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New research shows that a lack of sleep is a growing health problem around the world, and not just in developed countries.

It was found that Bangladesh, South Africa and Vietnam have extremely high levels of sleep problems. On the other hand, India and Indonesia reported relatively low levels of sleep problems.

Sleeplessness has been linked to such chronic illnesses as cardiovascular disease and diabetes. Sleep deprivation may impair physiological functions, for example, appetite or neuro-regenerative responses, and the immune system, which may actually explain the association of sleep with occurrence of many chronic diseases.

On the other hand, some people can actually sleep too much, such as the elderly, making them more prone to disease, weight gain and risk of heart problems.

Sleep is a key player in age-related health concerns, including Parkinson’s, Alzheimer’s and Sleep Apnea.  Helping your loved one find a healthy rest balance can help.

Parkinson’s
People with Parkinson’s disease performed markedly better on a test of working memory after a night’s sleep, and sleep disorders can interfere with that benefit, researcher has shown.

The findings underline the importance of addressing sleep disorders in the care of patients with Parkinson’s, and indicate that working memory capacity in patients with Parkinson’s potentially can be improved with training.

Alzheimer’s:
Alzheimer’s may reverse a person’s sleep-wake cycle, causing daytime drowsiness and nighttime restlessness. These sleep disturbances often increase as Alzheimer’s progresses. Eventually, round-the-clock naps might replace deep, restorative nighttime sleep.  The Mayo Clinic recommends how to a promote good night’s sleep.

Sleep Apnea:

Sleep apnea, the disruption of sleep caused by obstruction of the airway, interferes with sleep’s effects on memory. As many as one in three elderly men have at least a mild case of sleep apnea. 300 elderly women who were mentally and physically fit, with an average age of 82, led Kristine Yaffe, a professor of psychiatry at the University of California-San Francisco, to find that one in three women had sleep apnea. The women with sleep apnea were 85% more likely to show the first signs of memory loss.

Sleeping.

[Photo Credit: Daniel Morris, Flickr]

House Calls a practice of the past? [Photo Credit: (1946) U.S. National Archives and Photo Administration]

Are house calls a practice of the past or the future? Well, it depends on who you ask.  An article in the Ottawa Citizen recently write that “Doctors’ house calls aimed at seniors poised to make a come back”.  However, the Times of India stated that “The number of doctors visiting patients’ homes is declining steadily.   The Reader’s Digestagrees that “the centuries-old tradition of the house call is ailing and many experts believe it will die out altogether unless something is done.”

Prominent among those who welcome the return of house-calls are the elderly, many of whom have lost hope in the medical system and who don’t want to go to hospitals where they feel they will be prescribed unnecessary tests.

There are many benefits to reviving house calls:

  • The terminally ill or disabled have difficulty getting out of their home to commute
  • The care is more personalized and thorough
  • The practice renews trust in medical treatment and care
  • Helps avoid future visits to the emergency room
  • Less stress for patients and caregivers in organizing the trip to the doctor

However, there are also some disadvantages:

  • House calls are typically significantly more expensive
  • House calls are timely – the shortage of doctors and nurses in some regions would mean less time to see as many patients on a given day
  • The technology and tools used to conduct certain screenings and tests cannot be easily transported
  • Visits are often less structured outside of the office

The demand for home medical care is increasing, says the Times of India, and perhaps this is due in part to the global initiatives to age in place.   There are also new technology devices that allow people to be treated at home and be cared for without leaving their comfort.

Physicians in Australia observe that there has been a cultural shift in doctors wanting to spend more time at home with their families and for themselves as well.  For instance, Dr Tim Woodruff of the Doctors Reform Society of Australia says “Society has changed. I think people realize that doctors are people too and they’re not the only port of call, especially after hours.”

Dr. Samir Sinha, director of geriatrics at mount Sinai Hospital in Canada, is not losing hope.  He is among several doctors that continues to make house calls and is working with government to expand the house-calls program.

So are house calls one foot in or one foot out of the future of bedside practice?  Please share your thoughts with us.

With a life expectancy of 82.9 years for women and 79.4 years for men, one of the highest in the world, and a comprehensive health-care system, Icelanders are setting a good example for the rest of us.  Icelanders credit their many geothermal pools and spas with longevity and swimming is even given as a mandatory course in many primary schools to help embed this practice in their culture.

I recently visited Iceland and its many natural baths and health spas.  In a country where everything is fueled by geothermal gas, Iceland boasts countless geothermal pools and hot-pots.  The most famous of these, the Blue Lagoon in Reykjavik, allows you to sample mud masks, creams and skin care products while you lounge in the bright blue glacier water.

Many visitors to the Blue Lagoon are pensioner tourists who come to take advantage of the medicinal benefits and relax in the pool.

It’s hard to say whether the baths are the answer to living longer in Iceland, but many of the Day Care facilities for seniors continue to encourage the use of pools and even offer free entry for residents aged 67 and above. Aside from offering health benefits, the pools also serve as a place of socializing and help prevent loneliness among seniors.

Blue Lagoon

Blue Lagoon in Reykjavik, Iceland

This tradition of bath houses as medicine is not a new phenomenon.  Other cultures share in these traditions. In Russian tradition, it is widely believed that the steam bath has positive effects on the skin, lungs, nasal passages, joints and metabolism.  Veniki (brooms made out of leaves) are used in the baths to improve circulation.

In Arab communities, the hammam has been hailed as a source for relieving stress, relaxing muscles, easing respiratory problems and improving the skin.

In February 2012, Student British Medical Journal revealed a study on rising STI and STD rates, including HIV, in seniors. “Sexual Health and the Older Adult” estimated that in the US, UK and Europe rates of transmission doubled in the last 10 years.  

For instance, in Britian, HIV among the 50-90 age group comprised 20% of the reported infected population.

Some may shy away from this taboo subject, or turn a blind eye so as not to get involved. But if the health of the aging community is a primary concern of providers and care givers, sexual health is equally important.

One organization, Sexuality and Aging Consortium at Widener University in Pennsylvania, USA, has taken matters into their own hands and is providing education, safety instruction and guidance for professionals.  They have released numerous ads in public places to increase awareness and have caused a stir with their risqué YouTube videos.

In the media, the issue has come to attention in a more-light hearted article in June’s issue of The Atlantic about the re-release of the classic film Harold and Maude (1971), a film in which a woman pushing her 80’s is shown enthusiastically kissing and caressing a younger man.  The article explores senior sexuality through the eyes of pop-culture and the stereotypes of aging.

This week, the Journal of Medical Ethics published a report dealing with the subject of sex and seniors in a more serious tone. The report exposes lack of safety and discretion in nursing homes in protecting sex among seniors.  It discusses the difficulties in grappling with consensual sex, primarily in elderly with dementia, and the complexities providers must deal with regarding the subject.

How are care givers around the world responding to the sensitivity of this issue?
Hand in Hand

[credit: garryknight, flickr]

“Victims of elder abuse are parents and grandparents, neighbors and friends.  Elder abuse cuts across race, gender, culture, and circumstance, and whether physical, emotional, or financial. On World Elder Abuse Awareness Day, we call attention to this global public health issue, and we rededicate ourselves to providing our elders the care and protection they deserve.” President Barack Obama proclaimed yesterday at the White House in recognition of World Elder Abuse Awareness Day (WEAAD).

Around the world, providers, carers, families and friends are coming together to promote a unified message.  It starts with wearing the color purple today, to bring the world together in solidarity against abuse. 

In the England, Age UK is organizing 10K runs in honor of WEAAD and even parachute jumps nationwide!  In British Columbia, a special awards ceremony is being held to recognize special media contributions and initiatives that address the issue.

HelpAge International, a partner of IAHSA, offers us great examples to follow in Thailand, Nepal, Kenya, Kyrgyzstan, and more!

Larry Minnix, President and CEO of Leading Age, shares a message on WEAAD with “A Few Minutes with Larry Minnix”.

Recently, a law professor in Iowa has been encouraging nursing homes in the U.S. to extend their policies to allow residents to have pets. She has also been pushing for state legislation that would ease the ability for elders to move into their new homes with their furry friends.  The professor points to several studies that indicate the benefit of pets on the aging.

Feeding the dog

[Credit: Ed Yourdon]

 
According to such studies, pets have a very positive effect on the elderly:

1) Pets lower blood pressure and pulse rate
2) Patients with pets have 21% fewer visits to the doctor
3) Pets decrease depression and feelings of loneliness
4) They enhance social opportunities
5) Allow seniors to become more active
6) Pets offer affection and love
7) Pets ease bereavement of a loved one
8) Allow seniors to take better care of themselves
9) Provide a sense of security

Though a majority of aging care facilities still prohibit pets to make the transition with their owners, and reasonably so - some elders are too frail to take care of the pets, residents may have allergies that caregivers want to avoid, pets can carry illnesses, and facilities may not want to be burdened by the extra expense pets bring – the effects of these studies are touching hearts and catching on.

There are many options out there for promoting the use of pets in nursing-home care while maintaining the balance of your aging care community, and countries around the world are seeing the benefits:

Therapy Dogs International, a volunteer-based organization offers dogs as therapy by visiting nursing homes, hospitals and other facilities as needed.

In Scotland, an experimental program by Alzheimer’s Scotland and Dogs for the Disabled has been training dogs to help people with dementia.  The program will take affect this September with the aim of helping dementia patients maintain their routine and provide social benefits.

In Australia, the Center for Companion Health at The University of Queensland has been conducting research through clinical studies by bringing pets into hospitals and clinics.

In Japan, pets are quickly starting to outnumber people. Birth rates have been on a decline in Japan for several decades, and the aging community has found relief from loneliness in the companionship of pets.  Previously considered outdoor creatures, the Japanese are starting to welcome pets as one of the family, indoors.

Is this a growing trend in nursing homes and living facilities around the world or is it losing speed? Please share your experiences and stories of therapy pets in your region.

France’s new president, Francois Hollande, has called for a younger retirement age for some workers: a drop from 62 to 60.  What many countries consider to be an economic mistake, France sees as a “pillar of France’s social benefit system” (AP).

To be fair, Hollande has been trying to win over a people angered by his predecessor, Nicholas Sarkozy, who raised the retirement age from 60 to 62 not long ago.  Sarkozy’s age hike was viewed as unfair to low-income workers and Hollande’s change would help mothers and those who suffer workplace accidents.  

Yesterday, IAHSA attended a press release by the Geneva Association which issued a report on Addressing the Challenge of Global Ageing. Their recommendations for the international crisis were supportive of raising the retirement age.  Here is why:

  • To align retirement age with life expectancy
  • Relieve public finance
  • Increase taxes and social security contributions to stimulate economies
  • Increase Labor force participation

So what is the right thing to do? Of course this is subject to debate but The Geneva Reports leave us with a few ideas:

  • Offer incentives for part-time work beyond the official retirement age
  • Eliminate incentives for early retirement
  • Accept the need to save more

French flags

French Flags [Credit: Quinn.Anya]

It is not surprising that the land of the crescent moon is drawing many of Europe’s elderly to health tourism.  A land of mysticism, ancient history and beautiful landscape has much to offer in retirement services. 

According to the Anatolia News Agency, Turkey is leading an industry growth generating 130,000 visitors per year in the areas of rehabilitation, retirement homes and elderly care treatment at affordable rates for high quality of services.  Not far behind the leaders in Asia, it averages approximately $100 billion in global health tourism per year.

Credit: Dennis Jarvis

Turkey Health Tourism.Org gives the world a look into why Turkey is a leader in global health travel:

-  The country has the highest number of JCI accredited healthcare institutions in the world

-  It houses many regional headquarters of major international pharmaceutical companies

-  Nearly 60 internationally competitive medical faculties train thousands of Turkish and foreign medical students

Dr. Filiz Cevirme, General Coordinator of Private Hospitals and Healthcare Organizations Association (OHSAD) in Turkey says that people travel because of “exorbitant costs of healthcare in industrialized nations, ease and affordability of international travel, favorable currency exchange rates in the global economy, and rapidly improving technology and standards of care”.

 

Happy birthday to GERATEC (Gerontological Research Training Education and Caring), a member of IAHSA, which just turned “sweet 16”!

Under the direction of Margaret Van Zyl, Director of Strategic Partnerships at GERATEC and board member of IAHSA, the organization is well on its way to re-model long-term care in South Africa. Using values of integrity, innovation and “person-centered care”, they are transforming under-resourced homes in isolated rural areas, in a land with few resources but a huge heart. 

Margie Van Zyl getting to know the residents at Emseni Old Age Home in rural KwaZulu Natal, South Africa

Van Zyl is now working on the formation of the South African Care Forum, a not-for-profit, that will build a reputation for quality and best practice in long-term care.  It will influence policy making; be involved in advocacy and lobbying; become a clearinghouse for information, research and best practice; focus on networking and partnerships; and be involved in encouraging research and product development.

A recent success was the transformation of Ekuphumleni Old Age Home in Gugulethu which went from complete lack of maintenance and absence of progress to organized leadership, community involvement and a functional facility.  With the help of the Department of Social Development, GERATEC created a garden, an Eku Boutique, an interactive lounge and personalized living quarters for the residents.

We are very excited about GERATEC’s latest projects: 

  • The establishment of the Eden Alternative South Africa at the end of last year, with Rayne Stroebel, the Eden Alternative SA Coordinator
  • The development of Huis Ina Rens, the first small Green House in South Africa for people living with dementia
  • The ongoing administration and running of Ekuphumleni that was struggling with exploitation, corruption and lack of care.

Residents at the Emseni old age home at Rorkes Drift in KwaZulu Natal

Age-defying creams, potions, diets, exercise regiments, and meditation have all been prescribed to live a youthful, long life.  Today, the New England Journal of Medicine found that regular coffee drinkers live longer.  These stories are uplifting because we know that these are simple actions we can incorporate into our daily lives to live longer.

The oldest yoga teacher, at age 93, also has many things to teach us about the secrets of living longer while staying young.  Tao Porchon-Lynch of New York is inspiring for all of us wanting to know what we can do to remain active in older age. 

This week, she has been inducted into the Guinness World Records as the oldest yogi in the world.  She has been practicing yoga for over 70 years and teaches workshops and classes around the world.  However, it is not just her commitment to yoga practice which has enabled her to look so good and stay energetic as she reaches her centennial.

Here are the secrets Tao Porchon-Lynch can impart:

-          Exemplifying a positive “can-do” attitude

-          Staying open minded – she has synthesized aspects of Indian, European and American thought into her practice and every-day living

-          Remaining determined and focused

Catch up with Tao Prochon-Lynch at the World Karma Project in Ha Long Bay, Vietnam, November 18 – 24th, 2012.

You can read more on her insights in her book “Reflections: The Yogic Journey of Life

http://www.bbc.co.uk/news/world-us-canada-18068548

About this blog

IAHSA’s Global Ageing Network Blog was created because of you!! We got your message loud and clear – “Provide us with a quick and nimble communications vehicle so we can stay connected and create community across borders".

Questions? Email us at iahsa@leadingage.org.

Authors

Virginia Nuessle, Study Tour Director

Majd Alwan, Director, CAST

Alla Rubinstein, Program Administrator, IAHSA

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