Living Well in Later Years
Our area is rich with resources to address the unique needs of seniors.
Exercise and Community
“Today’s older adults are more health-conscious than ever before,” says Sharon Baldwin, senior director of marketing & healthy living at the YMCA of Dane County. “They’re living longer and have better functional conditioning. That is why the YMCA is constantly evolving to offer seniors the opportunity to maintain a healthy lifestyle, healthy relationships, and a positive outlook on life.”
Current YMCA programming for Baby Boomers, empty-nesters and older adults is specifically designed for men and women in their fifties and older. It utilizes water exercise, yoga, walking clubs, stretching and toning classes, volunteer opportunities, and social events to encourage physical, emotional, social and spiritual growth and well-being. Moving for Better Balance is a falls-prevention program that uses the principles and movements of Tai Chi to improve balance and increase confidence in performing everyday activities. As a result, this program helps seniors overcome their fear of falling so they can live stronger, healthier, more independent lives. The Press Play program offers older adults the opportunity to “press the ‘play’ button” and get re-started in activities they once enjoyed. Its focus is on re-discovering the joys of playing sports such as basketball or volleyball while creating a new and supportive network of friends.
“Our exercise classes are specifically designed to promote fitness and well-being while fostering friendships and camaraderie at the same time,” says Baldwin. “Our volunteer opportunities and social events help build lasting relationships and community ties that last a lifetime. The latest research shows that community engagement is critical for optimal health and well-being. But we’ve always known that at the Y.”
Baldwin says not to worry if you haven’t been active before now—it’s never too late to get started. The water is one of the safest and easiest places to make a new beginning; water exercise classes and adult swim lessons provide an all-in-one cardiovascular and resistance workout, yet are gentle on joints. Seniors working on physical rehabilitation from procedures such as hip or knee replacement are also well suited to water-based exercise and activities, as are those with disabilities.
“We’ve always believed if you can do it on land, you can do some version of it in the water,” says Baldwin.
What to Expect from Short-Term Rehabilitation
For most older adults, a short-term rehabilitation stay in a health care facility is a virtual unknown until an injury or unexpected surgery arises. And then the uncertainty can suddenly feel overwhelming. What will I be doing there? How long will I stay? How is it paid for? What can I bring? How, exactly, does it all work?
Oakwood Village answers these types of questions in its new Prehab Program, which is a series of complimentary, informative sessions designed to educate people on what to expect after surgery and to help them prepare for a short-term rehab stay. The Prehab Program is offered the first Thursday of the month at 10 a.m., alternating between the Oakwood Village Prairie Ridge and Oakwood Village University Woods campuses.
“There are so many things people want help understanding when it comes to a short-term rehab stay and what to expect,” says Keith VanLanduyt, vice president of marketing at Oakwood Village. “We have two skilled nursing programs—Hebron Oaks at Oakwood Village University Woods, and the Health and Rehabilitation Center at Oakwood Village Prairie Ridge—that have a reputation for strong clinical outcomes and the provision of safe and effective physical, occupational and speech therapy services. We serve hundreds of older adults each year in these programs and are proud to be a top choice for Madison residents in need of a short-term rehabilitation stay, post-surgery.”
The sessions address key issues such as misconceptions regarding the average length of stay; confusion as to what is and what is not covered by Medicare; general lack of understanding of the role private insurance plays and who assumes responsibility for authorizing payment; questions about what personal items can be brought; and curiosity about schedules and what a typical day might look like.
“Oakwood’s briefing didn’t miss a beat,” says Jerry Simono, who had already suffered an unpleasant experience at another rehab center when he sought out Oakwood’s Prehab sessions for an upcoming surgery. “They covered everything in the correct sequence. They even had a panel of knowledgeable staff present for questions.”
Vaccinations for seniors
Seniors are considered an at-risk age group for many diseases and conditions. Vaccinations are a quick, affordable, essential method of preventing or managing many of them. Dr. Cheryl Martin-Foster, a family medicine physician at Meriter Fitchburg, recommends vaccinating against shingles, flu, pneumonia and tetanus.
“A lot of people don’t even know if they’ve had chicken pox before,” says Martin-Foster. “Even if they’ve already had chicken pox or shingles, everybody over fifty should get the zoster vaccine.”
Varicella Zoster—commonly known as shingles—is an infection caused by the same virus that causes chicken pox. If you’ve had chicken pox, this virus lies dormant in your nerves and can become reactivated years later, becoming shingles—a blistering, painful rash along one side of your body. Shingles can flare up more than once and is more common in older adults.
“The Zoster vaccine is very safe and can prevent you from having to take a lot of medication,” says Martin-Foster, “not to mention contracting a really painful disease with possible consequences like chronic nerve pain.”
Pneumonia and influenza are two different ailments requiring two different vaccinations, and older adults are at higher risk for both. The national Centers for Disease Control estimates that thousands of people die from the flu each year, and about ninety percent of those deaths occur in people age sixty-five and older. The flu shot may prevent seasonal flu entirely, or it may shorten the duration and help manage symptoms if the flu is contracted. As for pneumonia, there is only a vaccination for a specific type, Streptococcus pneumonia.
“Strep pneumonia can be a really serious pneumonia, and a lot more serious in the very old and elderly,” says Martin-Foster. “These are the people most at risk of getting seriously ill, being hospitalized, or even dying.”
Finally, don’t forget about tetanus, for which a vaccination should be given every ten years. T-dap is the vaccination that protects against tetanus, diphtheria and pertussis (whooping cough), but many older adults skip it, thinking it’s just for kids or that they don’t need it.
“A lot of people think they don’t need the tetanus shot but it’s caused by a bacteria that’s ubiquitous,” says Martin-Foster. “It’s almost everywhere. So anytime you get a scratch or cut, you could get an infection that could lead to neuromuscular paralysis.”
Don’t ignore the signs of hearing loss
Maybe you hear a ringing in your ears. Maybe you only struggle when you’re watching television, and you find yourself relying more and more on louder volume or closed captioning. Maybe you can’t hear well when in a crowd, or you miss things that are said at a wedding, or you’re unable to hear your grandchildren properly. Or perhaps you’re irritating your spouse by asking him or her to repeat things.
“Usually people come in because there’s some event or condition that prompted them to finally get their hearing tested,” says Lisa Martin, audiologist at Zounds Hearing of Madison, a hearing center founded by a father in search of better solutions for his hearing-impaired daughter. “Patients just want to find out if they need a hearing aid.”
About one in three people over the age of sixty-five has a disabling hearing loss, but only about twenty percent of those people wear hearing aids. These numbers don’t include people who have only a mild hearing loss and are getting by without hearing aids.
“It’s the third most-common chronic condition, behind arthritis and hypertension, but it’s a very underserved population,” says Martin. “A lot of people wait seven to ten years before they get tested. Often times they are in denial.”
Today’s hearing aids are worlds away from the hearing aids of previous generations. They’re barely noticeable. At Zounds, hearing aids are rechargeable so there’s no need to keep track of, or fumble with, tiny batteries; just put them on the charger at bedtime and pop them back in your ears in the morning. Zounds has developed patented noise reduction technology that allows the user to precisely tune the aids for better hearing in noisy environments.
“In my fifteen years of working with hearing aids, I’ve seen them change immensely in terms of the precision of the circuitry,” says Martin. “Our patients say, ‘I can’t believe I walked around for so many years missing so much.’”
Is Assisted Living For You?
One of the toughest questions older adults face is whether to remain in their homes or make the leap to assisted living.
“Leaving your current situation can be a terrifying thought, but there are many resources out there that can help you decide what the next step is in your life,” says Whitney England, property manager at Monona Meadows, a seventy-six-unit apartment community for ages sixty-two and older. “Do not be quick to turn down any ideas, because one of them could be the best decision of your life.”
England says when maintaining a mortgage payment or keeping up with household maintenance and yard work becomes too much of a burden, it might be time to start thinking about the next chapter.
“Usually it is time to move out of your current situation when you cannot maintain it financially, physically, or mentally,” says England. “Apartment complexes are a great option because maintenance in the home and yard is someone else’s job. It’s stress-free, less expensive, and allows spare time to be used for leisure activities, which is what your golden years should be all about.”
Studies show remaining active and social is crucial for good health. At Monona Meadows, residents are encouraged to take advantage of the natural community established within the building, including frequent parties, potluck suppers and bingo, euchre and Skip-Bo games in the community room. A social services coordinator is provided for residents’ needs, and service opportunities are available through Project H.A.N.D.S.® (Helping Angels National Donated Support), which provides services to the homeless or those in need by sewing, knitting and crocheting mittens, hats, scarves, blankets and stuffed animals.
“New residents are usually surprised at how much more active they become once they realize they do not have to leave the building to enjoy life,” says England.
Why Choose Memory Care?
Memory Care facilities should be designed, built and staffed based on the unique needs of those with dementia or Alzheimers.
“Things we process without a second thought can be overwhelming to a person with dementia,” says Carla Durst, RN Administrator at All Saints Assisted Living and Memory Care. “Inability to process environmental stimulus can lead to withdrawal and social isolation in a home setting or [in] assisted living. Memory Care environments should reduce anxiety and confusion.”
The sight of a parking lot can be a trigger to a resident to believe his or her ride has arrived and that it’s time to ‘go home,’ for example. Hallways and courtyards should be accessible to provide natural walking paths for exercise and fresh air. Exits should utilize sophisticated security systems and blend in to their surroundings, when possible, to reduce the desire to leave.
At All Saints, caregivers receive special training and certification in Alzheimer’s and dementia care, and the staff-to-resident ratio is low.
“Our RNs, dietary, activity and housekeeping staff all focus on connecting with our residents to keep them engaged in daily living,” says Durst. “Family members often question if it’s too soon to move their loved one. We’ve found if admitted in the earlier stages of dementia, everyone’s adjustment can be smoother.”
Financial and Estate Planning
“If aging loved ones have already involved you in their personal financial and estate planning details, they’ve given you a great gift,” says Durst. Health care crises are stressful enough; uncertainty about end-of-life wishes or finances on top of it all can leave family members completely overwhelmed.
“People are generally uncomfortable talking about this because it forces us to address our own mortality,” says Durst. “But these decisions are so much harder if frank discussions haven’t occurred.”
To help start the conversation, Durst and her staff at All Saints Assisted Living and Memory Care developed a booklet called Information for My Family. It organizes and documents financial, medical and personal information, making it readily available in an emergency. Concise, easy to use and free, Durst says the peace of mind it provides is priceless.
“We should all fill one out,” says Durst, “no matter our age.”
Enhancing the Lives of Seniors with Memory Loss
Art and storytelling can be powerful activities for older adults experiencing memory loss. Artisan Assisted Living and Memory Care in Middleton encourages the telling and retelling of life stories in a comfortable and reassuring residential setting. Artisan offers two unique signature programs: the Artist in Residence and the Life StoryBook. Telling stories through guided art-making allows residents to share wisdom and leave a legacy, and it honors their lives. The Life StoryBook provides a glimpse into someone’s past while at the same time becoming an important part of the design of Artisan’s daily enrichment programming to incorporate each resident’s unique interests and abilities.
“The goals of both programs are the same: offering residents with memory loss the gift of personal affirmation and a validation of one’s life journey,” says Artisan’s Cindy Senke. “Research has shown that through guided art-making residents with memory loss can realize strengths, express untapped creativity, and improve self-esteem.”
Residents want to feel positive and uplifted, says Senke. The Life Storybook is about happy memories, important connections, and a focus on the good things in life. In partnership with the family, the Artisan team creates a StoryBook for each resident by listening. Through cherished memories and photographs, the Life StoryBook preserves a rich history.
Artisan also uses the Life Storybook as a frame of reference for personalizing daily living.
“We all benefit from feeling understood; sharing the Life StoryBook has a calming effect and promotes a sense of deep connection in our community,” says Senke. “Having somebody recognize who you were—the street you grew up on, the people you love, the places you went, the food you liked to cook, and the career, talents and hobbies you embraced—just feels really good.”
For residents with dementia who may have lost verbal skills, the Artist in Residence program offers an opportunity to express feelings through choice of color and form. Artisan residents are invited to work with a professional artist/therapist in a variety of media, including oils, watercolors, graphite pencils, pastels, photography and other organic art materials. Family members are invited to participate and each completed work becomes a priceless gift to loved ones.
“This is often a profound experience,” says Senke. “To be understood, express emotion and take pride in a completed project is meaningful and inspires hope.”
Staying Home but Not Alone
Many people don’t realize the difference between hospice care and palliative care. Both address physical and emotional discomfort, symptoms and stress to help people feel and cope better, but while hospice is for patients with a prognosis of six months or less who are seeking comfort rather than cure, palliative care can help during any stage of serious illness.
“Even while your doctor works to manage the progression of your illness through curative treatment, adding palliative care to your plan may help ease your troubling symptoms and address your worries,” says Agrace Chief Medical Officer Dr. Michael Ostrov. “We often hear seniors describe having a chronic or serious illness as a ‘roller coaster ride.’ Care Navigation is our response.”
Care Navigation is a special palliative care coaching service that helps seniors navigate the health care system and manage appointments and medications, with guidance from an Agrace nurse. The goal is to keep patients well at home and prevent the need for hospitalizations. The nurse also helps locate community resources to help seniors stay in their homes longer.
“Many seniors have lived in their homes for decades and have a strong desire to age in place,” says Ostrov. “But when people
are living with a chronic or serious illness, their home can present new challenges, or even hazards.”
Agrace Care Navigation includes an in-home safety screening to identify risks for falls, which can lead to a trip to the emergency room or to hospitalization. Some people may be managing an illness well at home, but then an event such as an emergency room visit creates a major setback. Suddenly there are new medications to manage. They may have a hard time keeping track of multiple follow-up appointments. Navigating illnesses, unexpected surgeries and more can become a full-time job, but you don’t have to go it alone.
“Perhaps adult children that live far away are looking for peace of mind that their parents have a local ally in navigating the health care system,” says Ostrov. “Just knowing that they have phone support from a nurse twenty-four hours a day, seven days a week puts many patients at ease.”