- Is memory loss normal with ageing?
No, memory loss is not a part of ageing. But processing speed of memory slows down and we might need to be reminded about things more often. Once registered, recalling is not a problem. Memory loss is not a normal ageing phenomenon.
- How much physical exercise is needed?
In older adults of the 65 years and above age group, physical activity includes leisure time physical activity, transportation (e.g. walking or cycling), occupational (if the individual is still engaged in work), household chores, play, games, sports or planned exercise, in the context of daily, family, and community activities. The recommendations from WHO in order to improve cardiorespiratory and muscular fitness, bone and functional health, reduce the risk of NCDs, depression and cognitive decline are:
- Older adults should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week or do at least 75 minutes of vigorous-intensity aerobic physical activity throughout the week or an equivalent combination of moderate- and vigorous-intensity activity.
- Aerobic activity should be performed in bouts of at least 10 minutes duration.
- For additional health benefits, older adults should increase their moderate-intensity aerobic physical activity to 300 minutes per week, or engage in 150 minutes of vigorous-intensity aerobic physical activity per week, or an equivalent combination of moderate-and vigorous-intensity activity.
- Older adults, with poor mobility, should perform physical activity to enhance balance and prevent falls on 3 or more days per week.
- Muscle-strengthening activities, involving major muscle groups, should be done on 2 or more days a week.6. When older adults cannot do the recommended amounts of physical activity due to health conditions, they should be as physically active as their abilities and conditions allow.
- Is it necessary for a person to suffer from memory issues after 60 years?
No, but as is mentioned above, the processing speed slows down. The best way to register things is by repeated recall.
- Is bone health decline normal with ageing?
Bone health decline is also a part of ageing, due to increased Osteoclastic activity and in women due to reduction in estrogen post menopause but extent of decline is based on how active you are and have been in your life; and calcium and vitamin D intake in your diet. The RDA values for Calcium is 1200 mg daily, and that of Vitamin D is 800 IU daily.
- What can a caregiver do to make sure that the elderly remembers to take his/her medicine?
A caregiver can arrange the daily medicines in a pill box which has the days of the week labelled properly. He can also set alarms on the phone to remind his family member to take his medicine. He can ask him to note down on a notebook at what time he has taken the medication and can review it to check if he has been regular with his medicines.
- Travelling to doctor with an older patient is always tiring, are home visits available?
As geriatric medicine is a new and upcoming branch, the number of doctors in the field are few and it is a little difficult to find doctors who perform home visits, nonetheless, Geriatric healthcare vans have been installed in Delhi, to cater to the problems of elderly in old age homes, and depending on where you are located, there are many private hospitals and clinics that are offering home visits for elderly.
- Mother keeps repeating herself, is it normal, she is 72 years?
The phenomenon of repeating oneself is called perseverance and can be an early marker of dementia. It could also be due to a psychiatric issue. Mild behavioural impairment (MBI) is a syndrome characterized by the appearance of neuropsychiatric symptoms in elderly persons. MBI is a potential marker of incipient cognitive decline and Alzheimer’s disease. It would be better that you schedule a visit to the geriatric OPD and psychiatric OPD to confirm that she is fine, where her memory and attention will be tested by trained personnel. If something seems to be out of order then further investigations and treatment if required can be started.
- With the age the person had socially withdrawn, don’t feel like meeting anyone, is it normal?
There can be many reasons why an elderly person has decided to isolate himself/herself, like memory loss causing distress and loss of confidence in oneself, anxiety, depression. It should be evaluated in the OPD, as a socially withdrawn person will gradually go into social isolation which is a risk factor for many diseases like hypertension, diabetes, heart disease, stroke and premature death. So it will be a good idea to schedule a visit to the OPD.
- Care giving guidance regarding dementia care
- To be patient and understanding with your elderly family member
- To be observant to any new problems that have developed like loss of control of body functions, falls, memory loss, confusion
- To not reprimand or argue with him/her as what is happening is not in their control
- Continue to express love and care
- Focus on functional ability instead of inability
- Engage in multidisciplinary care, seek help from a social worker/occupational therapist
- Taking care of Activities of Daily living which comprises the following areas: grooming/personal hygiene, dressing, toileting/continence, transferring/ambulating, and eating
- Taking home safety measures related to dementia care and keep in touch with emergency health providers
- Spend quality time with them
- To know when is the right time to let go and not prolong their suffering
- To get help when needed and to find someone to talk to whether it be a friend/family member/ therapist/doctor as it can be very difficult mentally and emotionally to be a primary caregiver and to see someone you care about fall prey to dementia. Have some personal leisure time for your own mental health.
- Is there a cure for dementia?
There is no cure but there are ways to slow down the process, with medication and by maintaining a fit and healthy lifestyle and diet (Mediterranean diet pattern) and being regular with your medications. In addition to this, it is important to engage your mind and body by exercising (including both resistance training and aerobics), yoga, stretching and balance training.
- What are the early signs of dementia?
Memory problems, mood and personality changes, getting bored, difficulty performing tasks that were once easy to accomplish, difficulty in remembering words, misplacing things, getting lost on the way back home, and most importantly forgetting immediate events like having eaten a meal/leaving the stove on; are all early signs and if present should be evaluated.
- Why is exercise so important for older adults?
Exercise is important for the body as well as the mind
- Keeps their muscles strong and joints flexible, will enhance mobility and balance and prevent falls.
- Helps decrease bone health issues, and prevents the development of vascular complications like Coronary artery disease, hypertension and stroke.
- Reduces the chances of developing memory issues and psychological issues like depression.
- Prevent cognitive impairment and memory loss
- Releases happy hormones
- Prevents age related degeneration of different organs
- What can I do to lower the stress that caregiving causes?
- Take care of your own health by eating right, sleeping well and taking your own medications correctly.
- Ask for help when required. Join a support group or talk to a friend/family member/doctor.
- Take time for yourself to perform a stress busting activity like yoga/jogging.
- Try not to feel guilty about something you can’t provide to your elderly family member and hire someone to help or try intermittent hospice care if you cannot manage on your own.