Living well and aging well

	A standing-room only crowd listens to the morning keynote session at the at the fourth annual Catholic Charities Aging Conference held May 15 at the Bishop O’Connor Center in Madison. (Catholic Herald photo/Kevin Wondrash)

MADISON — All of us want to know how we can live well and age well. Catholic Charities (CC) of the Diocese of Madison gave plenty of suggestions on making that happen at its annual Aging Conference.

The fourth annual conference held on May 15 at the Bishop O’Connor Center in Madison drew a record number of participants.

Bill Hamilton, director of Aging Services for Catholic Charities, welcomed those attending the day. “As a leader in providing aging services, Catholic Charities is happy to provide this community outreach,” he said.

He noted that CC has six programs for older adults: Elder Mentor, Companion Care, Respite Care, Adult Day Center, Caregiver Training, and the All Saints Neighborhood. “We have a really nice package of services for older adults,” said Hamilton.

Many of these programs, he said, are aimed at helping people stay in their homes. Exhibits at the conference featured CC programs as well as other community resources.

The day included two keynote speeches and a choice of eight breakout sessions.

Taking care of your heart

In the morning keynote speech, Dr. Patrick E. McBride, talked about “Taking Care of Your Heart.”

Dr. McBride is a professor at the University of Wisconsin School of Medicine and Public Health in cardiovascular medicine and the Department of Family Medicine at the UW School of Medicine and Public Health. He also directs the UW Hospital and Clinics’ Preventive Cardiology program.

Dr. McBride said he primarily works in heart disease prevention. “We talk about the body, mind, and spirit,” he said.

He noted heart disease and stroke are the leading causes of disability and death in the United States.

“But I have some good news,” said the doctor, pointing out that in the past 30 years, strokes have decreased by 70 percent and heart attacks by 50 percent. The decreases have led to prolonging life expectancy by over four years.

Strokes and heart attacks can be prevented, he said. However, there is a vast amount of information on how to do that, much of it available on the Internet. “Much of that information is wrong,” said Dr. McBride, warning that we have to be cautious about what we read.

He noted that many of the same risk factors for heart disease also apply to cancer: smoking, a poor diet (low in fruits and vegetables), and lack of physical activity.

The most common form of cardiovascular disease is blockages in the blood vessels. People must monitor their blood pressure, cholesterol, and diabetes (if they have it) for signs of trouble.

People can prevent blockages developing in their blood vessels by quitting smoking and eating a better diet. “Blockages are like a nuclear waste dump. They can rupture at any time,” said Dr. McBride.

Other risk factors for heart disease include obesity, stress, family history/genetics, and age.

He warned about the growing obesity trends, especially among children who spend too much time sitting and drinking too much soda.

Adults also are more sedentary and eat more meals outside the home.

“Take care of yourselves with a healthy lifestyle. Exercise and eat right,” said Dr. McBride.

He suggested the following actions to reduce the risk of heart disease and stroke:

• Daily activity, including 150 minutes a week of aerobic exercise and walking (8,000 to 10,000 steps a day of walking as measured on a pedometer).
• Healthy eating with a variety of foods, including fruits and vegetables. He suggested the Mediterranean Diet and the DASH Diet. The best foods are those we make ourselves, natural foods that are lower in sugar and salt, the doctor advised.
• Moderate use of alcohol (no more than one drink a day or two on social occasions).
• Avoid tobacco use. “If you don’t smoke, don’t start. If you smoke, quit. Avoid others’ tobacco smoke,” said Dr. McBride. “This is the most preventable cause of death in the U.S.”
• Use aspirin daily (best dose is 81 to 162 mg.), especially for men over age 50 and women over age 65.
• Control blood pressure and cholesterol.
• Maintain optimal weight. Even losing five or 10 pounds can help.
• Take your medicine!

Dr. McBride recommended a risk assessment tool available at healthdecision.org He also said the American Heart Association website (heart.org) as well as the government websites (CDC.gov and NIH.gov) have reliable information.

Understanding dementia

In the afternoon keynote session, Dr. Kim Petersen talked about “Understanding Alzheimer’s Disease and Non-Alzheimer’s Dementias.”

Dr. Petersen is a semi-retired dementia specialist who has worked in geriatrics and dementia services for more than 30 years.

Dr. Peterson defined dementia as “a medical syndrome of global intellectual decline in multiple domains,” such as: memory, calculation, language, and orientation. Also “activities of daily living must be impaired to qualify for a diagnosis of dementia,” he added.

Dr. Petersen said the issue of dementia is an important one for those who are aging, because the older one gets, the chances for dementia increase. Almost 50 percent of people age 85 and up have some form of dementia. He said over the next 20 years, this age group will grow significantly because of the Baby Boomers getting older.

Prior to a person suffering a dementia, he or she first has a “mild cognitive impairment.” This includes: increasing memory lapses and a progressive subtle decline in one’s performance of daily activities.

“If we’re ever going to have a treatment, much less a cure or a stabilization of dementia, it’s almost going to have to be at this level,” he said.

He added there is a lot of research being done at that level to try to determine what causes dementia — which could occur as a result of a progressing mild cognitive impairment into a dementia.

Two-thirds of all dementia sufferers have Alzheimer’s Disease.

Features of the disease include: difficulty learning and retaining new information, difficulty making a plan and carrying it out, difficulty making good decisions, language impairment, and difficulty understanding the purpose of objects.

There are seven stages to the disease, from a normal adult to suffering from a mild cognitive impairment to a very severe cognitive decline.

Fifteen percent of all dementia suffers have a type called “Lewy Body” dementia.

Lewy Body affects men more than women, and Dr. Petersen said it is often misdiagnosed.

Features of Lewy Body include: mild memory impairment, disorganized speech and visual hallucinations — which are experienced by 80 percent of Lewy Body patients. Other features include motor features of Parkinson’s Disease and REM sleep disorder, which can lead to sleepwalking.

Tying into the earlier keynote on cardiovascular health, Dr. Petersen next talked about vascular dementia. He said a stroke can increase the chances a patient will suffer a dementia.

Vascular dementias are more common in males, and their risk increases with advanced age.

Risk factors include: hypertension, heart diseases, diabetes, obesity, and smoking.

Dr. Petersen also talked about a dementia more common in people ages 45 to 65 called “Fronto-Temporal” dementia. Part of the brain will shrink as part of this disorder.

This particular dementia is not primarily a memory disorder, but changes one’s personality.

It also changes a sufferer’s judgment and hinders them from learning from their mistakes. Fronto-Temporal patients will do the same actions over and over again.

There will also be changes in their language ability — ranging from decreased speech to saying lots of words without meaning.

Physical activity

In one of the breakout sessions, Sue Wenker, a physical therapist at the University of Wisconsin-Madison, talked about “Physical Activity: What Is the Big Deal?”

She emphasized the importance of physical activity for good health. “We just don’t do enough of it. We sit too much,” said Wenker. “We need to get up and move around.”

People look for a “magic pill” for good health, and Wenker said physical activity is indeed that “magic pill.”

The benefits of regular physical activity — especially for older adults — include preventing heart disease and stroke, lowering high blood pressure, controlling diabetes, and preventing osteoporosis, obesity, colon cancer, breast cancer, anxiety, depression, risk of falls, and injuries from falls.

What is physical activity? Wenker said it is anything that makes you move your body and burn calories. This can include walking, jogging, swimming, biking, gardening, washing your car, or cleaning the house. “Something is better than nothing,” she emphasized.

Wenker suggested that older people should include four areas of physical activity in their lives: aerobic exercise (30 minutes of moderate intensity five days a week or 20 minutes of vigorous activity three days a week); strengthening activity two days a week on non-consecutive days to work major muscle groups; flexibility exercises two days a week, 10 minutes each day; and balance exercises to reduce the risk of falls.

“Our bodies are meant to move. As we age, we should keep moving,” Wenker said.

Better communication

In another one of the breakout sessions, speaker and trainer Karrie Landsverk talked about “Communicating to Build Positive Relationships.”

Landsverk specializes in communication, generational gaps, and relationships.

She said communicating can be a challenge because, “we view the world through our lens,” we think “our perspective is right,” and there is a “disconnect in delivery” between two or more people.

A big reason for these challenges, she said, is everyone is a different type of communicator. If one doesn’t learn, accept, or adapt to those differences, the challenges will remain.

“If you really want to be effective in your relationships, personal or professional, you need to be willing to be flexible and adapt,” she said. “We have to be the ones who are willing to meet in the middle or go beyond the middle because the whole point is you want to have them hear your message.”

“If your delivery isn’t effective in a way that they’re going to actually hear your message,” she added, “then what’s the point of it?”

Landsverk outlined four different types of communicators, which can be abbreviated as “TEAM” — “thinkers,” “engagers,” “adventurers,” and “movers.”

“You need all of these styles represented if you want that functioning team or organization,” she said. “You want them to feel they all have a voice because they all have unique strengths.”

Thinkers were defined as those who: seek facts to understand, plan before taking action, play by the rules, and are uncomfortable with impulsive decisions. Landsverk used the analogy of thinkers in a grocery store will have a list, be very organized, and be in-and-out with a calculator on hand to make sure everything was right at the check-out.

Engagers were defined as those who: value relationships, thrive on positive attention from others, enjoy and need small talk, and show a wide range of emotions. Landsverk said engagers go to the grocery store not because they have to, but because they want to talk to people. They’ll make small talk and want to have a good time.

Adventurers were defined as those who: value creativity and freedom, are creative in their communication, speak rapidly and use humor, exaggerate, and think outside the box. Landsverk illustrated adventurers saying they are crisscrossing in aisles in a grocery store and are sometimes easily distracted. They would never have a shopping list.

Movers were defined as those who: make decisions quickly, are goal-oriented, competitive, and multi-task while speaking. She said movers likely wouldn’t go to the grocery store; they would probably delegate the duty to someone else. If they do go, it’s because they have to, and they would probably use a self checkout line.

Landsverk said most people are likely to be a blend of several or all the styles, but one will be dominant most of the time.

She also emphasized “no style is better than the others.”

In order for communication between others to work, Landsverk said, one has to adapt to the other styles. She added, “we can only control us,” and it’s important to “control how we respond to others.”

In order for everyone in a group be to heard, Landsverk said, one should “create the opportunity that allows all to express their thoughts and opinions, focus on message versus delivery, and value strengths, rather than limitations.”

Self-care strategies

In an afternoon breakout session, Peggy Weber, a registered nurse, talked about “Ten Self-Care Strategies for Life.”

Weber especially discussed the importance for caregivers to take time to care for themselves and value themselves.

Her 10 strategies were:

1. Take care of yourself by trusting and understanding yourself. She suggested people have to stop and think to find peace in themselves. Silence is the beginning of peace. “Have some quiet time. Just sit and be quiet and pray,” said Weber.
2. The art of valuing yourself involves being assertive — not being aggressive, but gentle and assertive. People should say how they feel to family members and friends. Sometimes writing it out ahead of time or talking in front of a mirror helps.
3. The art of valuing yourself involves embracing your polarities. Pay attention to opposites and inner-pulls in yourself.
4. The art of valuing yourself involves recognizing and dealing with your own grief and loss. Sometimes this doesn’t just mean death, but changes of all kinds, such as moving, losing a job, or health changes. “Whenever there’s a change, there’s a loss. Whenever there’s loss, there’s a grief reaction,” said Weber. “We need to express our grief. Seek out and ask for support.”
5. The art of valuing yourself involves learning to let go. “Let go of people and situations that we can’t change,” Weber advised.
6. The art of valuing yourself involves choosing “nourishing” rather than “toxic” relationships. Weber suggested doing a “relationship inventory” to determine how we feel about relationships and whether they are positive or negative, whether we feel valued and loved, and whether we can openly resolve conflicts.
7. The art of valuing yourself involves dealing constructively with your anger. “We have to learn to deal with anger and direct it in a positive way,” said Weber.
8. The art of valuing yourself means taking care of your body. Take time for movement, exercise, and relaxation. “Each day, do something for yourself,” said Weber.
9. The art of valuing yourself involves making your home a haven, a quiet retreat. Weber suggested everyone should have a room with a chair, couch, or piano where we can be quiet.
10. The art of valuing yourself involves developing meaning and purpose in life. Make a list, and prioritize where you want to put your energy.

Talking about driving

Another of the afternoon breakout sessions was called “We Need to Talk: Conversations About Driving.”

Darcie Olson, occupational therapy assistant instructor at Madison Area Technical College, discussed the difficult topic of talking with older loved ones about limiting or stopping driving.

She said older drivers, while mostly safe on the roads, do have an increased risk of accidents or injury, especially with changes in medication and declines in physical and mental functions.

Olson added older drivers prefer conversations about their safety be handled within the family, with the exception of possibly including a doctor in the talks as well.

“Never assume it’s an easy process to hand over the keys,” Olson said. She added friends and family “can’t just assume old people don’t need to drive.”

People who stop driving often feel depressed, angry, or socially isolated.

Olson said friends and loved ones should “recognize warning signs” and “not let them go by” if there are concerns over driving.

Some of these signs could include scrapes on the car, near misses, and confusion operating the vehicle.

When it comes to discussing these observations with an older driver, Olson encourages everyone to “avoid overreacting,” “discuss the observations,” and “make objective decisions,” such as limit driving or stop driving immediately.

When an older loved one needs to stop driving immediately, Olson said it’s important to remove his or her access to the car — make sure you have all of the keys or they can’t easily get access to a car if they get rid of it. She also said it’s important to figure out transportation alternatives to keep them active and social.

Olson added there are many reasons why these conversations with loved ones can be a challenge. One is overall discomfort with the situation. Another is a role reversal; sometimes where the son or daughter needs to tell their parent what is best for him or her. Another is a desire to avoid whatever conflict may arise from bringing up the topic. Sometimes a child will also recognize an additional burden stemming from the parent not being able to drive anymore, or on a limited basis.

Olson said there are a number of assessments to determine an older person’s driving abilities.

One of these is “CarFit,” which is a free assessment of a driver’s fit inside of his or her car. More information is available at www.car-fit.org

Another is with a certified driving rehabilitation specialist through the American Occupational Therapy Association (AOTA). These will require a doctor’s referral and may be covered by insurance. They can include vision and visual perception testing, cognition testing, and strength or other performance tests.

For more information on seniors and driving go to www.aarp.org www.aota.org or www.YouTube.com with keywords “senior driving.”