Lifestyle and Safety Management

Posted By SHL Librarian

Presented by: Candace Mindigo, RN, BSN
Manager, Stanford Aging Adult Services
Stanford University Medical Center
October 28, 2009

Lecture Overview:

  • Diet and exercise are among the most important tools for maintaining health.
  • Keep blood pressure down by following a Mediterranean or DASH diet.
  • Keep your legal papers up to date and have copies located in one place so they are easy to find.
  • Modify your home to prevent falls-the No. 1 reason people come to the emergency room.
  • Stimulate your brain cells by taking on new mental challenges

With more and more adults living longer, it’s important to be aware of the many things you can do to make your later years healthful and stimulating, and keep you out of the hospital.

Heart disease, cancer, and stroke are responsible for 70 percent of all deaths. Certain steps can help lower the chances of developing these disorders.

Weight control. Many aspects of heart disease are preventable by developing healthy lifestyle habits, said Candace Mindigo, RN, manager of Stanford Aging Adult Services, at a presentation sponsored by Stanford Hospital Health Library. About one-half of deaths in the United States are attributable to preventable risk factors, particularly physical activity. Few Americans exercise enough, and 80 percent of men and 70 percent of women between the ages of 65 and 74 are overweight or obese.

Studies have shown that regular exercise can lower the risk of heart disease; delay onset of diabetes; improve blood pressure; reduce risk of falls and osteoporosis; and enhance cognitive function.

“To age well you need to maintain a healthy weight through diet and regular physical activity,” she said. “Even adding a small amount of exercise to your routine shows immense benefit. And as far as diet goes, less if better.”

Diet. Mindigo suggests following a Mediterranean or DASH (Dietary Approaches to Stop Hypertension) diet to keep blood pressure down. These diets are low in salt and emphasize generous amounts of fruits, vegetable, healthy fats, and whole grains. She suggested a diet that includes about 25-35 grams of fiber daily, three to four servings of fish a week, and only one or two servings of red meat a month. A good guideline, she suggested, is to compose your diet of 40-50 percent complex carbohydrates, 20-30 percent protein (chicken, salmon or white fish, eggs, tofu and soy products), and 30 percent monosaturated fat (olive oil, avocado, nuts).

Each person should know what his or her healthy weight and BMI (body mass index) should be, as well as cholesterol and glucose levels. It’s also important to keep up with annual screenings and booster shots, and to keep in touch with your primary care physician.

Because of increased longevity, more adults are living with multiple chronic conditions and are taking medications that can interact, affecting both physical and mental well-being.”Because the body’s metabolism changes as we age, it’s important to keep your physician up-to-date on your medications to avoid negative drug interactions,” Mindigo said. “Many people end up in the emergency room because they do not see a doctor on a regular basis.”

She also suggests finding ways to reduce stress, whether using guided imagery, meditation, or joining a support group. “The important thing is to take time during the day to do something you enjoy,” she said. “It helps to lower the heart rate.”

Paperwork. Be sure to bring all your legal papers up to date and have copies located in one place so they are easy to find. Older adults should complete an advance health care directive, living will, durable power of attorney for health, financial power of attorney, living trust, and conservatorship. Simplify finances by arranging for direct deposit and automatic bill payments, and minimize the number of accounts you maintain.

“People often don’t want to think about these things, but it is important to have them done,” Mindigo said. “You want to make your own decisions about your health, and it’s a gift to your children if you can be organized now, before anything goes wrong.

“Out-of-control paperwork, such as unopened mail, unusual purchases, disorganized paperwork, or late bills, is a warning sign for concern, she added.

Home safety. Falls are the No. 1 reason people come to the emergency room. Thirty percent of people over age 65 fall each year, which rises to 50 percent in people over age 80. Exercises that strengthen legs allow you to catch yourself in a fall, and Mindigo suggests taking calcium and Vitamin d daily to reduce the chance of osteoporosis.

Stanford established the Farewell to Falls program to assess potential trouble spots for seniors at risk for falling. The home-based program, free for Santa Clara and San Mateo county residents 65 and older, provides home visits to evaluate potential problems. Participants receive individualized suggestions and periodic follow-up phone calls from volunteers.

Because more than 60 percent of falls occur at home, Mindigo stressed the importance of making some simple modifications for safety:

  • Get rid of all throw rugs.
  • Remove clutter.
  • Use bright lights.
  • Use shoes with good support.
  • Keep items in easy reach.
  • Move electrical cords form walkways.
  • Install grab bars in the bathroom.
  • Have your vision checked regularly.

 Driving. “Giving up driving is a major step and needs to be grieved as a loss,” Mindigo said. “As your vision changes, you lose depth perception and have slower reaction time.  The time to back off is when driving makes you nervous. Or have a family member come with you and see if they’re comfortable with your driving skills.”

Cognition.  Exercising the mind is just as important for mental agility as physical activities are for a healthy body. While some occasional forgetfulness is normal, losing track of activities, forgetting how to accomplish common activities, repeating phrases, or having trouble handling money are not. “Keep your brain cells stimulated by taking on new challenges,” said Mindigo. “Maintain a balance of mental and physical activities, and stay socially active. Connecting with family and friends is good for you at every level.”

About the Speaker
Candace Mindigo, RN, BSN, is manager of Stanford Hospital’s Aging Adult Services, a program that provides specialized care and access to resources for older adults. The program’s extensive network offers consultations and assessments, assistance with appointments, physician referrals, advocacy, coordination of services, access to community resources, and educational workshops. Most of these services are free to community members.

For More Information:

Stanford Health Library can do the searching for you. Send us your medical questions.

Stanford Aging Adult Services
http://www.stanfordhospital.com/forPatients/patientServices/geriatricHealth

Stanford Farewell to Falls
http://stanfordhospital.org/clinicsmedServices/medicalServices/emergency/fallPrevention.html

Healthy Aging (Centers for Disease Control)
http://www.cdc.gov/aging/