Wednesday, February 29, 2012

Hear We Go! Gender and Hearing Loss

Photo by Simon James
Age is the strongest predictor of hearing loss. A population-based study of 3,556 participants in Beaver Dam, Wisconsin showed the hearing loss in increasing percentages by age bracket:

21% of 48-59 year olds
44% of 60-69 year olds
66% of 70-79 year olds
90% of 80 to 92 year olds

(Data adapted from Table 5)

Aging is often a gendered experience. As women age, they are at greater risk of living alone, being in poverty, suffering from depressing and developing certain physical problems such as osteoporosis, hypothyroidism, and fibromyalgia. Men, however, experience a greater risk for hearing loss. There are various hypotheses for why men are at greater risk. Men often participate in recreational activities and occupations that have high decibel levels, including military service.

Thursday, February 23, 2012

Label Clothing for Nursing Home Residents

Photo by Bruce Guenter
If a person has moved into a skilled nursing center--for a short stay post-surgery or as a permanent move--it means they are having trouble managing day-to-day tasks, including laundry.  

Residents can have family members do their laundry for them; however, many residents rely on the laundry services provided at the nursing home.  

It's important to label items clearly with a laundry pen or by affixing an iron-on or sew-on label. 
By checking a few online Q&A sites about labeling clothes for nursing home residents, kids going to summer camp, and children in daycare, I found this information:  

Permanent Markers (i.e., Sharpies).
These are convenient, but they only last for about four washings.
Fabric Markers.   The ink lasts longer than permanent markers, but fabric markers are a little harder to find.  If your grocery store doesn't carry them, try a craft store or buy them online.
Iron-on Labels.   These are easy to apply if you know how to wield an iron, but these iron labels do not adhere well on some fabrics.  You can pay to have these printed or run them through your computer.
Sew-on Labels.  These are more expensive and more time consuming to sew on, but they are sturdier and have a longer life than marking with a permanent marker or a laundry pen.

Wednesday, February 22, 2012

Bingo--More Than Meets the Eye

Photo by Kimberly Malvar
Attending Monday bingo in the skilled nursing center for fifteen months has shown me that this supposedly simple game requires the players to manage multiple skills.
Players must have adequate vision, hearing and the fine or gross motor skills to play. 
During a round, someone asks, "Did the caller say '50' or '60'?" They also need the cognition to retain the number in their mind while scanning each number on three cards.

For reasons having to do with vision or with cognition, sometimes a 3 will look like an 8, a 7 like a 1. They also have to perceive the winning patterns.

Almost each resident in skilled nursing has trouble with at least one of these tasks, but they find ways to accommodate age-related changes.

Laura sits at the front table so that she can see each ball as it comes out of the mixer. She relies on her vision since her hearing is impaired. Sam uses large-print cards. Bill places his cards on a non-stick mat and wears gloves that keep his fingers from forming a fist. These aids help him push the windows closed without the assistance of a staff member or volunteer.

A handful of residents have every skill set required to play bingo. They just have lower-body challenges to manage, so once they maneuver their wheelchair into place, they are ready to play without impediment.

Betty receives gentle reminders from a volunteer about when she can call bingo. Even though she struggles to remember that five numbers in a row is the desired pattern, she shows great accuracy each week over the course of 11 games in finding the called numbers on her cards. Even though she has memory problems, she still possesses enough skill with her hearing to help others at her table.

Residents at tables throughout the dining room take turns helping each other in this way: one might have the better hearing, her neighbor the better vision. This co-operation reinforces the importance of social skills required for bingo. They tease each other for winning too often or not at all.

Gladys wins the current round, so she receives a dollar in winnings. The caller shouts out, “If there are no others, this round is closed. Clear your cards.” An adult son walks into the dining room and pulls a chair next to his father. Another resident comes in from an appointment in the beauty parlor and tries her luck for the last two games.

The weather outside worsens. Everyone looks up to see the rain splashing heavily against the windows before turning to hail. The noise of the storm mixes with the sound of the bingo balls tumbling in the cage. One by one, the numbered balls escape down the shoot and line up to be called in the next game.


Is It Dementia or Only Delirium?
Age-related Changes to How We Write
Activities of Daily Living and Instrumental Activities of Daily Living
Don't Be a Boy Scout: Preserving the Independence of Older Adults

Friday, February 17, 2012

Age-Related Changes to How We Write

Photo by Marc Moss
With the boomers moving into late adulthood, many are posing questions about what constitutes healthy aging in a variety of areas such as cardiovascular health, respiratory health, and cognitive health.

Unfortunately, more research to date has been done with diseased older adults as opposed to healthy older adults. Older adults would benefit from learning what changes might be disease related and what changes are normal and expected as part of healthy aging. Gerontologists and other scholars are now starting research to rectify this ommission in the literature. Nevertheless, some research exists here and there that describes healthy aging.

For example, T. L. Mitzer and S. Kemper published a study in 2003 that analyzed the biographical statements of 118 older women (ages 78 to 91) in an effort to find an explanation for what contributed to stronger writing samples. Strong writing samples did not correlate to the writer's age. Instead, strong writing was produced by those who were in better physical condition, had higher educational levels and higher cognitive status. The high-level writing samples had the following characteristics: less-varied vocabulary, longer utterances, more clauses per utterance, more grammatically complex structures, fewer fragments.

Monday, February 13, 2012

Does an Aspirin a Day Keep the Cardiologist Away?

Photo by and parsecs to go
Over the last decade, I have heard several people casually mention the benefits of taking aspirin daily as a way to prevent a heart attack or stroke. The only side effect mentioned was the risk of stomach ulcers.

Note: I am not a doctor. Please consult with a licensed medical professional about the medications you are taking, even over the counter medications. 

Recently, I have found that people need to weigh the benefits against multiple risks of taking aspirin daily. My concern is that people often take aspirin on their own initiative without consulting with their physician.

Last week, two dozen of my fellow graduate students and I had the assignment to research, share, and discuss research-based articles on the topic. (The links here are more consumer friendly for the more part.) These readings warned of these risks:

· Stomach ulcers
· Abdominal bleeding
· Bleeding all along the GI tract
· Further bleeding to the brain during a hemorrhaging stroke
· Ringing in the ears
· Hearing loss
· Cataracts
· Allergic reaction
· Interactions with various prescription drugs such as steroids, anticoagulants and other NSAIDs
· Interactions with dietary supplements

Wednesday, February 8, 2012

Glasses, Hearing Aids, and Dentures Not Covered by Medicare

Photo by Kent Landerholm
While Medicare does provide many benefits to older adults, there are several tests, items and services that are not covered by Medicare. This link leads to a webpage that provides a searchable list so that you can determine what Medicare does and does not cover.

Notably, Medicare does not cover the cost of hearing aids, dentures, or eye glasses (with the exception of one pair of glasses fitted after cataract surgery). This is unfortunate because of the following facts:

  •  CDC reports that About 25 percent of adults 60 years old and older no longer have any natural teeth.
  • People 65 plus have visual impairments at 3x the rate of people under 65: 18% vs 6%.
  • About 1/3 of Americans between the ages of 65 and 74 have hearing problems. About 1/2 the people who are 85 and older have hearing loss. 
These items are vital for communication, but as the facts above show, they are commonly required.  Also,  they need to be replaced frequently, either because of changing need or because they are lost. They are easily misplaced in the home, but they can also turn up missing during hospital stays. Perhaps these factors played into the decision that individuals must pay for these items as one way to control Medicare costs.

This may be an inelegant analogy, but car insurance does not cover the costs of replacing air filters and fan belts perhaps for parallel reasons.

Beneficiaries and their family members should remain aware of these exceptions and others in order to reserve funds for these much needed items. Go online or contact your local Area Agency on Aging to receive additional information about what Medicare does and does not cover.  

Added 8/8/2012. Since writing this, I have learned about AUDIENT, a program to help cover the cost of hearing aids.

AUDIENT helps low income people nationwide access quality hearing aids and related care at a significantly lower cost.
AUDIENT income qualifies families to be eligible for a discount on brand name hearing aids available through the AUDIENT Alliance's national network of dedicated hearing care providers. 

Brand selection includes Oticon, Phonak, Siemens, Widex, & Unitron hearing aids. Any age – Income Test is 250% of FPL – size of household counts.


Overcoming Communication Disorders Senator and Mrs. John Glenn Inform
Hear We Go: Gender and Hearing Loss
A Detached Retina Needs Immediate Care

Tuesday, February 7, 2012

Talking with Older Adults: Serving as a Witness

Photo by ClockworkGrue

As a life-long reader and a decades’ long teacher of English, I love to read. I cherish the information conveyed by the pages of a book. For similar reasons, I enjoy talking with older adults. They are dynamic storehouses of history. I delight in hearing of their experiences from the 1950s, 1940s, 1930, and even the 1920s--decades before my birth.

Yesterday, I had the privilege of talking with Gladys Bever, a woman who will turn 102 this summer.  Talking with her about  her childhood allowed me a glimpse into events from the 1910s. I visit her almost every Monday, and our conversations are often about the events of her week: what she had for lunch, who visited her on the weekend, a new photo added to the collection on her windowsill, the status of her newspaper that often takes an indirect route to her room at the nursing home. In an effort to open a new topic of conversation, I pointed out that we are both from California.

With that prompt, she talked about the presence of horses in her life during her childhood in a town 30 miles north of Sacramento. She and her older brother used to ride in a horse-pulled cart to school. After describing the horse, she then mentioned that she and her family traveled--sometimes by horse, sometimes by train--to the city of San Francisco where her aunt worked as a physician. She enjoyed the sites of that grand city and her time playing in some of the public parks.

Then she casually mentioned that she attended the World’s Fair held there in 1915, the year that she turned five.

Friday, February 3, 2012

Outrunning Father Time and the Grim Reaper for Those 50+

Photo by Rita T 
When I hit my late 40s, I became crushingly tired. I asked my doctor to run a series of tests in an effort to find the cause: Anemia? Thyroid problems? Diabetes? The labs came back with no evidence of a disease or disorder. I ended up talking to a number of middle aged women and doing a little reading. I concluded that the aging process was zapping my energy levels, and this was only going to affect me more each year. I now understand from first-hand experience that older adults need to expand their fitness regime to include the following:

· Cardiovascular /Aerobic Exercise (walking, elliptical, swimming)
· Strength Training / Weight Lifting (weight machines, free weights, hand weights)
· Flexibility /Stretching (yoga, pilates, calisthenics)

I had practiced yoga regularly in my early 40s, which helped me with flexibility and with stress management. However, it did not increase my muscle mass the way strength training does. By lifting weights, I increased the amount of muscle I have, which improved my metabolism. Cardiovascular exercise not only addresses heart health. It helps with cognition, balance, digestion, and more. Even with adding strength training and cardio to the flexibility workouts did nothing for "the middle aged spread." My weight that was not coming off even with upping my cardio to two hours a day, five days a week.