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This notion of offering specialized culture-specific hospice and palliative care programs is spreading quickly.  There are many communities that already offer culture-specific teams to care for particular ethnic groups or those sharing common languages, religious affiliations or traditions.

Now, Hospice of the Good Shepherd in Boston, Massachusetts, is accommodating Russian-speaking residents by offering a Russian-speaking team composed of a social worker, nurse, home health aides and art therapist.

Residents are presented with care options in their native language, meals of traditional foods, and medical advice within a culturally sensitive framework.  The program has been received with open arms and hearts by the patients and their families.

This program is of particular significance for the Russian-speaking community because of the infrequency of such practices throughout Russian history.

“The lack of palliative and hospice care for people with terminal illnesses in Russia is a problem that has not been addressed for decades.” says Olga I. Usenko, a Russian physician, “In addition, palliative medicine is still not recognized as a specialty in the Russian Federation medical system and the majority of medical professionals do not have adequate knowledge about modern methods of pain management.”

Anna Sonkin recently highlighted the challenges of accessing palliative care and the lack of resources in Russia, which is affecting children as well as the elderly.

Hospice of the Good Shepherd recognizes this need and is doing more than its part for the Russian-speaking community by expanding its initiative internationally.  In Moldova, for instance, they are helping to purchase equipment, conduct training exchanges and develop hospice programs which have only begun to grow in the last 10 years.

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[Photo Credit: Tom Page, Flickr]

For a list of hospice and palliative care in Russia and CIS countries, see the list from Pallcare.ru (in Russian).

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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]

My garden does not whet the appetite; it satisfies it. It does not provoke thirst through heedless indulgence, but slakes it by proffering its natural remedy. Amid such pleasures as these have I grown old.
– Epicurus

A recent study in the American Heart Association’s Journal Circulation, found that heart health can be improved by regularly engaging in leisure and household activities such as gardening.

Gardening is not new to rehabilitation.  Spending time outdoors, embracing nature and actively engaging in an pastime seems intuitive to good health.

Still, it is sometimes overlooked as one of the best natural remedies that can help in fighting health problems associated with old age and dementia. Gardening can provide the health and fitness a person requires to stay active. The effects of gardening are rejuvenating for the elderly.

Unlike previous research, Circulation  tracked participants for over 10 years and demonstrated that activity over the long haul consistently  reduced inflammatory markers and therefore may be important in preventing physical effects related with ageing.

Previously, Virginia Tech had issued a related study on the benefits of horticulture therapy. It concluded that the benefits included:

  • improvement in attention
  • reduction of pain symptoms
  • lessening of stress
  • modulation of agitation
  • reduction in medications needed
  • improvements in symptoms of dementia
  • reduction in number of falls

These successes are popping up in the news more and more.  Today, for instance, a U.K. man shared his ability to overcome depression through gardening.

However, one report found that not all gardens are equally beneficial. “Among their findings: users mostly visited gardens seeking relaxation and restoration from mental and emotional fatigue. Tree-bordered vistas of fountains or other water features, along with lush, multi-layered greenery of mature trees and flowering plants, appealed most.”

Other researchers found that creating a standard checklist of features can ensure the healing power of gardens.  These elements include:

  • Lush greenery
  • Sculptures and variety in views
  • Atmosphere that facilitates interaction
  • Interactive engagement of multiple senses
  • Accessible entryways and pathways
  • Relaxing sounds

In addition to adapting garden spaces, tools and equipment too can be modified or adapted to help the elderly or disabled begin or continue gardening while reducing physical stress.

Please share your gardening health successes with us and tell us what gardening means to you.

Conflict of interests

[Photo Credit: HyperBob, 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.

Doctors have been saying all along that physical exercise is essential for healthy ageing, better moods and fewer accidents.  But it’s not just aerobic exercise like walking – the exercise of choice for the majority of seniors – that keeps the doctors away.  While walking is “beneficial to heart fitness [it] does little to protect the exerciser against falls or loss of bone mass” says the Sydney Morning Herald.

The Australian Journal of Science and Medicine featured a study “Walking not enough for older Aussies” that looked at Australians over 65 years of age using the Exercise Recreation and Sport Survey.  Not only applicable to Aussies, this study gets at the heart of the overload of information out there on what’s healthiest, what seniors should be doing, and how best to do it.  Every person holds different interests, ability and fitness level that might work best for them.  What is important is that seniors seek out the regiment that works best for them while integrating various forms of exercise.

Key findings from the study are applicable no matter what the choice of fitness may be:

  • Varying exercise routinely increases your health
  • Combining aerobic, strength and balance exercises is key to maximizing health benefits
  • Exercising in groups increases motivation and reduces loneliness
  • Combining exercise with healthier eating habits optimizes your health
  • Some physical exercise is better than none at all

“Raising awareness on the types of activities that can most benefit the elderly, including those that achieve several fitness dimensions all at once, given that few older adults choose to participate in multiple activities is certainly warranted,” says Dr Dafna Merom, lead author of the study.

Old Runner A3

[Photo Credit: Maxwell GS, Flickr]

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.

handicap

Credit: twinpix

In this economy, it’s important to invest wisely and to live prudently without sacrificing the health of your loved ones.  Making smart choices about purchases can affect the quality of care you provide or receive.

Around the world there are ways to save on all the disability aids and technology you need without burning a hole in your pocket or leaving your home.  We did a bit of research and came up with these:

In Australia:

 E-bility features a classifieds section for second-hand beds, chairs and more only for sale within Australia.  

In the UK:

Preloved , similar to Craigslist, offers a variety of miscellaneous items but has a large selection of mobility walkers, bed liners, and scooters both new and used for a fraction of the retail cost.  You can buy and sell equipment online.

DisabledGear – In addition to practical gear, DisabledGear has some thrilling disability gear for the adventurer like a Quad Tetrapalegic Off-road Vehicle and E-Cycle Trainer.

Demand – So much more than a re-seller, Demand also fixes broken equipment as needed.

In the US

The Mobility Market specializes in mobility aids, though there is a small fee for posting items worth $50 or more.  There is also a UK equivalent.    

Globally:

Apparalyzed covers over 20 countries in Asia, Latin America, Europe and the Middle East and ranges from modified furniture, to aids and equipment.  You can also request items by posting a “wanted” ad for your desired piece.  

Ebay – A classic favorite, Ebay really does have it all. Try searching for individual items to buy or swap out your items.  Depending on the seller, most items can be shipped around the world.

Please share your secrets and experiences with us to better the global community and accessibility for all!

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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