Positive Ageing

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Mental Health care for residents

Although more likely to be mentioned in the media for extreme examples of poor care, I believe that managers and staff of residential aged care facilities generally do a good job. However, one aspect of care that I know is under resourced is the mental health care of the older residents. Although the physical, medical and often spiritual welfare of the resident is managed well, mental health is largely ignored, misunderstood or undermanaged. I believe that access to mental health professionals in aged care residential facilities is as important as access to other allied health professionals, particularly considering the proportion of residents reported to be experiencing dementia and/or depression. I read this article in The Conversation only this morning which discusses this exact issue.
http://theconversation.edu.au/why-its-time-to-properly-diagnose-and-treat-depression-in-aged-care-10152

While I commend the Deakin University team for raising this issue and developing residential staff training that can be implemented immediately, I question how realistic or fair it is to expect the staff to provide the breadth of care asked of them. Determining what behaviours are due to dementia and what are a result of depression is not always straightforward nor can it be done quickly. I believe that in the future as the field of geropsychology grows in Australia, a natural progression will be to employ older person's mental health specialists to provide this care in all residential facilities.  Whether provided on a full time, part time or as needed basis, the importance of access to mental health care for older residents will need to be properly acknowledged and addressed.  Depression in particular is not a part of 'normal' ageing and people should have the right to mental health support and care when needed, regardless of age or setting.

People or purpose?

I know it has been a while since my last post and this has been due to a number of reasons, mainly my large workload last year. My blog has not been the only activity in my life to suffer in 2012, and for 2013 I have decided to focus more effort on being sociable and catching up with friends and family. To be honest although I always enjoy dinner and coffee with friends, I am also very happy being with my husband and children on a Friday night, sharing a bottle of wine or two (my husband and I, not the kids of course!) and playing my 90's dance floor fillers.  I am also very comfortable with my own company so when work, study and family commitments increased in 2012, my social life was first to take a back seat.

I read constantly about the importance of friends and socialising for longevity and also in the literature regarding risk reduction for Alzheimer's. I recognise the enjoyment that being around friends can bring but being a natural introvert I also question whether this is as important to everybody as it is suggested. I have long suspected that it is not the social interaction that keeps one healthy as they get older, rather the sense of purpose this interaction brings. Lunch, group activities, walks with friends, or coffee with a girlfriend can create a sense of purpose for the day: the feeling of still being valued and interesting and engaged with the community. There is emerging research on the importance of having a sense of purpose in older life to remain healthy and active. I have so much I still want to do and achieve in my life so I hope that I never lack purpose, whether that be working, volunteering at the op shop, traveling, undertaking adult education, looking after my grandchildren or just taking in the shoe sales with my mother. However, I must admit that having dinner and a dance with girlfriends after one too many champagnes still holds considerable appeal to me and hopefully 2013 is the year to do this more often!

Green tea and me

I always think green tea tastes better accompanied by some form of ceremony or during an “occasion”. I can appreciate the immense health benefits of green tea but believe that it never tastes as good unless it is served to me “properly” in a small pot with little matching tea cups. Although there is no drink that tastes acceptable in a Styrofoam cup, tea of any form is particularly ruined by it.

Whenever I go to a Japanese or Thai restaurant I will almost always order green or jasmine tea with my meal. However at home I will rarely make myself a pot of green tea, even though I have the cute teapot, matching cups and plenty of green tea leaf at my disposal (see photograph- very cute indeed).

My husband recently gave up alcohol and coffee for 4 weeks and he lived on green tea. He has not reported any noticeable feeling of immense health or euphoria but he was the only member of our family who did not come down with a nasty cold recently. Even I, who claim to never get sick, suffered terribly while my green tea drinking husband cruised through the household epidemic calmly preparing our regular honey lemon drinks and administering our medications (baby panadol for the children and cold and flu tablets for me).

So I guess it is no real surprise, to our family at least, to read in a recent research article that the regular consumption of green tea was associated with a significantly lower risk of functional disability in the older population. The effect of drinking green tea was influenced by the amount of consumption, with an inverse relationship between how much tea the respondent drank and their level of functional disability. This relationship was supported even after controlling for potentially confounding variables such as quality of the diet, social support, community activities and level of education.

Although I don’t believe that I will ever crave green tea like I do a freshly brewed coffee in the morning or a strong Daintree tea in the afternoon, I think that research such as this will influence me to join my husband in his green tea drinking at least once a day. I will just make it a really big cup!

Reference: Tomata, Y. et al., (2012). Green tea consumption and the risk of incident functional disability in elderly Japanese: the Ohsaki Cohort 2006 Study. The American Journal of Clinical Nutrition, 95, 732-9

Restless Leg Syndrome (RLS) and the unsettling facts

It wasn’t until I was in my mid 20s that I discovered that the strange sensation I occasionally felt in my legs at night had an official name: “Restless Leg Syndrome”. Unless you have experienced this syndrome it is hard to describe it accurately but for me it occurred only at night when trying to fall asleep and produced a tingly feeling throughout my legs that made it necessary to move immediately. It is not painful. but cannot be ignored and if severe enough would result in my having to get up for half an hour or so until the sensation disappeared.

I never knew that others also experienced this syndrome but apparently it occurs in approximately one in twenty Australians.  Personally, RLS would only occur infrequently, approximately once or twice a month during my 20s, and I attributed it to low levels of physical activity during the day.

However, I was quite surprised to read in January/February’s edition of Australian Ageing Agenda that preliminary results of a neuroscience research project indicate that people with RLS have up to 80 percent less function in the brain region responsible for movement control compared with healthy people. That is some deficit! The researchers also argue that the disorder exhibits similar characteristics to Parkinson’s Disease.  The prevalence for RLS is higher in the older population and they are continuing to explore the syndrome in ongoing research within the 50 to 70 year age group in the hope of gaining a better understanding of its cause.

Strangely, I rarely experience RLS now that I am in my late 30s, probably because I am exhausted after working, taking care of my young children and undertaking regular physical exercise! I have also always considered it a mild inconvenience and until I read this article had no idea that it was considered a serious medical condition, that for some requires medication to manage.

Does anybody else experience RLS? And if so how does it affect your life?

Fingers crossed I continue to be largely “RLS free” for the remainder of my healthy life. Or at least until I work out how to make up that 80 percent deficit!

To retire or not to retire. Your life may depend on it.

I have just started to attend a local Toastmasters group in an effort to improve my public speaking ability. Actually, I think my ability is quite fine- it is the complete dread I have of doing it that is the real problem.  During our supper break one of the young women stated that all people should be able to retire at 55 years of age and not be “forced” to work way into their 60s.  I always find the discussion of working and ageing interesting because from the studies that I have read in this area, it seems that many people largely enjoy their work and the sense of purpose that is derived from this as they enter their older years. 

Increasing longevity will naturally necessitate the continuation of some form of paid employment, be it part time, full time or casual, later in our lives than previous generations would have expected. I don’t think this is a bad thing either, particularly when a person is motivated, experienced and able to offer a lot of professional insight to those younger colleagues.

The Longevity Project is a book that follows up on the participants of the Terman studies and key characteristics of this group that have correlated with longevity. The Terman study began in 1921 by Dr Terman who collected information on approximately 1,500 boy and girls considered to be the brightest in their class (as selected by their teacher) to determine the sources of intellectual leadership and high potential.  Dr Terman died in 1965 but others have continued the research with this group.

Dr Friedman and Dr Martin spent twenty years following up the remaining 720 Terman study participants, and based on detailed characteristics collected at study commencement, were able to explore why some people live well into old age while others die prematurely.

The book discusses a whole range of variables and factors that influence longevity, but one of the clear findings was that those who continued to work later into their lives lived considerably longer than those who did not. Whether the work was paid or unpaid, it was the productivity itself that kept people living longer and in better health. This variable appeared to have a stronger effect than social relationships, sense of happiness and well-being. In particular, those who with the more “successful” or challenging careers lived longer than those with the least successful careers.

So based on that, thanks for reading and let's all get back to work!


Reference: Friedman, H.S. & Martin, L.R. (2011). The Longevity Project. Scribe:Victoria

Alzheimer's or normal memory loss? How can you tell?

Just as all first year psychology students imagine that they are experiencing key symptoms of mental or behavioural illness discussed by the lecturer each week, many people as they get older start to worry that lapses in memory are a sign of cognitive decline, most seriously Alzheimer’s disease. I read early on in my gerontology studies that forgetting where you put your keys is quite normal, however forgetting what it is you are meant to do with those same keys can signify some underlying cognitive issue.

Differentiating age-associated memory decline from a more clinically significant cognitive disorder is difficult for clinicians. Ahmadi and colleagues have just released the findings of a study that reviewed the use of the “Alzheimer’s Questionnaire”- a 21 item informant based dementia assessment tool. The study is not particularly large (51 cognitively normal and 47 participants with amnestic mild cognitive impairment) but the authors reported that the brief questionnaire was highly predictive of amnestic mild cognitive impairment. In particular, the domains that were sensitive to cognitive impairment were focused on the repetition of statements, orientation, ability to manage finances and visuospatial disorientation.

Accurate, sensitive and reliable testing that can be undertaken easily within the primary healthcare setting is always welcome. As are the treatment responses to such diagnoses which continue to evolve in this area.

Reference

Ahmadi, M., Davis, K., Belden, C., Jacobson, S. & Sabbagh, M. (2012). Informant-reported cognitive symptoms that predict amnestic mild cognitive impairment. BMC Geriatrics, 12(3), www.biomedcentral.com/1471-2318/12/3

Successful Ageing

Researchers who conducted a large South Australian study of almost 2000 adults aged 70 years and over, reported that those who are regarded as ageing more “successfully” are those that not only live longer but also experience a better quality of life. In brief, the study found that successful ageing was influenced by physical function and health, lifestyle, and psychological status.

As defined by the Australian Psychological Society “successful ageing” involves the maintenance of mental, physical and social health.  To minimise disability or ill health as we age we can undertake actions such as:

Physical Fitness: maintenance of physical strength, ability and resilience. Many of the physical health issues such as cardiovascular disease and high blood pressure may be due to modifiable behaviours rather than the ageing process itself.

Intellectual fitness: keeping the mind engaged, stimulated, challenged and active. This can include learning new things and taking up new hobbies and the acquisition of unfamiliar skills.

Social fitness: remaining socially engaged with family, friends and the wider community. This not only decreases the likelihood of isolation but also enables others to be aware of subtle behavioural changes.

Purpose fitness: this refers to the positive feelings and control over one’s life and maintaining a sense of purpose. In addition, older adults who hold more positive self-perceptions of ageing are more likely to undertake preventative health behaviours.

Attitude to ageing: A longitudinal study of 660 people aged 50 years and over found that the median survival of those with more positive self-perceptions of ageing at baseline was 7.6 years longer than those with negative self-perceptions. Ageing self-perception had a greater impact on survival than did gender, socioeconomic status, loneliness and functional health for the group.  


The reason that I frequently read and write about such research is because I find it exciting that so much of how we age is influenced by our own thoughts, attitudes and behaviours.

Once again I ask you to consider how you yourself will age?


Andrews, G., Clark, M. & Luszcz, M. (2002). Successful Aging in the Australian Longitudinal Study of Aging: Applying the MacArthur Model Cross-Nationally. Journal of Social Issues, 58(4), 749-765.

APS (2000). Psychology and Ageing. A position paper prepared for the Australian Psychological Society. Produced by a Working Group for the Directorate of Social Issues- APS: Melbourne.

Levy, B., Slade, M., Kunkel, S. & Kasl, S. (2002). Longevity increased by positive self-perceptions of aging. Journal of Personality and Social Psychology, 83(2), 261-270.

Levy, B.R. & Myers, L.M. (2004). Preventative health behaviours influenced by self-perceptions of aging. Preventative Medicine, 39, 625-629.

Ageing disgracefully

I acknowledge that this post is slightly off topic, but it is my blog and I grant myself permission to digress on occasion. My colleagues showed me a Youtube clip yesterday that features a young women who each week presents a video of herself discussing a wide range of topics. They are presented as mock-information type sessions that tell you how to get ready for a first date, what girls do when they drink too much, what men think of women and other such highly informative content. She actually has great comedic timing and makes some very funny and truthful observations about men and women.  However what struck me immediately was how crude her language was and more incredibly how popular she is. Maybe one thing is directly linked to the other. One clip I watched had had over 9 million views and that was quite modest compared to other clips which notched up over 35 million views!

Material like this and "reality" shows such as Jersey Shore present women (and men) behaving incredibly poorly yet are highly viewed, followed and endorsed by so many members of the public.  Is this what we aspire to? Largely uneducated young women with terrible makeup, too  little clothing apologising after their 7th yager bomb jello shot to some pointless man that they have just cheated on, with his best friend/cousin/neighbour or all three? Even walking in the street or sitting on a train I hear the use of expletives as adjectives, nouns and sentence punctuation during reasonably banal daily conversation. I don't understand when this became regular language. A New Yorker commented on a blog recently that Australians are comfortable using foul language in regular conversation and that it is just a part of our contemporary vocabulary. Maybe I am alone here but I find that perception really sad. Perhaps even more so because he is right.


Postive ageing or negative ageing?

I suspect that this New Yorker cartoon may not provide support to my arguments about positive ageing but it is one of my favourites.....


Keep on moving!

I strongly believe that people should be physical and mentally active throughout their lives.  Physical exercise increases strength, agility, endurance and can prevent the onset of chronic illness, including dementia. I know myself that exercise also provides clarity in thought and improves my ability to manage stress in all aspects of my work and home life. It is often during an exercise class that solutions to problems with a work project or study assignment present themselves.

I need to confess at this point that I am certainly not a health fanatic, and I enjoy the good things in life a little too much at times like many others. However I try to compensate for my frequent indulgences by participating in approximately 3-4 fitness classes a week comprising a range of high impact and strength classes such as Pilates. People often perceive the gym as a place populated with intimidating men and women with bulging biceps and perfect physiques. I am sure those gyms are out there but the fitness centre chain that I am a member of is attended by a diverse group of people at various levels of fitness. I participate in a wide range of classes such as zumba, step, weights and Pilates and I can honestly say that within each class, those aged over 65 would comprise approximately one third of the group.  This morning I took a complicated zumba class in which one of the regulars is a man I would estimate to be in his late 70s. He looks rather serious when doing some of the more robust Latin hip thrusts, but he always turns up each class eager and ready to try the new moves.

Admittedly I am not the most flexible person and I find yoga to be a serious challenge, particularly for my calf muscles that have grown accustomed to wearing high heels everyday. In a recent class however I was astounded by the flexibility of a woman who must be in her 80s at least. She is fit, toned, brimming with health and was able to do the most advanced moves in line with the instructor.

This post is not about chastising people who do not exercise or an attempt to make people feel guilty about their behaviour, rather to reiterate the message that healthy ageing needs to encompass activities that take care of your physical as well as your emotional and mental health.  Exercise encompasses a wide range of options such as walking, Pilates, swimming, aqua aerobics and yoga. Any activity is better than no activity. Just don’t set your yoga mat up next to the oldest lady in the centre of the room. Without a doubt she will show you up!

Tag Cloud

Recent Posts

  1. Mental Health care for residents
    Tuesday, January 15, 2013
  2. People or purpose?
    Friday, January 11, 2013
  3. Green tea and me
    Monday, March 05, 2012
  4. Restless Leg Syndrome (RLS) and the unsettling facts
    Wednesday, February 22, 2012
  5. To retire or not to retire. Your life may depend on it.
    Wednesday, February 15, 2012
  6. Alzheimer's or normal memory loss? How can you tell?
    Friday, February 10, 2012
  7. Successful Ageing
    Tuesday, January 31, 2012
  8. Ageing disgracefully
    Saturday, January 21, 2012
  9. Postive ageing or negative ageing?
    Thursday, January 19, 2012
  10. Keep on moving!
    Saturday, January 14, 2012

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