Our muscles and bones respond to the stresses that we put on them with our activities of daily living.  As our lives become less vigorous our muscles and bones lose strength. The best way to overcome this is to keep our leg muscles strong by performing some basic exercises each day.

If you are inactive for an extended period of time and then you challenge your muscles by trying to perform a task that you have not done regularly your muscles may not be there for you.  For example, if your main activity for years has been walking, then one day you need to move more quickly to avoid traffic, your legs may not have the power you need to speed up and you may end up falling.  This is where “Use it or Lose It” comes into play.  If you do not regularly put a baseline of demands on your body, especially your lower body, then you become weaker.  This is why falling is the biggest health risk for seniors. 
 
The good news is that keeping your leg muscles strong and having good balance helps to improve your mobility and prevent falls. Try to do these exercises everyday for best results.

Chair Squats:  Stand in front of a sturdy chair. In a controlled and steady motion sit into the chair, then stand up. Work towards not using the arms on the chair and standing back up without resting. Remember to breathe throughout. Start with a few repetitions and progress to 10 repetitions twice per day.

Leg Extensions: Sitting up straight in a supportive chair slowly straighten out your leg and lower it back down. Work towards holding your leg out for ten seconds while breathing normally.  Start with a few repetitions and progress to 10 repetitions three times a day.

Hamstring Curls:  Hold on to a sturdy chair back or grab bar. Stand up tall with your eyes forward. Keeping your knees shoulder width apart bend one knee so that your heel comes up toward your back. If this is difficult only lift your foot up as high as you are comfortable with.  Start with a few repetitions and progress to 10 repetitions three times a day.

These exercises are designed to keep your legs strong and to prevent falls.  It is important to stay active so also consider going for a walk with a friend, or joining an appropriate exercise program offered through a local seniors’ center, or a recreation center. 

Our caregivers are trained and educated by a registered Kinesiologist on fall prevention techniques. This includes key exercises and stretches designed to maintain and increase strength and mobility.

The basic goals of palliative care are to decrease the patient’s physical symptoms, provide personal care, provide home support if the patient is being treated in their home, and even to address the spiritual concerns of the patient and provide resources and support for their families. More specifically, palliative care does the following:

• It intends to neither hasten nor postpone death.
• It enhances the quality of life.
• It provides relief from pain and other physical symptoms such as depression, confusion, shortness of breath and loss of appetite.
• It addresses the emotional and spiritual concerns of patients and their families.
• It affirms life, and regards dying as a normal process.
• It offers a support system to help patients live as actively as possible until their death.
• It can begin at any point in an illness and can be done in conjunction with therapies intended to prolong life, such as chemotherapy or radiation therapy.

Caregivers or care aids are essential to the palliative care system, particularly when the patient is being treated in their home. Caregivers not only provide home support by means of housekeeping, meal preparation and personal care, but they provide companionship for the patients which is crucial in increasing their quality of life.

Karp Homecare offers compassionate and professional palliative care for clients in Vancouver, Burnaby, Surrey, Coquitlam, Maple Ridge, Richmond and North Vancouver.

Often times, the family of Alzheimer’s patients wish to keep them at home rather than in a hospital or other facility. This is possible, especially in the early stages. However, there are adjustments that must be made to make the home safe, and to ensure the patient is getting the care they need.

• They will need to be checked in on regularly by family or friends.

• Someone must ensure they are taking their medications as directed.

• The balance between safety and independence must be assessed frequently. While it may be important to the patient and their family for them to maintain their independence, their safety is the top priority.

• Minor modifications to the home may be required to ensure the patient’s safety. For example, area rugs might have to be removed to prevent falls, and grab bars in the bathroom could be helpful. Additionally, it may be necessary to keep locks on certain doors, and to disable the stove and other potentially dangerous appliances.

• Effort should be made to ensure the patient is physically, mentally and socially active. They should regularly engage in some form of exercise, even if it is just a daily walk. Mental stimulation, such as reading, doing puzzles and playing games, is known to slow the progress of some types of dementia. In addition, regular social interaction will likely improve their quality of life.

As the disease progresses further, the patient’s ability to be independent will decrease. A change in personality may be apparent; they might suffer from dramatic mood swings, they may be particularly irritable or uncharacteristically aggressive, and they could have significant difficulty communicating due to a language breakdown. At this point in the disease more frequent care will be required. The patient will likely be unable to complete any chores, or even maintain their own personal care. They may eventually have difficulty eating, and their food will have to be pureed or fed to them. Family members may take on these tasks, or the family may choose to hire a care aid to assist the patient. If it becomes too difficult to keep the Alzheimer’s patient in their home, there is the option of moving them into a retirement home or assisted-living environment. This is something many families choose to do, as being a caregiver for a loved one is extremely difficult, and it can be devastating for them to watch a loved one degenerate in their care.

Eventually, the symptoms of Alzheimer’s escalate from cognitive difficulties to other medical issues. Because the disease is degenerative, it gradually breaks down the body’s ability to perform mobility functions. It also breaks down the body’s organs so they are no longer able to function properly. Some examples of medical conditions that can affect Alzheimer’s patients are pressure ulcers, malnutrition, oral and dental disease, respiratory infections and eye infections. Eventually, professional treatment will be required for patients and in the final stages of Alzheimer’s, treatment focuses on relieving their discomfort for the remainder of their lives.

Karp Homecare offers caregivers that specialize with Alzheimer and Dementia care in Vancouver, Burnaby, Richmond, Tri-Cities, North Vancouver, Surrey and Langley.

It’s true that doing chores isn’t bad for you; however, it could be using up precious energy that would be better exerted elsewhere. As you get older your muscles and bones begin to lose strength, and if you don’t use them for prolonged periods they stop working the way you want them to. If you tire yourself out from an afternoon spent folding laundry or tidying the bedroom, you likely won’t go for a brisk evening walk or attend a water aerobics class– both activities that would be much better for your health. Regular exercise is as important as ever as you grow older; it will boost your mood and energy, help your memory, and even protect you from chronic disease. Staying active will also protect against injury, as keeping your leg muscles strong and having good balance will help prevent falls. Falling is a great concern for many seniors, as it is the greatest cause of injury death in adults 65 and older, and one in three seniors experience a fall each year.

So, how do you find a balance between staying active and taking care of your home? It might be time to find some home support. Sometimes, people think that a caregiver is hired only when the elderly client can no longer take care of themselves, but this isn’t necessarily true. Care aids not only provide personal care such as help bathing, dressing and grooming, they also provide companionship, prepare meals, and perform housekeeping duties. If you are still healthy and able to take care of yourself, it is still beneficial for you to have someone provide home support. This way, your energy won’t be wasted slaving over the stove, and you’ll have the time, freedom and motivation to get out there and exercise.

For information about the Veterans Independance Program provided by Veterans Affairs Canada click here

So you’ve seen your physician and revamped your home. Finally, the most important step when it comes to fall prevention is to make sure you use it, don’t lose it.

Keeping your leg muscles strong and having good balance helps to prevent falls. As we age, our lives become less vigorous, and our muscles and bones begin to lose strength. When we don’t use our muscles for prolonged periods, they stop working the way we want them to. If for years you’ve been relatively inactive, with walking as your main form of activity, you won’t suddenly be able to rush across the street to avoid traffic. It’s been too long since your legs have been challenged, since they’ve been put under any pressure; they might not be there for you anymore and you could end up falling. Resistance exercises to strengthen your lower body are necessary to make sure your body will be there for you when you need it.
Additionally, poor balance contributes to the risk of falling, and there are plenty of simple exercises you can complete to help reduce that risk.

If you’re wondering what kind of shape you’re in, there are a couple of tests you can give yourself. To test the strength of your legs, sit down in a chair. If you can’t get up without using your hands, you are at a greater risk of falling. To test your balance, stand next to a counter you can easily grab onto. See how long you can stand on one foot without touching the counter for balance. If you can’t stand on one foot for 10 seconds, you have an increased risk of falling.

The good news is, there are plenty of exercises you can do to strengthen your lower body and improve your
balance. Weight training at the gym will strengthen your legs, and yoga and tai chi are great for balance. Here are some other exercises you can do from home; try to complete them every day for the best results.

Hamstring Curls

Hold on to a sturdy chair or grab bar. Stand up tall
with your eyes forward. Keeping your knees shoulder width apart, bend one knee
so that your heel comes up towards your back. If this is difficult, only lift
your foot up as high as you are comfortable with. Start with a few repetitions
and progress to 10 repetitions three times a day.

Step-ups

Stand facing a step or low bench. Lift one leg up
onto the step and, while holding that position, lift your other leg up until
you are standing on the step with your legs shoulder width apart. Lower your
legs back down to the floor, first with the leading leg, then with the second.
Start with a few repetitions and progress to ten repetitions three times per
day.

Heel-to-Toe Walking

While holding onto a counter or rail for balance,
walk while placing the heel of one foot directly in front of the toe of the
other. As you become more advanced, you can do this exercise while just gently
touching the counter.

Leg Extensions

While sitting up straight in a supportive chair,
slowly straighten out your leg and lower it back down. Work towards holding
your leg out for 10 seconds while breathing normally. Start with a few
repetitions and progress to 10 repetitions three times per day.

While a fear of falling is common among older adults, it’s doesn’t have to be debilitating. By keeping up with your doctor’s appointments, paying close attention to your environment and keeping your lower body strong, you can continue to have an active and fulfilling life well into your retirement years.

Part Two: Proofing your Life

So you’ve visited the doctor and checked your eyes. You’re healthy as can be, or you’ve at least been diagnosed and begun to take steps to improve what’s been hindering your walking ease.

The next step is to take a look at your environment. Make sure your home is well-lit and free of clutter. Use bright bulbs throughout your home, night-lights in the bedroom, bathroom and hallways, and don’t keep clothes or books on the floor. Make sure electrical cords are safely tucked away, and remove throw rugs or use double-sided tape to make sure they won’t lift up off the floor. It’s also a good idea to always have easy access to your phone, so you’re never rushing to grab it when it rings. Keep a telephone next to your bed, and have a portable one you keep with you throughout the day.

Also, make sure all your stairwells have adequate handrails, and that you’re always holding on while going up and down stairs. You could also install grab rails next to your toilet and inside your shower, and place a non-slip mat on the bottom of your bathtub.

When outside of your home, take special care when stepping over a curb, walking through gravel or walking through crowds of quick-moving people. Remember it’s okay to take your time, and move at your own pace. You might feel more comfortable taking an elevator instead of the stairs or escalator, or shopping in the middle of the day, when there are fewer people rushing about. It’s also a good idea to carry a backpack or a fanny pack to keep your hands free. Finally, make sure you’re wearing proper footwear. Rubber, non-slip soles with good support are the best. Also, thin soles with no heel will help you maintain your balance. Try to find a pair or two you actually like the look of—that way, you’re more likely to want to wear them every time you go out.

When it comes to your health, it’s not worth it to take risks. Paying close attention to your surroundings and keeping your home as bright, clean and safe as possible will play a big part in reducing the risk of falls.

See Part Three Fighting the Fear of Falling – Keeping your Muscles Strong

When you’re young, a tiny trip over a rogue electrical cord or a stumble on the bottom stair is no big deal—a bit of dust on your knee, or a harmless bruise on your wrist. But for older adults, it’s a very real fear. Falling is the greatest cause of injury death among adults 65 and older; it’s estimated that one in every three people in this age group will experience a fall each year. While about half of these falls cause only minor injuries, about two per cent are fatal. Moreover, some have estimated that more than 50 per cent of older adults who break a hip from falling will die within one year.

But I’m not trying to scare you. In fact, the fear of falling in itself causes great distress and anxiety among many older adults. Elderly people who have fallen once often develop an intense fear of falling again, and limit their activity as a result. This not only lessens their quality of life, but the decrease in daily activities will actually make a fall more likely for these men and women. A fall, or the fear of a fall, often leads to inactivity, which leads to weakness, which in a cruel twist of irony leads to a greater risk of falling.

So what can be done? Is all hope lost for retirees? Of course not—there are plenty of ways to reduce the risk of falling, while still enjoying a high quality of life.

The first step is to get checked out. If you’re noticing you have trouble walking, it could be due to weak leg muscles or poor balance. But there may be other factors involved as well, and it’s important to make sure your physician is aware of any struggles you are dealing with. Difficulty walking could be a symptom of a specific medical issue, like arthritis or other joint diseases, dementia, stroke, anemia, Parkinson’s disease, or muscle and bone diseases, to name a few. If you are suffering from one of these conditions, it’s important your physician knows, so they are better equipped to deal with both your difficulty walking and the underlying medical issue.

You should also discuss any medications you take with your physician, even the ones that are available over the counter. Some medications have side effects, like dizziness, drowsiness or disorientation, which can increase the risk of falling. If halting these medications isn’t an option, taking them in the evening before bed can help reduce that risk.

Your eyes need regular care, too. If your vision is blurry, you’re more likely to misstep, trip, or accidentally run into an object. Seeing an optometrist every year will ensure your eyeglass prescriptions are up to date, and that any other visual restrictions, like glaucoma or cataracts, are treated.

The fear of falling is scary, and it’s not something you need to deal with on your own. Make sure you take advantage of your health care professionals, and remember that they’re there to help keep you safe and strong.

See “Part Two Fighting the Fear of Falling – Proofing your Life”

Falls account for 13 percent of injury-related deaths in Canada, according to a 2004 Statistics Canada report. Another Statistics Canada report, from 2005, shows that falls account for more deaths than poisonings, homicides, HIV, influenza or liver disease septicaemia and viral hepatitis.  The same organization reports that 49 percent of people aged 65 or older who have injurious falls sustain fractures—most likely to the arms or hands, then the legs or feet and followed by fractures to the hips.

There are several reasons we become more susceptible to devastating fall-related injuries as we age; we lose protective bone and muscle mass, we are commonly affected by mobility-limiting disease like arthritis, and we tend to adopt a more sedentary lifestyle that further reduces our balance and mobility.

For older adults, a fall is often a precipitating event that leads to a generalized decline in health and can result in death. Our bones take longer to heal when we are older; a fracture that would slow someone in their 20s or 30s for six weeks could leave someone in their 60s or 70s bedridden for even longer. Bedridden older adults are at risk of pneumonia and blood clots—among other problems—and hasten the process of muscle loss.

What can you do if you are worried about falls? Don’t wait for one; be proactive—and not reactive—about your health. If you haven’t done this, don’t write-off your health either—know that it is truly never too late to adopt an active lifestyle.

While all exercise helps us maintain mobility and prevent falls, there are also specific exercises we can perform, many from home, that target important muscles used for balance. Try the following:

Hamstring Curls: Stand up straight and hold onto the back of a chair, with your feet shoulder-width apart. Lift one foot by bending at the knee; bring your heel up as high as you can. Try three sets of 10 repetitions for each leg daily.

Chair Squats: Stand in front of a chair, ready to sit down. Slowly lower your body until you are seated—trying to avoid placing weight on the arms of the chair—and then slowly stand right away. Work up to three sets of 10 repetitions daily.

Leg Extensions: While seated in a chair with your back straight, slowly raise one leg at a time, making it parallel to the floor. Hold your leg out for up to 10 seconds (you’ll likely need to build endurance) before lowering it. Eventually, you should be able to do three sets of 10 repetitions for each leg daily.

Shaun Karp is a certified personal trainer.  For further information call 604-420-7800 or go to www.karpfitness.com.