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Exercise and COPD: an oxymoron?

Does Mom say she feels too weak to exercise? Does Dad run out of breath just walking down the street? People dealing with COPD often believe that exercise will make things worse. Actually, in moderation, quite the opposite is true.

Very real benefits. Even people with severe COPD can become more physical. Something as simple as arm lifts or singing can improve breathing and reduce fatigue. Exercise also helps with the fuzzy thinking many older adults experience with their COPD—because it gets more oxygen to the brain. Plus, people who engage in physical activity even just three times a week have been able to reduce the severity of COPD flares. If they have to be hospitalized, they get home sooner. Best of all, it’s not that hard to achieve these improvements.

Talk with the doctor first. Don’t challenge your loved one to a mile starting out! A balanced approach is required with COPD. The goal is to stretch breathing capability and stamina a little bit at a time without getting overly tired. Your family member’s doctor can give guidelines about when to stop and when to push past that initial feeling of “today is not a good day.”

Ask for pulmonary rehabilitation. The doctor may be able to prescribe a special exercise class for people with COPD. Exercising under supervision supports your loved one to feel safe. A class also presents the chance to talk with others who face the same challenges, which helps combat the isolation and depression that are common with COPD.

Tips for making it easier. Have your loved one

  • pick an activity that is pleasurable;
  • start small and increase gradually;
  • find an exercise buddy. This adds fun and supports commitment;
  • ask to be trained on “pursed lips breathing.” This technique makes it easier to exhale deeply and bring in enough oxygen.

Does better breathing feel impossible?
At Senior Care Management Services we have seen how people with COPD who didn’t think they could exercise can actually improve their breathing with very light, supervised activities. Even a physical therapist coming to the home a few times can guide your relative to exercises that will reduce that scary feeling of air hunger. Give us a call at 703-329-0900. As the Northern Virginia experts in family caregiving, we can help you get the support needed to make each day the best it can be.

 

Savoring good experiences

Sharing happy experiences, like sharing a good meal, warms and strengthens friendships and family bonds. There are other benefits to savoring positive experiences. Even in the privacy of your own thoughts, reflecting on pleasant memories is an easy and effective way to increase your overall happiness.

Hard wired to focus on the negative
Have you noticed that even a small negative event can grab your attention repeatedly over the day? Positive events, by contrast, rarely come back to mind. That’s human. Our brains are hard wired to pay attention to threats.

Retraining our brains
As a family caregiver, you may find yourself focused on the things that aren’t going well. This zaps your energy. It also sets you up for depression, a common occurrence when caregiving. Fortunately, as humans we can retrain our brains to notice the positive for a more-balanced assessment of our days.

Try this exercise

  • Before bed, write down three good things that happened over the day. They don’t have to be big events. Just things that felt positive. Maybe a good conversation or a leisurely walk. Include as much detail as you can.
  • For each one, also write down “why” it was positive. Knowing what uplifts you tunes you into future opportunities for positive activities.
  • Take 30 seconds to relive or savor each memory. Close your eyes. Were there particular smells at the time? Sounds? Thoughts? Immerse yourself in the full memory of the event.
  • If possible, tell others about the event over the next few days. The recounting of it helps seal it in your awareness.

Why it works
“Neurons that fire together wire together.” The more memory traces you create of positive experiences, the more adept your brain will become at recognizing the positives. You won’t lose your ability to identify threats. But you will form more-accurate assessments of your life and increase your overall sense of happiness.

Does the positive elude you?
If finding the positive is difficult, it may be a sign that you could use some caregiving help. As the Northern Virginia experts in family caregiving, we at Senior Care Management Services understand that it’s a lot to shoulder. Give us a call at 703-329-0900. Let’s talk and see what we can do together to bring more positives to your day.

When your parent drinks too much

Alcohol is a sensitive subject. Consider asking your parent’s doctor or a respected friend to initially bring up the subject. Tell them the reasons for your concern: slurred speech, unexplained falls or bruises. Be specific in your examples. Your parent will have less face to save with a trusted friend or professional than with their own child.

If you do talk, don’t say “alcoholic.” Even if it’s applicable, this is a loaded term. Tread lightly. A confrontation will just make your relative defensive and could jeopardize your relationship long term.

Instead, clear yourself of judgments about what he or she “should” do. Your relative is an adult and has the right to make unwise or unhealthy choices. He or she is doing the best they can, using the coping strategies that are readily available to them.

Open the door. Let them know that you notice some things aren’t working well and that you care. Rather than preach, create an invitation: “I notice you’ve been falling” (or losing weight, or seeming kind of withdrawn). “Are you concerned? Want to talk?” If yes, great. If no, just make it clear you’re available any time.

Casual help. Rediscovering meaning, purpose, and connection is one route to recovery. Separate from a conversation about alcohol, help your loved one explore ways to feel engaged with life, perhaps through involvement with others. Maybe you can go together to a social activity to make the first time easier. Or you might help remove barriers by providing transportation or covering costs.

Formal programs. Older adults also respond well to short-term interventions that address the specific isolation and loneliness of late life. If your loved one shows interest, help him or her find a recovery program that is geared to the needs and concerns of aging.

Is alcohol a problem?
Alcohol use is surprisingly common in late life. At Senior Care Management Services we see it frequently. As the Northern Virginia experts in family caregiving, we can help you strategize about optimal ways to approach the situation. Give us a call at 703-329-0900.

Late-life veterans’ issues

If the person you care for is a combat veteran, you may not have heard much about those experiences. You are not alone. In generations past, veterans made it a point to put the war behind them and “forget.” But things can take a dramatic turn in later life. As they face the challenges of serious illness, many vets start having symptoms that appear to be a delayed form of PTSD.

Common triggers
Physical pain, need for medication, or dependence on others can bring up old, traumatic memories. Dad may start to have nightmares or insomnia. Or you might notice an unexplained change in Mom’s temperament. Researchers believe this comes on because the stress of illness makes it too hard for the mind to continue suppressing the bad memories. For instance:

  • Trouble breathing from an illness such as COPD brings up past anxieties.
  • Pain can provoke memories of one’s own or another’s injuries.
  • Medications for pain or other conditions can cause fuzzy thinking. This in itself interferes with keeping combat memories at bay.

Moral and spiritual concerns
Sadly, combat veterans have experienced the worst humanity has to offer. Your family member may have had to bury feelings about things he or she was called on to do in the line of duty. As the reality of “meeting one’s maker” draws closer, overpowering emotions of shame, guilt, and regret may arise.

What you can do.
Veterans typically don’t like to talk about their wartime experiences. But they will talk with another vet. The Veterans Administration is aware of these late-life issues. They have counseling available for vets and for family members. In addition, hospice and palliative care programs often have a “We Honor Veterans” program. Their practitioners are specially trained to support the care needs of those who selflessly answered the call of duty.

Let us help.
At Senior Care Management Services we have deep respect for the contribution of our men and women in uniform. As the Northern Virginia experts in family caregiving, we can guide you to resources that will help ease the invisible wounds your loved one carries from their service. Give us a call at 703-329-0900.

Does Mom have a drinking problem?

Alcohol use is on the rise among older adults. And it’s not easy to spot. Many of the signs resemble common problems of aging. And who wants to think that when Mom stumbles, for instance, it might be because of drink?! There’s a lot of shame associated with drinking, so older adults—especially older women—often hide the activity.

Chronic drinking
About two-thirds of older adults with drinking problems have been drinking much of their lives. They’ve been “getting away with it.” Or they may have stopped in middle age, and then relapse in late life.

Late-life triggers
The remaining one-third of older adult drinkers with a problem are people who may even have been teetotalers in their youth. Keep your eyes open! Even if Dad never seemed interested before, alcohol could be his “comfort” now. Loss makes elders particularly susceptible, for instance after the death of a spouse or a move to a new living situation. Pain or failing health are other common triggers. Even something as happy as retirement can pull the rug out, removing friendships, identity, and daily routines. With so much idle time, it’s easy to fall into a drinking habit without realizing it. When one drink becomes two or three, it can lead to dependence.

Loss of meaning and purpose are huge culprits
Loneliness and isolation lead to depression and anxiety. Without social contacts, it’s just too easy to “self-medicate” the emotional pain with alcohol. Older women generally, and men who have lost their partners, are especially vulnerable to drinking in later life.

Signs of a drinking problem

  • Unexplained falls and bruises
  • Moodiness, irritability
  • Poor sleep
  • Weight loss
  • Forgetfulness
  • Changes in appearance and hygiene
  • Increased secrecy, hiding bottles

In a follow-up blog post, we will describe constructive ways to raise this sensitive subject with your loved one, as well as things you can do to help him or her.

 

Are you worried?
Maybe this is a new issue. Or maybe your relative has been a lifelong drinker at no small expense to the family. As the Northern Virginia experts in family caregiving, we at Senior Care Management Services know how delicate this issue can be. And sometimes even painful. Give us a call at 703-329-0900 to talk about the options. You don’t have to face this alone.

Balance exercises to prevent falls

If remaining independent is a goal for your older relative, bringing some balance to his or her life is essential—balance exercise, that is.

All it takes is short but consistent focus for Mom or Dad to significantly reduce the chance of a fall. In one study, two 15-minute sessions of balance exercises over a six-month period was enough to make a difference. That’s only 30 minutes a week. Depending on your situation, this may even be something you can do together.

  • Routines are simple. Mom won’t be daunted by the balance activities recommended by the National Institute on Aging. Standing on one foot and heal-to-toe walking are easy to do at home.
  • No muss, no fuss. No special clothing, no special gear, and not even much floor space is needed for balance activities. Dad can even hold on to a table or chair until he feels more stable.

Tai-chi
It turns out the most effective exercise for preventing falls is tai chi. This gentle activity has been practiced in China for centuries. Tai-chi involves slow, graceful movements combined with controlled breathing and awareness of the body’s position.

Research has shown that people who practiced an hour of tai-chi three times a week for three months experienced a 43% reduction in falls. They also had a 50% reduction in injuries from a fall.

Tai chi is best done with a teacher and in a class. But if that’s not an option, there are DVDs that teach tai chi. The local library may even have some to lend out.

Get the doctor’s okay first
There are many reasons a person might have poor balance. Just to be safe, ask for a fall risk assessment before starting an exercise program. You want to be sure your loved one has all the bases covered.

Does your Mom or Dad need help with balance?
The exercises aren’t difficult, but they do take time. And it’s much easier to stick with them if they can be done with others. Let us help you explore the options. As the Northern Virginia experts in aging well, we at Senior Care Management Services are quite adept at helping older adults become more physical and focus more positively on their bodies. Give us a call at 703-329-0900.