Archive for July, 2005

Physical Activity in Older, Rural, Hispanic, and Non-Hispanics

From Medicine & Science in Sports & Exercise®
Physical Activity in Older, Rural, Hispanic, and Non-Hispanic White Adults
Posted 07/15/2005 Carolyn J. Swenson; Julie A. Marshall; Susan K. Mikulich-Gilbertson; Judith Baxter; Nora Morgenstern

Abstract
Purpose: Understanding variations in physical activity patterns is important for planning health interventions. This study describes age-related change in physical activity in 903 rural Hispanic and non-Hispanic white (NHW) adults age 55-80.

Methods: The Physical Activity History assessed 13 categories of productive and recreational activity during the past year with up to four assessments per participant from 1987 to 1998.

Results: The most common activities were walking and home maintenance/gardening. Productive and recreational physical activity levels were lower in women than men (P less than 0.0001), and within each gender group Hispanics had lower levels of both activity types than NHW (P values less than 0.05). In men, productive activity steadily declined with age in NHW and Hispanics. Recreational activity increased slightly until age 63, then decreased after age 70. In women, productive activity initially stayed stable then decreased in NHW after age 63, and in Hispanics it decreased at younger ages before stabilizing after age 70. Recreational activity levels decreased steadily with age in all women, with a steeper rate of decline in NHW than Hispanics. In both ethnic groups, activity levels were lower in diabetics than nondiabetics, except for recreational activity in women where levels did not differ by diabetes status.

Conclusions: The most common activities were similar to other studies of older adults, both recreational and productive activities contributed to total activity, and physical activity decreased in all gender-ethnic subgroups with age. Hispanic women reported the lowest activity levels….

US anti-war grannies face justice

Tucson’s Raging Grannies have been holding regular protests

Elderly members of a US anti-war group called the ‘raging grannies of Tucson’ are due in court following a protest at an Arizona military recruitment centre.

They have been accused of trespassing after entering the centre earlier this month, saying they wanted to enlist.

The group, mostly women in their 60s and 70s, said they wanted to go to Iraq so their grandchildren could come home.”
….
The Raging Grannies, who are associated with the Women’s International League for Peace and Freedom, have held protests outside the Tucson recruitment centre every week for three years.
….
Nancy Hutchinson, an Army spokeswoman in Arizona, told AP news agency that those opposed to the Iraq war should contact their legislators rather than bother recruiters.

“They need to direct their frustrations at people who have the power to change things,” she said.

Painful result with new reycling bin

The wheelie bin in New Zealand is the same as the US huge Rubbermaid-type with two back wheels which many places use for curb-side pick-up of garbage.
Wheelie bin
23 July 2005 By LEIGH van der STOEP

An 87-year-old Browns Bay man has been left with permanent damage to his elbow and a ruptured artery after taking out his recycling wheelie bin, despite North Shore City reassurances the bins are safe for the elderly.

Tony Creasey spent a week in North Shore Hospital after falling two weeks ago while taking out the recycable waste in his new blue wheelie bin, issued by the city earlier this month.

“I had to get the bin up on the pavement and there was very little to put in it. When there’s very little to put in it, it’s very unstable. When I pushed it up on to the edge of the pavement it fell over and took me with it,” he says.
….
But North Shore City maintained the bins were safer than the old blue recycling crates.
…steps have been taken to ensure the safety of the bins and various groups such as Grey Power were consulted before the new system was launched.

“As far as I’m concerned these pose less of an occupational and safety issue than carrying a heavy crate filled with glass bottles.”


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Grate Sidewalks (Bad gate)

Grate sidewalk

The grated sidewalk (I’m sure there is a regular name but we just say it is the walk) is the metal seen at the bottom of the wooden ramp.

Yes, that is a wooden ramp–which gets wet in the snow and rain–which is the fire escape for the adult day center folks (our most frail) located on the second floor of the senior center.

bad gate
Yes, that is a closed gate latch on the only exit for the day center folks coming from the fire escape from the second floor. (Hey, SHE did remember to unlock the gate that day. On the big Thanksgiving Day meal, below, it was forgotten to unwrap and unlock the exit.)

Yes, there is no No Parking sign in front of the only exit.

2006 A message dated March 2006 was tacked inside the building near the food line asking elders to remind staff if they find the gate is locked. This is something of an improvement, however, no one should open the building in the morning except through the gated entry. And it isn’t enough to unlock the gate latch. It should be locked open. Have you ever tried to open a chainlink fence latch in an emergency (try it with one hand behind your back and the other holding a pillow or tied down by the elbow)?

Yaktrax Walker may reduce outdoor falls during winter

YakTrax

A Simple Gait-Stabilizing Device May Reduce Falls in the Elderly [read article here]
http://www.yaktrax.com/
A recent medical study confirms Yaktrax keep the elderly safer on ice and snow.
Read the complete article in PDF here.

I tried one set of these and didn’t find them that comforting–I felt like my foot was rolling on the springs, especially on inside floors. However, I have known others who like them. Maybe they should be removed inside, no?

The PPS (post-polio syndrome] may also find them useful.

My preference is for 1/4 inch flat sheet metal screws (slotted) that I insert into the soles of my boots. However, if your neighborhood has snow grates (see photo on this bloggie), the screws can sometime get caught and may trip someone [usually, the screws just pull out].

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
News Author: Laurie Barclay, MD, CME Author: Hien T. Nghiem, MD

July 14, 2005 — The Yaktrax Walker ([YW]; YakTrax, Port Orchard, Washington), a simple gait-stabilizing device, may reduce outdoor falls during winter in the elderly, according to the results of a prospective, randomized study published in the June issue of the Journal of the American Geriatrics Society.

“Falls may occur more frequently in the winter in northern latitudes because of more hazardous environmental conditions and suboptimal vitamin D status,” writes Fergus Eoin McKiernan, MD, from the Marshfield Clinic in Wisconsin. “Improving gait stability in these conditions should result in fewer falls and injuries.”

In this study, 109 northern U.S. community-dwelling, fall-prone persons age 65 years and older were randomized to wear either YW or their usual winter footwear outdoors during the winter of 2003–2004. Mean age was 74.2 years.

Study participants completed fall diaries, documenting 93 indoor slips, 13 indoor falls, 714 outdoor slips, and 62 outdoor falls during 10,724 diary days. Although risk of indoor slips or falls was comparable in both groups, the relative risk (RR) of outdoor slips for YW was 0.50 ()

Of 19 outdoor falls, 12 occurred when subjects assigned to wear the YW were not doing so. No serious injury or fracture occurred in either group. The number needed to treat for the YW to prevent one nonserious injurious fall in one winter was six. Given that the cost of one pair of YW is less than $20, the author suggests potentially large cost savings for those who wear the YW.

Study limitations include likely underestimation of the reported magnitude of outdoor fall reduction with YW and possible lack of generalizability to elderly patients who were more or less fall-prone than those in this study.

“YW may reduce the risk of outdoor winter falls, and of nonserious injurious falls, in older community-dwelling people with a history of previous falls,” the author writes. “Targeting the most appropriate fall-reduction intervention to the right population should yield the best rate of therapeutic return. Under appropriate environmental conditions, YW appears to be an inexpensive means of preventing falls and nonserious injurious falls in fall-prone, ambulatory, community-dwelling older people during the winter.”

The Marshfield Clinic Research Foundation Physician Research Fund funded this study. Yaktrax provided the YW devices free of charge and provided Marshfield Clinic Research Foundation with $20 per study subject in compensation for study participation. The study subjects received their blinded compensation after study completion.
J Am Ger Soc. 2005;53:943-947


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HomeMods!

Home modification is adaptation to the living environment intended to increase ease of use, safety, security and independence. Some home modifications include:

* Lever door handles that operate easily with a push
* Handrails on both sides of staircase and outside steps
* Ramps for accessible entry and exit
* Walk-in shower
* Grab bars in the shower, by the toilet, and by the tub
* Hand-held, flexible shower head
* Lever-handed faucets that are easy to turn on and off
* Sliding shelves and lazy susan in corner cabinet
* C or D ring handles on cabinet doors and drawers for easy gripping

Home Modification can Promote Independence and Prevent Accidents

* Many persons are living in older structures that are deteriorating to the point that they are hazardous and contribute to the falss and injuries.

* Home modification and repair can help prevent accidents and falls. Research by the National Centers for Disease Control (CDC) suggests that one-third of home accidents can be prevented by modification and repair.

* Modification to the home environment can be a key factor in increasing the likelihood of older persons remaining independent and injury-free in their homes and active in their communities as long as they desire.

* Home modifications can enhance comfort, increase safety, prevent injuries, and facilitate ongoing access to community social, recreational, and supportive activities and services.

* Removing barriers and safety hazards also helps reduce the stresses associated with the reduction in physical capabilities as people age.

Improve our community by better serving the older people

Suggestions for how we can improve our community by better serving the older people of Bethel

In January and February 2004, about two dozen senior people from Bethel and the Delta had pre-lunch brainstorming sessions at the Eddie Hoffman Senior Center and Chrissie Shantz Adult Day Center. Those present came up with ideas about the kinds of programs and activities they think are, or would be, useful to themselves and to others over the age of 55. I took notes and Beverley Bell of the EHSC staff or Barbara Liu (contract interpreter) assisted in translation. Any errors are mine.

It should be noted that those present were also thinking of the 300 other older people in Bethel. Their consideration was for all people residing in or using Bethel.

[Currently, no more than about twenty-five per cent of people over 62 (approximately 80 people) take advantage of City services. Fewer than 12-20 people consistently use congregant meals.]

Every year the City is required by the State to do a survey of those eligible for services, both current recipients and those not participating, in order to improve the program. The Senior Advisory Board must review the survey and add to it where necessary. Other ideas may come from this public process, if the senior program director and City staff would ever allow participation from the elders .

A couple of other things to note-

  • The seniors pointed out where they need assistance to do or organize these things, but they are not expecting to be passive recipients. For example, it is more consistent if a senior center or other organization sponsors the fishing trips instead of seniors relying on family or neighbors. The ice auger, food, and transportation are arranged. In return, the seniors will share their catch (many widowed seniors now must purchase their white fish. Their small monthly cash income is needed for rent or utilities.)
  • Most of the suggestions feature peer-to-peer activities or active senior contributions to others.

Unfortunately, many of these ideas have been suggested before (see past 10 years of Senior Advisory Board minutes). The meal and transportation the City supplies are appreciated. But, given the number of times in the last several years the seniors have discussed transferring the programs to a new provider, there is a definite need to improve services.

There isn’t a need for a senior center building, per se. [The existing building is dangerous and in need of repairs.] But a place to themselves and to use as a base of operations is valued.

Transportation is essential, but a special cab fare for seniors (which could be subsidized by donations or grants) is preferred.

The availability of five meals per week is essential. However, meals could be provided by contract, such as through local restaurants or churches or by sharing resources with the other agencies in town who also provide congregate and home-delivered meals.

A consistent request is “something to do” in terms of the skills and expertise that seniors have to share with others, but which is not now taken advantage of.
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  • Meals-currently, one hot meal during weekdays. Otherwise some people are unable to cook for themselves. Include more native foods.
  • Transportation-need regular, well-publicized schedules; Senior Citizen cab rates
  • Wood shop (full-size)
  • Technical assistance with social security forms, tax returns, other forms is helpful.
  • Field trips-Hovercraft fishing is welcomed, National Guard hangar, berry picking, cultural center
  • Visiting patients at hospital
  • Need social meeting with friends and peers, welcoming place, quiet, absence of gossip
  • Entertainment, games, Bingo
  • Books, other information resources (e.g., collections for wood shop, common area library)
  • Regular exercise, whole body
  • Qasgim or Kashim and equivalent gathering places for women-to function as advising and learning place for young people and elders. This could be on a drop-in basis, too. Some place and time when those needing feedback or advice or to learn something new could gather. Kids could find someone to ask about parents, growing up.
  • Peer-to-peer opportunity to learn new things-Eskimo dance, skin sewing, other (many did not have opportunity to learn these special skills when younger)
  • Public notice board-listing events, opportunities, commemorations etc.
  • Experts bureau, organize expertise sharing-for example, UAF courses use elders as class room resources (with an honorarium); researchers need technical assistance or skilled informants and collaborators; engineers or planners need expertise in the community itself; municipal leaders need ideas for financial health, etc.
  • Used to have Seniors tutor or lecture at schools, heritage teaching, survival and household skills, as visiting advisors or visiting lecturers
  • Need information center by seniors in order to direct others to information, someone linking experts, coordinate information; newcomers bureau.
  • Peer advice on civic services, such as pre-pay monthly for meals and transportation
  • Collective senior advocacy or intermediary, for example, reckless snow machine by underage drivers; piped water filters need changing (seniors now collect their own rainwater for drinking)
  • Cross-cultural assistance in Anchorage with hospital
  • Design, publish Y-K inter-cultural or transcultural guidebook for healthcare, school, Federal, State, private employees, et al. Sort of a Yup’iit Fieldguide to Gussacks Fieldguide to Yup’iit. (See Joan Metge & Patricia Kinloch Talking Past Each Other.) Provide training to medical personnel and others-“we want to help you learn how you can do your job better”
  • Regular informal gatherings or dialogues, twice a month, facilitated by Senior Advisory Board
  • Gather ideas
  • Invite people to visit, such as Russian day or Cup’ik day. Invite people from their work, e.g., LKSD, ONC, AVCP, USDA, Hovercraft, YKHC, etc. Then people would know what seniors do.
  • Pre-lunchtime seminars, symposia, brown-bag seminars, guest speakers, similar events.
  • Discussion of current events. For example, people may have children or great grandchildren or nieces in Qatar-why are they there? or be curious about the origins of SARS.

O’Folks (off their rocker)

Old age isn't a disease.

Arctic sunset

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