“It does not matter how slowly you go as long as

you do not stop”

Confucius

Healthy Aging

Social

Engagement

Healthy Diet

Spirituality

Life

LaughterPhysical

Exercise

Healthy

Brain

Candace Harrington, DNP, APRN, AGPCNP-BCEast Carolina University College of NursingClinical Associate Professor

01/11/2017 Albemarle Area Agency on Aging SymposiumElizabeth City, NC

• Overall physical, mental, social, and spiritual well-being

• Minimize disability

• Live longer

• Decrease problems that make us sick

• Improve physical and mental ability

• Enhance quality of life

SUCCESSFUL AGING

Centenarians

• Fastest growing segment of population, ≥ 85 second fastest

• Currently 40,000 (1/10,000)

• 3 million baby boomer estimate

• Markedly delay or escape age-relateddiseases (Heart, Stroke, Diabetes,Alzheimer’s)

• 90% independent at 90, 75% at 95

• Older you get, healthier you’ve been

247wallst.com/.../statistics-and-observations-of-living-to-be-100-years-old-centenarians/

Longevity Factors

• Long life

• Tendency to have certain diseases

• Good genes age-related disease in late 90s

• Child born naturally who is 40 4x more likely to live to 100

• Healthy lifestyle live to 80s – lean, no tobacco, handle stress well, exercise, social contact

Christensen, K. & Vaupel, J.W. (1996). Determinants of longevity: Genetic, environmental, and medical factors. Journal of Internal Medicine 240. 333-341

Perception is RealityAging and Longevity

• Things keep getting worse as I grow older

• I have as much pep as I did last year

• As I get older I am less useful

• I am as happy now as I was when I was

younger

• As I get older things are

(better, worse, same)

as I thought they would be

Levy, BR and Slade, MD, Journal of Personality & Social Psychology, 2002, 261-270

Perception is Reality

Personality and coping strategies - resilience

Self Confidence increases

Long term helping relationships with elders

Long term partnerships/marriages

Involvement with life and living

Active coping responses

(George Vaillant, 1993)

Use It or Lose It!

Healthy Brain

Frontal lobe(thinking, memory, behavior, and movement)

Parietal lobe (language and touch)

OcciptalLobe(sight)

Cerebellum(balance and coordination)

Temporal Lobe(hearing, learning, and feelings)

Brain stem (breathing, heart rate, and temperature)

Healthy Brain

It is good for you!

Routine &Repetition

Healthy Brain

Routine &

Repetition

Make Lists

Use Calendars

Voice

reminders

Keep notesStay Organized

Healthy Brain

Stay Organized

Routine &

Repetition

Practice

Mindfulness

Multitasking is for the birds!

Healthy Brain

Stay Organized

Routine &

Repetition

Good for your heart---

Means good for your brain!

Multitasking is forthe birds! Heart

Health

Healthy Brain

Stay Organized

Routine &

Repetition

Get in the habit!

Games

Recipes

Foreign Language

Computer Skills

Social Media Anyone?

Multitasking is forthe birds!

Heart

Health

LearnNew Things

Healthy Brain

Stay Organized Routine &

Repetition

Sleep Well

Reduce Stress

Keep your sense of humor

Multitasking is forthe birds!

Heart

Health

LearnNew Things

PracticeSelf Care

Health Benefits of Laughter

• Laughter relaxes the whole body.

– A good, hearty laugh relieves physical tension and stress, leaving your muscles relaxed for up to 45 minutes after.

• Laughter boosts the immune system.

– Decreases stress hormones and increases immune system improving your resistance to disease.

• Laughter relieves stress and anxiety

– Improves the function of blood vessels and increases blood flow

http://www.dartmouth.edu/~eap/library/Laughter_Good_Medicine.pdf

Laugh!

High Self-EfficacyPersonal belief in our ability to succeed in

specific situations or accomplish a task.

• Challenge to master

• Requires effort

• Focus on problem solving

• Visualize success

• Calm, clear thinking

• Persistent

• Likely to succeed

Older and Wiser

https://www.palmpressinc.com/product-tag/mouse-and-helmet

Wisdom

Expert knowledge about life and sound judgment based on prior actions, successes, and trials

Example:

In his wisdom, Thomas Edison invented the light bulb

But only after he learned 1000 ways not to make it!

Creativity

• Creative people continue to excel in their vocations even into their 80s and 90s!

“Health is the greatest gift, contentment the

greatest wealth, faithfulness the best

relationship”

Buddha

Healthy Aging

Social

Engagement

Social Interaction

Social relationships are associated with internal body markers of health

May be associated with lower levels of an inflammatory factor implicated in age-related disorders• Alzheimer’s disease • osteoporosis• rheumatoid arthritis• cardiovascular disease• some forms of cancer.

Focus on evaluating and improving the health of individuals

prevention of secondary conditions and chronic illness

Health Promotion:

Sedentary lifestyle

Food choices

Use of tobacco products

Lack understanding

of consequences

Lack of motivation to

changeAlcohol Use

Why Health Promotion?

• Past emphasis on prevention of disabling conditions.

• Neglect of individual health.

• New focus on evaluating and improving the health of individuals

• Prevention of resulting illness and chronic conditions

(Rimmer, 1999)

Promote Healthy Aging

through Lifestyle

Changes

Lifestyle Choices = Health

Lifestyle

Food choices

Use of alcohol

Use of tobacco products

Understand consequences

Motivation to change?

“The afternoon knows what the morning never suspected.”

― Robert Frost

Healthy Aging

Healthy Diet

A poem….

If it flies in the air (has wings)

Swims in the sea…

Grows from the ground…

…on a bush or a tree,

Eat it and healthier

you will be

There are exceptions to every rule…

“We are never too old to set another goal or

dream a new dream”

C.S. Lewis

Healthy Aging

Physical

Activity

and

Exercise

Strength Balance

Endurance Well-being

PHYSICAL ACTIVITY AND EXERCISE

Reduces Fall Risk…

Personal Factors for Falls

• Aged (over 65 years)• Female• Low mobility or fragility – lower extremity

weakness, and poor grip strength • Functional impairments - limited Activities

of Daily living (ADL)• Poor gait and balance • Low body weight

Tenetti, 1998; Gehlsen, 1990; Nevitt, 1989

Environmental Risk Factors for Falls

• Polypharmacy – four or more prescription medications combination

• Home hazards – Clutter, or loose rugs

– Poor lighting on stairs and hallways

– Lack of bathroom safety, e.g. grab bars in bathtub

• Footwear

• Busy street or elevated walkways

• Lack of attention to surroundings

FEAR OF FALLING LEADS TO ACTUAL FALLS

Why?

Fear of Falling

• Loss of self confidence

• Decrease of physical activity level and quality of life

• Fear of not being able to get up after a fall

Salkeld, G. et al. (2000); Stel, V.S,. Smit, J.H., Pluijm, S.M., Lips, P. (2004)

CYCLE OF DECONDITIONING

Cycle of De-conditioning

Higher level of fatigue and

pain

Cycle of De-conditioning

Higher level of fatigue and

pain

More sedentary

lifestyle

Cycle of De-conditioning

Higher level of fatigue and

pain

More sedentary

lifestyle

Decrease in physical activity

Cycle of De-conditioning

Higher level of fatigue and

pain

More sedentary

lifestyle

Decrease in physical activity

Downward spiral in fitness

Cycle of De-conditioning

Higher level of fatigue and

pain

More sedentary lifestyle

Decrease in physical activity

Downward spiral in fitness

Increase in health

problems

Increase risk of fall related

injury

HEALTH PROMOTION

Physical Activity

Benefits of

Activity

Components of Physical Fitness

• Muscle strength and endurance

• Flexibility

• Body composition

• Cardiovascular endurance

Benefits of Physical Activity

• Decrease blood pressure

• Increase strength, CV endurance

• Increase balance

• Increase lung and breathing function

• Improve immune function

• Reduce depression and anxiety

• Lose fat, gain muscle

• Decreases fall risk

“Today is the oldest you’ve ever been and

the youngest you’ll ever be again”

Eleanor Roosevelt

Healthy AgingSafe

Choices

Tobacco Use

Nonsmoker? Previous Smoker?

Benefits of Quitting Tobacco

• Quitting has immediate as well as long term health benefits.

• Quitting improves the health of those around you.

• Quitting provides a good role model for everyone around you, including your children.

Creating a Quit Plan

• Ask yourself what is the impact of smoking on my health? Money, quality of life, relationships

• Set a quit date.

• Prepare for withdrawal– Your healthcare provider can help!

• Choose method of quitting– 1-800-QUIT-NOW

• Ask for support

• Plan and use new coping strategies

• Don’t give up!

Source: Quit Guide: You can quit smoking. QUITPLAN.com

Success is Possible!

• Given the right support, people living with mental illnesses quit at the same rate as those without mental illnesses

• Quit plan• New coping skills• Social support• Medications • Access to resources

Williams JM, et. al. Learning about Healthy Living: Tobacco and You Manual. Revised 2012.

What to Expect When Quitting

• Nicotine Withdrawal– Irritability, sleepiness, anxiety, anger, sadness,

restlessness, insomnia, increased appetite, sweating

• Triggers– Situations or people that trigger the urge to smoke

• Social situations– Who will ask you to smoke? How will you say “no”?

• Relapse

• Weight management

Source: https://www.quit.com/quit-smoking.html

Coping Strategies

• Substitutes and Distractions

• The 5 Ds

– Delay, Distract, Drink water, Deep breaths, Discuss

• Manage overall stress

– Physical activity, Sleep, Journaling, Music,

Taking time to relax, Healthy eating, etc.

• Control the environment

Source: https://www.quit.com/quit-smoking.html

Why E-Cigarettes Are Not A Smoking Cessation Tool

• Unregulated

• Unknown levels of chemicals

– Several of the same chemicals as tobacco smoke

• Unknown levels of nicotine

• Still an addiction

– Risk of getting addicted to both

Photo: Christian Coombes/Getty Images

Source: http://www.lung.org/stop-smoking/smoking-facts/e-cigarettes-and-lung-health.html

Smoking Cessation Medications

• 7 approved medications

– 5 nicotine replacement therapies

Call 1-800-QUIT-NOW

• Treats nicotine withdrawal

• Doubles chance of successful quit

• Can start using before quit date

• Can use more than one

• Covered by insurance, medical assistanceWilliams JM, et. al. Learning about Healthy Living: Tobacco and You Manual. Revised 2012.

Supporting Someone Who’s Quitting

• Understand

• Praise

• Be there

• Check In

• Help them to relax

• Be positive

• Be in it for the long haulSource: https://www.quit.com/quit-smoking.html

“Age is something that doesn't matter, unless

you are a cheese”.

Luis Bunuel

”

Healthy Aging

Medication Use

Safe Choices

Safe Medication Use

Know the Risk

All medicines (prescription & nonprescription) have risks as well as benefits; and you need to weigh these risks and benefits carefully for every medicine you take.

Risk

Safe Medication Use

Respect

Respect the power of your medicine and the value of medicines properly used.

Respect

Risk

Risk

Safe Medication Use

Responsibility

Take responsibility for learning about how to take your medicine safely.

Responsibility

Respect

Know Your Medicines!

What is this medicine used for?

Is this a BRAND or GENERIC?

Where do you store it?

How to take it? How much?

How often/what time of day?

With or without food, with or without other medicines?

http://www.ismp.org/

Know Your Medicines!

What should you expect or do? How to tell if the medicine is working?

Possible side effects and what to do about them?

Tests or monitoring needed?

If you miss a dose?

Institute for Safe Medication Practices. http://www.ismp.org/

Your Medicine List

• When visiting any healthcare professional:

– Take your Medicine List, which contains information on:

• All prescription medicines, including eye drops, creams, ointments, lotions, samples.

• Nonprescription medicines, herbals

• What are the medicines used for.

• How to take the medicine.

Institute for Safe Medication Practices. http://www.ismp.org/

Your Medicine List

Make copies of your list.

Give one to your doctor, one to your pharmacist, and one to a loved one.

Carry one with you and keep a copy at home.

Make sure to keep it updated!

Institute for Safe Medication Practices. http://www.ismp.org/

Ways to Avoid Medicine Use Problems:

The OTC Drug Fact Label• All over-the-counter

medicines in the United States have a Drug Facts Label that looks like this:

• Learning to read the Drug Facts Label will give you the knowledge to make better decisions, and use OTC medicines safely.

Institute for Safe Medication Practices. http://www.ismp.org/

Reading the OTC Drug Fact Label

Active Ingredient(s): Chemical compound in the medicine that works with your body to bring relief.

Uses: This sections tells you the ONLY symptoms the medicine is approved to treat.

Warnings: This section tells you what to avoid and who should not use this.

Institute for Safe Medication Practices. http://www.ismp.org/

Reading the OTC Drug Fact Label

Directions: Recommended daily dosage and frequency. Follow this strictly.

Other Information: Tells you additional information such as proper storage.

Inactive Ingredients: A chemical compound that has no effect on your body.

Institute for Safe Medication Practices. http://www.ismp.org/

Ways to Avoid Medicine Use Problems: Written Information

• The information sheet you get with your prescription medicine contains useful information to help you get the best results and avoid problems. Read it carefully.

• The information sheet tells you:– What the medicine is used for.– How to take your medicine correctly.– What side effects to watch for and what to do if they occur.– Warnings and Precautions– Storage

Does something you see or read concern you? Do not stop the medication until you talk to your healthcare provider

Institute for Safe Medication Practices. http://www.ismp.org/

Resources You Can Use

Safe Medicine Use Information:www.talkaboutrx.org

www.bemedwise.org

http://www.accessdata.fda.gov/videos/cder/mimh/index.cfm

Buying Medicines Safely on the Internet: http://www.fda.gov/Drugs/ResourcesForYou/ucm0805

88.htm

http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm529517.htm

Health Promotion Disease Prevention

Gambert, S.R. (2009) https://www.asn-online.org/education/distancelearning/curricula/geriatrics/Chapter26.pdf

Talking with Your Healthcare Provider

Prior to your visit, make a list of questions.

Ask about: Questions you may have about a disease, symptom(s),

or medicines. The need to continue current medicines. Non-drug treatments Over-the-counter preparations Need for follow-up appointments, lab work.

You are the leader of your healthcare team!

Source: change4life.co.uk

“You can’t help getting older but you don’t have

to get old”

George Burns

Healthy Aging

Social

Engagement

Healthy Diet

Spirituality

Life

LaughterPhysical

Exercise

Healthy

BrainSafe Choices