Staying Healthy Archive

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When someone you love won’t create an advance directive

What if someone you love doesn't have an advance directive? That's common, although the underlying reasons may differ. Basic barriers include thinking that an advance directive isn't needed, not wanting to think about death or serious illness, not wanting to burden people, not knowing enough about advance directives and health care choices, needing help to fill out the forms, and lack of time with the doctor to discuss the matter. A person's ethnic or cultural background can also be a barrier: minorities tend to be more suspicious of health care providers and resistant to talking about or completing advance directives. According to AARP, African Americans in home health care and nursing homes are half as likely as whites to have advance directives.

To deal with this situation, try asking your loved one two simple questions, even if you think you know the answers.

The doctor will see you now, in your home

The old-fashioned house call is back in a big way. Here's how it works.

It's hard to get to the doctor when you don't drive anymore or you're struggling with several chronic medical conditions. The result may be missed appointments and a lack of needed care.

But a growing trend makes it far easier for older adults to get medical attention, bringing routine exams and diagnostic tests to the patient's doorstep. It's called home-based medical care — when doctors, nurse practitioners, physician assistants, or other providers visit and treat older adults right in their homes.

Dive into a swimming regimen

Lap swimming offers a total-body workout of strengthening, stretching, and aerobic conditioning.

When you think of a swimming workout, you may envision an athlete pounding away at the water, racing from one end of the pool to the other. But you don't have to break speed records to reap the rewards of swimming back and forth, and you don't even have to do the competitive swimming stroke known as the crawl.

"The pace is up to you, and any stroke is fine. Breaststroke, sidestroke, and backstroke are often favored because a lot of people don't like putting their face in the water, like you have to do with the crawl," says Leigh de Chaves, a physical therapist and clinical supervisor of rehabilitation services at Harvard-affiliated Brigham and Women's Hospital. She also swam competitively in college.

New thinking on daily food goals

Stop aiming for a particular amount of servings in each food category and focus on total daily intake.

Trying to hit the mark on a healthy diet can be challenging. You need to eat enough of the right foods to meet your body's vitamin and mineral needs.

Experts have tried to guide us over the years by recommending goals of daily food servings — such as five to eight servings of fruits and vegetables per day. But your idea of serving sizes may differ from someone else's. That's led to confusion and, now, change.

Medically tailored meal programs linked to fewer hospital stays, lower costs

News briefs

As we've reported before, free medically tailored meals are making a big difference for older adults who have chronic illness or are recovering from a hospital stay. The meals are provided by nonprofit agencies and are customized to your dietary needs — like a potassium-controlled diet if you have kidney disease, or a diet low in vitamin K if you're taking a blood thinner. Now an observational study published online April 22, 2019, by JAMA Network Open suggests that taking part in a free medically tailored meal program is linked to fewer admissions to hospitals and nursing homes, as well as lower medical costs. Researchers looked at about 1,000 adults with health problems such as cancer or diabetes. Half took part in a free medically tailored meal program for about a year; the other half did not. During a two-year follow-up, people who received medically tailored meals had 49% fewer hospital admissions and 72% fewer nursing home admissions than those who did not receive meals. Getting the meals was also tied to a 16% reduction in medical costs each month. To find a program near you, check out the partner section of the Food Is Medicine Coalition (www.fimcoalition.org/partners).

Image: © FredFroese/Getty Images

Walk your dog, break a bone?

News briefs

Owning a dog has many benefits, and a great one is the exercise you get from taking the leashed pet for walks. But there's also a potential risk for older adults who walk their dogs: broken bones. According to a study published online March 6, 2019, by JAMA Surgery, researchers who combed through 13 years' worth of data from emergency departments across the United States identified a rising number of fractures among older adults walking leashed dogs: 1,700 in 2004, climbing to almost 4,400 in 2017. Most (53%) of the bone breaks were in the upper arm, and 17% were hip fractures. Almost 30% of the patients required hospital admission during the study period. Either a large dog (which can knock you down or pull you over) or a small dog (which can get under your feet) can pose a fall risk, especially if you have problems with balance. How can you protect yourself? The authors suggest obedience training can help keep Fido from putting you at risk.

Image: © monkeybusinessimages/Getty Images

Bust your belly for a healthier heart

If your abdomen looks like an apple (or a beach ball), it's a sign that something hazardous lies beneath.

What's a telltale sign of potential health problems? Look down. Whether you call it a potbelly or spare tire, this noticeable bulge can be more dangerous than you realize.

"It's common for men to put on a few extra pounds every year as they age, but they really should pay attention to increasing waist size," says Dr. Jody Dushay, an endocrinologist with Harvard-affiliated Beth Israel Lahey Health. "Any extra weight around the waist can be especially detrimental to your health."

A look at better vision

Lens replacement surgery can fix cataracts and eliminate the need for glasses.

There is a good chance you wear some kind of glasses. And there is an even greater chance you one day will need cataract surgery. Now you can take care of both problems at once.

As you age, the lenses inside your eyes lose their flexibility. This process, called presbyopia, leads to the need for reading glasses or bifocal/progressive spectacles as you reach middle age and beyond. Over the years, your lenses also become progressively cloudy, a condition known as cataracts, which causes blurry vision that glasses alone cannot fix.

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