From Women’s Wisdom Circle February, 2010 e-newsletter published by Christiane Northrup, MD

As we embrace the possibilities for our parents to age gracefully, independently, and in the right environment it is important to think beyond the norm. When Maria Tadd sent me a copy of her book "Happiness is Growing Old at Home," I quickly realized that the information she had to share would strike a chord with many baby boomers whose parents are in their 70's, 80's, and 90's. She addresses many of the issues that adult children face when their parents become frail.

It's important to realize, however, that many, many people over the age of 70 are not frail or infirm. My mother, age 84, and her best friend Anne, age 87, are currently planning an RV trip up the coast of California this winter. They will be driving across the country together. Anne, who lives alone and chops all her own wood for heat, told me at Christmas that she senses a whole new beginning with her artwork. In addition to her calligraphy, she has visions of creating much bigger, brighter paintings.

Tadd points out that most seniors are on at least five prescription medications. My mother and Anne aren't on any! I just read an article about Jack LaLanne, the fitness pioneer, who at the age of 95, still exercises two hours per day. LaLanne is a shining example of how to age well. He says that dying is easy. But staying fit and healthy takes effort. Please remember that what we think of as "normal aging" is really optional. Our brains and bodies remain capable of growth, change, and new learning at any age.

That said, I know that many of you have parents who are not going to change their lifestyles, who will need assistance to stay in their homes, and may need a friendly robot. (I would love a robot to do the housecleaning and the laundry. Wouldn't you?) – Christiane Northrup, MD

Home Sweet Home…for Aging Parents

Helping elders lead an independent lifestyle

How many times have we heard "Home is where the heart is?" After all, nothing is more nurturing than being in an environment that is familiar—one that nurtures the heart and soul and feels a bit like a pair of well-worn slippers. How lovely it is to see a friendly face, have a neighborly chat, pet the old dog next door during an afternoon stroll, or walk through rooms filled with keepsakes held dear.

The familiar incorporates all aspects of life, not just the walls that house so many memories. It includes the cultivation of long-lasting friendships developed over time; caring neighbors who provide a sense of security and well-being and who check in from time to time or bring freshly picked tomatoes from their garden; and a trusted team of physicians and other health care providers. It also includes the threadbare carpet, the dingy walls that cry out for a new coat of paint, the chipped countertop, the old, over-stuffed, leather recliner, and memories of days gone by—the joys, the laughter, the good times, and the not-so-good times. It is basically the context and content of one's life.

To give up one's life as one has lived it for decades can be a truly frightening prospect. And so, it is no surprise that our elders want to remain in their homes where they feel safe, comfortable, and, above all, happy. According to AARP, nearly 90 percent of seniors and 80 percent of baby boomers want to remain in their homes for as long as possible. If we are to help our elders remain independent, we need to look at aging from a holistic perspective.

Exercise for Independence

One of the most important things we can do for aging parents is to encourage them to remain active. Our parent still may be young at heart, but as the years march on, muscle tone and muscle mass decrease. The joints become stiffer and the stamina once enjoyed seems to vanish. Tasks that once were taken for granted, such as cleaning under the bed or climbing a stepstool, become challenging over time. The knees no longer bend like they used to, and climbing a stepstool requires balance and agility, which are often compromised as old age sets in.

Although obesity, diabetes, and heart disease are on the rise, many diseases are preventable and easier to manage if we adhere to a reasonable diet and follow an exercise program. And, although the sooner we engage in healthy eating and exercise the better, studies have shown that it is never too late to start, even for the "oldest old." In a recent study conducted in Israel, researchers found that the three-year survival rate was three times higher for mid-to-late 80-year-olds who were physically active at least four hours a week.

As the years pass by, you may notice that your parent starts to shuffle a bit. Her stance might widen or her balance may become shaky—signs that she may be more prone to falling. According to the Centers for Disease Control and Prevention, more than one-third of people 65 years of age and older fall each year, and those who fall once are two to three times more likely to fall again. Fall injuries are responsible for significant disability, reduced physical function, loss of independence, and are the leading cause of injury deaths in people 65 years of age and older. Because falls can be so debilitating, it is important to look at ways to prevent them.

Fortunately there are exercises to help strengthen muscles and restore balance, thus minimizing the incidence of falling. Studies have shown that yoga, tai chi, and Pilates promote endurance, strength, flexibility, and balance. Many senior centers recognize the importance of these particular forms of exercise and more and more centers are offering them. (Information on various exercises provided in this article is intended for educational purposes only. Before your parent tries a new exercise program, she should consult her physician.)

Embrace 21st Century Technologies

As our parents age, they will need some kind of assistance to remain independent. Already there is a shortage of certified nurse assistants (CNAs), and this shortage will become significantly worse as baby boomers will be drawing from the same pool. With an onslaught of seniors needing services, the market is ripe for high-tech innovations and alternatives. Digital lifestyle technologies are slowly being adopted by the elderly, allowing them to stay longer in their own homes. They also can lighten the burden of caregivers and ultimately reduce health care costs. Here are some new innovations to consider:

To learn more about the availability of lifestyle enhancing devices and about what is on the horizon, visit http://www.agingathome.info/ and click on "Updates."

Explore Options Early

Do your homework before there is a crisis. Doing your research before your parent needs assistance, when there are no time constraints, will give you an opportunity to scope out the various options and identify the services your parent may need. When you are not stressed out and pressed to find services, you can query agencies in a more relaxed way and make a list of in-home care agencies and facilities that will be able to provide the type of care your loved one deserves.

If you don't do your homework before a crisis occurs, you will find that there are not enough hours in a day to make all the calls, screen the various agencies, and try to put all of the many pieces together that will enable your parent to stay at home or be able to return home after a hospital or rehab facility stay. When that time comes, often unexpectedly, the more information you have at your disposal, the better equipped you will be to hire the services that will be right for your loved one.

Empower Elders When Possible

As we watch our parents age and perhaps begin to show signs of frailty, we need to have an honest discussion with them about where they want to live out their days as well as their viable options in terms of finances, support services, and the possibility of other residential models. Most will say they want to age at home and that they do not want to move into a retirement community, assisted living, or a nursing home. You may have even heard your parent say, " I don't want to be around old people. "

However, sooner or later, because of changes in either her physical and/or mental status, she will need assistance. Given the size of our aging population and the rapid graying of our society, for these wishes to be realized we need to consider a wide variety of available resources, such as the Beacon Hill Village model, the creation of Naturally Occurring Retirement Communities (NORCs), alternative nontraditional, residential models, and new, high-tech devices. We must also continue to design and develop innovative solutions that will allow our elders to age in place.

As we embrace the possibilities for our parents to age gracefully, independently, and in the right environment it is important to think beyond the norm. Imagine how liberating it would be for your elder to wake up according to her own biological clock, to eat breakfast mid-morning, to go outside and listen to the songbirds, feel the warmth of the sun and be one with nature—to be among all those little treasures in life that feed the soul. With a little planning and creativity, all this and more can be available to your aging parent.

This article contains excerpts and adaptations from Happiness Is Growing Old at Home by Maria Tadd. Note: The content of this article applies to all aging parents, but in an attempt to avoid the clumsiness of "his or her" and "he and she," Ms. Tadd has elected to use "her" and "she" with the non–gender-specific "parent."

Reprinted with permission

Christiane Northrup, MD, a board-certified ob/gyn, is a visionary pioneer, beloved authority in women’s health and wellness, and the author of the ground breaking New York Times bestsellers Women’s Bodies, Women’s Wisdom and The Wisdom of Menopause. Through her exclusive Women’s Wisdom Circle, Dr. Northrup shares cutting-edge medical and lifestyle advice.

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