Staying healthy in old age
Your Health
DR GITA MATHAI
India is a young country. Thirty per cent of its population is below the age of 30 and seven per cent over the age of 60. In this scenario, writing about old age may seem inappropriate as it apparently affects only a minority!
This, however, is a fallacy, as the burden of caring for the seven per cent — financially, physically and emotionally — falls on the rest of the population.
Parents grow old, children often live far away and the elders refuse to move in with the next generation as they wish to retain their independence. Responsibility can no longer be relegated to relatives or neighbours. Visits to your parents are a good time to check if they are being able to cope.
Physical appearance provides invaluable clues. Parents should appear clean and well groomed. Failure to bathe, brush teeth or wear clean clothes indicates an inability to keep up with daily routine. This may be due to physical weakness, dementia or just depression.
Adults usually have a fixed routine. If you carefully watch the way parents do things around the house, you might find inexplicable illogical changes in the routine. The house may be dirty and housework neglected. Also, they may be absent-minded, like leaving things on the stove and forgetting about them. These are danger signals indicating that care is required.
Make sure the lighting in the house is bright, especially in hallways and bathrooms. Narrow staircases and slippery front steps are also difficult to navigate. Banisters are essential. Supporting bars need to be embedded near the toilet and bathing areas. Otherwise the chances of accidental falls and fractures are greater.
Good nutrition is essential for immunity (to prevent diseases) and muscle mass (for strength to prevent falls). To monitor nutrition, keep an eye on the weight, the quality of skin, hair and nails. Older adults may suffer from malnutrition even when they can financially afford an adequate diet. They may be unable to shop for the materials required. Cooking may be troublesome, time consuming or they may be physically unable to do it. Medications, illness or a recent hospitalisation may dull taste and reduce the appetite. Diet restrictions (on salt, sugar, oil, fluid and spice) owing to diseases may make the food unappetising and inadvertently limit intake. Social isolation and depression can also lead to people eating less.
If necessary, meals (at least once a day) can be delivered from outside.
We all have memory lapses and these are greater and more frequent with increasing age. Glasses and keys may be constantly misplaced. Memory loss is abnormal if it extends to names of close relatives (children, grandchildren, nieces and nephews), the way to the neighbourhood shop or dosages of regular medications. At that point, medical evaluation is required.
Lifestyle and chronic diseases occur with ageing. It is important that all medical details and prescriptions be neatly filed chronologically. This should then be placed in an accessible place. Medical check ups and visits to the doctor should be scheduled regularly. Medical containers should be neatly labelled. If tablets are in strips, the person should be able to distinguish one medicine from another. Some look very alike (calcium tablets and metformin) and it is possible to make disastrous, life-threatening mistakes.
Hearing and eyesight should be checked regularly and timely corrective measures taken. Hearing loss and partial loss of eyesight leads to dependency and feelings of social isolation. Cataract surgery and hearing aids (if required) often are lifesavers.
Sleep disturbances are common in older adults. In some it may be because of Alzheimer’s, when the sleep-wake cycle is disturbed , leading to daytime drowsiness and night-time restlessness. In many it may be because of medications, snoring (obstructive sleep apnea) or restless legs or just depression.
Good sleep can be promoted with
Exposure to a few hours of bright sunlight in the morning
Not taking caffeine (tea or coffee) after 1pm.
Adjusting medication with the help of the doctor so that any tablets with a stimulatory effect are taken in the morning.
Avoid sleeping tablets as they are habit forming and cause confusion.
Daytime sleep should be avoided at all costs. No one can sleep for more than 6-7 hours a day. If this quota is used up during the day, night sleep will be affected.
Medically treat any diseases that might interfere with restful sleep.
At the age of 60, elders need a dose of pneumococcal vaccine to prevent the development of silent and often fatal pneumococcal pneumonia.
Physical activity for at least an hour a day should be encouraged. Walking will help with appetite, lifestyle diseases, balance co-ordination, depression, dementia and sleep disturbances. It will also entail some social activity as they will meet other walkers.
A little extra effort will pay off in the long run to make old age hassle free for everyone, both the elderly and the young adult.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Wednesday, January 25, 2012
Thursday, January 19, 2012
are you an addict?
Are you an addict?
Your Health
DR GITA MATHAI
The middle-aged woman had diabetes, hypertension and high cholesterol. She looked through her prescription carefully. “My other doctor gave me sleeping tablets as well. I can’t sleep at night.” Apparently she had been taking increasing doses of sedatives over the last 20 years!
Fifty years ago, it was easy to define an addict: a person who took unhealthy amounts of substances such as alcohol, marijuana, tobacco or opium, and then became physically and psychologically dependent on them. Family and friends suffered as a result of the addict’s mental and physical deterioration.
Today the scenario has changed. “Addicts” are also viewed as people with abnormal psychological dependency on activities such as gambling, playing video games, watching or reading pornography, surfing the Internet, working (workaholics), exercising, watching TV, or even shopping. Once can also suffer from a spiritual addiction, preaching penance and fasting to the point of self-harm.
It is difficult to define the point at which a hobby or interest becomes an addiction. Here are some simple guidelines that suggest you’re an addict.
You become moody, irritable or depressed when unable to obtain the product (alcohol, drugs, cigarettes or the Internet) or perform the activity.
You spend an undue amount of time on the activity: playing cards, meditating, or SMS-ing for three to four hours every day, irrespective of other pressing appointments.
You need increasing amounts of the product, or time spent on the activity, before there is a feeling of satiety.
The medical profession can sometimes be blamed for certain addictions. A patient may use the medication prescribed to help him or her deal with pain beyond the prescribed period for the “legal high” it provides. These medications are not banned and can be easily obtained with doctor shopping, or the help of the friendly neighbourhood pharmacist.
People usually take sleeping tablets innocuously at first but become addicted to them later. Unexpected people are addicts. Some very respectable Aunties and Uncles are regular consumers.
The new addiction is the Internet. It has caught you too if you:
log into the Internet as soon as you get in to work.
check several times a day, even in the midst of other important activity.
feel agitated if the Internet connection is down.
Addicts cause a great deal of pain and unhappiness to members of their family who often ask, “Why don’t you just stop?” But that is easier said than done.
Addiction is dependent on a very powerful brain chemical called dopamine, which is normally released either for survival or when there is intense pain and pleasure. Levels build up as more and more pleasure is derived from the addiction, asking the person to “do it again”. The brain thinks that the activity is essential for survival and it signals the rest of the brain to resume the activity. Addiction is difficult to handle because it affects multiple brain circuits, including those involved in reward, motivation, learning, memory, and inhibitory control.
Not everyone is equally prone to addictions. A great deal depends on the cultural background. The percentage of alcoholics is less in societies where religious laws forbid drinking or it is unacceptable culturally. Conversely, if there is alcohol or drug abuse in the family, children are likely to learn by imitation. Inherited genes also may make you crave the higher dopamine level. Poverty, lack of education and unemployment provides a stressful environment, which can make you prone to addiction. The inability to cope may also make you vulnerable to addiction.
But while the presence of any of the above factors makes you more susceptible, it does not necessarily lead to addiction.
Any addiction, from drugs and alcohol to excessive exercise and religion, does elevate the mood in the short term but in the long run your life, health, personality and social relationships suffer. The feelings of anxiety, guilt, lack of confidence, anger, responsible for the addiction, eventually return.
Addiction often goes untreated because it is not recognised or accepted by the affected person. After all, excessive prayer or exercise can be considered “a good thing!” Relapses are frequent, especially in the case of subtler addictions like eating. Effective treatment requires specialised care by psychiatrists, psychologists and counsellors.
In 2012, it may pay to have moderation in your life, in exercise, eating, religion, and the Internet. If you feel that you are addicted, seek treatment. Recognising the problem is the first step to solving it.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Your Health
DR GITA MATHAI
The middle-aged woman had diabetes, hypertension and high cholesterol. She looked through her prescription carefully. “My other doctor gave me sleeping tablets as well. I can’t sleep at night.” Apparently she had been taking increasing doses of sedatives over the last 20 years!
Fifty years ago, it was easy to define an addict: a person who took unhealthy amounts of substances such as alcohol, marijuana, tobacco or opium, and then became physically and psychologically dependent on them. Family and friends suffered as a result of the addict’s mental and physical deterioration.
Today the scenario has changed. “Addicts” are also viewed as people with abnormal psychological dependency on activities such as gambling, playing video games, watching or reading pornography, surfing the Internet, working (workaholics), exercising, watching TV, or even shopping. Once can also suffer from a spiritual addiction, preaching penance and fasting to the point of self-harm.
It is difficult to define the point at which a hobby or interest becomes an addiction. Here are some simple guidelines that suggest you’re an addict.
You become moody, irritable or depressed when unable to obtain the product (alcohol, drugs, cigarettes or the Internet) or perform the activity.
You spend an undue amount of time on the activity: playing cards, meditating, or SMS-ing for three to four hours every day, irrespective of other pressing appointments.
You need increasing amounts of the product, or time spent on the activity, before there is a feeling of satiety.
The medical profession can sometimes be blamed for certain addictions. A patient may use the medication prescribed to help him or her deal with pain beyond the prescribed period for the “legal high” it provides. These medications are not banned and can be easily obtained with doctor shopping, or the help of the friendly neighbourhood pharmacist.
People usually take sleeping tablets innocuously at first but become addicted to them later. Unexpected people are addicts. Some very respectable Aunties and Uncles are regular consumers.
The new addiction is the Internet. It has caught you too if you:
log into the Internet as soon as you get in to work.
check several times a day, even in the midst of other important activity.
feel agitated if the Internet connection is down.
Addicts cause a great deal of pain and unhappiness to members of their family who often ask, “Why don’t you just stop?” But that is easier said than done.
Addiction is dependent on a very powerful brain chemical called dopamine, which is normally released either for survival or when there is intense pain and pleasure. Levels build up as more and more pleasure is derived from the addiction, asking the person to “do it again”. The brain thinks that the activity is essential for survival and it signals the rest of the brain to resume the activity. Addiction is difficult to handle because it affects multiple brain circuits, including those involved in reward, motivation, learning, memory, and inhibitory control.
Not everyone is equally prone to addictions. A great deal depends on the cultural background. The percentage of alcoholics is less in societies where religious laws forbid drinking or it is unacceptable culturally. Conversely, if there is alcohol or drug abuse in the family, children are likely to learn by imitation. Inherited genes also may make you crave the higher dopamine level. Poverty, lack of education and unemployment provides a stressful environment, which can make you prone to addiction. The inability to cope may also make you vulnerable to addiction.
But while the presence of any of the above factors makes you more susceptible, it does not necessarily lead to addiction.
Any addiction, from drugs and alcohol to excessive exercise and religion, does elevate the mood in the short term but in the long run your life, health, personality and social relationships suffer. The feelings of anxiety, guilt, lack of confidence, anger, responsible for the addiction, eventually return.
Addiction often goes untreated because it is not recognised or accepted by the affected person. After all, excessive prayer or exercise can be considered “a good thing!” Relapses are frequent, especially in the case of subtler addictions like eating. Effective treatment requires specialised care by psychiatrists, psychologists and counsellors.
In 2012, it may pay to have moderation in your life, in exercise, eating, religion, and the Internet. If you feel that you are addicted, seek treatment. Recognising the problem is the first step to solving it.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
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