The importance of (not) sitting

sitting is good

I read an article recently where it states that sitting for long periods is the new smoking.

Till recently, say till about 2 generations ago, people were more actively involved in manual work involving standing, walking and running. However, with more work moving to the desk, we are finding most people spending at least 9 hours a day sitting at their desk.

These prolonged periods of inactivity, according to health experts, can lead to obesity, heart diseases, muscular issues including back problems, as well as dementia. The WHO has identified lack of physical activity as one of the biggest killers on this planet.

While most of these articles and TED talks are focused on the young, this is true for the ageing population as well. Especially because many elders spend even longer hours sitting. So, if you notice that you are sitting for long periods of time, please change your life style as soon as possible. Go for short walks more often, join an elder yoga class, stand around for longer periods or join a gym. This should help keep at least some of the problems at bay.

Having said that, there is at least one time when sitting is of paramount importance. And that is when you are trying to put on your underwear and trousers. Most of us, especially the men, do this while standing. As your flexibility decreases, the chances of your foot getting caught inside and making you trip increases quite rapidly. So, always, always sit down before your wear your clothes.

Now, if you are in the habit of wearing your clothes in the bathroom, the situation is even more dangerous. Yes, I know, you have been doing it for several years, practically since you started dressing yourself. Nevertheless, times have changed and you have become older.

Get a shower bench or shower chair for your bathroom. After you wipe yourself, quickly wipe the showerchair as well and then sit on it to wear your clothes safely.

Remember, a fall can lead to a lot of complications and additional dependency on others.

Sometimes, sitting is good.

24-hour helpline for elders to be launched

elder-abuse-300x300The city may soon get a 24-hour helpline for senior citizens in an initiative taken up by Young Men’s Christian Association (YMCA), in association with Sneha Sandhya and HelpAge India.

The helpline at the YMCA, a first-of-its-kind initiative in the city, will provide medical assistance and emotional support for senior citizens. “We have discussed the issues raised by senior citizens with the YMCA management, who have shown their eagerness to come up with the much-needed helpline. The facility will be launched by the end of the month,” Ch. Venkat Rao, secretary of Sneha Sandhya, told The Hindu .

Sneha Sandhya, which has a membership base of over 500 senior citizens, is also planning to establish a day-care centre for the elderly. “We have approached government officials to look for a suitable land to build the facility. With growing issues concerning senior citizens, geriatric support systems are the need of the hour,” Mr. Rao said.

At present, Sneha Sandhya has a centre at Prema Samajam, where it offers yoga training and free medical check-up.

The HUG bridge

At a time when there is a severe disconnect between the youth and senior citizens, HelpAge India, Sneha Sandhya, AU-NCSA Centre for Gerontology, and AU Department of Social Work have joined hands to come up with a novel programme called HUG or ‘Help Unite Generations’.

As part of this, a sensitisation programme will be held at AU Platinum Jubilee Guest House on July 25 involving the youth and senior citizens.

“The programme will facilitate an interactive platform between youth and senior citizens, where the elderly can explain their expectations from the younger generations and the problems they are facing. Similarly, the youth can come up with views and suggestions to address those,” Mr Rao said.

According to a recent HelpAge India survey for ‘Elder Abuse: The Indian Youth Speaks Out’, of the 2,000 youths, including women, surveyed, 73 per cent accepted that elder abuse existed in society. However, only 4.6 per cent of them intended to report such cases to the police. Even lesser, 1.1 per cent, wanted to approach an NGO and 15.6 per cent wanted to intervene and speak to the elder about fighting abuse.

Read the full article here.

Staying safe in a bad world

Aluminium-Door-Security-GrillThere is an article in a newspaper today that states that Tamil Nadu stands second in the number of senior citizens murdered so far this year.

Quite shocking. But I am not surprised. Most seniors are very trusting and let strangers into the house. For example, when we go to deliver products to houses, many times we find that the elderly, alone at home, opening their doors wide, inviting us in and offering us refreshments!

However, not everyone is like that and some of our customers have shown us that it is possible to be just as friendly and courteous without compromising on safety.

Take the case of Mrs. M. She lives in a ground floor apartment in a complex with about 25 apartments. Her son lives in Canada and the daughter in Saudi Arabia. They take turns and ensure that each one visits at least once every six months and stays for a couple of weeks, but the rest of the time Mrs. M lives by herself. She has some mobility issues, but manages to get by with a walker.

Here are a few things she does to keep herself safe:

1. She has a good rapport with the security chap at her complex. He is an old guy himself, but he asks a hundred questions before he lets us in, even if we have been there many times before.

2. She has built excellent relationships with her neighbours. One or the other is always peeping in and checking if she is all right. Obviously, it helps that she has a sunny disposition and seems to be able to make them laugh with her.

3. She has had installed a grill door which allows here to keep the main door open without compromising on safety. She says she make it a point to keep the grill door locked all the time and opens it only to let the maid in and ensures that the maid locks the grill again as soon as she is in.

4. She stations herself near the window which also has a grill with large enough gaps to allow her to complete most transactions through the window without having to let people into the house. So the milk, post, couriered packages, and almost everything else other than the gas cylinder gets to her through the window. As for the gas cylinder, when I enquired, she told me that the same guy has been delivering her gas cylinder for the last 18 years and she know him very well and would not allow anyone other than him to deliver.

I am sure these are fairly easy ways to keep oneself safe. Remember, the theives are looking for easy targets and even the smallest of efforts you take to keep yourself safe will go a long way in detracting them from trying to target you.

Have a safe life!

Tips on balance as you age

Falls are relatively common in older adults who live at home, and increase with advancing age. Falls are associated with an increase in mortality, a reduction in mobility and greater dependence in activities of daily living.

Balance, the ability to control and maintain your body’s position as it moves through space, is such an integral part of daily life that most people rarely give it conscious thought. Your brain, muscles, and bones work together to maintain your body’s balance and to keep you from falling, whether you’re walking, rising from a chair, or climbing stairs. They also let you navigate sloping or uneven surfaces.

There are conditions, which may impair your sense of balance and contribute to falls. The effects of aging are the most common causes of balance problems; injury, certain drugs, alcohol and disease can also trigger problems.

It’s important to find out what you can do to decrease your risk and improve your general health and mobility. Individual programs of muscle strengthening and balance retraining, home assessments, exercise classes are beneficial.

Physiotherapy can help.

Working with a physiotherapist can produce exceptional results in many cases. Even if some of your natural sense of balance has been diminished over time, Physiotherapists are experts at retraining your body to make the most of its capabilities.

A physiotherapist will likely review your medical history and determine your general physical condition, as well as conduct an inventory of tests specifically designed to measure balance and gait.  After the physiotherapist has determined what is impairing your balance, (s)he will design a program of exercises and activities just for you, with an emphasis on strength, flexibility, and proper gait.

All exercises should be planned for maximum safety and security.

If you have balance problems related to the inner ear, physical therapist may also try interventions known as Vestibular rehabilitation. Vestibular rehabilitation includes techniques that help the inner ear respond to a change in position. Conditions that may require vestibular rehabilitation include Vertigo, Dizziness, or Nausea.

Eye exercise for balance

eye-exerciseStep 1.

Focus your eyes on a target 10-20 feet away while you change from sitting to standing and back again with your eyes OPEN. Make sure that you land softly when you sit!

Step 2.

Repeat with your eyes CLOSED.

Step 3.

Feel the position of your body as you move.

Be sure that you keep your weight forward on the front of your feet, knees apart, Chest forward, and spine erect feet, may lack the flexibility and range of motion necessary to avoid falling.

Strength, flexibility, and endurance are crucial to maintaining balance and preventing falls.

Half circle sway

sway-exerciseIf you have experienced falls or problems with balance,  get your physiotherapist’s permission before doing this exercise.

Step1.

Stand with your feet shoulder-distance apart.  Hold something for safety.  Breathe deeply and relax.

step2.

Lean forward slowly from the ankles, without bending at the hips. Feel how about 70% of your body weight is now on the balls of your feet.

step 3.

Return to the neutral starting position. Now, lean slowly to the left. Feel how about 70% of your body weight is on the left sides of your feet.

step 4.

 Return to the upright position. This time lean slowly to the right, feeling the shift in your weight.

step 5.

Now put it all together: Practice making graceful half-circle sways from left to center to right and back again. Begin with small half circles, and gradually increase to see how far you can move your body without taking a step.

Even if your basic perception of balance is good you have normal vision and no inner ear problems you can still be at risk for falls if your muscles are weakened or stiff, or if you tire easily.

Older adults, particularly those with osteoporosis have very valid concerns about falling and often restrict their physical activities to prevent such a mishap.  Physiotherapy can help you learn to maintain higher levels of strength, flexibility, and endurance in a way that still feels safe and secure.  Many Researches indicates that the risk of falling in older adults can be reduced dramatically when specific exercises, activities, and interventions are prescribed by physiotherapists.

There are instances, however, in which physiotherapy alone may not be appropriate. If you have an inner ear disorder, for example, you will need to consult a physician.

 

Choosing the right walking aid

As you age, it is not uncommon to have balance problems. Reasons could be as diverse as heel pain to dizzy spells. Once you have gone to the doctor and ensured that the underlying problem is being taken care, it may be a good idea to get your self a walking aid so as to avoid falls.

The simplest aid is a cane. They come in various materials from wood to plastic to metal, with different grips. You hold them in your stronger hand and use it to put some weight on them when you walk.

The next option is a tripod. It is similar to a regular cane, but has 3 legs at the bottom. The wider base affords you greater stability.

Another similar option is a quad cane or a quadripod. This is similar to a tripod, but has 4 legs at the bottom. All these canes are usually height adjustable except the wooden ones.

If your balance problem is severe, the other alternative is to use a walker. A walker is a four-legged contraption that provides you much greater stability. Within walkers you have static walkers, recriprocal walkers and reciprocal walkers with wheels. The static walker requires you to lift it and move forward each time, while the reciprocal walkers allow you to slide them forward, one side at a time. These afford the best support for people who find walking unaided difficult.

To check out all the mobility aids, go here.

If you have balance issues, keep an appropriate walking aid handy. Its much better to have a walking aid with you than to have a fall and break some bones!

Senior friendly railway stations

At Old is Gold Store, wherever we go, we make it a habit to look at all public places such as railway stations, resorts, hotels and restaurants through the eyes of a senior citizen so that we can highlight all the senior friendly places to our customers.  Given our record in India, we can safely state that it is easier to document and list all senior/disabled friendly places (a very short list) than enumerate all the places which are not senior friendly (a very long list indeed).

Recently, on a trip to Varkala in Kerala, we were pleasantly surprised to find the railway station had ramps for entry to the station, ramps for entry to the canteen, free stretcher and wheelchair service and an easily accessible and readily available wheelchair at the station.

I could not spot the toilet though in the short time that we were there, so I cannot state whether the toilets were senior safe.  Also we did not find an elevator to help people cross over to the other track (we had to climb a flight of stairs to get on to the over-bridge and climb down on the other side).  Nevertheless, we appreciate the builders of Varkala station and hope that more public places take the cue from Varkala.

If you have noticed places that have taken special care to make all areas accessible, please write to us at involve@oldisgoldstore.com with photos.

Most of our elderly parents live in denial

protecting elderlyMost of our parents, even though they have become older and have lost some of their balance, still believe that they are completely capable of living unaided.  Genuine inability to notice the gradual deterioration of faculties along with not wanting to “burden” their children with their difficulties plus pride leads to this deadly state of denial.  And sometimes as children, we are also lulled into a false sense of belief that all is well, especially when we are living away from them – until there is some unfortunate accident that leads us to re-look at the situation with new eyes.

A few incidents involving our customers can help illustrate this problem as well as enable you to identify such situations and take necessary measures to ensure that your parents lead a safe and secure life.

I will narrate below one such incident involving one of my favorite customers.  An elderly lady, she walked into our showroom one bright sunny day to take a look at what we had on offer.  “Saw your advertisement and was curious to know what you have for us oldies…”, she said with an impish grin.  I showed her the different products we had and she clucked at each of them as though to say, “maybe for other older people… I don’t need these now”.  Finally we came to the walking sticks section and she picked up one of them, checked the price, paused a bit, chuckled and said, “I might be needing this one of these days”.  She then put the stick down and added “just not yet” and left the shop.

She came again a couple of days later saying she was just passing by and wanted to drop in and say hello.  I noticed a slight stutter in her steps and her hand against the wall, but pretended that I hadn’t noticed anything.  Her eyes wandered around the shop and I caught her glancing at the walking sticks.  “Not for another six months at least”, she half muttered to herself. She then shook her head, made small talk with me and went away.

A week later she was back.  This time she said “I keep coming to your shop and going away empty handed.  The least I can do by way of encouragement is to buy something. This time I am determined to buy something from your shop just to show you that I appreciate what you are doing and for all the times you have patiently listened to my chatter”.  Then she looked around and said, “what can I get for Rs. 500?” and then she looked at one of the walking sticks she had spied during her previous visits.  She grabbed at one and pretended to be surprised that it was priced exactly at Rs. 500.  “Humph, might as well buy this then, even though God know I don’t need it now.  I only rarely feel dizzy when walking anyway” she said and bought the stick.  She unwrapped it then and there and declared, “Now that I have bought it, I may as well use it whether I need it or not”!  Now, every time she visits us, she has her trusted walking stick firmly in her hand.

It took this tough lady 3 visits to convince herself to buy a walking stick, something she needed quite desperately.  Most of our customers are like that when they come by themselves – reluctant to accept that they are no longer as sprightly as before.  Some times, one of their children or a younger relative accompanies them and in that case there is usually a lot of argument before the young person says “I will buy this now.  You can use it when you want”.  Invariable, whatever they buy gets used from that day forwards.

When you are living away from your parents, it is usually not possible to find out exactly how they are getting on.  You end up going by their word, which is not always as objective as we would like it to be.  So remember, you need to be a lot more proactive when it comes to ensuring that your parents have all the protection and safe guards they need to lead an accident-free and safe live.

Limited Mobility and flying

If you are flying domestic or international, and have mobility issues, it is important that you understand what facilities your selected airline carrier provides. Different Indian airlines seem to provide different levels of service and some charge for the services while others provide this for free. Also different airlines have different rules regarding powered wheelchairs and the kind of batteries they use.

Here are the links to the relevant pages for the different airlines in India for your ready reference.

1. Air India.
2. Jet Airways.
3. Spice Jet.
4. Indigo.
5. Kingfisher.
6. Go Air.

Have a safe flight.

Foot care for diabetics

Over 60% of diabetics suffer from some form of nerve damage.  This is called diabetic neuropathy. People with diabetes can, over time, develop nerve damage throughout the body. Some people with nerve damage have no symptoms. Others may have symptoms such as pain, tingling, or numbness-loss of feeling-in the hands, arms, feet, and legs. Nerve problems can occur in every organ system, including the digestive tract, heart, and sex organs.

People with diabetes can develop nerve problems at any time, but risk rises with age and longer duration of diabetes. The highest rates of neuropathy are among people who have had diabetes for at least 25 years. Diabetic neuropathies also appear to be more common in people who have problems controlling their blood glucose, also called blood sugar, as well as those with high levels of blood fat and blood pressure and those who are overweight.

The most common type of diabetic neuropathy is peripheral neuropathy, which essentially affects hands, arms, legs, feet and toes.  In many cases people lose sensation in these area and hence injuries to these parts of the body, especially feet and toes go unnoticed, leading to infections which could eventually result in amputation, septicemia and even death.

The importance of foot care for diabetics cannot be stressed enough.  Here are some precautions to take:

1. Inspect your foot daily (Visual surveillance of extremities(VSE))
2. Wash foot in lukewarm water
3. Use correct footwear
4. Do not walk bare foot
5. Do not walk with ulcer in the foot
6. Get periodic foot exams
7. Do not sit with legs crossed
8. Do not trim corns and calluses
9. Do not apply heating and cooling pads on legs
10. Cut nails carefully

In addition, there is whole range of special footwear available today that can keep your foot safe and free of infection.  We have already covered some of the silver yarn based socks.  You can read more about them here.

So what do you look for in footwear (shoes or sandals), if you are a diabetic?  The diagram below gives you a quick overview of some the important features necessary in prophylactic footwear:

Click here to buy prophylactic footwear specially designed for diabetics and people with arthritis.

Travelers Thrombosis – Precautions and prevention

Anti-Embolism StockingsFor many decades now and especially since the beginning of the IT boom, Indians have been settling down in all parts of the world, for business, work or other purposes.  The one thing common to all the Indian diaspora is their strong ties with their homeland, especially to their friends and relatives living in India.  This has resulted in a lot of travel back and forth making Indians among the largest populations of frequent long distance travelers.

Most families travel once a year to their home land and in turn parents who reside in India travel abroad to spend time with their children and grand children on a regular basis.  This article is specifically for the elderly who travel by air to be with their family and shows how some simple precautions can reduce the chances of Deep Vein Thrombosis(DVT).

The elderly who travel long distances by air are at high-risk of what is being called Travelers Thrombosis.  In medical terms this is known as Deep Vein Thrombosis (DVT) and  Pulmonary Embolism sometimes collectively called Venous Thromboembolism.  DVT is a common medical condition in the population. The disease process in DVT occurs because of blood clotting, most frequently in the large veins of the calves. Sometimes these clots break free and travel up the veins through the heart to lodge in the arteries of the lungs. This related condition is known as pulmonary embolism (PE), and it may cause sharp chest pain or breathlessness. PE may be life-threatening if the embolus (circulating clot) is large.

Causes for DVT can be both acquired and inherited.  The Inherited ones could be due to deficiency of one or more of Antithrombin, Protein C, or Protein S.  Additionally people with blood groups other than O are also at slightly elevated risks.

The acquired causes include:
1.  Old age.  [Most of our parents]
2.  Major surgery or orthopedic surgery [Many of our parents go through knee replacement surgeries.  This is one major cause for DVT].
3. Cancers, especially pancreatic.
4.  Immobilization, sitting in one position for long hours, and travel, especially by air. Bed-ridden patients also are at high-risk.
5.  Hormonal replacement therapy.

There are several other causes which are not limited to older people.  Please refer wikipedia for more details.

DVT can be quite painful and even life-threatening.  Here are some precautions you can take when traveling by air:

1.  Drink plenty of non-alcoholic fluids.  Ideally water, fruit juices, and isotonic drinks.
2. Regularly massage your calves and mobilize/rotate your ankles
3. Wear comfortable, loose clothing that does not restrict blood flow.  Light cotton wear is ideal.  Saris and salwars are fine. Avoid tight jeans.
4. Move around during transit breaks.  Avoid moving around in the cabin during the flight as you risk injuries due to turbulence.
5.  Be vigilant for the symptoms of DVT, in particular pain in the calves, during and for up to a month after long flights. If symptoms occur, seek medical advice without delay.

Finally, there are stockings called Anti-embolism stockings that apply about 15 -20 mm Hg of pressure at the ankle and reduced pressure as they go up the leg. These stockings help in preventing DVT.  They come in various sizes and in two models – Above knee, and below knee. At Rs. 800 to Rs. 1200 a pair, they are a steal when you consider how much pain and suffering they may actually save you from.

It is important to choose the right size and type for them to be effective.  Too loose and they will not have the desired effect and if they are too tight, they may become like a tourniquet and restrict blood flow.  Similarly some people find the thigh-length stockings uncomfortable and just end up rolling it down till their knees.  These people are better off buying the below-knee model at the outset.

Before measuring, please ensure that there is no edema (swelling due to fluid collection), deformity of the leg, arteriosclerosis and skin conditions such as dermatitis.  You can take measurements while lying down or standing up.  There are basically 3 measurements you need to take – thigh circumference(g), calf circumference(c) and ankle circumference(b).  Then compare these against the size chart provided by the manufacturer to choose the one closest to your requirements.

If you are a senior citizen and are traveling by air, don’t leave home without it.  You can buy your Anti-DVT stockings here.