By Judith Graham, Kaiser Health News

When Dr. Christopher Callahan examines older patients, he often hears a similar refrain.

“I’m tired, doctor. It’s hard to get up and about. I’ve been feeling kind of down, but I know I’m getting old and I just have to live with it.”

This fatalistic stance relies on widely-held but mistaken assumptions about what constitutes “normal aging.”

In fact, fatigue, weakness and depression, among several other common concerns, aren’t to-be-expected consequences of growing older, said Callahan, director of the Center for Aging Research at Indiana University’s School of Medicine.

Instead, they’re a signal that something is wrong and a medical evaluation is in order.

“People have a perception, promulgated by our culture, that aging equals decline,” said Dr. Jeanne Wei, a geriatrician who directs the Donald W. Reynolds Institute on Aging at the University of Arkansas for Medical Sciences.

“That’s just wrong,” Wei said. Many older adults remain in good health for a long time and “we’re lucky to live in an age when many remedies are available.”

Of course, peoples’ bodies do change as they get on in years. But this is a gradual process. If you suddenly find your thinking is cloudy and your memory unreliable, if you’re overcome by dizziness and your balance is out of whack, if you find yourself tossing and turning at night and running urgently to the bathroom, don’t chalk it up to normal aging.

Go see your physician. The earlier you identify and deal with these problems, the better. Here are four common concerns that should spark attention — only a partial list of issues that can arise:

 
Fatigue. You have no energy. You’re tired all the time.

Don’t underestimate the impact: Chronically weary older adults are at risk of losing their independence and becoming socially isolated.

Nearly one-third of adults age 51 and older experience fatigue, according to a 2010 study in the Journal of the American Geriatrics Society.  (Other estimates are lower.) There are plenty of potential culprits. Medications for blood pressure, sleep problems, pain and gastrointestinal reflux can induce fatigue, as can infections, conditions such as arthritis, an underactive thyroid, poor nutrition and alcohol use.

All can be addressed, doctors say. Perhaps most important is ensuring that older adults remain physically active and don’t become sedentary.

“If someone comes into my office walking at a snail’s pace and tells me ‘I’m old; I’m just slowing down,’ I’m like no, that isn’t right,” said Dr. Lee Ann Lindquist, a professor of geriatrics at Northwestern University’s Feinberg School of Medicine in Chicago.

“You need to start moving around more, get physical therapy or occupational therapy and push yourself to do just a little bit more every day.”

 
Appetite loss. You don’t feel like eating and you’ve been losing weight.

This puts you at risk of developing nutritional deficiencies and frailty and raises the prospect of an earlier-than-expected death. Between 15 and 30 percent of older adults are believed to have what’s known as the “anorexia of aging.”

Physical changes associated with aging — notably a reduced sense of vision, taste and smell, which make food attractive — can contribute. So can other conditions: decreased saliva production (a medication-induced problem that affects about one-third of older adults); constipation (affecting up to 40 percent of seniors); depression; social isolation (people don’t like to eat alone); dental problems; illnesses and infections; and medications (which can cause nausea or reduced taste and smell).

If you had a pretty good appetite before and that changed, pay attention, said Dr. Lucy Guerra, director of general internal medicine at the University of South Florida.

Treating dental problems and other conditions, adding spices to food, adjusting medications and sharing meals with others can all make a difference.

 
Depression. You’re sad, apathetic and irritable for weeks or months at a time.

Depression in later life has profound consequences, compounding the effects of chronic illnesses such as heart disease, leading to disability, affecting cognition and, in extreme cases, resulting in suicide.

A half century ago, it was believed “melancholia” was common in later life and that seniors naturally withdrew from the world as they understood their days were limited, Callahan explained. Now, it’s known this isn’t so. Researchers have shown that older adults tend to be happier than other age groups: only 15 percent have major depression or minor variants.

Late-life depression is typically associated with a serious illness such as diabetes, cancer, arthritis or stroke; deteriorating hearing or vision; and life changes such as retirement or the loss of a spouse. While grief is normal, sadness that doesn’t go away and that’s accompanied by apathy, withdrawal from social activities, disturbed sleep and self-neglect is not, Callahan said.

With treatments such as cognitive behavioral therapy and anti-depressants, 50 to 80 percent of seniors can expect to recover.

 
Weakness. You can’t rise easily from a chair, screw the top off a jar, or lift a can from the pantry shelf.

You may have sarcopenia — a notable loss of muscle mass and strength that affects about 10 percent of adults over the age of 60. If untreated, sarcopenia will affect your balance, mobility and stamina and raise the risk of falling, becoming frail and losing independence.

Age-related muscle atrophy, which begins when people reach their 40s and accelerates when they’re in their 70s, is part of the problem.  Muscle strength declines even more rapidly — slipping about 15 percent per decade, starting at around age 50.

The solution: exercise, including resistance and strength training exercises and good nutrition, including getting adequate amounts of protein. Other causes of weakness can include inflammation, hormonal changes, infections and problems with the nervous system.

Watch for sudden changes. “If you’re not as strong as you were yesterday, that’s not right,” Wei said. Also, watch for weakness only on one side, especially if it’s accompanied by speech or vision changes.

Taking steps to address weakness doesn’t mean you’ll have the same strength and endurance as when you were in your 20s or 30s. But it may mean doctors catch a serious or preventable problem early on and forestall further decline.

Family members of aging adults typically travel one of two paths to becoming a caregiver: the sudden sprint, or the gradual march.

The sudden sprint towards providing care for a loved one is often set off by an unexpected event—a stroke, a fall, complications from surgery—which acts as a catalyst, escalating your family member’s care needs practically overnight.

The gradual march in the direction of caregiving is less abrupt. You can’t say exactly when it began, but you’ve started noticing little changes in how your family member interacts with the world around them. Perhaps they’re getting lost while driving to the grocery store, maybe they’re having trouble keeping track of their medications, or balancing their checkbook—tasks they’ve performed countless times over the years, without any problems.

If an aging family member is consistently exhibiting these kinds of behaviors, they may soon be in need of extra care.

Here are 22 common signs your loved one may need extra help:
 

Physical

Fluctuating weight
Balance problems
Poor hygiene
Sleeping too much or too little
Unexplained burns and bruises (especially on the legs and arms)

Home Environment

Unkempt yard
Unusual carpet stains
Excessive clutter (several weeks’ worth of newspapers, piles of junk mail)
Unusual odors (urine, garbage)
Not enough food in the house
Failure to turn off stove, or water after use

Emotional

Mood swings
Abusive behavior (most likely verbal)
Lack of motivation
Uncharacteristically anti-social behavior

Cognitive

Confusion
Memory loss
Repetition
Hallucinations

Other

Dents and scratches on the car
Unfilled or untaken prescriptions
Unpaid bills

Whether these problems appear suddenly or slowly, they are all warning signs that indicate your loved one is having trouble attending to their own needs.

Being able to identify the presence of these red flags as soon as possible will enable you, your aging loved one, and the rest of your family to come up with a plan that ensures everyone’s needs get met.
 

Normal Aging, or Alzheimer’s Disease: What’s the Difference?

As a loved one ages, one of the questions that may come up for you and your family is how to tell the difference between the cognitive changes associated with “normal aging,” and those that could signal serious health conditions, such as dementia.

At this time, there’s no definitive way to distinguish between benign memory slips, Alzheimer’s, or other forms of dementia, but it may help to consider this as a general rule of thumb: occasionally misplacing the car keys is normal, while forgetting what to do with them is not.

Here are a few additional indicators that your loved one’s cognitive troubles may be caused by something more serious than the simple advance of age:

• Bad judgment (poor financial decisions, public outbursts)
• Movement issues (stiff movements, hunched posture)
• Loss of inhibition (saying or doing socially inappropriate things)
• Language problems (can’t form coherent sentences)
• Hallucinations and delusions (seeing things that aren’t really there)
• Trouble performing familiar tasks (can’t remember how to get to the doctor’s office)
• Memory loss that interrupts daily life (regularly forgets recent conversations)

Ultimately, it’s up to you and your family to determine if, and when, a loved one’s cognitive issues warrant investigation by a medical professional.

 
Provided courtesy of AgingCare.com, the go-to destination for family caregivers. AgingCare.com offers resources and support for those taking care of elderly parents. This article is one of a series of articles included in the eBook, Family Caring for Family. Download your free copy at www.AgingCare.com/ebook.

Has your loved one recently celebrated their 65th birthday? If so, then they now qualify for Medicare. Keep reading for a crash course on a few facts that you need to know about this program.

Medicare Eligibility is not Based on Income

Unlike Medicaid which is made available to individuals whose income falls below a certain income level, eligibility for Medicare does not depend on income. Medicaid is a fully federally funded program, whereas Medicare is paid for partly by Social Security and Medicaid taxes, partly by the premiums that people with Medicare pay, and partly by the federal budget. If you are age 65 or older, under 65 and depend on Social Security Disability Insurance, or have End-Stage Renal Disease, then you are eligible for Medicare.

There Are Four Different Plans

Once you qualify for Medicare, you have a range of plans available to you, and each plan offers different benefits. Original Medicare is comprised of Parts A and B. Once you turn 65, you’ll automatically be enrolled into Part A, which is a free program as long as either you or your spouse paid the Medicare payroll tax for at least a decade. Part B covers doctor visits and outpatient services, and there is an income-based component in determining cost. Part C, also called Medicare Advantage, is a private insurance option that covers the benefits of Parts A and B. Part D is a prescription drug plan that offers coverage for prescription medications.

You May Need Supplemental Insurance…But You May Not

Medicare is a wonderful program, but it doesn’t cover everything. Depending on your loved one’s healthcare needs, they may find themselves overwhelmed with copayments and deductibles. This is where supplemental insurance, or Medigap, comes into play. Medigap policies are sold by private insurance companies and mainly cover Medicare deductibles. Medigap can only be used alongside Parts A and B, so if you’re enrolled in Part C, you’ll need to drop out before your Medigap coverage begins.

Many seniors find that any savings that they get with a Medigap plan are offset by the monthly premiums, which can be several hundred dollars. For that reason, most find that unless they’re making weekly trips to the doctor’s office for expensive tests and lab work, Medicare sufficiently covers their needs.

There Are Several Enrollment Periods

When you turn 65, the government will send out an eligibility notice. If you’re already getting Social Security benefits, you’ll automatically be enrolled; otherwise, you’ll need to send in your application by the due date. If you don’t sign up for Part B during that time, you’ll have an opportunity to during the enrollment period that runs from the first of the year through March 31. However, you’ll pay a 10% penalty for every 12-month period that you delay in signing up for Part B, unless you are still employed.

If you are employed, you’ll have an 8-month period after you retire to apply for Part B without penalty. If you should miss that enrollment period, then you’ll need to wait for the open enrollment period, which runs every year from October 15 through December 7. During this time, you can also enroll in Parts C and D.

Medicare is a wonderful program that ensures that seniors are able to receive quality healthcare after they retire. To learn more about the program and the options available, visit the Medicare website.

As we’re approaching the holiday season, you may have opportunities over the upcoming months to visit family. These reunions often showcase how aging parents and other loved ones have changed over the course of the year. This time together can provide a wonderful chance for you to evaluate their health and quality of life and to recognize if any changes need to be made.

Keep reading to learn how to identify the common issues that your senior loved one may be facing.

General Health

Unfortunately, chronic health problems among seniors are not unusual. While aches and pains are often a part of the aging process, there are things to watch for, such as:

• • Frequent trips to the emergency room

• • Noticeable weight loss

• • Lack of appetite

• • Loss of interest in activities and socialization

If you notice any of these signs that your loved one’s general health is declining, then you may want to accompany them on their next visit to their doctor or talk to someone who can help you determine whether changes in your loved one’s care should be made.

Activities of Daily Living

Daily living activities are everyday tasks that must get done, whether we do them ourselves or have someone assist us with them. From basic tasks (bathing and grooming, eating, getting around the home and using the toilet) to more complex tasks (money management, transportation, housekeeping duties and shopping), there are a range of self-care activities that must be taken care of to ensure a high quality of life.

If you have the opportunity to visit a senior loved one over the coming months, try to take a discreet inventory of their food pantry and refrigerator, particularly if they live alone. Keep an ear out for any clues that they are struggling financially or that they have difficulty getting around town.

Mood and Mental Health

Has your loved one’s personality changed drastically since your last visit? Do you detect a hint of depression or anxiety that wasn’t there before, or do they express frustration over memory problems?

Cognitive changes are normal in older adults, and depression often accompanies traumatic events, such as the loss of a spouse or a change in their living arrangements. If your loved one seems disengaged or if their behavior is unusual, then it may be time to have a conversation with their doctor.

Safety

Most seniors wish to maintain their privacy and independence for as long as possible; unfortunately, this is often done at the expense of their safety and wellbeing. Here are a few areas of safety to watch for:

• • Are they managing their money well? Do they have the ability to buy what they need, and are you worried about them falling for scams?

• • Do they wander or get lost?

• • Have they had changes in memory or judgement that may jeopardize their safety?

• • Do they manage their medications well (taking the right pills at the right times, properly measuring dosage, etc.)?

• • Have they had car accidents or close calls?

• • Have they had changes in balance or ability? Are they prone to falls, or have they had frequent visits to the ER?

• • Is their home a safe environment with a proper heating and cooling system, grab bars and other accessibility aids?

Oftentimes, simple changes can be made to offset the challenges that come with aging, such as showing your senior loved one how to buy groceries and other necessities online, making their home more accessible or having a caregiver visit a few times a week. By observing your senior loved one this holiday season, you can ensure that they continue to enjoy a high quality of life.