Category Archives: North America

North America is bounded to the north by the Arctic Ocean, to the east by the Atlantic Ocean, to the west, and south by the Pacific Ocean, and to the southeast by South America and the Caribbean Sea. It is the third largest continent by area and the fourth by population.

Health Benefits of Pet Ownership for Seniors

As most pet owners already know, our pets are best friends and considered part of our families. Especially in nursing homes where the elderly suffer from depression, loneliness, and lack of social contacts, pets can be very therapeutic, improve the quality of life, and alleviate emotional and physical problems. Research has shown that stroking and even talking to a pet lowers one’s blood pressure and heart rate which can lead to an increase in life expectancy. When a person is stroking a pet, a chemical reaction takes places and a high level of mood enhancing hormones, such as serotonin, prolactin and oxyctocin is produced, while less stress hormones are released.

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In the US, pet therapies, also called animal-assisted therapies, are very common and popular in nursing homes. Owning a pet might not be for everyone because of the many responsibilities that come with a pet ownership. Pet therapy allows the elderly to spend time with a pet, usually a dog, and feel closeness. In addition, the elderly have something to look forward to and feel that they have a purpose in life again. While pets in nursing homes can ameliorate the psychological state of mind, they also contribute to an improved physical health of the elderly such as reduced need for medication and improved vital signs. The elderly who take their dog for a walk prove to have improved mobility, more social interactions, and enjoy their daily exercise routine. It has been researched that older pet owners walk significantly farther when they walk with a dog, which can contribute to the fact that pet owners require fewer doctor visits.

The European Union understands the importance of pet ownership for the elderly. As part of the Europe 2020 Initiatives, a new campaign was launched to promote the benefits of pets for the elderly. The motto is called “Animals are good for us, be good to them. We care.” IFAH Europe, the International Federation for Animal Health Europe, started a Facebook page where anyone can get information on how to care for pets. The elderly are also asked to post personal videos about how they enjoy their lives with a pet. This campaign promotes the benefits of pets for the elderly and may raise awareness of the elderly’s emotional needs.

In Romania, pet therapies are just as common, but dogs used for pet therapy have a different story to tell; they are street dogs. Bucharest, the capital of Romania, has more than tens of thousands of street dogs. The dogs have always been seen as a plague and had a bad reputation due to a few fatal incidents with city residents. After a 4 year-old boy was killed by a street dog in 2013, a law was published stating that street dogs will be euthanized unless they have a home. As a response to the law and a vision to save the dogs and give back to the community, the organization Vier Pfoten started a project and trains street dogs to be used for pet therapy in nursing homes. What a great idea to save street dogs in Bucharest as well as give comfort and companionship to elderly!

Martina Lesperance is a Health Educator and Screening Technician in El Paso, Texas.

Aquatics for Life

Inactivity in the elderly has become an ever increasing epidemic in the United States. Politicians as well as insurance and health care providers need to band together to reverse this trend to insure the longevity and quality of life. The elderly are not only at risk for lifetime diseases such as diabetes and heart disease; they are at risk for greater loss in bone density which translates into greater probability of falling and breaking bones.

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Land-based physical activity is important for the elderly as it increases muscle and strength development, bone density and endurance which are both respiratory and cardiovascular. On the other hand, aquatic exercise benefits EXCEED land-based activities since it trains muscle parity and balance. Land-based exercise in the elderly is fraught with potential for injury. Likewise, unsupervised weight training can lead to torn muscle fibers, strained or torn ligaments, and unbalanced overtraining of some muscles while not sufficiently training the complementary muscles equally. Water exercise in a class format allows for participants to work at their own comfort level of perceived exertion. Good water instructors will always cue participants to work below the threshold of pain. In other words, participants can work to tension and ask for modifications of moves when in pain.

For the elderly, a good rule of aquatic exercise is to be mindful of aches and pains in advance of a water workout. If two hours later, the pain is greater than before training, then the participant has done too much. At this point, they can notify the instructor for modifications of moves that may affect their pain experienced. Because aquatic exercise trains complementary muscle pairs like biceps and triceps, the potential for injury in land-based exercise or activities of daily living (ADL) is reduced. Moreover, aquatic activities not only balance muscle pairs, they inherently strengthen the core muscles which provide for better over-all balance and strength. Core strength can show some correlation to immunity and overall health.

All seniors, especially those who are overweight, need to exercise in a muscle-balancing, core strengthening and reduced-risk-of-injury environment. Aquatic exercise is perhaps the ultimate life-time sport!

Felecia Fischell is an aquatic specialist with 25 years experience in aquatics. She leads aquatic classes and consults as an aquatic personal trainer and a swim instructor in and around Smith Mountain Lake, Virginia, USA. The Founder of FunLife Aquatics Consulting and Personal Training, Felecia presents at health fairs and has given aquatic presentations to high schools, Howard County Board of Education, Howard County General Hospital and Howard Community College.

Dementia Village: A Unique Place

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Dementia
can affect anybody and there is no cure for it. It is estimated that in 2050, more than 16 million Americans will have Alzheimer’s, which is the most common form of dementia. Dementia is a disease that affects the mental ability to perform everyday life activities. A person who has dementia progressively experiences a decline in memory loss which results in confusion and even fear. Imagine if you could not remember your own spouse, children, or even forget where you are at a certain time? People with dementia live in their own world and as the disease progresses, need help from care givers. Oftentimes, this care will be provided in a nursing home.

In Holland, a Dementia Village called “Hogewey”, has been created where every patient has dementia. The nursing home has specialized itself to provide care to dementia patients and offers amenities that the elderly need to feel at home and secured. All rooms face a courtyard in which patients can sit outside, enjoy the sun, and even go for a walk on a trail. Physical exercise is important for all ages and even for elderly with dementia. Exercise benefits the brain cells and oxygen flows to the brain. For the families, it is a relief to know that their loved ones are taken care of and can live in a world that is true to them.

Hogewey is certainly a unique place and its positive effects on patient care have already been studied by Germany, Switzerland and USA. In the USA, a dementia village is already in planning. It will be based in San Luis Obispo and called Maha Cielo Village. No one knows how much it will cost to build the village or how much the monthly rent will be for elderly. Just so you know, the construction of Hogewey cost $25 million, of which $22 million was funded by the Dutch government. Although it is a great project, not every patient with Dementia may be able to afford the monthly rent of $7000 at Hogewey or at any other Dementia Village. Government agencies, insurances, non-profit or private organizations may have to come on board and support patients needing financial assistance.

Martina Lesperance is a Health Educator and Screening Technician in El Paso, Texas. 

The Healing Power of Optimism – A Positive Outlook Can Improve Quality of Life and Health

The Benefits of Staying Positive

There are many benefits associated with staying positive. This is supported by the fact that a continually growing body of research points to the benefits of viewing things in a positive light rather than negatively. Researchers believe that positive thinkers have no lasting negative effects since they are able to handle the effects of stress much more effectively than negative thinkers. Stress leads to fatigue, headaches, insomnia, and many other health issues which can in many cases be attributed to negative thinking.

                                                                                  Photo Credit: Philips Communications

Focus on the Positive

During a drastic life change such as losing a job, loved one, or chronic illness, it is often hard to view things in a positive light. There are many times when the blame is focused inward which compounds the stressful effects. Optimists focus on the good and what they can change in the situation rather than assume the solution is out of their control. When it comes to a chronic illness or the loss of a job (especially when a company is doing regular cutbacks, etc), there often are not many things a person could have done differently. The key to managing stress is believing one can make a change and then working little by little to implement the change.

Life Events and Their Correlation with Attitude

One long-term study conducted by Harvard researchers looked at 99 of the 1944-1945 graduating class members. The graduating members answered questions from surveys and the researchers rated the questions from positive to negative. The study found a strong correlation over the years with those who had always been positive, those who changed from negative to positive in their early to middle adulthood and those who went from positive to negative over the course of the study. They found that those who had always been positive and those that changed from negative to positive fared the best. On the contrary, those that changed from positive to negative and those that remained negative throughout had many more health complications. Their overall health situation was also much worse.

Why Does Pessimism Lead to Harmful Health Consequences?

As discussed above, pessimism in early adulthood that was not corrected led to health risks in later adulthood. What was causing the elevated health risk? When the body is stressed, it produces a hormone called cortisol. This hormone was great for our ancestors who needed to be alert in situations of peril. However, many day-to-day stressful activities such as a mean boss can lead to elevated cortisol levels. Scientists have known for years that elevated cortisol levels interfere with learning and memory, lower immune function and bone density, increase weight gain, blood pressure, cholesterol, and more.

A Case Study of Positive Thinking

One last case study is in regards to a doctor who studied 750 Vietnam War veterans. These veterans were prisoners of war that were abused and tortured. Dennis Charney, MD, dean of Mount Sinai School of Medicine, had all 750 veterans take a test and noticed one thing in common. Those who did not develop post-traumatic stress disorder or suffer from depression or depression-related symptoms had optimism at the top of the list of ten things that set them apart from the other veterans. Next to optimism was selflessness, humor, a belief in a higher power, and that there was meaning behind their lives and risks – all aspects of a positive outlook.

Jacob Edward is the Manager of Prime Medical Alert and Senior Planning in Phoenix, Arizona, USA. Jacob founded both companies in 2007 and has helped many Arizona seniors and their families navigate the process of long-term care planning. Senior Planning provides assistance to seniors and people with disabilities in finding and arranging assisted living in Phoenix, as well as applying for state and federal benefits.

Promoting Advance Directives, Reducing Medicare Spending

*This article was extracted from a longer, in-depth, paper written during my internship with a policy forum in Washington, D.C. 

More and more people are living to the age of 100. As our longevity increases, it is crucial to have an advance directive to make health care decisions, which may reduce the overall cost of end-of-life care. While Medicare guarantees access to health insurance for individual Americans and lawful residents aged 65 and older, the program faces significant fiscal challenges over the long-term. Advance directives may reduce Medicare spending since older adults can opt out of aggressive medical intervention by dictating their wishes in the event of a life-threatening illness. As Congress continues to debate over the best way to fix Medicare, costs will likely increase if older adults continue to ignore advance directives.

Living Will document with pen, closeupAbout 27.4 percent of Medicare expenses for the elderly are spent in the last year of a person’s life. Advance directives can reduce that percentage because older adults may not prefer lifesaving machines that impact costs. If a person wants to avoid lifesaving machines without having an advance directive, doctors will keep such people alive at the expense of other patients. The latter will be deprived of necessary medical treatment and hospitals may become overcrowded. Also, these machines and other medical resources will contribute to the cost of care because they are expensive and scarce. Unless people write binding living wills, families are reluctant to “pull the plug,” and medical professionals are afraid of being sued if they do. Increasing the use of advance directives is necessary for preventing such problems.

Studies have shown that adults are more likely to complete advance directives that are written in everyday language and less focused on technical treatments. However, many people are currently unaware of advance directives and even fewer complete them. Since advance directives are very lengthy and tedious to complete, most seniors prefer family surrogates. The present state of healthcare systems also compounds the problem. For instance, there are only two states that offer living will “registries.” Residents can file their living will and allow doctors and other healthcare providers to have access to their documents. However, the Washington State living will registry has been closed by the state government because of lack of funds, among other problems.

If insurance pools take into account the costs spent on people that will never get well, premiums for younger and healthy people are going to be very expensive. It is difficult when people are without an advance directive and do not want lifesaving machines. At the same time, if such people wish to have invasive and aggressive medical treatment in poor prognosis states, then health systems should accommodate and respect their wishes.

Advanced directives are not only for the elderly. Our society is getting older, and people have to deal with it. Health professionals need to determine effective ways of promoting advance directives among elderly patients. For example, a study showed that a replicable intervention mainly targeting doctors achieved a moderate increase in advance directives among older ambulatory patients. Future interventions may need to address doctors’ attitudes and comfort discussing these documents since patients cite their physician most often as the one who influenced them most to make a health behavior change. Increasing the use of advance directives among elderly persons is essential since it reduces Medicare spending and the national budget concurrently.

Living wills and health care proxies need restructuring hence these documents have to be well prepared to reduce confusion, jargon, and ambiguity. It is also vital for healthcare institutions to advocate and support the use of advance directives. More states should invest in the living will “registries” and promote advance directives to increase enrollment. If a patient has an advance directive and requests lifesaving machines, families and health professionals should respect their wishes. In the long run, advance directives are necessary because they can reduce the overall cost of end-of-life care for individuals and families.

Sophie Okolo is the Founder of Global Health Aging.

Why Growing Old in the U.S. Sucks…and There is Nothing (Something) We Can Do About It

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I am close to thirty years old. According to the latest data from the World Bank, I can expect to live another 45 to 50 years (Current U.S. life expectancy 78.7 years). However, the quality of those years is up for debate. Our current baby boomer population, on average, is sicker than their parents. The childhood obesity rate for children across the world, but especially in the US, has led many to the conclusion that this generation will become the “sickest generation” in the history of mankind. On top of this, with the population of Americans aged 65 and older expected to double within the next 25 years, there will no doubt be a strain placed on an already taxed healthcare system.

Of course many will argue that numerous aspects of our health are the result of our own personal decision making. This is very true but consider for a second that many individuals, maybe some within your own community, do not have a choice. Maybe they don’t have access to healthy eating options. Maybe they live in an area that exposes them to environmental pollutants. Maybe their occupation requires labor that over time will contribute to chronic pain. For many individuals, we live in a society where the choice has been taken from them or made on their behalf.

For all of us, aging can and possibly will be a difficult process. The unfortunate reality is that we live in a country that has the best intentions, but poor execution. I personally look forward to my next 40-50 years, but I know that many others are not. We must consider that the aging process is not created equal, and that there are many who are and will be unjustly dealt an unfair hand. Aside from the education and outreach initiatives conducted with regard to healthy living and chronic disease, there must be a greater emphasis on policy implementation that catches those at risk. According to the Global AgeWatch Index, Sweden is the best country in the world for the elderly. With reduced costs and an individualized approach, Sweden puts forth a strong effort to ensure the quality of life of its aging population. These efforts illustrate that it’s not impossible for strides to be made in improving or at least maintaining our country’s aging populace.

To give everyone a fair chance, there must be equality at the starting point. It is not enough to expect that public health interventions and education for those at risk for the development of chronic disease will suffice as a method to prevent potential long term health problems. There needs to be more of an effort to eliminate that “risk” to begin with to ensure that children born today, no matter location, race, or socioeconomic status are born with the same expectation of a healthy life. So maybe there is something we can do about it. With time, effort, and collective sacrifice, all Americans can have the opportunity to experience their potential 78.7 years in full health and vitality.

Udo Obiechefu is an E-Tutor for the Master of Health Promotion and Public Health program at Robert Gordon University.

Caring for the Needs of the Aging Workforce

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As the American population continues to age, there is an opportunity and a need to adequately respond to the unique needs of older adults. Ensuring a social structure that considers the needs of the aging is important, particularly as it is projected that by 2030, the number of Americans 65 and older will double and comprise nearly 20% of the total population. Comprehensively responding to the needs of the aging should include measures that protect the health, well being, and quality of life of older adults.

Included among the social changes that have been observed within the aging population in the U.S. is that more older American adults are delaying retirement and choosing to remain in the workforce past the traditional retirement age of 65. The desire to remain employed stems from improved quality of life among the aging and the capacity to continue working. However, for many older Americans, there is also a need to continue working due to economic pressure. According to recent research, 75% of Americans that were nearing retirement in 2010 had less than $30,000 available in their retirement accounts. With dwindling access to Social Security funds and the projected extension of the eligibility age to receive Social Security funds to 67 years of age in 2017, financial insecurity for the aging is requiring older workers to remain employed beyond the time they may have considered retirement.

There are benefits to older adults remaining in the workforce – both individually and occupationally. It has been noted that among older adults who remain employed, their cognitive capacity is less likely to diminish as compared to their non-employed peers due to mental engagement within the workplace. Additionally, research has shown that employers value the presence, contribution, and input of older workers and report that older employees exhibit knowledge related to job tasks, respond resiliently to job-related stressors and changes, and are willing to learn new tasks quickly. Added financial resources are also a significant benefit for older Americans who remain employed beyond retirement age.

Recent economic crises, however, have left few immune to financial loss. For older adults, financial loss as a result of the “Great Recession” have led to this need to continue working and raise enough money on which to live after retirement. For older adults who lost their jobs during the recent economic downturn, many reported that they continued searching for employment with little luck due to hiring preferences in many industries for younger employees. This represents a persistent area of vulnerability for the aging, as financial uncertainty after retirement remains a reality for many.

Diana Kingsbury is a PhD student and graduate assistant in prevention science at the Kent State University College of Public Health.

Alzheimer’s and Parkinson’s: A Great Threat to the U.S. National Budget

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Since the last Presidential Election, the national budget has been a sore spot for Republicans and Democrats, the two major political parties in the U.S. While government programs such as the Affordable Care Act (ACA) are leading debates on reducing the national budget, politicians are oblivious of a looming threat to the budget. People with Alzheimer’s and Parkinson’s diseases require constant and very expensive care. Also, these debilitating illnesses can prevent affected persons from working, which may have a devastating long-term impact on the budget.

Alzheimer’s disease (AD) is the sixth leading cause of death in the U.S. and an estimated 5.4 million Americans currently suffer from AD. If current population trends continue, the number of people with Alzheimer’s disease will increase significantly unless the disease can be effectively treated or prevented. The U.S. population is aging and the risk of Alzheimer’s increases with age. For instance, Alzheimer’s usually begins after age 60 and the number of people with the disease doubles for every five-year interval beyond age 65. About five percent of men and women ages 65 to 74 have Alzheimer’s disease and it is estimated that nearly half of those age 85 and older may have the disease. Parkinson’s disease (PD) is the second most common neurodegenerative disorder after Alzheimer’s disease and affects one million people in the United States. Symptoms of PD include muscle rigidity, tremors, and changes in speech and gait that worsen as the illness progresses over time. PD is more common in the elderly and most often develops after age 50. Sometimes, Parkinson’s disease occurs in younger adults. When a young person is affected with PD, it is usually because of a form of the disease that runs in families.

With strong research investment, heart disease deaths in the U.S. fell by 13 percent in the past decade. Alzheimer’s deaths rose by 68 percent from 2000 to 2010 and continue to increase. The issue is not how, but why we cannot increase our investment in research into fighting these diseases that have a tremendous impact on both the individual and society. Alzheimer’s and Parkinson’s get comparatively less funding than other top diseases because they are more common in the elderly and largely ignored. Stigma is another reason why it is hard to raise money since people with Alzheimer’s and Parkinson’s rarely talk about the disease. Also, Alzheimer’s is different from other diseases because Alzheimer’s patients rarely lead marches to fight for more funding since their memory is impacted. It is important to our nation’s economic future to reduce the deficit, but we cannot ignore the importance of investing in Alzheimer’s and Parkinson’s research. As the nation’s older populations grow, the cost of care for these diseases will rise dramatically. In fact, Alzheimer’s is expected to cost the U.S. more than $1 trillion annually and persons who leave the workforce to care for an affected family member impact economic productivity. Increasing funding for Alzheimer’s and Parkinson’s will require difficult choices and shared sacrifice in spending reductions and increased revenues.

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As the U.S. Congress continues to agree or disagree on the best way to fix Medicare, a government health program, the national budget will likely increase if there is no dramatic increased investment in research into fighting Alzheimer’s and Parkinson’s disease. The devastating statistics continue to increase and rising health care costs pose a great problem to the U.S. economy.

Sophie Okolo is the Founder of Global Health Aging.

Fighting Loneliness – Pet Therapy for the Elderly

For many, retirement and old age is a welcome stage of life with few responsibilities, and a lot of time to pursue interests. To others, it brings on that dreaded feeling which no amount of pills and doctor appointments can cure – loneliness. According to AARP, over a third of Americans over 45 years are lonely. Retirement, decreased mobility and income source are all contributing factors to increased social isolation. Studies show that loneliness puts the individual in greater risk of diseases and illness, and greatly impacts their well-being and quality of life.

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A variety of interventions are in place to combat loneliness in the geriatric population. They focus on various high risk groups and employ various individual and group approaches. There are also several programs in place, including social and cultural outings, health promotion, community engagement and group support. However, few show direct improvement in reducing loneliness among the elderly. A study comparing eighteen different interventions in Netherlands concluded that only two of them significantly reduced loneliness – one, an individual, at-home intervention for the elderly with chronic disease, and two, a group intervention in a residential home that included discussion and coffee breaks. There is limited success in identifying and employing interventions that significantly reduce loneliness

Another lesser known intervention to battle loneliness is the use of companion animals. Pet ownership and interaction positively contribute to the overall wellbeing of elderly citizens as pets can instil a sense of responsibility and purpose in the elderly, and provide much solace from loneliness. The role of Animal-assisted therapy (AAT) is increasingly being explored in elderly care. AAT is a formal, documented process with scheduled sessions and a treatment goal. AAT most commonly uses dogs, but is not restricted to fish, rabbits, cats, horses and dolphins. AAT should not be confused with service animals, and animal-assisted activities (AAA). Service animals and AAA are more spontaneous and do not necessarily have a treatment goal. Both AAT and AAA can help in increasing social behaviors, interaction with people as well and decreasing loneliness among the elderly.

In addition to temporary animal companionship, several organizations also look to provide seniors with the opportunity of pet ownership. The ‘Seniors for Seniors’ program is employed among many non-profits and animal shelters across the United States. This program looks to place adult dogs and cats with willing and able senior citizens. Since older dogs are usually house-broken, trained, and come with a fully developed personality, they can serve as great companions to the elderly.Several animal welfare organizations such as SAVE, Paws and the North Shore Animal League America successfully run such a program, often providing financial and other support to senior adopters. Pets for the Elderly Foundation, is a non-profit solely focused to this cause. It provides financial support to adoption centers around the United States that place dogs and cats with senior citizens.

Animal therapy, in all its forms, is a burgeoning field of study in geriatric care. There are only a handful of scientific studies documenting the efficacy of AAT on loneliness, but current research shows positive trends. Despite the challenges of working with animals, the therapeutic role companion animals can play in fighting loneliness is promising.

Namratha Rao is currently pursuing her MSPH in International Health in Social and Behavioral Interventions at the Johns Hopkins University Bloomberg School of Public Health.