Health and Wellness In-Service

1. Benefits of Healthy Living in the Older Adult Amanda Bernabe Jillian Keefe Springfield College

2. The GSSSI’s mission remains the same for the past 72 years to keep people age 60+ living at home safely and independently by providing assistance and access to a comprehensive range of services. Their goal is to provide assistance and services to the frailest in the greater Springfield area.

3. Objectives: • To expand your knowledge on the benefits of a healthy diet, exercise, and social wellness • To learn about the cost effectiveness of healthy living and explore the benefits of a healthy lifestyle on specific disorders/diagnoses • How to apply this information when working with your clients and their families

4. Fun Facts… “For the first time in history, people aged 65 and older will soon outnumber children under the age of 5” “For the next 20 years 74 million Baby boomers will retire. This means that 10,000 new retirees will be added to the Social Security and Medicare rolls each day” Life expectancy is now up to 78.3 years

5. “The US Administration on Aging reports that in 2009 the population of those 65 and older represented 12.9% of the US population, or about 1 in 8 Americans. This number is expected to rise to 1 to 5 by 2035”

6. We always hear of various health promotion programs and the importance of wellness education for clients and their families, but do they really make a difference??

7. WHY SHOULD WE IMPLEMENT HEALTH PROMOTION PROGRAMS??? National Center for Health Statistics predicts by 2030 the US will have an estimated population of 70 million older adults 65+. This indicates an immense need for increased health related services and education that would lead to health and quality of life among older adults.

8. Various Components of Health Promotion Programs.... • Diet • Exercise • Social Supports • Pain Management

9. 1. DIET We all know the components of a healthy diet, but why don’t we put it into practice?? What are the proven benefits of a healthy diet? Long term and short term…

10. Evidence of How a Healthy Diet Impacts an Older Adult… • Foods high in antioxidants (beans, artichokes, berries, broccoli, spinach, nuts, green tea, plain tea) help prevent a process which damages cells of the body which are linked to specific cancers, Alzheimer's disease, and Heart disease • Studies have shown that antioxidant rich foods also aid in increased skeletal muscle repair and prevents atrophy (Loss of muscle mass due to inactivity or injury)

11. Healthy Diet Affects Quality of Life • Good nutrition promotes health-related quality of life by averting malnutrition, preventing dietary deficiency disease, and promoting optimal functioning • Meals may also add a sense of security, meaning, order, and structure to an elderly person’s day; imbue that person with feelings of independence, control, and sense of mastery over his or her environment **Dining with others can also fulfill that social component to quality of life**

12. Focus on the healthiest carbohydrates, such as fruits, vegetables, whole grains, legumes (beans, peas and lentils) and low-fat dairy products. • Fiber can decrease the risk of heart disease and help control blood sugar levels. Foods high in fiber include vegetables, fruits, nuts, legumes (beans, peas and lentils), whole-wheat flour and wheat bran. • Substitute fish for red meat (have less fat and cholesterol)

13. Diabetes “The prevalence of diabetes has doubled in the last 16 years” - New York State Health Foundation Ways to reverse this diabetes epidemic are to take preventative measures for the younger generation and to work on self-management for those who already have it

14. Diabetes Resources American Diabetes Association- provides assistance with diets, funding opportunities, community programs, and proper treatment and care Diabetes program through Nutrisystem “Diabetic Plans” tab offers diets with low glycemic index and specific diets for weight management

15. Tips for Type 1 (Aperson with Diabetes Type 1 does not produce insulin. In the majority of cases this type of diabetes appears before the patient is 40 years old. That is why this type of diabetes is also known as Juvenile Diabetes or Childhood Diabetes. Diabetes Type 1 onset can appear after the age of 40, but it is extremely rare) • Carry a quick source of sugar (gum, candy) • Inject in muscles that you don’t use for activity • Eat 20-30 min after injection • Eat 1-2 hours before exercising

16. Tips for type 2 (The vast majority of patients who develop Type 2 did so because they were overweight and unfit, and had been overweight and unfit for some time. This type of diabetes tends to appear later on in life) • Exercise • Get more active • Eat 1-2 hours before exercising • Carry fast acting sugar

17. Foods to avoid- Mayo Clinic • High-fat dairy products and animal proteins such as beef, hot dogs, sausage and bacon contain saturated fats. • Trans fats. These types of fats are found in processed snacks, baked goods, shortening and stick margarines  • Sources of cholesterol include high-fat dairy products and high-fat animal proteins, egg yolks, shellfish, liver and other organ meats • Aim for less than 2,000 mg of sodium a day

18. Diabetes (cont.) • Very important to keep alcohol intake to a minimum • Body processes alcohol similar to the way it processes fat. Drink very minimally when blood glucose levels are stable • Substitute sugar for a carbohydrate (if you want to eat a cookie, substitute that for a potato)

19. A study was done to evaluate overall fitness, obesity and body fat levels in males 20 years and older • They found significant higher glucose (sugar) levels in the adults ages 65+ • The cause of this was glucose intolerance which found that peaks from ages 20-50 is caused by poor diet and lack of fitness (this shows how it is important to be proactive rather than reactive in the case of health management) • Cognitive Performance is an inevitable consequence of growing old

20. By having a regular…. • Exercise regimen and healthy diet • Can offset the decline process • In the sense of preventative intervention in older adults was found to have a significant effect in reducing cardiovascular disease, osteoporosis, arthritis, diabetes, cancer, obesity, cognitive decline, and depression

21. From our research we have compiled these helpful tips that all older adults should know.. • Older adults should reduce calorie intake by 10% by age 75 • Maintain fat intake by 30% or less • Restrictions on diet may vary depending on health conditions (Diabetes, Cardiovascular disease, medications, and weight management) • Keep hydrated • Introduce vitamin supplements to diet-medical input from physician should directed

22. TIME TO SWEAT • http://www.youtube.com/watch?feature=player_detailpage&v=vhZ2fYQj6IM

23. 2. EXERCISE… “Is the best non-pharmological way to offset cognitive decline that is associated with aging”

24. Research shows that older adults who are fit are more physically and cognitively functional than unfit younger adults • A study conducted on exercise in the older adult population concluded: • Older males that regularly exercised had quicker reaction times and could process information more efficiently that older inactive males Example- These slow reaction times lead to a higher incidence of car accidents, of falls, and other injuries

25. Barriers to exercise* • Excuses of time • Place and access • Self esteem • Occupational role • Pain

26. Physical activity, a healthy diet, and medication management can decrease fall risk • Regular activity lower risk of falls, maintains independence, controls weight, and improves bones, muscles, and joints • Impacts your body structure and functions negatively and increases risk for various diseases • Research suggests, that a poor diet and no exercise will soon surpass tobacco as the leading cause of death • Sarcopenia is a direct cause of decrease in muscle strength in older adults • Reduced strength is a major cause of older adults increase in disability prevalence Positive Negative

27. Ways to Exercise • Aerobic exercise is shown to be the most beneficial for older adults because it increases oxygen intake and insulin action • Fitness levels correlate with decreased mortality rate and increased life expectancy • Research shows that no group can benefit more than older adults, strength training improves balance and gait which in turn lead to decreased falls

34. Ouch! That hurts What causes pain? • Pain occurs when there is a noxious event, such as an injury or inflammation to an area of the body causing excitation of pain receptors in tissues Pain interferes with a person’s participation in meaningful activities

35. Types Acute- lasts from seconds to days . A warning that an injury has occurred (break, fall, sudden bruise) Chronic- Recurs or persists for greater than 6 months. Usually difficult to identify the source of the pain which can greatly impact an individual’s functional independence (arthritis, low back pain)

36. Ways to treat pain at home Thermal Therapy (heat therapy) • Use in 15 minute increments • Decrease pain and stiffness • Improve range of motion • Improve blood flow • Promote relaxation & healing

37. Some conditions that could benefit from thermal therapy are: muscle spasms, chronic pain disorders, chronic arthritis • WHEN NOT TO USE- poor sensation, compromised circulation, anti-coagulation medication, swollen areas, tumors and cancer, advanced cardiac disease (body inadequately spreads heat), pregnancy (systemic effects of circulating blood on fetus are unclear), infection, RA (cautious various dosages of heat exacerbate joint inflammation)

38. Do it at home • Warm towels • Heat packs (Rite Aid, Wal-mart) • Make your own using feeding corn or uncooked rice in a sock in microwave for 1 min • In the clinic or at home- Paraffin baths ($29 Target) used to decrease stiffness and improve range of motion, decreases pain, allows for even distribution of heat (mostly hands)

39. Cryotherapy (Cold Therapy) • Application of cold agent for 15 minutes to relieve pain and reduce edema and inflammation following a trauma • Used for management of acute injuries Cooling Agents: Cold packs- zip lock bag and ice cubes Cold bath- cold water might initially report cold aching or burning sensation which is normal at first but if persists, discontinue

40. Cold Therapy Used for • Any type of Swelling • Exercise induced muscle soreness • Osteoarthritis (wear & tear) • Rheumatoid arthritis (auto-immune disease) • Acute injuries

41. 4. Importance of Social Supports • Assists older adults with answers to common problems such as financial and household maintenance • Boosts the immune system and reduces the likelihood of illness • Speeds up the recovery process, reduces psychological stress, reduces the risk of mortality and CVD • Decreases the risk of loneliness and depression

42. Evidence… Social support appears to boost immune system, reduce likelihood of illness, speed up recovery process, diminish the need for medication, reduce psychological strain and cognitive impairment, and lower the risk of death from heart disease ( Eng et. al 2002) You always hear of when a spouse passes away, the widow does soon after…In these cases, support is instrumental and can be from anyone

43. A study revealed that pet owners with heart disease had a significantly higher 1 year survival rate than those who did not own pets • Even those who have chronic illnesses, evidence of social supports decreased depression rate, perception of pain, and mood). Peer support groups – people with common concerns to share ideas, feelings, etc. • When older adults are faced with a problem the first step they take is to appraise their resources such as people around them

44. Religious Participation • Associated with lower psychological distress. Older adults who lack social supports utilize religious participation as a means with which to manage psychological distress. WHY? Older adults are frequently not inclined to visit a mental health professional when experiencing psychological stress

45. Types of Support Emotional Support- provides people with a sense of love, reassurance, and belonging. When they feel that they are being listened to, and valued, they develop a healthy sense of self-worth Instrumental support-tangible aid i.e.: financial help and household maintenance. This has been shown to lead to a decrease in emotional stress and greater life satisfaction. Informational support-advice, feedback, suggestions for problem solving

46. Cost- Effectiveness of a Healthy Living Lifestyle Study done on 361 men and women 60+. They were divided into 3 groups. 1 intervention group, activity group, and control group. In the intervention group the participants engaged in a weekly social activity program. In the activity group the participants engaged in craft projects, some community outings, games. The control group did nothing.

47. Results: Subjects were evaluated at baseline, after the 9mo treatment phase, and 6 month follow up. Evaluation tool: Short Form Health Survey (SF-36). 90% of the therapeutic gain observed after treatment was retained at follow up in the absence of any further intervention Costs: OT group-$548 per person, activity group $144 per person, control group- 0$. Care giving medical costs- Healthcare costs at follow up were substantially lower for the OT treatment group ($967) activity group ($1,726) and control group ($3,334) after 1 year post intervention.

48. Resources DIET • MyPyramid.com (balanced meals, healthy eating tips) • Shape Up America- www.shapeup.org (farmers market, cookbook, diary, portion control, activity calculator) • Nutrisystem.com – Diabetes tab

49. SOCIAL SUPPORTS • Alzheimer’s Association (24 hr toll free link to access information about local chapters, community resources, free publications) 800-272-3900 www.alz.org • American Cancer Society (education, support programs, workshops, transportation programs, publications, financial aid) 800-227-2345. www.cancer.org • American Diabetes Association (local chapters for support and referrals, outreach programs for minority communities) 800-342-2383 www.diabetes.org • American Heart Association (cookbooks, guides on treatment and prevention) 800-242-8721 www.americanheart.org

50. SOCIAL SUPPORTS (CONT.) • National Stroke Association (survivors, caregivers and family) 800-787-6537 www.stroke.org • National Association on Mental Illness (support groups, education, advocacy) 800-950-6264 www.nami.org • National Digestive Diseases Information Clearinghouse (support groups, referrals, fact sheets on a variety of gastrointestinal diseases) 800-891-5389 www.digestive.niddk.nih.giv • National Senior Services Corps )Retired Senior Volunteer Program , Foster Grandparent Program, Senior Companion Program) www.seniorcorps.org • AARP