Not sleeping well can lead to a number of problems. Older adults who sleep poorly are more likely to have a depressed mood, attention and memory problems, excessive daytime sleepiness, more nighttime falls, and more use of sleep aids. Poor sleep habits, lack of exercise, unhealthy diet, untreated sleep disorders, and other medical problems can all contribute to sleeplessness in older adults. To improve your quality of sleep it’s important to understand the causes of your sleep problems and make the necessary lifestyle changes.

No matter what your age, sleeping well is essential to your physical health and emotional well-being. For seniors, a good night’s sleep is especially important because it helps improve concentration and memory formation, allows your body to repair any cell damage that occurred during the day, and refreshes your immune system, which in turn helps to prevent disease.

Common causes of insomnia in seniors
The most common causes of insomnia in older adults include:
• Poor sleep habits and sleep environment. Examples of poor sleep habits are irregular sleep hours, large or spicy meals before bed, consumption of alcohol before bedtime, and falling asleep with the TV on.
• Pain or medical illness. Pain can keep you from sleeping well. In addition, many health conditions such as a frequent need to urinate, arthritis, asthma, diabetes, nighttime heartburn, menopause, and Alzheimer’s can interfere with sleep.
• Medications. Seniors tend to take more medications than younger people. Combinations of drugs, as well as the side-effects of individual drugs, can impair sleep or even stimulate wakefulness.
• Lack of exercise. If you are too sedentary, you may not feel sleepy or feel sleepy all of the time. Regular aerobic exercise during the day, at least 3 hours before bedtime, can promote good sleep.
• Psychological stress or psychological disorders. Significant life changes like the death of a loved one or moving from a family home can cause stress. Anxiety or sadness can also keep you awake, which can, in turn, cause more anxiety or depression.
• Sleep disorders. Restless Legs Syndrome (RLS) and sleep-disordered breathing such as snoring and sleep apnea occur more frequently in older adults.

Tips for Improving Sleep
• Exercise regularly. Exercise releases endorphins that can boost mood and reduce stress, depression, and anxiety.
• Expose yourself to sunlight. Bright sunlight helps regulate melatonin and your sleep-wake cycles. Try to get at least two hours of sunlight a day.
• Limit caffeine, alcohol, and nicotine. All are stimulants and interfere with the quality of your sleep. Alcohol may seem to make you sleepy, but it will disrupt your sleep.
• Make sure your bedroom is quiet, dark, and cool, and your bed is comfortable. Noise, light, and heat can interfere with sleep. Try using an eye mask to help block out light.
• Maintain a consistent sleep schedule. Go to bed and wake up at the same times every day, even on weekends.
• Go to bed earlier.  Adjust your bedtime to match when you feel like going to bed, even if that’s earlier than it used to be.
• Develop bedtime rituals. A soothing ritual, like taking a bath or playing music will help you wind down. Relaxation and stress management techniques, such as deep breathing and progressive muscle relaxation, take some practice but their benefits can be substantial.
• Limit your use of sleeping aids and sleeping pills. Many sleep aids have side-effects and are not meant for long-term use.
• Keep naps short and early in the day. Most people benefit from naps of 15-45 minutes. Any longer may make you feel groggy. Napping too late in the day may disrupt your nighttime sleep.
Excerpted from helpguide.org

ALS Walk – Saturday, October 22, 2011
Scottsdale Stadium
9am – Check-in Time
10am – Walk start time
ALS Team website: http://web.alsa.org/goto/carecorner

MS Walk – Saturday, November 5, 2011
Phoenix Zoo and Desert Botanical Garden
5:30am to 7am – Check-in Time
7am – Walk Start time
MS Team website: http://goo.gl/oE6b6

*Participants who raise a minimum of $50 before the day of the walk will gain free access to the Phoenix Zoo the day of the walk!

Photo from last year’s ALS event:

Team Care Corner

Scientists have long struggled to identify the underlying disease process of ALS (also known as Lou Gehrig’s disease) and weren’t even sure that a common disease process was associated with all forms of ALS.

In this new study, Northwestern University researchers said they found that the basis of ALS is a malfunctioning protein recycling system in the neurons of the brain and spinal cord. Efficient recycling of the protein building blocks in the neurons are critical for optimal functioning of the neurons. They become severely damaged when they can’t repair or maintain themselves.

This problem occurs in all three types of ALS: hereditary, sporadic and ALS that targets the brain, the researchers said.

The discovery, published Aug. 21 in the journal Nature, shows that all forms of ALS share an underlying cause and offers a common target for drug therapy, according to the researchers.

“This opens up a whole new field for finding an effective treatment for ALS,” study senior author Dr. Teepu Siddique, of the Davee Department of Neurology and Clinical Neurosciences at Northwestern’s Feinberg School of Medicine, said in a university news release. “We can now test for drugs that would regulate this protein pathway or optimize it, so it functions as it should in a normal state.”

This finding about the breakdown of protein recycling in ALS may also prove useful in the study of other neurodegenerative diseases, specifically Alzheimer’s and other dementias, the Northwestern researchers said. Currently ALS afflicts an estimated 350,000 people around the world.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about ALS.

Excerpted from article by Robert Preidt (SUNDAY, Aug. 21) HealthDay News Retrieved from healthyday.com

Examples of home modifications that make staying at home easier as we age include:

• lever-type doorknobs
• cabinet pulls that are easier to grab (i.e. “D” shape)
• improve/add lighting, such as hallways, stairs, and “task lighting” such as lighting under kitchen cabinets
• install higher toilets – currently used in many new homes
• low or no-threshold stall showers with built-in benches or seats
• grab bars in the bathroom
• wide doorways and hallways
• side-by-side refrigerators and raised front- load washers and dryers that minimize stooping and bending
• easily reachable electrical outlets and switches

Important home design features for safety and ease of use  are not just for staying in one’s existing home. Incorporating many of the above features at the time of construction add minimal to no cost, and reduce the need for modification later on.  Many features described above are becoming commonplace in new-home construction and remodeling jobs.(3) These homes providing “Universal Design” – design features that make good sense and “grow and age” with their residents – will hopefully make it easier and safer for future generations to “age in place” – at home.

(1)Administration on Aging, U.S. Dept of Health & Human Services

(2)Administraton on Aging, U.S. Dept. of Health & Human Services

(3) National Assn. of Home Builders Survey, 2009, in AZ Republic 1/8/11

Falls are a tremendous threat to a senior’s ability to remain independent; 25% of those who fracture a hip end up needing life-long nursing care. (1) The statistics clearly indicate why it is so important to avoid falls among seniors.

• 2/3 of those who fall will fall again within 6 months;
• more than half of all fatal falls involve those 75 and over;
• among those 85 and over, one fall in 10 results in a hip fracture;
• 1/4 of those who fracture a hip die within six months of injury

Many falls can be prevented through relatively easy measures:

1. Exercise

Exercise increases your strength, balance and coordination, and makes you less likely to fall. Weak muscles and poor balance make one more likely to fall.

2. Home safety

• Remove items that you can trip over such as shoes or clothing on the floor and electrical cords.
• Remove throw rugs, or at least use double sided tape to keep rugs in place
• Install grab bars next to the toilet and in the tub or shower
• Improve the lighting in your home, indoors and outside the home. Use brighter bulbs. Use night lights around the house.
• Have an adequate number of phones so that you are not running for the phone when it rings

3. Medications

Some medications can make you drowsy, light-headed or affect your balance. Have your doctor or pharmacist look at your medications to determine if any of them could put you at risk for falls.

4. Vision

Have your eyesight tested. Some falls occur as a result of declining vision (including not wearing one’s glasses, especially at night).

Given the potential severity of falls and the likely recurrence once one falls, it is important to avoid falls at all costs. The above preventive measures go a long way towards avoiding falls and allowing seniors to remain independent in their homes. Some temporary occurrences such as a change in medication, weakness due to being hospitalized or post-surgery or related situations may increase one’s risk of falling for a limited period of time. In these situations, it is best to have a family member or caregiver nearby at all times in order to prevent falls and keep the individual safe. Devices such as walkers and canes may also provide some support if someone is not completely stable and steady on their feet. While there is sometimes resistance to using a walker or cane, it is a far better solution than the risk of falling.

(1) Colorado State University Extension Service 2011

Think of walking as an easy way to burn calories and stay fit while you go about your daily routine. It’s fine to walk in spurts of 10 minutes or more throughout your day or week.
• Especially for seniors or others who have not been physically active, it is important to get approval from their doctor before starting a walking program;
• Start with a short-term goal; i.e. walk for 5 or 10 minutes every day; or increase your number of steps by 300 to 500 per day.
• After you’ve made walking a habit, set a longer term goal, such as walking briskly for at least 30 minutes a day, or working up to 10,000 steps a day.
• To stay motivated, find a walking partner, such as a family member, friend or caregiver. Daily dog walks are also a great way to keep up your walking routine.2

There are many ways to walk more without going on a long walk. Use the stairs instead of the elevator, park farther away at the store, or instead of watching TV or going out to eat, go out for a walk.

Walk Safety Tips
• Choose a safe place to walk. Find a partner or group of people to walk with you. Your walking partner should be able to walk with you on the same schedule and at the same speed.
• Wear shoes with thick flexible soles that will cushion your feet and absorb shock.
• To avoid stiff or sore muscles or joints, start gradually and build up.
• Do not wear headphones and be aware of your surroundings.

To get the heart healthy benefits of walking, you need to walk briskly enough to increase your heart rate and breathing, but not so fast that you can’t talk comfortably.

1 Martina Navratilova, from AARP, Sept. 29, 2010
2 Walking for Wellness, WebMD

•  How long can I afford care in my home?
• What if I run out of money…but still need home care?
• Do I need an attorney… or a financial planner? 
• Are there any resources to help me stay in my home?

Do you have some of the above concerns?  There are several financing options and community resources you may wish to consider to assist with paying for in-home care.

Funding Sources for Home Care

1)  ALTCS – Arizona Long Term Care System (part of Arizona’s medicaid program) – For those who meet the medical and financial eligibility criteria, this State of Arizona program may provide an in-home caregiver to assist you with your personal care, homemaker and companion care needs.  To apply, contact the State to initiate an ALTCS application (602-417-6600). There are also companies that can help you through this process for a fee. 

2)  Reverse Mortgages – A Reverse Mortgage is a “loan in reverse”.  This type of unique loan is a loan against your home that you do not have to pay back for as long as you live in your home.  To be eligible for a “reverse mortgage” you must be 62 years of age or older, have home equity amounts established by the lender, and meet other specific eligibility criteria.

  3)  Veterans Benefits – Veteran households may be eligible to receive additional monthly cash benefits which can be utilized to purchase in-home care services. The veteran must have been “honorably discharged”, served 90 days or more of active duty with at least one day during a wartime period (veteran did not have to be actively engaged in a war effort), meet family income and assets criteria, be 65 years of age or older OR be disabled if younger than 65 years of age. A surviving spouse of a veteran meeting the above guidelines may also be eligible.

4)  Long Term Care Insurance – Some seniors have previously purchased private long term care insurances to assist them as they age.  If already purchased, these policies often cover in-home care services. If you live in Care Corner’s service area and are considering our services, we will be glad to help you determine your long term care insurance benefits and eligible covered services.

6)  Voluntary Health Organizations – Many people with chronic or other health conditions may benefit from working with an appropriate voluntary health organization. There may be “respite dollars” and/or other helpful benefits or support available through these individual agencies.  Examples of voluntary health organizations are the ALS Association, Multiple Sclerosis Association, Alzheimer’s Association, and American Cancer Society.

7)  Worker’s Compensation – Individuals who have been determined as eligible for “Worker’s Compensation” benefits may also be able to access short-term home care and/or other services in the home.  Please contact your assigned Worker’s Compensation Case Manager to discuss if you are one of those eligible individuals.

 FOR RESOURCES AND SPECIFIC CONTACT INFORMATION, PLEASE VISIT THE “RESOURCES” PAGE OF OUR WEBSITE, WWW.CARECORNER.NET

 For further assistance or questions in Phoenix metro area, please call us!

 CARE CORNER PERSONAL SERVICES

           Phoenix/West Valley        602-943-4321

           Scottsdale/East Valley     480-833-8889

The extreme heat is particularly dangerous for those 65 and older for a number of reasons: their bodies don’t adjust as well to extremes in temperature, and they are more likely to have a chronic medical condition or be taking prescription medicines that affect the body’s ability to cool itself, says Colleen Keller, Director of the Hartford Center of Geriatric Nursing Excellence at ASU. Diuretics and some heart medications, in particular, can affect how well a person’s body responds to heat. Many older people don’t drink enough liquids, which also increases their difficulty coping with hot weather. Keller urges older people to drink plenty of cool fluids and eat cold fruit with high water content, like watermelon, cantaloupe and apples.
Even healthy seniors should try to avoid the hottest times of the day. Do things early in the morning, and take plenty of shade and air-conditioning breaks. Air conditioning is the #1 protection against extreme heat.

Excerpted from article by Candy Sagon, from AARP Bulletin, July 6, 2010

The great news is that there are many more options than there used to be. Assistance can be provided in the home by caregivers, or there are a wide variety of assisted living homes and facilities available in the Phoenix metro area. Some factors to consider when making the tough decision about whether to keep your loved ones in their home, or move them to a retirement community or assisted living are discussed below.
1. Mental and physical capabilities of your parents
Most people can function adequately at home unless:
a) they need the availablity of nurses or medical personnel much of the time;
b) they are at high risk of falling and must be supervised at all times for their safety;
c) their dementia or cognitive disfunction does not allow them to make rational decisions, requiring constant supervision or the availability of on-site help
When conditions (b) and (c) are present, they can still be cared for in their home if the family is willing and able to provide caregiver services around the clock or however much is needed to ensure the person’s safety. If not, the individual should be in a closely supervised setting, such as an assisted living “group home.”
2. The individual’s personality and social support system

From our observations, people who are living at home and have friends and family seem to do very well staying at home as long as possible. In addition, seniors who have not been highly social and involved in activities outside the family throughout most of their lives may be much happier in their own home. If people were not actively engaged with others when they were younger, they don’t generally change as they get older. Conversely, people who are very social, have always been actively engaged with others, and are “joiners” seem to do well in assisted living. I know of one man who is an avid bridge player, and loves being in assisted living as he has a ready-made group of bridge partners!
3. The individual’s “bond” with their home

It is much more traumatic for some people to give up their home – especially if it has been the family home for many years – than it is for others.

These factors can sometimes be difficult to determine, especially for close family members who are emotionally involved. It can be helpful to get the assistance of a professional, whether your parents’ primary care doctor, a social worker or geriatric care manager to get an objective assessment of the situation. For possible resources, see the “Resources” page on Care Corner’s website. Care Corner also provides assessment services and recommendations through our professional social work and nursing staff. We work closely with assisted living experts who can assist with finding the right community if it is determined that in-home care is not the best solution for the client.