind, the urine color can be affected by certain foods, vitamin supplement or medical treatment. 

Stay hydrated out there!

Peace and health.

April

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Vitamins by Age Group

Vitamins and supplements are a big industry, and there are so many to choose from.  Trying to figure out what to take, which makers have a better product and if it really adds value to your health. 

A dietary supplement is just that, it is a dietary ingredient intended to add further nutritional value to your own diet.  We do know that by eating the right amounts of fruits, vegetables, nuts, protein and dairy, we fulfill our daily requirements of vitamins needed to sustain a healthy body.  But a busy lifestyle doesn’t always allow for the perfect meal planning, so our bodies tend to suffer from lack of certain nutrients needed daily, so the next best thing is to reach for the vitamins/supplements to make up for those we are lacking.

That being said, what dietary supplements are the most important?  And what are the necessary amounts needed, as it varies with age and the daily diet doesn’t always provide all the nutrients needed.

According to WebMD:

Infants (0-12mos.):  Since infants can’t consume as many calories as adults, a diet high in fat supplies more than twice the calories of carbohydrates or protein.  Fat also supplies the essential fatty acids that attribute to proper brain development. Breast Milk, formula and animal products provide fat and cholesterol, which is necessary for a healthy nervous system.  Babies need Vitamin D every day to build strong bones and teeth.  Iron is needed as well to help support an infant’s rapid growth and development.

Toddlers & School Aged Children (1-8yrs.): Toddlers need about 1,400 calories a day. Milk provides calcium and vitamin D for the growing bones.  Everyone between 1-70 years old should get 600IU of vitamin D daily, about the amount found in five 8-ounce glasses of milk.  According to the American Academy of Pediatrics, children of all ages who drink less than 32 ounces of vitamin D added milk daily need vitamin D supplements.  As a child’s diet begins to reflect the family’s eating patterns, the child may be at risk for a diet low in calcium, vitamin D, potassium, and fiber, according to the 2010 Dietary Guidelines for Americans. Kids who avoid meat and other iron-rich foods, or any food group, may need a multivitamin supplement to fill in nutrient gaps.  Children who don’t consume enough milk or calcium and vitamin-D foods may require extra calcium.

Pre-teens and Teens (9 to 19 years old): Adolescence is the time for a child’s final growth spurt.  A child’s body begins preparing for the changes to come starting around age nine.  Nearly half of all skeletal growth occurs during the teen years.  Rapidly growing bones trigger a higher demand for calcium and the body responds by boosting calcium absorption from food and depositing it in bones to make them longer and thicker.  From age 9-18, children require 1,300mg of calcium daily, about the amount found in 32 ounces of milk.  Children of all ages require 600IU of vitamin D, which promotes calcium absorption in the body.  Iron requirements increases at age 14 to support increased blood volume and muscle mass.  Teen girls due to menstruation need more than boys to make up for monthly losses.  Inadequate iron intake can lead to anemia, the most common nutrient shortfall for teen girls. Teens who skimp on animal products run a greater risk for iron deficiency and insufficient intake of vitamin B12, calcium, and vitamin D, among others.  A daily multivitamin helps to fill in small nutrient gaps in a teen’s diet.

Adults (19 to 50 years old): Calorie needs decrease when you’re done growing.  A woman’s iron needs increase again in adulthood, to 18mg daily.  During pregnancy, iron requirements rise to 27mg daily, which is difficult to satisfy with food alone. 

Folic acid is another important nutrient during the childbearing years.  This B vitamin helps to prevent birth defects during early pregnancy.  The Institute of Medicine encourages women who may become pregnant to consume 400 micrograms of folic acid daily from fortified foods, dietary supplements, or a combination of the two.

With the exception of pregnancy, calcium absorption starts decreasing during adulthood.  Women, and men, should satisfy their daily calcium needs during this stage, which arte 1,000mg to reduce the risk of bone fractures later on in life. Calcium and vitamin D supplements make sense if you don’t consume the recommended 24 ounces of low-fat (1%) milk or fat-free milk or yogurt, or a combination of these every day – or if you don’t get the recommended calcium and vitamin D from other foods besides dairy.

Senior (50years old and older):  Nutrient needs change with advancing age for several reasons:  the body absorbs less, it requires more, or it needs less of certain nutrients.  For example, after menopause, women need less iron – 8mg daily – compared to 18mg daily during childbearing years – but they require more calcium.  As estrogen production decreases during menopause, more bone is broker down than constructed.  In addition, the body absorbs less calcium than it did earlier in life.  After age 51, women should consume 1,200mg calcium daily and men need 1,000mg.  Vitamin D needs go up with age, too.  After age 71, you should get 800IU daily.  Unless you drink 64 ounces of mild each day, you need a vitamin d supplement.

It’s harder to absorb naturally occurring vitamin B12 after age 50, because your body is less able to grab the vitamin B12 from foods and absorb it.  The body easily absorbs synthetic B12, however, which is why experts recommend it as the primary B12 source for people over 50.  Foods fortified with vitamin B12. Such as breakfast cereals and other, grains, or a multivitamin can help you meet your vitamin B12 needs.

Also keep in mind that certain nutrients interfere with over-the-counter and prescription medications.  As always, ask your doctor or pharmacist about the dietary supplements you take and how they may affect your medications.