More about Aging in Place:

As we come to the close of 2009, let’s recap what we’ve learned about aging in place.  The goal of aging in place is just as it sounds, helping people to age in place, within their homes.  For the older population, this may mean the difference between being able to stay and age in their homes or moving out and living with family members or at a nursing home.  The aging in place concept is great for older adults but is also beneficial for all populations.

Everyone from baby boomers to senior citizens wants to be able to live out their golden years in the comfort and security of their own homes.  Baby boomers make up 28% of the US population and own 48% of all homes.  Boomers, now more than ever, are looking for ways to age in place realizing that they may need to make changes to their current homes or move into one that will allow them to do so.  An AARP survey stated that 89% of older adults said that they wanted to stay in their current homes as they aged.

Numerous professionals that may work with individuals who desire to Age in Place.  They can include:

• Builders and contractors
• Occupational therapists (OTs)
• Physical therapists (PTs)
• Realtors
• Engineers
• Social workers
• Interior designers

In keeping with National Diabetes month, The Aging Suite will be discussing diabetic neuropathy this week.  Diabetic Neuropathy can occur in all of the body’s organs, impacting the way in which individuals function safely in their homes. This impact can be due to issues such as sensation and vision loss as well as muscle weakness.  By educating our readers about diabetes’ effects on the body, we hope to continue in our efforts to help the elderly population successfully age in place.

It’s estimated that 60 to 70 percent of people with diabetes have diabetic neuropathy.  Diabetic neuropathy, nerve damage caused by diabetes, can occur in all of the body’s organ systems.  The cause of the nerve damage can be due to several factors such as:

• High blood glucose levels
• Abnormal blood fat levels
• Nerve inflammation
• Low insulin levels
• Smoking or alcohol use

Risk Factors for Diabetic Neuropathy include:

• Being overweight
• Being a diabetic for a long time period
• Diabetics who have a difficult time controlling their blood sugar
• Diabetics who have high levels of blood fat
• Diabetics with high blood pressure

There are 4 classifications of Diabetic Neuropathies; they are, peripheral, autonomic, proximal, and focal.

Peripheral Neuropathies
This is the most common type of diabetic neuropathy and is nerve damage in the arms, hands, legs, and feet.  Symptoms include:

• Numbness or tingling
• Pain and cramps
• Loss of balance
• Muscle weakness

Autonomic Neuropathies affect the eyes, heart, lungs, kidneys, sex organs, as well as the urinary, respiratory, and digestive systems.  Symptoms include:

• Hypotension
• Being unaware when your blood sugar levels drop
• Constipation
• Nausea and vomiting
• Diarrhea
• Urinary tract infections
• Urinary incontinence
• Erectile dysfunction

Proximal Neuropathies are more common among older diabetics and individuals with type II diabetes.  This type of neuropathy initially starts off as pain in the legs, thighs, buttocks, or hips.  Proximal neuropathies cause leg weakness, resulting in mobility issues.

Focal Neuropathies are unpredictable and can cause severe pain.  It often impacts nerves in the legs, head, and trunk.  This type of neuropathy occurs more often in older adults and can cause:

• Double vision
• Pain in the lower back and pelvis area
• Thigh pain
• Chest or abdominal pain
• Bell’s palsy

Diabetic Neuropathies can be prevented by managing your blood sugar levels and keeping them to a normal or as close to normal as possible range.   Diabetic foot care is also essential.  Sores and ulcers can lead to infection.  Diabetic neuropathies that cause pain may be treated with pain medications.  For those who experience urinary tract infections, they may be treated with antibiotics.  Your physician may prescribe occupational and physical therapy to address muscle weakness.  Check out this week’s technology in the Suite to learn more about diabetic foot care.

Source:   National Institutes of Health

Occupational Therapy

Occupational therapists (OTs) also work with a wide range of populations, ranging from pediatrics to geriatrics.  In the home setting with adults with physical impairments, OTs may work with individuals with diagnoses that include arthritis, multiple sclerosis, knee and hip replacements, individuals who have suffered a stroke, and individuals with low vision deficits such as macular degeneration and diabetic retinopathy.  OTs work with their patients on functional daily living skills that in the home can include improving independence with dressing, toileting, bathing, training individuals to use adaptive equipment to help increase their independence with self help skills, getting in and out of the tub/shower and on and off the commode, and preparing meals safely.  Another important role of the OT may include performing a home safety assessment and making recommendations that can improve the individual’s safety and independence in their home.   To learn more about occupational therapy, check out the following links

http://www.aota.org/

http://www.bls.gov/oco/ocos078.htm

Physical Therapy

Physical therapists work with a wide range of populations ranging from pediatrics to geriatric.  In the home setting, PTs may work with adults diagnosed with Parkinson’s disease, stroke victims, recipients of knee or hip replacements, back surgeries, or individuals suffering from the effects of a recent fall.  The home health PT may work with patients on getting up and down stairs safely, getting in and out of bed/chairs, getting in and out of a bathtub/shower and on and off the commode.  They may also teach their patients how to safely use walkers and canes to get around their homes as well as address balance and strengthening exercises.  This was just a brief summary of what PTs do in the home and the populations they may work with.  To learn more about physical therapy, check out these links.

http://www.apta.org//AM/Template.cfm?Section=Home

http://www.bls.gov/oco/ocos080.htm

The Aging Suite is dedicated to providing older individuals, and their families and caregivers, with tips and tools for aging well at home.  Aging Suite embraces the concept of Aging in Place, defined by the National Aging in place Council as the ability to continue to live in one’s home safely, independently, and comfortably, regardless of age, income, or ability level.

While The Aging Suite provides general information and tips on topics that may impact older individuals, the information provided is not intended to replace the services of skilled professionals, such  occupational and physical therapists  (OTs and PTs).  Many individuals need these rehabilitation services to help them return and live at home safely.  OT and PT services can be crucial in helping people return to everyday functional skills. 

Visit The Aging Suite next week when we discuss the role of the OT and PT in the home environment.