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Helpful Tips to have Healthy, Glowing Skin as You Age

You’ve heard how important it is to take care of your skin. From using sunscreen to proper moisturizers, skin care tips are everywhere for men and women of all ages. Aging causes substantial effects on the skin, but you can minimize these effects by following some diligent skin care practices. From spending too much time in the sun to your diet and bad habits like smoking, everything you do throughout life can either damage or help to protect your skin.

With summer just around the corner, we thought now is a great time to discuss some of the common effects of aging on the skin and what you can do to prevent or minimize skin damage later in life.

Common effects of aging on your skin

There are some changes that naturally occur in the skin as you grow older, many of which will occur to some degree regardless of your lifestyle habits and skin care regimen. names several changes you can expect as you age, including:

  • rougher skin texture
  • lesions, such as benign tumors
  • loss of elastin or elastic tissue, leaving a slack or loose appearance
  • thinning of the epidermis or the outer layer of skin, leading to a more transparent appearance
  • flattening of the area between the epidermis and the dermis (the layer beneath the epidermis), leading to more fragile skin
  • thinner blood vessel walls, leaving your skin more susceptible to bruising

And of course, repeated exposure to the sun without adequate UV protection has been linked to the development of skin cancer. All of these changes are changes that most seniors would prefer to avoid. But what can be done to help prevent the changes associated with aging skin?

Lifestyle habits that affect skin health and aging

Prevention is key, and it’s never too late to start looking at skin care and lifestyle habits that you could change to minimize further skin changes associated with aging. Senior Living lists a multitude of common lifestyle habits and other factors that can speed up the aging process of the skin, including:

  • Smoking cigarettes—if your skin isn’t enough of a motivator to help you quit, quit for your respiratory and cardiovascular health.
  • Unprotected sun exposure—it’s true that natural sunlight helps to boost your mood and can have many other positive impacts. However you can enjoy the benefits of the bright summer sun without damaging your skin by applying sunblock before venturing outside, even for a short walk.
  • A sedentary lifestyle—yes, exercise is even good for your skin! Regular exercise helps to tone your muscles (reducing the likelihood of sagging skin) and increases blood flow, which is also good for skin health. Not to mention, the vibrant energy regular exercise provides will put a smile on your face and add a glow to your skin.
  • Failing to moisturize your skin—your body doesn’t have to be dehydrated for your skin to be dry. In fact, it’s often the harsh, cold winters that wreak havoc on skin’s natural moisture. Moisturize, moisturize, moisturize. Using a humidifier in heated rooms is also a good idea, as some forms of home heat can sap the air of moisture.
  • Alcohol use—a diuretic, regular or heavy use of alcohol can lead to dehydration, but it can also lead to permanent skin damage. That’s because alcohol dilates small blood vessels near the skin’s surface while also increasing blood flow near the surface of the skin. This can lead to permanent damage over time, creating a flushed appearance or even showing broken blood vessels just below the skin’s surface.
  • Too much stress—while there’s no substantial clinical evidence that definitively and conclusively links stress to skin damage, there is plenty of anecdotal evidence and other factors that make the link between stress and skin aging a logical conclusion. For instance, stress increases the body’s production of the stress hormone cortisol as well as other hormones that communicate with oil production glands. Increased oil can lead to adult acne and other problems with the skin. Additionally, cortisol causes blood sugar to rise, which increases the production of glycation. Glycation negatively affects collagen (a substance that helps to give skin its plump, youthful appearance), leading to less collagen and more wrinkles.
  • Not enough sleep—”beauty sleep” is a common expression, but there’s some validity behind it. Not only will you feel tired and sluggish, you’re more likely to be over-stressed when you don’t have enough sleep. And, you could develop dark circles and bags under your eyes.
  • A poor diet lacking in vitamins and nutrients—you are what you eat, and so is your skin, to some extent. The food you eat is what gives your body the essential vitamins and minerals it needs to function at its best. Vitamin C and Vitamin E both promote skin health and help to protect the skin against sun damage, while healthy zinc levels support cell turnover. Do your homework and eat a healthy, balanced diet rich in vitamins and minerals for optimal skin health.

How to protect your aging skin

Most of the contributors to aging skin are avoidable with some simple lifestyle changes. No matter how old you are or how much damage your skin has already experienced, it’s never too late to begin taking better care of your skin. The National Institute on Aging offers a few essential tips to care for  your skin at any age:

  • Limit your time in the sun—the sun’s rays are the strongest between 10:00 a.m. and 4:00 p.m., so avoiding too much sun exposure during these hours is a good idea.
  • Remember, clouds do not filter out UV rays—you can still get a sunburn on a cloudy day or while you are in water.
  • Use a sunscreen with an SPF (sun protection factor) of 15 or higher—look for a sunscreen that offers “broad spectrum” protection, which is noted on the label. Apply sunscreen 15 to 30 minutes before going outside, and reapply at least every two hours—more often if you’re swimming or sweating.
  • Wear sun-protective clothing—wide-brimmed hats protect the delicate skin on your face (and protect your eyes from harsh sunlight, too). Good quality sunglasses that block 99 to 100 percent of the sun’s rays are a good idea as well. Finally, opt for loose, lightweight clothing with ample protection, such as long skirts or long-sleeved shirts that are light enough to keep you cool while still protecting your skin from the harsh sun’s rays.
  • Avoid tanning beds and sun lamps—awareness surrounding the dangers of tanning beds and sun lamps has grown substantially, but reminders are always helpful.

No matter your age, you’re never too old to start taking better care of your skin. While you may not be able to reverse previous damage to your skin, you can certainly minimize and even avoid damaging your skin further through ordinary lifestyle changes and habits you never knew were damaging to your skin.  Most importantly, remember that sunscreen as we enter the hot summer months when the sun’s rays are strongest.

Summer Issues: Dehydration is a Concern for Older Adults

According to John Muir Health, “Dehydration occurs when your body doesn’t have enough water and other fluids to function normally.” While dehydration is a common problem for people of all ages, it’s a particular concern for seniors.

Why older adults should be concerned about dehydration

Older adults have a decreased sense of thirst, and their kidneys don’t conserve body water as well compared to younger people with healthy kidney function. Beginning around age 50, older adults may begin to feel tired and sluggish rather than experience the familiar sensation of being thirsty. As such, they may opt for a nap rather than a tall glass of ice water. Coupled with medications that can dry out the body, the natural progression of aging and its effects on the body make older adults especially prone to dehydration.

Mayo Clinic offers an informative explanation of why older adults are particularly susceptible to dehydration, especially in the hot summer months: “Your body’s ability to conserve water is reduced, your thirst sense becomes less acute, and you’re less able to respond to changes in temperature. What’s more, older adults, especially people in nursing homes or living alone, tend to eat less than younger people do and sometimes may forget to eat or drink altogether. Disability or neglect also may prevent them from being well nourished. These problems are compounded by chronic illnesses such as diabetes, dementia, and by the use of certain medications.”

In the warm summer months, when the body is losing even more fluids through perspiration, seniors should pay close attention to how much water they’re consuming and be sure to drink the recommend amount of water daily.

Symptoms of dehydration

There are several symptoms to watch for that may indicate dehydration, including:

  • a dry sensation in the mouth or on the tongue with thick saliva
  • inability to urinate or urinating only small volumes of urine
  • dark or deep-yellow urine
  • headaches
  • few or no tears when crying
  • cramps in the arms or legs
  • general feelings of weakness or being unwell
  • fatigue or irritability, confusion, sluggishness or fainting

The symptoms above are indicators of mild dehydration, which can often be remedied by drinking plenty of fluids and ruling out underlying causes. But in some cases, the symptoms go unnoticed or don’t become obvious until the person is in a state of severe dehydration. In these cases, the symptoms are much more alarming, such as:

  • low blood pressure
  • convulsions
  • extreme thirst
  • irritability and confusion
  • very dry mouth, skin and mucous membranes
  • sunken eyes
  • little to no urination and urine output is dark in color
  • rapid breathing and heartbeat
  • fever
  • deliriousness or unconsciousness in the most extreme cases

If you or a loved one are experiencing any of the symptoms above, seek immediate medical attention.

How to prevent dehydration in the elderly

When it comes to dehydration, prevention is the best medicine. As a caregiver or family member of an elderly loved one, you can play an active role in ensuring your loved one is getting enough fluids and taking other steps to prevent dehydration. outlines several valuable tips for helping your loved ones consume enough fluids and prevent dehydration:

  • Encourage aging loved ones to drink small amounts of fluids throughout the day. This is often easier than drinking large quantities at once.
  • Aim for 40 ounces of fluid daily, or five eight-ounce glasses of water or other fluid. Water is preferable to sugary beverages and soda.
  • Avoid coffee and alcohol, which can have a diuretic effect and actually contribute to dehydration.
  • Encourage your loved one to drink fluid with every meal.
  • If drinking is problematic, consider foods that have a high water content to help your loved one reach their daily water intake goal. Foods such as watermelon, cucumber and other fresh fruits and vegetables can help your elderly loved one meet her daily water needs.
  • Keep favorite beverages within reach and easily accessible throughout the day.
  • Sometimes older adults avoid drinking liquids due to a fear of incontinence. If this is the case, encourage her to drink more fluids earlier in the day and cut back on fluid intake in the evenings before bedtime.

Remember, the 40 ounces per day guideline is only a guideline; your loved one’s individual needs may vary, particularly if she has a condition such as diabetes. And in the hot, humid summer months, it’s a good idea to consume even more water to compensate for the additional body fluids lost through perspiration.

Married in Senior Living: Tips for a Smooth Transition

Many older adults are choosing to downsize, selling the large family home they’ve raised a family in and moving to a smaller accommodation that doesn’t require the same substantial maintenance requirements. Senior living communities are traditionally set up to accommodate individual residents, but as couples are increasingly making the move together, more communities offer options suitable for senior couples. But moving to a senior living community as a pair poses some unique challenges, as well as some unique opportunities. Here are a few tips for a smoother planning and transition process.

Consider your differing care needs

For some senior couples, the decision to downsize and move to senior living follows a change in health status for one spouse. But the differing care requirements can make choosing the right type of senior housing a challenge. For couples with differing care needs, continuing care retirement communities (CCRCs) are often a good option. CCRCs enable seniors to age in place, offering independent living, assisted living, skilled nursing and memory care on the same campus. That means spouses requiring different levels of care can remain in close proximity.

Likewise, the need for privacy should be a consideration. Couples who prefer a greater sense of privacy may opt for a senior living community offering apartment-like spaces for couples or even single-family homes rather than a larger, private room within an assisted living community or similar type of senior living.

Look for amenities that meet both spouses’ needs

Senior living communities, whether you’re considering a move to independent living, assisted living, a retirement community, or a CCRC, offer varying services and amenities. Before you make a move with your spouse, look for senior living communities that offer not only the care and support both you and your spouse require, but also the activities and amenities that suit both of your abilities and interests—as a couple and as individuals.

For example, one spouse may enjoy a day on the golf course while the other joins a group of residents for an outing at a nearby shopping center or local attraction. Just as in life before senior living, you’ll have activities that you choose to do together, as well as activities you’ll participate in independently.

Creeate a plan for financing your move

Senior living is a significant expense, and while larger, private rooms or small apartments are offered by many senior living communities for couples, these are typically more costly than a standard room. There are also additional fees associated with joining the community as a couple, such as a monthly second person fee. Downsizing and selling the family home, as well as possessions that are no longer needed or wanted, is often a strategy older adults use to help pay for senior living.

Retirement communities are another senior living option for adults and couples 55 and older who want to maintain their independence and privacy but reduce the maintenance requirements that come with home ownership. These communities, along with CCRCs, sometimes allow seniors to purchase a single-family home or apartment, more suitable in size to their now-downsized lifestyle, with services such as lawn maintenance and cleaning services available to residents. Because these homes are purchased by residents, this is a feasible option for many senior couples who are in a position to sell their existing homes and purchase a smaller home or apartment in retirement community. The appeal of retirement communities isn’t merely reduced home maintenance, but also easy access to a community of seniors within the same age range who share similar interests and activities.

As more and more couples are growing old together, the number of married couples choosing to move to senior living is increasing. As such, senior living providers are offering more options to meet the varying needs of married couples within larger communities. From retirement communities to continuing care retirement communities and even options in assisted living, married couples can find an senior living option that will meet their needs and budget.

New Retirees are Three Times More Likely to Move to the Western United States

Seniors desire to retire near protected public lands.Moving to Florida and spending the days on the links may be the cliché associated with retirement, but that’s not the preferred lifestyle for this incoming wave of newly 55+ retirees. Instead, it’s the Western United States, spanning Arizona to Montana to Washington, which is proving a draw as reported in The Gold Rush: How Public Lands Draw Retirees and Create Economic Growth written by the Center for Western Priorities. Instead of golf courses and shopping being desired amenities, it’s protected public lands, such as wilderness areas, national parks, recreation areas and wildlife refuges, because of their recreation opportunities. And this desire to spend retirement outdoors is evidenced by a steady increase in the number of purchased American the Beautiful Senior Passes for the past seven years, with a reported 395,597 in 2007 to 509,647 in 2014.

Between 2000 and 2010, more than half a million seniors moved to the Western United States, so what is the draw? A survey conducted by Colorado College’s State of the Rockies Project found that the top three reasons seniors choose to live in the West are “clean air, clean water and environment,” a “healthy outdoor lifestyle” and “ability to live near, recreate on and enjoy public lands like national parks and forests.” What you would expect to be the primary draw, access to healthcare, ranked fourth on the list.

Figure 1. Survey results of the Colorado College’s State of the Rockies Project

Courtesy of The Gold Rush: How Public Lands Draw Retirees and Create Economic Growth, March 11, 2015

But it’s not just the availability of protected public lands, concentration is also a factor; the report noted that retirees are three times more likely to move to a community with more protected public land than they are to move to a community with less protected public land. This new influx of retirees also has an additional benefit for the communities—job creation. The report found that one job is created for every 1.8 retirees who move to a community. These jobs span all business sectors including banking, construction and health care services.

If this trend of moving to the West continues as more baby boomers enter retirement, it won’t be golf clubs that we often visualize in association with retirement. Instead, it will soon be hiking boots and skis.

Starting the Conversation: When It’s Time to Stop Driving

Last week, we discussed the many transportation options that exist to help aging adults maintain their independence after handing over the car keys. Now that you’re familiar with the alternative transportation choices and know where to turn to find out what resources exist in your local area, you are prepared to have this difficult discussion with your aging loved one. But how do you start the conversation, and how is this difficult subject broached successfully?

First, know the warning signs Elderly woman in car

The first step is determining whether it’s really time to have the talk with mom or dad about their safety on the roads. outlines several warning signs that could indicate it’s time for an aging adult to stop driving. Some key warning signs include:

  • Taking medications with warnings against operating vehicles or machinery - While some medications have warnings regarding drowsiness, dizziness and other side effects, some also have explicit warnings advising patients not to drive or operate heavy machinery until they know how a medication will affect them.
  • Combined medication effects - Some medications can cause stronger or different side effects when combined. If your loved one’s physician has prescribed a new medication, it’s a good idea for mom or dad to avoid driving until they know exactly how this specific combination of medications will affect them. Your loved one’s pharmacist can also be a helpful resource for learning about the side effects associated with certain medication combinations.
  • Vision impairment - Vision deteriorates with aging for many older adults. Problems with vision, such as a loss of peripheral vision, can create challenges for older adults behind the wheel, making it difficult to interpret the full visual field. Likewise, sensitivity to light, trouble seeing in the dark or blurred vision are safety concerns for drivers.
  • Hearing impairment - While it is possible to drive with a hearing impairment, auditory cues are more important than you may think for safe driving. When older adults experience sudden or significant hearing loss, it may be time to evaluate their safety on the road.
  • Slow reflexes and decreased range of motion – Drivers must be able to react quickly and adapt readily to sudden changes or unexpected situations on the road. Older adults with slowed reflex response and decreased range of motion may not be able to react quickly enough to avoid accidents.
  • Problems with memory – If your aging loved one is suffering from memory loss, it might be time to consider having the talk about giving up the car keys. Memory impairment can actually be quite dangerous for older adults who drive. For instance, a memory lapse could cause your loved one to forget where she was going and sometimes just keep driving until she realizes she’s in unfamiliar territory.
  • Too many close calls – If your loved one has had multiple close calls or minor accidents, scrapes and dents, it’s time to take a look at whether it’s time to stop driving.

When you realize the dangers that exist if your aging loved one continues to drive, starting this difficult conversation becomes a bit easier to broach. All it takes is a split second and a single mishap for an accident that could cost the life of your loved one or another passenger or driver. Here are some tips for starting and following through with the discussion.

Understand it may take several conversations

The first time you bring up the subject of handing over the car keys, your aging loved one may not immediately acquiesce. Often, learning that he/she is unsafe on the road is difficult to hear and a harsh reminder that he/she is, in fact, getting older. Be gentle when you bring up the topic and plan ahead so that your first discussion is happening well before it’s urgent that your loved one stop driving immediately. This allows you time to have a preliminary discussion, get your loved one’s thoughts about her safety behind the wheel, and find out what specific concerns she may have about no longer driving.

Do your research and offer alternative transportation options

Once you learn what your loved one’s concerns are and whether she feels that it may be time to stop driving, you can do some research. If being isolated and unable to get to important appointments or to the grocery store is a concern, present a specific plan for meeting these needs and information on the alternative transportation options available in your local area.

Be respectful of their independence and opinions

Ultimately, the decision is not yours alone. Unless your loved one is incapacitated, the choice to stop driving is truly his, although you can provide input and support. Be respectful of your loved one’s desire to maintain his independence and offer advice and opinions while stating your commitment to ensuring that his independence is maintained should he decide to give up his car keys.

Know your options when the need is urgent

Unfortunately, some families encounter situations in which an aging loved one is truly unsafe on the road yet he/she can’t accept that it’s too dangerous to continue driving. If the need is urgent, and it’s imperative that you get your loved one off the roads as soon as possible, there are legal options. Most families turn to these options as a last resort, as they’d rather not have to force their loved ones to hand over the keys against their will. If you reach this juncture, here are a few legal options for getting your aging loved one to give up the car keys recommended by

  • The physician - Older adults may be more likely to listen to the advice of their physician, so enlisting the doctor’s help to talk with mom or dad about giving up the keys can be helpful. In fact, the American Medical Association recommends that physicians counsel their patients directly, and they can even ask for and accept the car keys. A physician can also write a medical status report that caregivers can take to the Department of Motor Vehicles (DMV).
  • The optometrist or ophthalmologist – These providers can have a similar discussion with an older adult as a physician would, explaining how the patient’s vision impairments make it unsafe to continue driving.
  • Your state’s Department of Motor Vehicles - As a family caregiver, you can meet with your local department representatives to present background and health information. This is followed by your request for your aging loved one to receive new vision exams, paper tests and possibly an examination drive with an inspector. Decisions or actions are determined by the inspectors, and the driver receives notice prior to the renewal date on her driver’s license. Even if your mom or dad passes all required tests and exams, you’ll at least have peace of mind that she is deemed safe to drive independently. Note that each state has its own licensing standards and protocols, so the specific process may be different depending where you live.
  • The family attorney – An estate attorney can discuss the implications for the estate with the family should an accident occur, such as a loss of assets should a lawsuit arise from an accident. Your attorney may agree to sit down to discuss the reasons why mom or dad should stop driving with you and other family members.
  • The police - While most caregivers hesitate to take this step, notifying the police for minor accidents and violations facilitates the creation of a report, and the police can make their own request to the Department of Motor Vehicles for new testing if they feel it’s warranted.

Having this conversation with an aging parent or other aging loved one is never easy. But when you consider the alternatives and the dangers that exist if an elderly driver continues to operate a vehicle when it’s truly dangerous, you may realize it’s time to put your fears aside and do what’s necessary to keep your loved one and other drivers and passengers safe on the road. Above all, remember that your loved one’s safety and ability to remain independent are the top priorities.


Loss of Mobility: Predictors, Challenges, and Solutions

The aging process often leads to a decline in mobility among older adults. According to Mescape, anything that influences the musculoskeletal, neurological or cardiorespiratory systems can impact mobility. Pain and obesity are two key predictors of mobility challenges that accompany aging, and chronic conditions can exacerbate mobility issues, as well as disabilities such as vision or hearing loss.

Mobility issues not only make it challenging for older adults to navigate without assistance through their homes and public spaces but, in severe cases, can make it difficult to perform other activities of daily living (ADLs) such as bathing and dressing. A loss of mobility doesn't mean a loss of independence.

Predictors of mobility loss

Musculoskeletal pain is a common complaint among older adults, and while the specific pathway is unclear, it’s suspected that severe pain in the lower body causes people to become less active. This decreased activity contributes to a decline in muscle strength and the development of mobility limitations.

That said, studies have shown that musculoskeletal pain contributes directly to mobility limitations even when other factors on the pathway, such as self-rated health, chronic conditions and symptoms of depression, are accounted for. This loss of mobility occurs directly through impairments and functional limitation. One example is a hip fracture, which causes persistent pain in many cases and poor muscle strength and power in the affected leg. Despite proper treatment of the fracture, a hip fracture often leads to muscle power asymmetry in the legs, and subsequently, mobility decline.

Obesity is another proven predictor of loss of mobility, although the specific impacts of obesity on mobility have only recently been studied in-depth. Obesity contributes to a loss of mobility through the increased mechanical load placed on the body, “which increases their energy expenditure, placing increased demands on aerobic capacity and muscle strength compared with normal-weight individuals doing similar physical tasks,” Medscape describes.

A 22-year follow-up study found that individuals, who were overweight in midlife but without impairment, were at double the risk of future mobility limitations compared to peers of the same weight. When being overweight was compounded by two or more impairments (poor hand grip strength, squatting test or self-reported difficulties with running), the risk of mobility limitations is six times that of a normal-weight peer without impairments.

Of course, other conditions contribute to mobility loss; Alzheimer’s disease or dementia, Parkinson’s disease, or multiple sclerosis all impact the central nervous system (CNS). Additionally, a decrease in bone mass or density, a decrease in flexibility of the joints, muscle atrophy, and other changes in the muscle tissue can also contribute to a loss of mobility.

Challenges of loss of mobility

A loss of mobility leads to a myriad of challenges and increased risk of injury in older adults. According to, mobility issues can increase the risk of falls, which can lead to serious injury such as hip fractures or even head injuries. Even if a fall does not lead to an injury, older adults then develop an increased fear of falling. This fear in turn leads to a decrease in activity, facilitating a vicious cycle of decreased activity contributing to a greater loss of mobility.

A loss of mobility makes it difficult for older adults to navigate certain areas of the home, such as bathrooms which often have tile flooring that becomes slippery when wet.  It can also become more difficult to walk freely throughout the home or navigate outdoor areas, such as a lawn or sidewalk, where the terrain is not level or unfamiliar. Driving can become more difficult as reaction time slows.

Preventing loss of mobility

A landmark clinical trial published by the University of Pittsburgh and seven other field centers in the Journal of the American Medical Association in May 2014 found that physical activity prevents loss of mobility among older adults. As a result of this longest-running randomized clinical trial evaluating physical activity in the elderly, the study recommends that something as simple as a 20-minute brisk walk around the neighborhood each day can significantly help older adults maintain their ability to walk.

“The study showed that prescribed daily physical activity would prevent older adults’ loss of mobility, defined in the study as the inability to walk 400 meters, or about a quarter of a mile. That is approximately equal to a trip from a parked car to a grocery store or a walk through a neighborhood,” according to the University of Pittsburgh’s published report.

For older adults who have already experienced a loss of mobility, remaining as physically active as possible will help to prevent further decline. Lifestyle modifications, changes to the home environment, and mobility aids are other solutions that help older adults with mobility loss maintain their independence. These solutions include:

  • the use of mobility aids, such as a walker, cane, or wheelchair
  • ensuring the home is clutter-free and free of clear hazards that increase the risk of trips and falls
  • one-level living modifications
  • ramps and other easy-access modifications
  • grab bars in bathrooms

There are many tools, aids, and modifications that can make life simpler for an older adult with mobility decline. Medical alert systems, for instance, can provide a safety net for older adults should they happen to fall when caregivers or other family members are not readily available to help. The degree of decline, the individual’s current living environment, family support, and other factors should be carefully considered when developing a plan for an older adult to continue to live independently, but safely, when a loss of mobility is present.

Coping with Swallowing and Eating Difficulties

Swallowing seems an innate function for younger people, but our swallowing ability is actually a function that often declines with age. It’s often frustrating for older adults when a meal that’s always been enjoyable suddenly proves challenging because of swallowing difficulties.

Deterioration in swallowing function is sometimes attributed to weakened or absent teeth, loss of moisture in the mucosal surfaces of the mouth and throat, or decreased muscle strength in the throat that slows swallowing and increases the difficulty of swallowing hard or dry solid foods, according to Today’s Geriatric Medicine. Swallowing Difficulties in Older Adults

Dysphagia is a term used to describe “problems with neural control or structures in any part of the swallowing process.” Swallowing difficulties are often a consequence of a medical condition, such as stroke, diseases that impact the nervous system (such as Alzheimer’s or dementia, Parkinson’s disease, or multiple sclerosis), and even surgeries affecting the head and neck.

When swallowing difficulties are a more serious concern

If you notice your loved one is no longer enjoying mealtime or has difficulty eating, it’s a good idea to discuss these changes with their physician because sometimes swallowing difficulties can be a sign of a more serious problem or even lead to a more serious condition such as aspiration pneumonia. Aspiration occurs when food or liquid enters the windpipe, causing coughing and choking during eating. This frequently occurs in older adults with later stages of Alzheimer’s disease or dementia, who, over time, lose their ability to perform activities of daily living (ADLs), including eating. If aspiration happens frequently, the person is at risk of developing aspiration pneumonia. When decreased swallowing function is the result of a neurological disease, cancer, or stroke, it is often difficult to prevent the eventual loss in function.

How to preserve swallowing function

Maintaining an adequate nutritional intake is a concern for older adults, even without swallowing difficulties, so difficulties with swallowing or dysphagia only exacerbates this challenge. Often, normal changes in swallowing ability occur gradually, and older adults simply adapt to these changes over time. The Swallowing Disorder Foundation outlines several strategies which you can have your loved one use to maintain swallowing ability and prevent minor swallowing difficulties from becoming more severe, including:

  • taking good care of their teeth
  • practicing good oral hygiene
  • chewing carefully
  • taking smaller bites

If your loved one often experience coughing during swallowing, having them tuck their chin to their chest prior to swallowing can help to protect their airway. There are also swallowing tests that can help diagnose the problem so that appropriate treatments can be prescribed from physicians or speech-language pathologists.

Liquid thickeners and other solutions for swallowing difficulties

Older adults who have swallowing difficulties may be referred to a speech therapist who can help older adults retain as much swallowing function as possible through the use of targeted exercises. For older adults who have difficulty swallowing liquids, thickeners are helpful for reducing aspiration. Thicker liquids travel more slowly down the throat, giving the person’s muscles and nerves more time to complete the swallowing process before the liquid enters the lungs and places the person at risk of pneumonia.

Ensuring their loved ones continuing to receive proper nutrition should be a top priority for caregivers. Often older adults who have trouble swallowing may avoid eating because it’s no longer enjoyable. Foods with a thicker consistency, but are not solids, such as Jell-o, yogurt or pudding, are often good choices. Other foods that are naturally easier to chew and swallow, such as oatmeal, beans and pasta, are also good to incorporate into meals.

Parentgiving offers several valuable tips for coping with swallowing difficulties, including:

  • avoid foods that crumble, like crackers, which can lead to gagging
  • make sure your loved one drinks enough water (6 to 8, 8-ounce glasses each day) to help maintain moisture in the mouth and throat
  • offer gum or candies between meals, as this helps to keep the mouth moist by inducing glands to produce saliva
  • puree or blend foods to break them down into a smooth consistency that is easier to swallow.
  • choose moist foods, mashed potatoes is a good starch option, whenever possible over dry, rough foods such as grains.
  • steam foods such as vegetables for a softer, easier-to-chew consistency

If your loved one is experiencing difficulty swallowing, talk with their physician to determine if further tests are needed to pinpoint a cause and rule out more serious conditions. Whether swallowing difficulty is a normal progression of aging, caused by a chronic disease, or the result of a stroke or similar event, there are strategies you can use to ensure your loved one receives adequate nutrition. A speech therapist or speech-language pathologist can help you formulate a specific treatment plan to help your loved one retain as much swallowing function as possible and develop modifications to ensure your loved one continues to receive adequate nutrition and avoids the negative consequences of poor nourishment and dehydration.

Vision Loss: A Normal Part of Aging, or Something More?

When you enter your 40s, 50s and 60s, you may begin to notice that it becomes more difficult to read small print. You may find yourself squinting to read books you easily read when younger. It may become difficult to decipher the dosage instructions on a box of medication. Difficulty seeing clearly when reading and other close work is one of the most common problems adults develop between the ages of 41 and 60, according to the American Optometric Association.

Some vision loss is a normal part of aging

Some vision loss is actually a normal change in the eye’s ability to focus which occurs with age. Known as presbyopia, this condition gradually worsens over time. There are other common vision challenges that occur with age as well, including:

  • needing more light to see clearly
  • problems with glare from vehicle headlights or sun reflecting from windshields or pavement
  • changes in color perception, making it more difficult to tell the difference between certain shades
  • reduced tear production

Cataracts, considered an aging-related disease of the eye, is such a common condition among seniors that many experts consider cataracts a normal part of aging. According to a report by the CDC, more than half of all people age 65 and older have cataracts. Normal changes in vision can often be corrected with eye glasses, contact lenses, or laser eye surgery, or in the case of cataracts, with cataract surgery.

When vision loss becomes a problem

However, substantial vision loss is one of the most common causes of elderly losing their independence. The CDC reports that 1.8 million non-institutionalized elderly people in the U.S. report some difficulties with activities of daily living at least in part due to visual impairment. The most common danger caused by visual impairment is an increased risk of falls and fractures, leading to hospitalization, nursing home placement, disability or even premature death.

To put it in perspective, 92 percent of adults age 70 and older wear prescription lenses. Eighteen percent also use a magnifying glass for reading and other close work. The number of seniors who have difficulty seeing clearly even with corrective measures increases with age, ranging from 14 percent among seniors aged 70 to 74, up to 32 percent among adults age 85 and older.

Visual symptoms can be warning signs of serious underlying conditions

Vision changes in middle age and beyond can also be a warning sign of a more serious underlying condition. The American Optometric Association points out several visual symptoms that can indicate a more serious condition:

  • Vision that fluctuates - If the clarity of your vision fluctuates from day to day, this can be a sign of hypertension (high blood pressure).
  • Floaters and flashes - Seeing floaters from time to time is actually normal; these are typically shadowy images of particles that float in the fluid that fills the inside of the eye. However, if you suddenly see more floaters than normal, and they are accompanied by bright, flashing lights, it could be an indication of retinal detachment (a tear of the retina).
  • Loss of peripheral vision - A loss of peripheral vision, or side vision, can be a warning sign of glaucoma. Glaucoma is a disease in which the optic nerve becomes damaged and no longer transmits visual images to the brain. Unfortunately, symptoms often don’t appear until damage to your vision has already occurred.
  • Distorted vision - Do straight lines now seem warped or wavy? Is there a blind spot in the middle of your visual field? This can be a sign of age-related macular degeneration (AMD), a disease of the macula, a part of the eye’s retina that’s responsible for the central visual field, where visual acuity is typically sharpest.

How to cope with loss of vision

Some diseases of the eye are treatable, like some normal vision loss can be corrected with corrective lenses or surgery. However, other diseases of the eye cause permanent damage that is not correctable by corrective or surgical procedures. Whether your vision loss is correctable or not, there are some general tips and strategies you can use to decrease your risk of falls, fractures and other accidents as a result of poor vision in your day-to-day life.

  • Have regular eye exams - A regular visit to your optometrist can pinpoint problems like glaucoma and other diseases of the eye before you begin having symptoms that can lead to permanent vision loss.
  • Keep your environment well-lit - If you have trouble seeing in dim lighting, make sure your home has ample lighting to illuminate the areas where you spend the most time, as well as in difficult-to-navigate areas, such as stairs and hallways.
  • Remove clutter -For seniors with visual impairment, it can be difficult to discern objects such as cords that extend across a room or hallway or a throw rug with a turned-up edge. These hazards can easily lead to dangerous falls. Keep your home as clutter-free as possible, removing hazards and spacing out furniture to allow for ample walking room.
  • Wear sunglasses in bright sunlight - Ultraviolet light can lead to the development of cataracts, so protect your eyes when you’re out enjoying the sunshine.
  • Mark the edge of stairs with brightly-colored tape - If navigating stairs proves especially challenging, marking the edges with brightly-colored tape makes it easier to discern individual steps to avoid trips and falls. In fact, contrasting colors are helpful visual aids when it comes to things like doors and door frames, plates and place mats, and other everyday objects that may not be easy to differentiate from the objects next to or behind them.
  • Decide when to give up the keys - If your vision loss is severe and not correctable with corrective lenses or other measures, it may be time to give up driving for your own safety and the safety of others. Talk with your optometrist, your primary physician, and your family to determine when it’s time to hang up the keys.

While some vision loss is considered a normal part of aging, you should be mindful of warning signs that could indicate a more serious problem. Having a regular eye exam is the best way to pinpoint these problems before they become major issues. Even with substantial vision impairment, it’s possible for many seniors to live happy, independent lives with the right support and safety precautions.

Planning to Pay for Care: Is Long-Term Care Insurance the Right Choice?

It’s no secret that the cost of long-term care is high, and costs have been rising for several years. The rising costs are an obstacle, but many seniors find no way to avoid the eventual need for long-term care services. In fact, 75 percent of all people over the age of 65 will eventually need long-term care, according to a study by Mutual of Omaha.

Even more disheartening are other long-term care statistics: The average cost of a one-year stay in a skilled nursing community, according to sources like AARP and CNN Money, are estimated between $50,000 and $80,000. It’s no surprise, then, that many seniors spend their retirement savings within a year or two of a long-term care need arising.

For these reasons, planning for long-term care at a younger age is essential. Long-term care insurance is one option to ensure that your care needs will be met as you grow older. A typical long-term care insurance policy covers not only nursing home services, but home healthcare, assisted living communities, respite care, and even services such as adult day care and hospice care.

But knowing whether long-term care insurance is right for you, what tax implications exist, and what your policy should include aren’t easy questions to answer. Our guide to long-term care insurance, “Long-Term Insurance: Planning for Your Future,” outlines the basics of long-term care insurance and how these policies work to offer financial protection and ensure that you or your loved ones will have access to the care you need as you grow older.

For more information about the costs of long-term care, how long-term care insurance works, consumer protections, and how to determine if long-term care insurance is right for you, read our comprehensive article here.

Navigating the 2015 Tax Season: Helpful Tax Advice for Seniors and Caregivers

Tax season is in full swing, much to the chagrin of many tax payers and even a few overwhelmed accountants. But for seniors and caregivers, tax season means it’s time to round up medical expenses, mileage, and other expenses associated with your own care or the care of a loved one for the 2014 tax year. It’s no secret that taxes can be confusing, so it’s often difficult to know what tax benefits you or your loved ones are eligible to receive. (And to make things a little more complicated, tax credits, deductions, and thresholds often change from year to year.) These tips will help you navigate this tax season successfully and minimize your tax burden.

Deducting out-of-pocket medical expenses

For many tax payers, the threshold for deducting out-of-pocket medical expenses has increased from 7.5% of adjusted gross income to 10% of adjusted gross income for the 2014 tax year (for which you’ll file in early 2015). But if you or your spouse are over the age of 65, you’re exempt from that increase through the 2016 tax year (to be filed in 2017). What that means is you’re eligible to deduct the amount of your out-of-pocket (unreimbursed) and allowable medical and dental expenses that exceeds 7.5% of your adjusted gross income. Tax advice for seniors and caregivers

In other words, if your total out-of-pocket, allowable medical expenses equals 10% of your adjusted gross income, you may deduct the 2.5% that exceeds the 7.5% threshold, but not the entire 10%. Travel expenses for medical care are also eligible, including mileage on your vehicle, bus fares, parking fees, and related expenses. A complete list of all qualifying medical and dental expenses can be found here.

Determining if your care recipient qualifies as a dependent

For caregivers, one of the most common questions to arise is whether the care recipient qualifies as a dependent on the caregiver’s tax return. A general rule of thumb is that an individual may qualify as a dependent when the care provider provides more than 50% of the recipient’s support for food, housing, medical care, transportation, and other basic needs.

The care recipient must also be a relative to qualify as a dependent, such as a mother, father, grandparent, mother-in-law, or father-in-law, but the dependent need not live with you as long as you are providing at least half of the person’s total support.The care recipient’s adjusted gross income must be less than $3,950, and he or she may not file a joint return with his or her spouse in order for a caregiver to claim the individual as a dependent. The good news is that if your loved one meets the eligibility requirements as a dependent, any out-of-pocket costs you contribute to his or her care will count towards your personal 7.5% or 10% threshold for the medical expense deduction.

Assisted living and other long-term care costs

If your loved one resides in an assisted living community, dementia care community, or other long-term care community, some or all of these costs may be deductible on your taxes, as well. According to MarketWatch, medical professionals must deem your loved one “chronically ill” in order for you to be able to deduct the full cost.

“The IRS defines this as either having severe cognitive impairments that require round-the-clock supervisory care, or needing help with at least two activities of daily living, such as bathing, eating, dressing and using the toilet. Full basic monthly expenses can be deducted for those who meet these definitions,” explains retirement reporter Elizabeth O’Brien. If your loved one is not deemed chronically ill, you may still deduct the portion of assisted living or long-term care fees that go toward medical care and expenses, such as nursing services, certain therapies, and medications.

What about long-term care insurance?

Qualified long-term care insurance premiums also count towards your out-of-pocket medical expenses. According to IRS Publication 502, “a qualified long-term care insurance contract is an insurance contract that provides only coverage of qualified long-term care services.” The Publication further clarifies that in order to qualify as a medical expense deduction, a long-term care insurance contract must:

  • Be guaranteed renewable,
  • Not provide for a cash surrender value or other money that can be paid, assigned, pledged, or borrowed,
  • Provide that refunds, other than refunds on the death of the insured or complete surrender or cancellation of the contract, and dividends under the contract must be used only to reduce future premiums or increase future benefits, and,
  • Generally not pay or reimburse expenses incurred for services or items that would be reimbursed under Medicare, except where Medicare is a secondary payer, or the contract makes per diem or other periodic payments without regard to expenses.

There is also a per-person limit on the amount of premiums that may be deducted, as follows:

  • For those age 40 and under: $370
  • For those age 41 to 50: $700
  • For those age 51 to 60: $1,400
  • For those age 61 to 70: $3,720
  • Age 71 or over: $4,660

Elderly Dependent Care Credit

IRS Publication 503 outlines the Child and Dependent Care Credit, which allows caregivers to receive tax credits if they paid someone to provide care to a dependent in order to be able to work outside the home or seek outside employment. These payments cannot be made to a person whom you could claim as a dependent on your tax return, a spouse, or to the parent of the qualifying person. The Qualifying Person Test will help you determine if you are able to take this deduction.

The Child and Dependent Care Credit may be up to 35% of your qualifying expenses, with other limits and criteria applying to the total eligible amount. For instance, you (and your spouse, if filing jointly) must have earned income in the tax year in which the credit is claimed, and the total qualifying expenses “must be reduced by the amount of any dependent care benefits provided by your employer that you deduct or exclude from your income.”

Credit for the Elderly or Disabled Tax credit for the elderly or disabled

If you turned 65 prior to December 31, 2014, retired on permanent and total disability, and have taxable disability income, you may qualify for the Credit for the Elderly or Disabled. IRS Publication 524 outlines the eligibility requirements and income limits in more detail. Figure A will help you determine your eligibility, and Table 1 can be used to determine if your income exceeds allowable thresholds to qualify for the credit.

The amount of the Credit for the Elderly or Disabled ranges from $3,750 to $7,500, depending on a variety of factors such as filing status, age, the status of any dependents, and whether one or both spouses are 65 or older and retired on total disability.

Just a few years ago, there weren’t many tax benefits available to family caregivers or even senior citizens. But as the population ages and more individuals are serving as primary family caregivers to an aging loved one than ever before, the government is beginning to implement credits and eligible deductions to help seniors and caregivers reduce their tax burdens. Caregiving is stressful both emotionally and financially, so these tax benefits are a welcome relief that enables some caregivers to continue providing much-needed care and support to their aging loved ones. If you’re a senior or a family caregiver, be sure to talk with an accountant about all the possible tax benefits available to you to minimize your tax burden or maximize returns.