By: Alexandra Curkovic,  clinical nurse specialist, Hospital Elder Life Program 

Have you ever heard of delirium? This disorder isn’t commonly understood, but it is a common concern among older adults in the hospital (it can also affect kids).
It’s an acute disorder, which means it usually appears suddenly and doesn’t typically last too long. It can develop in as little as a few hours and symptoms tend to fluctuate in severity throughout the day. People with delirium have problems in attention and awareness. It is most common in older patients who are hospitalized, but the symptoms are not always easy to identify.

A patient with delirium may have difficulty following a conversation and may get confused about their environment to the point that they don’t recognize they are in the hospital. Changes to the patient’s physical environment—like moving a patient to a new room—may make symptoms worse.

What does hospital delirium look like?
People with delirium can act confused and may:• have trouble paying attention
• be forgetful
• be restless and upset
• have trouble concentrating
• startle easily to any sound or touch
• slur their speech
• ramble and jump from topic to topic
• not know where they are
• have trouble staying awake
• see and hear imaginary things
• mix up days and nights
• act confused for a short period of time during the day and then be suddenly okay
• drift into sleep during conversation

Delirium can have serious, negative effects on a person’s ability to function independently and can affect their quality of life long term. It can also increase a person’s likelihood of developing dementia.

A patient’s perspective on delirium:

John Vlainic, a former Hamilton Health Sciences employee, experienced delirium while he was in the hospital being treated for a serious infection. He describes the experience as completely disorienting. “I remember being adamant there were men on the roof outside my hospital room window,” he says, recalling one of the visions he imagined. “I also became convinced the machine warming my oxygen was dangerous. I decided I would unplug it in the middle of the night.”

John’s wife Ruth says it was concerning seeing her husband in this state. They were glad when his delirium started to lift after a couple days.

What’s the difference between dementia and delirium?

Dementia develops over months, with a slow progression of cognitive decline over years. On the other hand, delirium occurs abruptly over a few days or weeks, and symptoms can come and go during the day. A person with dementia is much more likely to develop delirium when hospitalized.
The main difference separating delirium from dementia is inattention and level of alertness. The individual with delirium simply cannot focus on one idea or task. This inattention is usually present in later stages of dementia.
Level of consciousness for patients with delirium may fluctuate from very tired to very easily startled state whereas patients with dementia are normally alert unless they are in the later stage. .

Risk factors for hospital delirium:

There are several risk factors that can make a person more likely to develop delirium. The tips below will help you to reduce these risk factors in the hospital:

1. Cognitive impairment: People with existing dementia or mild cognitive impairment are more likely to develop delirium. Look out for signs of changes in thinking like memory loss or difficulty with daily tasks.
How to help: If someone has cognitive impairment, keep their mind active while they’re in the hospital. Ask questions about current season, holidays, past hobbies and family members. Bring familiar items, like board games or books to their room to help occupy them.

2. Sensory impairment: Hearing or vision loss can make it more difficult for someone to assess their surroundings and can contribute to delirium.
How to help: Bring their sensory aids with you to the hospital and label them. If they typically wear hearing aids or glasses, make sure they wear them during their hospital stay.

3. Loss of mobility: Lack of movement can make someone more likely to develop delirium. A patient who walked independently before hospitalization may feel unsteady during their illness or after an operation, and need assistance with a walker or other mobility device.
How to help: Advocate for removal of tethers such as IVs and oxygen tubes, and urinary catheters. Encourage the patient to move throughout the day to keep their muscles strong. Family members can help!

4. Dehydration: When people get dehydrated, they are significantly more likely to develop delirium.
How to help: Watch out for physical indicators of dehydration like muscle weakness, speech difficulty, dry mouth and a pale lining inside of the mouth. Encourage drinking throughout the day. Talk to the care team to make sure your loved can safely drink.

5. Recently added medications: New medications can increase someone’s risk of delirium. The medications most often associated with delirium are benzodiazepines and anticholinergics.
How to help: Discuss alternative medications with the care team to reduce risk.


If delirium develops while your loved one is in hospital:

• Tell the staff right away if you see a change in thinking.
• Develop a plan of care with the staff to help with the confusion.
• Try to redirect to current season, date and place. Explain why they are in the hospital. You may need to repeat this many times. Do not argue if they see things differently.
• Continue to ensure glasses and hearing aids are worn if needed.
• Continue to ensure your loved one is eating and drinking well. Ask your nurse if it is okay to feed your love one.
• Continue to encourage walking.


Hamilton Health Sciences has a Hospital Elder Life Program (HELP) service available for patients over 75 who are in select clinical areas at Hamilton General or Juravinski hospitals. If your loved one develops delirium, ask if these services are available on their unit. Click here for more information about the HELP Program.
This helpful handout provides more information for patients and families can learn more about preventing delirium while in the hospital.

Each year, approximately 1,300 individuals in Ontario are admitted to long-term care (LTC) within 180 days of an acute care hospitalization for stroke or transient ischemic attack (TIA).  To better understand the sociodemographic characteristics and burden of care for stroke survivors admitted to LTC, a new provincial report was released by CorHealth Ontario and the Institute for Clinical Evaluative Sciences, entitled:  Ontario Stroke Evaluation Report 2018: Stroke Care and Outcomes in Complex Continuing Care and Long-Term Care. This report provides a review of data between 2010 and 2015, and delves into the nature and extent of rehabilitation therapy and stroke best practices available to stroke survivors in these settings.

The intent of this report is to inform system planning, facilitate and advocate for system change, and identify opportunities for quality initiatives and research.
Of stroke survivors residing in LTC, key findings for 2014/15 include the following:

• 2% were women
• 3% required extensive assistance with activities of daily living
• 8% were at high risk for depression
• 4% experienced bowel incontinence and or 61.3% were reported to have bladder incontinence
• 3% had severe cognitive impairment
• 6% were considered to be socially engaged
• 9% were admitted to inpatient rehabilitation prior to admission to LTC (an increase from 21.5% in 2010/11)
• 4% did not receive any core therapies (i.e. physiotherapy, occupational therapy and speech-language pathology) and no stroke survivors received all three core rehabilitation therapies. Given that time spent in therapist-supervised core rehabilitation is calculated over a 7-day period, the median number of minutes of physiotherapy received per day was 6.4.  Only negligible amounts of occupational therapy and speech-language therapy services were provided.
• 4% received nursing restorative care programming (a decrease from 28.5% in 2010/11)
• 5% experienced a fall
• 3% diagnosed with atrial fibrillation received anticoagulant medication within 90-days of discharge from acute care
• 1% died within 6 months of admission to LTC following their acute stroke or TIA.

Also of note were the low health-related quality of life scores (mean = 0.37 out of 1) and the proportion of stroke survivors in LTC over 85 years of age, which increased from 36.1 to 40.8 per cent over the five-year period.
Conclusions from the report specific to LTC are outlined below:

1. Stroke survivors in LTC settings have high care needs requiring extensive assistance with activities of daily living. Their low degree of social engagement and poor health-related quality of life are concerning.
2. Rehabilitation for stroke survivors in LTC is almost exclusively physiotherapy. The time spent in rehabilitation therapy and recreation therapy per day is minimal, and access to physiotherapy and nursing restorative care in LTC has declined over time. The low health-related quality of life scores may be attributed to the limited rehabilitation, nursing restorative care and recreation therapy, and the prevalence of depression and pain.
3. Defining the role of LTC in the stroke recovery trajectory will become more imperative as the shifting demographic is predicted to result in an increasing number of LTC admissions and increased stress on the overall health care system.

MORE: PUTTING A STROKE COACH IN EVERY PATIENT’S CORNER

This report also outlines the following recommendations specific to LTC which address changes at the system, regional and facility level:

1. Limited provision of rehabilitation to stroke survivors in LTC warrants review of resource allocation/care models for rehabilitation therapy and nursing restorative care programming to inform an appropriate model for this setting.
2. Regional Stroke Network Community and LTC Coordinators should advance stroke best practices and LTC staff education by:
   • Leveraging existing stroke care resources (e.g. Taking Action for Optimal Community and Long-Term Stroke Care©, Stroke Care Plans for LTC, etc.), existing technology (learning management systems, software solutions) and partnering with stakeholders such as the RNAO LTC Best Practice Coordinators.
   • Supporting specialized training of LTC staff in secondary stroke prevention and highly prevalent post stroke complications such as urinary incontinence, fall prevention, pain management, and post stroke depression.
   • Supporting LTC facilities in modifying care planning libraries to include best practice care interventions as outlined in the Stroke Care Plans for LTC (e.g., integrate the Stroke Care Plans into care planning libraries where gaps are identified).
   • Collaborating with LTC facilities to sustain current efforts and explore further innovations in fall prevention strategies and programs to promote safe mobility.

The LTC representative from your Regional Stroke Network is available to provide further information and to support quality initiatives aimed at enhancing  best practice stroke care provided to residents of Ontario LTC Homes. To access this representative within your area, please email CorHealth Ontario at info@corhealthontario.ca.

Direct Link: hospitalnews.com/ontario-stroke-evaluation-report-2018-stroke-care-and-outcomes-in-complex-continuing-care-and-long-term-care/

Submitted by Community & LTC Coordinators of the Ontario Regional Stroke Networks.

What It’s Really Like

Almost everyone knows someone who’s had cancer. But you might not be aware of everything they’re going through. To show someone you care, it helps to know what their day-to-day life is like, including things they may not tell you. If you take your cues from your loved one, you’ll be ready to help them during what can be a very hard time.

Offer the Right Kind of Help

“Let me know if I can do anything.” It sounds kind, but it puts the burden on your loved one to ask you. It’s better to make a concrete suggestion, such as, “Can I bring you dinner on Tuesday?” or “Want me to come to your next doctor visit? Call when you’re on the way to the grocery store and ask if you can pick up any items on their list. When someone has a serious illness like cancer, they might not want to ask for help but would love it if you stepped up without being asked.

Don’t Compare

If your aunt, co-worker, or neighbour had the same type of cancer as your loved one, try not to bring it up. Cancer is complicated, and although there may be some similarities, no two people have the same emotional and physical experiences. Listen to what theirs is, and they’ll appreciate that.
 
Stay in the Picture

You might find the thought of cancer overwhelming, and that’s OK. Your loved one probably does, too. If you don’t know what to say, that’s also OK -- they might not, either. A simple “I’m thinking of you” goes a long way, even if you don’t know what else to do. Send a card or an email. Talk about a book you read, a movie you saw, or a lunch you had with a mutual friend.

You Can Talk About Your Life

If you feel hesitant to talk about your life or send pictures of fun activities, relax. Your loved one would probably love to connect and hear about what’s going on with you. They still want a real relationship. When they hear your news and see what you’ve been up to, it gives them a break from thinking about their own situation.

Try to Be There

If you’re in the area, it’s nice to offer to go to a doctor’s appointment or treatment. This is especially true for someone who doesn’t have family nearby. Chemotherapy infusions take hours, and often people aren’t supposed to drive home afterward. You can offer to help with transportation, visit during the infusion, or both.

Call First

Just like with anyone else, check in before you visit. Your friend might be getting ready for a nap, or she might have a low white blood cell count and must avoid being around others. Or she may have appointments and isn’t available. Make sure she knows you’re coming and is up for it.
 
Take Visits One at a Time

Both during and after treatment, your loved one’s physical and mental energy levels can change, even by the hour. Nausea levels can change by the minute. If you have an awkward visit with your friend who doesn’t feel well at the time or who must cancel a visit, reach out again. If you have a great visit, know that it might be different next time but still means a lot.

You Don’t Have to Gush

It’s fine to give your loved one a compliment. But you don’t need to make a fuss over how good someone looks. They may wonder if you expected them to look awful. Remember that you can’t see cancer and or any pain someone may be feeling. And they probably don’t want to hear that they look tired or that they should be resting.

Touch Is Powerful

Offer a hug. Cancer can often involve a lot of physical pain, from chemotherapy, ports, surgeries, and a wide range of side effects. Someone who’s going through it might want to have some form of physical touch that doesn’t hurt. They might appreciate a hand massage, a hug, or a back rub. Ask them first.

Try Not to Give Medical Advice

It's great to ask how treatment is going and show your support. But don't suggest alternative treatments to replace their medicines, and remember that someone else's plan might not be right in this case. Encourage your loved one to share their concerns and questions with their doctors.
 
Pep Talks Are Tricky

You might want to say, “You will beat this!” And that might be true. But some people don’t like battle language, especially if their cancer is in a later stage. Their idea of “winning” might be different from yours. Also, your friend or loved one might want a cheerleader but not unrealistic talk. Listen for how they feel about their condition so you can show them your support, encouragement, and care.

What Not to Bring Up

Don’t ask about their odds. If they want to bring it up, they will.
Don’t call their cancer “the good kind.” They’re all hard to deal with, even if the outlook is good.
Don’t ask if they ever smoked, what they ate, or other lifestyle habits that could provoke shame or guilt.

Remember Their Family, Too

When one person has cancer, the family feels it, too. Ask close relatives how they’re doing. They may be having a tough time and a lot to do. Be there for them, too. It will mean a lot to your loved one who has cancer.

They May Have Mixed Feelings

Your loved one wraps up their cancer treatment. She might feel relief and gratitude to be done with it. Or she might feel concerned about the chance that their cancer could come back. Or she might have waves of all of those emotions. Plus, she might not have the energy or feel like her old self. After cancer, people need time to adjust.

Sources | Medically Reviewed on 12/04/2018
This tool does not provide medical advice. See additional information.

There is no one face of addiction: It affects individuals from every demographic regardless of gender, age, race or socioeconomic status.  Despite this, there is a prevailing misconception that older adults are not as vulnerable to substance abuse. Research however, shows that addiction in adults 65 years and older is a growing problem that is often under diagnosed and therefore, under treated.
 
Addiction Causes:
 
Older adults are particularly at risk at risk for prescription drug abuse because they are more likely to take medications to address co-occurring and age–related conditions.  These drugs which often have a high potential for addiction, include: 

• Opioids – used for pain management. Examples are Oxycodone, Fentanyl, and Morphine.
• Stimulants – used to enhance brain activity.  Examples are amphetamines and methylphenidate.
• Benzodiazepines – used to treat anxiety and insomnia. Examples are Diazepam, Chlordiazepoxide HCL, and Alprazolam.

 
Prescription drug abuse occurs when an individual misuses the medicine in a way that is not instructed by their doctor- such as taking more medication than prescribed or mixing the drug with alcohol.
 
The concurrent use of different medications is frequent among older adults. According to the Substance Abuse and Mental Health Services Administration (SAMHSA) 30 percent of people age 57 to 85 take at least five prescriptions, increasing the risk of unintended drug interactions and dependency.  In addition to the increased availability and accessibility of prescription drugs as persons get older, their body changes.  These changes will change the way their body absorbs and metabolizes medication, making them more vulnerable to addiction than a younger adult.
 
Older adults are going through stressful life changes, such as the loss of a spouse, development of a chronic illness, decreased mobility, all of which can contribute to depression and substance abuse.
 
Consequences:
 
The abuse of prescription drugs impacts the overall health of older adults in several ways. Medications can increase the risk of falling or having an accident; they can worsen neurological, respiratory, and other age-related conditions.  Overall, patients who abuse prescription drugs tend to have higher rates of morbidity.
 
Signs of Addiction:
 
Family members, caregivers, and health care providers mistake the signs of drug abuse for other physical and mental disorders associated with age.  Older adults are also more likely and able to hide their substance abuse as they are often retired and not prone to getting in trouble with the law, so there are seemingly less negative consequences to their behavior.
 
If you are concerned about an older adult’s us of prescription drugs, here are some signs to watch out for:

• Use of medications not as prescribed by the physician.
• Seeking a prescription from multiple doctors or filling prescriptions at multiple pharmacies.
• Behavior changes, such as becoming angrier or withdrawing from everyday activities.
• Defensive about and making excuses for taking the medication.
• Hiding medication.
• Previous substance abuse problems.

 
 What you can do:
 
When seeking help for an elderly patient contact: 
ConnexOntario 1-800-531-2600 for access to Addiction, Mental Health and Problem Gambling Services.
 
This article was taken from WebMD, with some modifications. 

Have you ever wondered how some people manage to look ageless?

Well into their 80's they have a youthfulness that belies their age, and still participate in activities that younger adults enjoy.

There are many factors affecting how we age but aging well, without mental and physical stress on our bodies, is within the reach of us all. Through a few simple daily practices and preventive measures, we can experience our senior years with a quality of life rather than simply clinging to life.
 
Tips for aging successfully:

• Prevention: Many diseases in later life are preventable through even minor lifestyle changes, even for people with chronic disabilities.
• Nutrition: Nutrition is an important component of aging well, since it improves physical well-being while regulating stress and promotes social inclusion and participation.
• Physical activity: Physical activity reduces by about 50% the risk of many disorders related to inactivity, such as heart disease and type 2 diabetes.
• Mental health: Total health is not merely about the absence of infirmity or disease but a state of complete physical, mental and social well-being.
• Join a program: In Canada, the New Horizons for Seniors Program is designed to empower seniors, encouraging them to share their knowledge, skills and experience with others in the community and enhance their social well-being.

 
Public Services Health & Safety Assoc.

Many people find it difficult to cope with grief in the winter months. This article by What's Your Grief offers some helpful tips to deal with these cold-weather challenges and maintain your mental health in the wintertime:


1.  Lack of SunlightA lack of sunlight, or the length of the night in some cases, can cause an increase in melatonin and a drop in the neurotransmitter serotonin and Vitamin D.  All of this can throw your mind and body out of whack and leave you feeling tired, irritable and blue.

Tip:  Do what you can to get outside, open the blinds, and hold on until daylight savings time.

2.  Cabin FeverCabin fever is not a technical diagnosis but it is a well-documented phenomenon (think early US settlers who spent long winters alone in their cabins). Cabin fever describes a state of restlessness, depression, and irritability brought on by spending time in a confined space or remote area.
Where grief is concerned, being stuck inside provides you with ample time to spend ruminating, thinking of your loved one, focused on difficult emotions, and replaying unpleasant memories with little distraction.

Tip:  It’s okay to spend time focused on your grief, but also find constructive ways to occupy your mind like puzzles, movies, games, organizing, home repairs, calling a friend, creating art, or writing in your journal.

3. Social IsolationThe predisposition for grievers to withdraw combined with cancelations, problems with transportation, and a desire to avoid the cold and snow can amplify your risk of falling into a cycle of emotional and social isolation.  Isolation and loneliness can have a negative impact on your physical and emotional health, which we discussed in detail in this post.

Tip:  Get out and go to a mall, store, support group, or place of worship.  When possible, push yourself to keep plans even if it means braving the cold.

4.  Not moving enoughYou already know that even a small amount of exercise can have a marked impact on your physical and emotional health.  Obviously, in winter your options for getting out and moving around are limited.  Snowy roads, icy sidewalks, and the cold make it virtually impossible to find many opportunities for exercise.

Tip:  Even though taking an hour long walk outside might not be possible, look for alternative opportunities to get at least 20 minutes of exercise a day.  Try walking outside for shorter intervals, get an exercise DVD, plan an indoor workout routine, or join a gym.

5.  Poor eating and weight gainThank goodness for bulky sweaters, am I right?  Studies show that caloric intake tends to increase about 200 calories a day beginning in the fall.  The rationale behind this increase is debatable as some researchers believe primitive impulses drive humans to stockpile calories in anticipation of short days and cold weather, while others think there’s just more opportunity to indulge in the winter (holidays, time spent inside, and the nostalgic connections associated with food). Regardless of why you eat, bad food can leave you feeling gross on many levels.

Tip:  Are you giving yourself permission to eat badly because you’re sad?  Are you eating out of boredom?  Are you eating certain foods because you associate them with the cold weather or holidays?  Be careful and be mindful of what you’re eating and why.

6.  It’s coldThat’s all.  Being cold is torture.

7.  You’re sadFor some, the holidays present a storm of grief triggers followed by months of feeling blah (see all of the above).  It’s possible that the events of November and December have set you adrift on a long grief wave that won’t recede until the spring thaw.

Tip:  Believe that things will get better and check out our section on coping with grief.

8.  You’re SADWinter-onset seasonal affective disorder (SAD) is a subtype of major depression that is characterized by symptoms that emerge in fall or early winter and recede during the spring.  These symptoms may start out mild and become more severe and include things like irritability, tiredness or low energy, problems getting along with others, hypersensitivity to rejection, heavy feeling in the arms or legs, oversleeping, appetite changes (craving carbs), and weight gain.  It goes without saying that SAD can complicate one’s ability to cope with grief and other hardship.

​Tip:  If you think you might suffer from SAD read more about it here and talk to your doctor about your concerns.

Alzheimer’s Awareness Month – January 2019
From: Public Health Agency of Canada

Statement

This year, during Alzheimer’s Awareness Month, I would like to reflect upon the journey of the many Canadians impacted by dementia. As the Minister of Health, I have heard from many individuals, families and caregivers of their experiences. As a daughter of a parent living with dementia, I know first-hand the toll it takes on individuals and their loved ones. 
I am proud to report that the Government of Canada is taking tangible steps to address the challenges of dementia and to improve the quality of life for the more than 400,000 Canadians aged 65 and older living with diagnosed dementia, as well as their families and caregivers.
I recently launched the Dementia Community Investment Fund that will provide $4 million annually for communities to address the challenges of dementia. Projects will promote awareness, address stigma, and equip families and caregivers with resources and tools to support people living with dementia while minimizing the impact on their own quality of life. Improving society’s understanding of dementia will help break down the barriers to treatment and make it easier for Canadians to ask for help when they need it.

The Centre for Aging and Brain Health Innovation, with continued support from the Public Health Agency of Canada (PHAC), is developing, testing and scaling-up products and services to support brain health with a focus on dementia. And with support for the Canadian Institute of Health Research, innovative research is bringing us closer to finding effective treatments and improving quality of life. 

​Finally, work is well underway to develop the National Dementia Strategy. Last May, PHAC’s National Dementia Conference brought together a broad range of stakeholder groups and partners from across the country, including individuals with lived experience to help inform the strategy. Their perspectives and valuable input will help ensure that the strategy reflects the needs of Canadians. 
This month, please join me in recognizing the Canadians affected by Alzheimer’s and dementia, as well as the extraordinary dedication of caregivers. I look forward to our continued work together to improve their lives. 

The Honourable Ginette Petitpas Taylor, P.C., M.P. 
Minister of Health

Official link to statement: www.canada.ca/en/public-health/news/2019/01/alzheimers-awareness-month--january-2019.html

Eat Healthier
As you age, your body still requires healthy foods, but you will need fewer calories. Strive to eat fruits, vegetables, whole grains, fish, low-fat dairy and healthy fats. Eat at least five servings of fruits and vegetables each day in a variety of colors. Eat nuts and beans daily along with fiber-rich whole grain bread, brown rice, and whole-grain pasta. Try to avoid fatty meats by choosing lean-meat options like chicken or turkey. Also, you can eat heart-healthy fish a couple of times each week. Add sources of calcium and Vitamin D to your diet like milk, yogurt or cheese. Healthy fats are great options (like olive and canola oils). You can spice up your food to add extra flavoring when cooking. You can seek out healthy choices through your physician or a dietitian.

Consider Dietary Supplements and/or a Multivitamin
Consult your healthcare provider regarding any supplements or vitamins that you would benefit from. There are over-the-counter options that may be helpful in your quest to stay as healthy and strong as possible.

Be Active
Even if you have a diagnosis that impacts your health (like heart disease, diabetes or arthritis), physical activity can still be safe for older adults. If so, this is encouraged and can often help with some of the symptoms related to these conditions. There are local resources available for you to explore exercise opportunities. www.canada.ca/en/public-health/services/publications/healthy-living/physical-activity-tips-older-adults-65-years-older.html

Visit your Healthcare Provider
As a rule of thumb, you should schedule an annual wellness check with your healthcare provider around your birthday. At this visit you can discuss any changes or concerns that you may have, the current medications that you’re taking, and any recommended health screenings or immunizations. The screenings may test your hearing, vision, or other conditions such as osteoporosis or breast or colon cancer. Of course, if you have any concerns about your health you should schedule an appointment with your provider right away. If you need help finding a healthcare provider, the following link can assist you with the search: www.ontario.ca/page/find-family-doctor-or-nurse-practitioner

Limit Your Alcohol
At any age, excessive alcohol consumption should be avoided as it can make you feel depressed, cause trouble sleeping, make you feel physically ill, and cause overall health problems. Older adults should be extra careful because it can interact with medications and increase your risk of falling. One drink is considered 12 ounces of standard beer, 5 ounces of wine, or 1.5 ounces of hard liquor. Older men should limit their intake to no more than 2 drinks daily, and older women to 1 drink daily. (There are variables to this based on other factors, such as weight.)

Prevent a Fall
Falls are the leading cause of injuries in older adults, and in fact, one in three older adults fall each year. There are steps you can take to help prevent a fall as well as exercises that can increase your strength, balance and flexibility. Check with your healthcare provider regarding medications you may be taking that increase your chance of falling. Remove items like rugs from the home that can cause you to trip and fall, and add night lights to help you see better in the dark. You can also install grab bars in the shower and seek out other equipment that may help with mobility. Check out the Government of Canada's website: www.canada.ca/en/public-health/services/health-promotion/aging-seniors/publications/publications-general-public/you-prevent-falls.html

Keep Your Brain Busy
The more you use your brain, the better it works. There are plenty of things you can do to engage your mind like read, do crossword puzzles or play solitaire or Sudoku. Socialization is also a great way to give your brain a boost, so explore social opportunities in your area such as clubs or senior center discussions. You could also volunteer, take a community education class, or even take a college course. Some colleges offer free courses for senior citizens.

Stop Smoking
It’s safe to say that if you’re a smoker, you already know that it’s a bad habit. Many older adults who smoke have been smoking most of their adult life. It’s never too late to quit! You can still reduce health problems, breathe easier, increase your energy and sleep more soundly if you stop smoking. Ask your healthcare provider for help with this. Even if you haven’t succeeded at quitting in the past, you shouldn’t give up hope. On average, most smokers who successfully stop smoking tried 4 times to quit before they gave up the habit. You can access breakitoff.ca  for additional resources.

Speak Up About Your Mental Health
About 1 in 5 older adults suffer from depression or anxiety. Some signs of depression are ongoing feelings of sadness, fatigue, changes in appetite, or losing the desire to do things that you enjoy. Also, you may have difficulty sleeping, feel worried or irritable, or a desire to isolate yourself. Talk to your support network and your healthcare provider if you’re struggling, or if you’re experiencing any of these signs for more than two weeks. Check out www.connexontario.ca for free and confidential health services information for people experiencing problems with alcohol and drugs, mental illness and/or gambling. They are funded by the Government of Ontario, their information and referral service is live-answer 24/7, confidential, and free.

Get Adequate Sleep
It’s important to get enough sleep to feel your best. Older adults should get 7-8 hours of sleep each night. Avoid daytime naps if this keeps you up during the night. You can access css-scs.ca for additional information and tips on how to sleep better. You should contact your medical provider if you have ongoing issues with getting adequate sleep.

We wish our readers a happy and health 2019!

Excellent article from WebMd- click link to go to site directly:
www.webmd.com/osteoporosis/bone-fracture-17/recover-osteo-fracture

When you have osteoporosis, bone fractures are high on the list of concerns. You'll want to take steps, like lifestyle changes and medicine, to help prevent them.
The most common fractures for people who have osteoporosis are in the spine, hip, wrist, and forearm. They each have their own long-term effects, but they do have some things in common.

General Issues
No two fractures are exactly alike. The effects on your life depend on which bone you break and how serious it is. But some things you can expect include:

Pain. This is different for everyone. It might have a ripple effect on your other bones, muscles, and joints as you change the way you do things to try to make it hurt less. Living with pain also can affect your quality of life, sleep, and mood, sometimes leading to depression. Talk to your doctor, who can suggest ways to help.

Problems with movement. Spine and hip fractures in particular can make it hard for you to get around. They affect walking, bending, pushing, and pulling. You can get help by using tools like a cane, a walker, or long-handled reachers.
When you don't move around much, you're more likely to have problems like heart disease, cancer, type 2 diabetes, and mental health conditions, such as anxiety. Your doctor can help you find ways to prevent or treat these conditions.

Emotional issues. It can be tough when things that used to be simple take more time or energy because of an injury -- or you can't do them at all. It may also make it harder to get out of the house, see friends, and get back to your normal social life. All those can affect your relationships. See a mental health professional who can help you manage problems you might have with anger, anxiety, hopelessness, or a sense of lost dignity.
Spinal Fractures When your vertebrae -- the small bones of your spine -- get thin and weak, it doesn't take a fall to break them. They can just start to crumble. And you may not feel any pain when it happens.
Your vertebrae work together to support your body, so a fracture can keep you from bending, leaning, and twisting the way you do every day -- as when you tie your shoes or take a shower. And once you have a spinal fracture, you're more likely to have another one.
If more than one vertebra starts to crumble, you may have a hunched-over posture that gets worse with time. That can cause severe pain and affect your lungs, intestines, and heart.
That's why spinal fractures can lead to many other issues, including:

• Constipation
  
• Lack of appetite
  
• Long-term back pain
  
• Loss of height  
• Nerve damage that causes numbness, swelling, and pain
  
• Pain in your belly
  
• Problems breathing
  

Hip Fractures:
As with spinal fractures, hip fractures affect the way you move and do things for yourself. And once you've fractured your hip, you're more likely to do it again.
Since you may be in bed as you heal -- and not very active -- hip fractures can lead to:

• Bedsores
• Blood clots in your legs or lungs
• Muscle loss
• Pneumonia
  

Your health care team will help you avoid or manage these problems.

Wrist and Forearm Fractures:
These can hurt a lot, but they tend not to have the same far-reaching effects as spinal and hip injuries. But they can still cause problems in your everyday life.
After all, you use your wrists and hands for so many tasks around the house and out in the world. For example, you might find it harder to write, cook, and do basic grooming tasks like brushing your teeth if the pain doesn't go away.

Your doctor or a physical or occupational therapist can help you find solutions to these issues.
WebMD Medical Reference
Reviewed by Brunilda Nazario, MD on May 23, 2018

04 December 2018
OTTAWA 
The Canadian Cancer Society (CCS) welcomes the announcement of the new national framework for palliative care. The framework was released December 4th 2018 by the Minister of Health Ginette Petitpas Taylor. 

CCS believes in guaranteed access to palliative care in Canada. Quality palliative care is an essential part of healthcare, and all Canadians should have affordable access to it. Palliative care provides people with cancer and their families with the care they need, when they want it, in the setting of their choice. 

The national framework for palliative care has identified goals and priorities to shift palliative care policy and programming in Canada, including:

• Palliative care training and education for healthcare providers and other caregivers
• Measures to support palliative care providers
• Research and the collection of data on palliative care
• Measures to facilitate equitable access to palliative care across Canada

Nearly 1 in 2 Canadians will develop cancer in their lifetime and about 1 in 4 will die from cancer, making cancer Canada’s leading cause of death. 

“A strong nationwide response to this growing number of cancer cases is important and the new national palliative care framework is a step in the right direction,” says Kelly Masotti, Director of Public Issues at CCS. “The guiding principles outlined in this new framework will help shift palliative care in Canada to be more person and family-centered to address the diverse needs of Canadians.”

As Canada’s primary source for trusted cancer information, CCS’s services help millions of people access treatment, care, and support, often while they continue to live at home or in a community setting.

About the Canadian Cancer Society
The Canadian Cancer Society is a national community-based organization whose mission is the eradication of cancer and the enhancement of the quality of life of people living with cancer. When you want to know more about cancer, visit our website www.cancer.ca or call our toll-free, bilingual Cancer Information Service at 1 888 939-3333.

For more information, please contact:
Rosie Hales
Communications Specialist
Canadian Cancer Society
National office
Phone: 416 934-5338


Read more: http://www.cancer.ca/en/about-us/for-media/media-releases/national/2018/national-palliative-care-framework/?region=nl#ixzz5a3mFwKGu