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Another Perspective About Elder Care

Yesterday was Father’s Day. I felt very blessed to celebrate with my Dad who is now 89.5, and is still living in his own home with my mother. So many of my friends no longer have the privilege of celebrating with their parents.

I have been thinking a lot about elder care lately. The horrific stories about the conditions in so many of our long term care facilities in Canada have caused me to feel very, very sad. How can we treat our parents and our grandparents like this?

The reality is that we no longer value family care giving in our culture. Extended families, except in some of our immigrant communities, is no longer the norm. An elderly wife will take care of her husband as well as she can, through her own failing health, until she can no longer manage his care at which point they may both need to be institutionalized. How can their kids help when children and parents are often thousands of miles apart, children have full time jobs and kids of their own to take care of?

How can children take care of that elderly person when the parent has advanced dementia, doesn’t know their own family, wanders away and start fires? Yes, at this point family care giving is extremely difficult, if not impossible. The person is institutionalized to keep them “safe”. This is the accepted “elder care” practice in our society. The rare exception is that if the parent or grandparent is wealthy, they may be able to fund a retirement home life and/or bring in enough services to support them in their own home, but this is not the usual case.

Our government is focused on improving elder care in institutions, which is an important issue. We do need fewer beds per room and more highly trained staff. However, more thought and money needs to go into supporting seniors in a setting they can thrive most in – their own home, or the home of a family member.

This can be accomplished by paying family caregivers and supporting aging in place with increased access to professional health care support in the community. Educational and support groups for family caregivers with non-medical backgrounds are also needed to enable them to take care of their loved ones. This will lead to happier, healthier seniors and end up costing the government, (and therefore taxpayers) a lot less than housing people in institutions. It will also mean fewer emergency hospital trips, less mental health interventions and less chronic disease in our seniors. Altogether, this will represent a huge savings economically for Canada.

Earlier intervention – especially at the point when a partner dies and a person is left on their own – can make a huge difference in offsetting chronic disease. Timely lifestyle changes can prevent mild cognitive impairment from developing into dementia. Our society believes that chronic disease is a sign of “aging” and that dementia is inevitable, and yet it doesn’t have to be. For example, prolonged loneliness, a sedentary lifestyle and reliance on fast foods, all risk factors for dementia, can be modified.

Where are the initiatives addressing these issues? According to the LIHN in Ontario, (the provincial home care overseeing agency), supporting aging in place has been a priority for the last five years. I don’t see much offered in the way of disease prevention. I don’t see much offered in the way of cognitive stimulation or physical training. Thirty minutes for help with a bath once a week, always provided by a different PSW, is not enough to support someone living at home. We need a radical overhaul of our elder care system, and that goes far beyond reducing beds in an institution from four to two per room.

Exercise is no longer my swear word….

I have a confession to make. I have not practiced what I  preach. All my patients over the years have heard me praise the virtues of exercise. Many of them have been motivated by my words to start their own fitness programs. I have just never been very good at it myself.  I have tried. I have joined gyms and quit gyms.  I have started and ended more home exercise routines than I have fingers and toes. Just take a look at the entire shelf of exercise books in my rec room.  Feast your eyes on the treadmill, the re-bounder, the free weights, the Swiss ball and the skipping rope.

The problem was that exercise felt like a duty. Another obligation. Not fun. Boring. When I did start a program I would inevitably spend all day procrastinating about doing a work out and then when it was very late at night promise myself to do it tomorrow instead.

A few weeks ago I was browsing a bookstore at a mall and saw “You are Your Own Gym”, by Mark Lauren. The good looking guy on the front cover drew my eye and I picked it up and read the back. “Forget about gym memberships” (Oh good, lets do that ). ” 125 exercises” – hmm –  that should help with the boredom factor. Although the book said Mark Lauren developed his program teaching special forces, I also saw lots of pictures of women doing the exercises. I liked the way each movement was pictured and described from easy to more challenging. This 50 something woman knew right away she could start with the wall-push-ups and have a chance of doing regular floor push-ups one day, but she also realized that handstand push-ups were about as likely as a berth on the Mars colony ship.

So I brought the book home, and being disinclined to spend a lot of time figuring out an exercise regime , decided to start with his most basic 10 week program because all the exercises were laid out and there were only four of them to do a few times a week. It looked easy. It was not. Much to my chagrin, I found I couldn’t even complete all the exercises in the first most basic arm workout. I was stiff and sore and had to spend extra time napping that day. OK, another failed exercise program headed for the dusty bookshelf.

Then I had an epiphany. Last year I developed back spasms due to my extreme inactivity. I had to start a regular stretching program to keep them at bay. One of the stretches was sitting in a semi-squat position with my back flat against the wall. I did that daily for about a month and then found one day I could stand up from squatting in front of the fruit drawer of the refrigerator without feeling like I would topple over. Without even realizing it I had strengthened my legs.

So based on this experience my thought was to throw out my perfectionist tendencies telling me that if I couldn’t do it “right” not to bother at all, and to instead do it as well as I could with the hope of increasing my strength over time. This is what I am  doing, and it is working. I am not as sore and exhausted.

I was interested to learn after my first couple of workouts that Mark Lauren also has a book specifically for women titled “Body by You”.  I did get this book out of the library, but it was mostly what I had started doing anyway, a more gradual approach to the body weight exercises.

So how is the program going now? I am  half-way through week four.  Last week a strange thing happened, though. I started to look forward to my workouts. I feel good after them now, a little sore and stiff but nothing major. I make sure to have a green smoothie with protein powder right after a workout and I think that has done a lot to reduce inflammation. I am feeling happier, and pleased with the butt and arm toning I am already noticing. This is the first exercise program ever that I miss on my rest days. I repeat, I actually miss exercising the days I am not doing the workouts. This is not me. This is some strange alien fitness loving replacement of me!  I like the alien me, though. I feel better and look better. I am slowing down aging and getting stronger and feeling calmer. I expect that I will use this book for years, there are so many variations of the body weight exercises. It will also be a book to pack when I travel, since the workouts can be done anywhere. Mark Lauren has an app out with his exercises as well, which even eliminates the need to pack the book.

Here’s a link to the book on Amazon. It is my affiliate link. You could also get the book out from the library first, and perhaps get out “Body by You” at the same time to compare them to see which one you prefer. Give his workouts a try and see if you, like me, will  no longer consider the word exercise as a swear word……