Daily Herald American Heart Association
Keeping the golden glow on your golden years

Wednesday, May 7, 2008

An apple a day may keep the doctor away according to the nursery rhyme, but it takes a bit more to keep seniors on the road to both physical and mental well-being.

With more than 60,000 centenarians in the United States and those numbers to rise to the 100,000 threshold in just a few years, Rick Germann, manager, After Care Services at Alexian Center for Mental Health, Arlington Heights, says keeping aging minds healthy and stimulated is the key to keeping you as young as you feel.

Rick Germann, manager, After Care Services at Alexian Center for Mental Health

"Retirement is a time of reflection," Germann says. "Looking back, seniors may say they feel out of sync, disappointed or sad when life doesn't go according to plan. Loss of independence, death and family loss could lead to decline, isolation, withdrawal, behavior and personality changes, agitation and frequent physical complaints."

Although depression in the elderly is a common problem, only a small percentage get the help they need. No one, he notes, whether they're 18 or 80, has to live with depression.

"Many assume seniors have good reason to be down or that depression is just part of aging," Germann says. "Despite the cause, depression isn't normal at any age."

Exercising the brain

Germann, who authored the book "52 Brain Busting Activities For Groups," says aging doesn't automatically mean memory loss, depression or loss of acuity.

"As we age, neurons do take longer to fire, we disengage and frequently become spectators in life," he reports. "Our brains literally become lazy and seem to operate on auto-pilot, using less and less energy."

To exercise the brain, Germann recommends avoiding social disengagement.

"Studies show that social engagement is what helps determine longevity, not simply physical fitness," he says. "Companionship is vital."

Education, he explains, also should be a lifelong pursuit and those challenges are what create stronger nerve connections.

"Any new learning experience challenges the brain," he says. "Pick up a new book, learn how to use the computer, study a foreign language, attempt Sudoku puzzles or get involved in a civic issue. Crossword puzzles, word games, puzzles, laughter and problemsolving can be a real cognitive workout for the brain."

He adds that drinking plenty of water and staying well hydrated each day helps speed the neurotransmission process. Cross-training activities involving peers and group challenges increase cognitive work out benefits.

An aging America

"The fact is that our population is aging and as we age, chronic medical problems, illness, loss of independence, death and all sorts of life changes and triggers place seniors at increased risk for mental health challenges," explains Shah Nawaz, M.D., an Arlington Heights-based psychiatrist and director of Northwest Community Hospital's adult inpatient psychiatric treatment unit.

"There's a stigma attached to mental illness that leads to many misconceptions," Dr. Nawaz says. "People tend to shy away from discussing these changes and in turn don't seek the very treatment which can help. Depression comes in many disguises and while patients report physical symptoms such as changes in sleep patterns or fatigue to their doctors, they actually may be clinically depressed."

Nearly 15 percent of seniors age 65 and older may suffer the symptoms of depression at any given time, notes Dr. Nawaz. By the year 2020, he speculates depression will be the second most common cause of disability.

"As health declines, depression increases," he states. ‘In fact, many studies show those who have suffered a heart attack and receive treatment for depression actually have a lower incidence of a secondary heart attack and even death."

Dr. Christopher D'Agostino, geriatric psychiatrist and director of outpatient geriatric services at Alexian Brothers Behavioral Health Hospital, Hoffman Estates, says the relationship between depression, anxiety and other mental health challenges is especially strong for those facing certain medical conditions including diabetes, Parkinson's disease, heart disease, cancer, thyroid conditions and stroke.

Dr. Christopher D'Agostino, geriatric psychiatrist and director of outpatient geriatric services at Alexian Brothers Behavioral Health Hospital, Hoffman Estates

"Risks for depression are particularly high for seniors after a first heart attack and studies show a 50 percent increase in three to five year post-stroke mortality rates for those not treated for depression."

Older adults, he says, frequently don't perceive depression and other mental health issues. With depression, dementia and anxiety topping the list, D'Agostino says substance abuse, bipolar disorder and schizophrenia also score high incidence among seniors.

"Seniors and the elderly may report a lack of interest in former hobbies or activities and we may note social withdrawal or nutrition problems, but it can be that depression, an underlying dementia or anxiety is the culprit," he says. "Making the initial diagnosis and receiving appropriate treatment is key."

With many older men using alcohol to self-medicate after retirement, Dr. D'Agostino says chemical dependency programs are taking note of the senior trends. Women, he says, frequently develop prescription drug issues.

"Mom's Vicodin prescription for her back pain and Xanax prescription may interact to mask symptoms of anxiety or depression," he explains. "These drugs also raise the risk for falls. Sadly, the most common referral for mental health help may come after a fall and potentially fatal hip fracture."

He says families usually are the first to recognize changes and occasionally do need to coerce seniors into treatment.

"But," he says. "Seniors who complete treatment do report the highest satisfaction rates

Keeping seniors healthy

The best offense in keeping seniors healthy in both mind and body may be a great defense, according to seniors and their loved ones who say keeping vital, being socially active and involved in family, church or community and stimulating mental acuity are the secrets to success.

Mary Susan Warsey, an oncology services pharmacist at the Advocate Center for Advanced Care, Park Ridge, who provides care for her 89-year-old mother, Olga, at home says her task is both a labor of love and a source of constant concern.

Her mom, a widow since 2000, had been extremely independent until suffering a stroke in November, 2005. Since that time, trouble with balance and failing eyesight have meant a loss of that independence and a move into Warsey's west suburban Lisle home.

"Mom loves to be busy, is very social, loves to be involved in the community, has always enjoyed crosswords and puzzles of all sorts, enjoys music, pets and more," Warsey says. "But a fear of falls and the need to navigate uneven surfaces with a walker have curtailed many of her favorite activities."

Warsey says she was fortunate to discover Advocate Lutheran General's Adult Day Care and its unique intergenerational program bringing together children and seniors of all ages for a variety of weekly events and activities.

A big plus, Warsey notes, is the fact that the same adult care building also houses both a preschool and nursery program, access to a variety of physician offices and outpatient physical, occupational and speech therapy services.

"In many ways, mom is very independent and would rather be on her own," Warsey explains. "Spending four days a week at the center certainly provides a variety of stimulating opportunities and she loves spending time with the youngsters who refer to her as Grandma Olga."

The medical model adult day care currently boasts an enrollment of 80, with a daily census of 40, says Edythe Hirasawa, manager of the 27-year-old program which was one of the first senior day care offerings in the country.

"We welcome a variety of seniors who are recovering from a stroke like Olga or face other medical challenges like Parkinson's disease, or dementia," she explains. A variety of stimulating activities including field trips, discussion groups, geography study groups, table games and an intergenerational program bringing together the young and the young-at-heart are designed to keep both minds and bodies stimulated, healthy and active."

Many of the seniors relish time spent in arts and crafts pursuits with the four and five year-olds, Hirasawa says, while others love cooing to the six- to15-month-old babies in their "baby mobile" strollers, or visiting youngsters in their preschool classrooms.


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