CSA Blog Senior Living Decisions: Motivating Factors and Fear of Change

When circumstances make it clear that it’s time for some older adults to make changes in their living situations, the decision can be difficult if not traumatic. Helping them through the process requires trust and understanding of the person’s needs and fears. Click here to read blog post.

When circumstances make it clear that it’s time for some older adults to make changes in their living situations, the decision can be difficult if not traumatic. Helping them through the process requires trust and understanding of the person’s needs and fears.

“I’m just starting to look into different senior living services and options.”
This is typically the first thing someone says when inquiring about senior living services. As many senior advisors know, whether they are working with seniors or their adult children, there is typically a motivating factor that is prompting the inquiry. This is also true for someone simply inquiring about in-home care or independent living, but the motivating factors usually increase in severity or complexity as the level of services needed increases. It is human nature to resist change until there is a reason, so it is natural that most people take a reactive approach when researching senior living services and options. They do so only when the situation is no longer safe, or when there has been an incident that requires a higher level of support.
It is usually clear to the advisor, family members, and even older adults themselves that a change in support is needed to continue living a safe and quality life. So why is it that despite a clear need, there is often a high level of resistance to make changes in support services or in the living situation?
There are several common objections among those faced with these types of decisions:
“I don’t want to lose my independence.”
“I have to sell my house before I can do anything.”
“I am still managing just fine in my home by myself.”
Even if these objections are true, the concern that prompted the inquiry still exists. But often the reality is that these are just excuses. There may be some level of validity, but most of the time there are deeper underlying fears that keep a person from making necessary decisions.
This is where the tug of war begins. A crisis or a concern causes people to feel that a change is needed, yet underlying fears pull them away from making the change, causing uncertainty as to which direction to go.
So how can you help someone through the ambivalence that comes with looking into senior living services and options? The key is to understand that this is not simply a transactional decision. It’s not just deciding to bring in additional services to their current home, or choosing a certain home or apartment in a senior living community. Rather, it’s an emotional decision where your main intent should be to help provide solutions instead of simply starting services. The higher the level of trust and education you are able to build with clients, the higher the likelihood they will make the necessary changes they need.
Here are some simple steps to build client relationships and to more effectively help someone through the overwhelming decision process about senior living options.
Learn the Motivating Factor
It is common for people to be guarded and private when initially inquiring about senior living services. This is often caused by having had an experience with an advisor who took a pushy approach. Clients also may not know where to begin their search or what to ask. An important question for the senior advisor to ask is, “What is happening or has happened to cause you to inquire about senior living services?” Knowing what is motivating the inquiry will help direct the conversation, and showing genuine care in addressing the concern will help establish initial levels of trust.
Understand the Day-to-Day
Gather information about what the day-to-day situation is like for the older adult. Often the crisis or emergency is only the tip of the iceberg, and most likely just a symptom of the current situation. Understanding the day-to-day challenges and contributing factors is important because often, when these are resolved, the urgency to make a change decreases. People are then more inclined to continue in the situation that caused the emergency in the first place. They are less likely to open up and be honest about the challenges when the immediate need goes away. A good question to ask is, “What is not working in your current situation?” As mentioned, this is a decision process. This step may take some time and include numerous phone calls, visits, and meetings with the older adult and/or family members. The very nature of building trust takes time, but as the level of trust increases, the layers will begin to peel away and the client’s level of education will increase as well.
Get to the Bottom of It
Advisors should try to find out what is really causing the ambivalence. It isn’t uncommon for people to be unable to fully recognize the true underlying fears and concerns that are preventing them from making the necessary changes to their living situations. The resistance may be because this is a topic that most people avoid until they are forced to look into it. Encourage clients to make a list of what is pushing them to make a change and what is keeping them from making the change. The simple act of writing out thoughts often helps people to identify what is creating their ambivalence.
Recognize the Fears
A senior advisor must understand the underlying fears. Fear is one of the main emotions people struggle with when faced with bringing additional services into one’s current home or moving from living in a single-occupancy home to a community environment, including:

• fear of losing independence;
• fear of losing control of day-to-day decisions;
• fear of change; 
• fear of the unknown; 
• fear of running out of money; 
• fear of not being the one to care for a spouse; 
• fear of admitting they need help;
• and fear of losing their identity.

It is critical to understand what the person’s individual fears are. A simple question that can open up this conversation is, “What do you feel you would lose if you made a change in your current situation?” Once the concerns are stated, follow up with questions that help you better understand them. For example, “What does independence mean to you?” Or, “What would help you feel like you were maintaining your independence?”
Readdress the Motivating Factor
The final step is to readdress the motivating factors for the initial inquiry. If the fears and concerns are not addressed, the importance of motivating factors often gets downplayed, and the fears win the tug of war. Yet, if advisors have a clear understanding of their clients’ fears along with a high level of trust, they are more equipped to help them stay focused on the motivation for change and the steps needed to address the concerns. A few simple questions to ask when helping someone struggling with ambivalence might be: “What do you feel you would gain by making this change?” And “What do you feel you would gain by waiting to make this change?”
People by nature tend to have a hard time with change due to the uncertainty of something new and not knowing what to expect. The greater the change, the more difficult the decisions required to make that change can be. It is often said that the decision to utilize senior care services or to move to a senior living community can be one of the most difficult decisions a person will ever make. The harder the decision, the higher the level of ambivalence. Hopefully, by incorporating this simple approach to addressing a person’s ambivalence, advisors will be able to increase the level of trust with their clients and more effectively help them through this difficult decision process.

http://www.optimumseniorcare.com/services/alzheimerscare.php

http://optimumseniorcare.com/blog/

https://www.facebook.com/OptimumseniorcareIL

Senior Spotlight Octogenarian Is Table-Tennis Champ

As a young woman in Austria, Lisa Modlich joined the French Resistance during World War II. Now, in her 80s, she’s using the same ferociousness to face down opponents across Ping-Pong tables around the world – and winning. Click here to view article.

As a young woman in Austria, Lisa Modlich joined the French Resistance during World War II and taught the Jews she knew to ski so they could escape the Nazis by crossing the Austrian border into Switzerland. Perhaps the grit she showed then is what helps her now to win table-tennis championships in her 80s.

The Houston woman has won 115 gold medals and 20 silver on the international, senior table-tennis circuit. In the 2010 World Veterans Table Tennis World Championships, where she competed for the first time in the over-80 bracket, she bested her competitors—notable in a field that is largely dominated by Europe and Asia.

After she won her first gold medal in the 1992 Houston Senior Olympics, “I got greedy and I wanted more,” she told Next Avenue. She went on to claim national titles and thrives on the competition. “You get a high after you play,” she says. “I don’t drink, but I think it’s almost like being drunk when you win a medal.”

Modlich was one of seven subjects for the documentary, Ping Pong, produced and directed by British brothers Hugh and Anson Hartford, who followed the international players to China for the championship.

During the war, Modlich escaped to Paris, then moved to Houston, where she worked as a translator for the United Nations. In fact, when Modlich competed for the world title of the 2010 championships held in China’s Inner Mongolia region, she learned conversational Chinese, adding to the five languages in which she is fluent.

Her current husband, Joachim, is a competitive sharpshooter who is 25 years her junior; they have been married 45 years. He is “a very good table-tennis player as well,” she says. “Once in a while he can beat me, but he’s a little younger.”

Before taking up Ping-Pong, Modlich was an avid tennis player. But at age 66, the retired legal secretary decided it was just too hot. “I gave up tennis up for a sport I could play indoors with air conditioning.”

She believes she has an innate talent for the game. “There’s a certain connection between eyes and elbow that you’re born with,” she says. “People can play 50 years and not win anything. The connection has to be there. You can learn how to play and how to hold the racquet, but the reaction to the ball is inborn. It doesn’t change with age. The muscles get slower, not your reaction.”

Practicing two to three hours a day, Modlich doesn’t understand why other Americans don’t do more physical activity. “Don’t get stuck behind the television, that’s all there is to it,” she told Next Avenue. Instead of watching television, get up and take up some sort of sport where you have to move—a fast sport like table tennis—and keep it up as long as you can.”

Sources

“Meet America’s 88-Year-Old World Table Tennis Champ,” September 4, 2013, Next Avenue

“Competitive table tennis champs like Lisa Modlich seem not to age,” September 9, 2013, Houston Chronicle

.http://www.optimumseniorcare.com/services/alzheimerscare.php

http://optimumseniorcare.com/blog/

https://www.facebook.com/OptimumseniorcareIL

Lifestyle Trends Reaching Out to People with Dementia
Many of us have parents, spouses or friends who are living with dementia. Although it’s often difficult to communicate with them, experts say they need respect and attention. What is the best way to reach out? Click here to view article.

As we get older, many of us have someone in our lives who has dementia. Maybe it’s your aging father in the nursing home, or your spouse who is showing early signs of Alzheimer’s, or even a neighbor. Maybe they’re not making sense or don’t respond when we say something. What’s the best approach to people whose minds may be debilitated?

Causes of Dementia

Dementia, including Alzheimer’s, is a progressive brain disorder that makes it increasingly difficult to remember things, think clearly, communicate with others or take care of yourself. Dementia can cause mood swings and even change personality and behavior. Yet, experts say, it’s important to remember that the person with dementia still has feelings and wants to communicate.

Richard Taylor, a retired psychologist, was diagnosed with Alzheimer’s-type dementia in 2001. Since then, he’s advocated for individuals with Alzheimer’s disease. In his blog, one of his goals is to show that people living with dementia are complete human beings “still possessing all the needs and wants” of every human, not “damaged goods.”

Because Alzheimer’s damages pathways in the brain, it’s difficult to find the right words and to understand what others are saying. Your loved one may incorrectly substitute one word for another or invent an entirely new word to describe a familiar object. He or she may get stuck in a groove—like a skipping record—and repeat the same word or question over and over. They may curse or use offensive language.

Some of the greatest challenges of caring for someone with dementia are the personality and behavior changes that often occur. Understanding what makes a person with dementia behave the way they do can help caregivers cope with the strange behaviors.

“I can’t begin to describe the relief my father felt (he actually broke down in tears) when I was able to explain to him that when Mom doesn’t recognize him but keeps asking for him by name, she is looking for her ‘young’ husband. He has found great comfort in starting to better understand her condition.” That comment is from the website for Creating Moments of Joy for the Person with Alzheimer’s or Dementia: A Journal for Caregivers, by Jolene Brackey.

The effects of dementia not only change over time but also may be better on some days and worse on others, so caregivers need to be flexible and open to whatever is happening. As the dementia gets worse, the person may not be able to communicate at all, but that doesn’t mean they don’t want to engage with others or don’t have needs or feelings.

Every Behavior Has a Purpose

If the person with dementia can’t tell us what they need, they may do something that seems inexplicable to us, like taking all the clothes out of the closet on a daily basis. Perhaps the person is fulfilling a need to be busy and productive.

Agitation may be triggered by a variety of things, including environmental factors, fear and fatigue. Most often, agitation, which includes irritability, sleeplessness and verbal or physical aggression, is triggered when the person feels that “control” is being taken away. Sometimes this can be handled in small ways, such as allowing someone who believes money is missing to keep small amount in a handbag or pocket.

People with dementia who wander, seemingly aimlessly, may be bored or looking for something. They also may be trying to fulfill a physical need—thirst or hunger, or a need for exercise. Discovering the triggers for wandering can provide solutions for dealing with this behavior.

Another characteristic of people with dementia is “sundowning”—a restlessness, disorientation and other troubling behavior that gets worse at the end of the day. Experts believe this behavior is caused by a combination of factors, such as exhaustion from the day’s events and changes in the person’s biological clock that confuse day and night. To alleviate this, you can increase daytime activities, particularly physical exercise.

“When someone is screaming from their room, what are they seeking?” Brackey writes. “Attention. When someone falls out of their wheelchair, what are they seeking? Attention. When someone is depressed in their room, what are they seeking? Attention.”

Connecting With Your Loved One

Many people might decide to stop visiting a parent or spouse, for example, because the person with dementia doesn’t seem to recognize them or doesn’t react to them. Yet new research shows that even when the person with dementia doesn’t remember a visit, the feelings will stay with them. A new study suggests that even if people with the mind-robbing illness quickly forget a visit or other event, the emotions tied to the experience may linger. The study included 17 Alzheimer’s patients who watched 20-minute clips of either happy or sad movies. Even though their memories of the films quickly faded, the patients’ feelings of happiness and sadness associated with the movies lingered for up to 30 minutes, the researchers reported (from “Emotional Life Lingers for Alzheimer’s Patients, Even as Memory Fades,” September 29, 2014,Medline Plus).

A website for caregivers (Dementia Care Notes) suggests a relaxed approach with people with dementia. “Sitting with a patient and talking can be a relaxing activity for both the patient and the caregiver. Patients often spend a large part of their days struggling to understand the world around them and doing what is necessary. . . . If we forget our helplessness and anxiety about the way the patients struggle, they will also feel less pressure and relax.” As an example, a son listened to his mother tell a long story about her brother running away from home and listed the cities he had visited and things he had done. “None of what she said was correct. By just sitting with her and letting her talk . . . the son experienced the strange world that was real to his mother, and just stayed with her for company. The mother, feeling happy that she had been heard, was more relaxed the whole day.”

Despite their problems, people with dementia often retain their ability to feel emotions and to sense emotions of others. A daughter, tired because of caregiving for her mother, one day sat near her mother and started talking about how tired and sad she was. Her mother reached out her hand and squeezed the daughter’s hand in sympathy. The shocked daughter realized that her mother, despite her dementia, retained her ability to feel love and sympathy, and had sensed the daughter’s sorrow and responded to it. . . . After this incident, the daughter started spending time with her mother just holding her hand, or talking of simple things, not asking questions or expecting answers, and found that she was able to connect back to the affectionate mother for at least some time every day.”

For other suggestions on how to communicate with people with dementia, see sidebar, “How to Communicate.”

Sources

“10 Tips for Connecting to Someone With Dementia,” May 2012, Next Avenue

“Communicating with people with dementia,” NHS

“Communication,” Dementia Care Notes

“Alzheimer’s: Tips for effective communication,” Mayo Clinic

“Changes in communication,” Alzheimer’s Association

How to Communicate

The Alzheimer’s Association offers suggestions for ways to approach and help someone with dementia that make it easier for both parties.

Experts say that it’s important to remember to respect people with dementia and avoid talking down to them or around them, instead of to them. You can best meet these challenges by using creativity, flexibility, patience and compassion. It also helps to not take things personally and maintain your sense of humor.

When first approaching a person with dementia:

• Identify yourself. Approach the person from the front and keep good eye contact; if the person is seated or reclined, go down to that level.
• Call the person by name. It helps orient the person and gets his or her attention.
• Use short, simple words and sentences. Lengthy requests or stories can be overwhelming. Ask one question at a time.
• Speak slowly and distinctively. Use a gentle and relaxed tone—a lower pitch is more calming.
• Patiently wait for a response. The person may need extra time to process what you said.
• Repeat information or questions as needed. If the person doesn’t respond, wait a moment. Then ask again.
• Turn questions into answers. For example, say “The bathroom is right here,” instead of asking, “Do you need to use the bathroom?”
• Avoid confusing and vague statements. Instead, describe the action directly: “Please come here. Your shower is ready.” Instead of using “it” or “that,” name the object or place.
• Encourage unspoken communication. If you don’t understand what is being said, ask the person to point or gesture. You may need to be more aware of nonverbal messages, such as facial expressions and body language. You may have to use more physical contact, such as reassuring pats on the arm, or smile as well as speaking.
• Be patient and supportive. Let the person know you’re listening and trying to understand. Show the person that you care about what he or she is saying and be careful not to interrupt.
• Avoid criticizing or correcting. Don’t tell the person what he or she is saying is incorrect. Instead, listen and try to find the meaning in what is being said. Repeat what was said if it helps to clarify the thought.
• Offer a guess. If the person uses the wrong word or cannot find a word, try guessing the right one.
• Focus on feelings, not facts. Sometimes the emotions being expressed are more important than what is being said. Look for the feelings behind the words. At times, tone of voice and other actions may provide clues.
• Turn negatives into positives. Instead of saying, “Don’t go there,” say, “Let’s go

http://www.optimumseniorcare.com/services/alzheimerscare.php

http://optimumseniorcare.com/blog/

https://www.facebook.com/OptimumseniorcareIL

• here.”

Your Money

Figuring Out Long-Term Care Costs
While most retirees say they plan on living out their years at home, a large percentage end up in assisted living or nursing homes. How much can you expect to pay for long-term care? A look at average costs and stays can provide a rough idea. Click here to view article.

A lot of financial advisors warn that retirees aren’t financially prepared for a long future existing only on Social Security, that they haven’t saved enough, that medical costs will eat more out of their budget than they think and that they aren’t prepared for long-term care. Although most retirees say they plan to live out their remaining years at home, a large percentage end up in assisted living or nursing homes. In fact, according to the Centers for Medicare and Medicaid Services, a majority of people over age 65 will require some type of long-term-care services, and more than 40 percent will need a period of care in a nursing home.

Retirees or those about to retire who want to figure out what long-term care might cost them can make an educated guess, based, of course, on averages. The MetLife Mature Market Institute’s market survey for 2012 found that:

• The national average daily rate for a private room in a nursing home is $248, while a semiprivate room is $222, up from $239 and $214, respectively, in 2011. That’s about $81,000 annually for a semiprivate room.
• The national average monthly base rate in an assisted-living community rose from $3,477 in 2011 to $3,550 in 2012. That would equal $42,600 a year.
• The national average daily rate for adult day services remained unchanged from 2011 at $70.

However, costs can vary widely depending on the state and region of the country where you live (see sidebar, “Differences among States”). It’s also important to remember that different states require—and different facilities offer— varying baselines of level of care, so one place might offer nothing more than three meals a day plus activities, while another facility includes providing medicines, for example, in its base rate. This is especially important regarding assisted-living, which is not federally regulated.

Differences by Sex, Marital Status

Long-term costs for long-term care also vary by sex and marital status. For example, single women, on average, live the longest in nursing homes. Below is a comparison of the average length of stay in a nursing home (from Long-term Care Association’s 2008 LTCi Sourcebook):

Female
2.6 years

Male
2.3 years

Married
1.6 years

Single/never married
3.8 years

Widowed
2.3 years

Divorced/separated
2.7 years

Average Stays for Long-term Care

The average nursing home stay is 28 months, according to the government’s latest National Nursing Home Survey (“How to Pay For Nursing Home Costs,” U.S. News & World Report). The average stay for assisted-living residents is 27 months, according to Kiplinger.com

Other organizations break down the long-term care figures differently (Alzheimer’s care, continuum of care). The National Clearinghouse for Long-Term Care Information makes it simpler. On average, a 65-year-old today will need some form of long-term-care services for three years, according to Kiplinger.com.

Figuring Out the Total Costs

To determine the average amount a person would have to pay for long-term care, you can extrapolate from the data:

• Cost of semiprivate room in a nursing home for average 28-month stay: $186,480
• Cost of assisted living (base level) for average 27-month stay: $95,850

If the average stay is three years for long-term care, your long-term care costs would be some combination of those two figures. Of course, if you need more assisted-living care than basic care, the cost goes up. If you’re a woman, you will probably pay more because you will live longer.

Another factor to throw into the mix is the average age of residents in long-term care. The median age of residents in nursing homes was 82.6 years; in assisted living, 86.4 years, according to MetLife.

If you’re wondering if you will live that long, the Social Security Administration provides calculations. For example, a man reaching age 65 today can expect to live, on average, until age 84.3, while a woman turning 65 today can expect to live, on average, until age 86.6.

Where Will Money Come From?

A recent Wall Street Journal article (“10 Things Retirees Won’t Tell You,” Sept. 21, 2014) said that nearly 60 percent of people over 55 who haven’t yet retired have saved less than $100,000 for retirement. So where will an individual find the approximately $200,000 needed for long-term care?

While Medicare does not pay for assisted living, it will help pay for nursing home care for up to 100 days if certain conditions are met (from Senior Home):

Medical News
Eating Well: Best Diet for Older Adults
As we get older, calorie and nutrition needs change due to more body fat and less lean muscle. Less activity can further decrease calorie needs. The challenge for older adults is to get proper nutrition and modify their calorie intake. Because no food provides all of the nutrients, experts say it’s best to eat foods representing all the various food groups. Click here to view article.

As you get older and want to maintain your health, it is important to focus on the kinds of food you need for your body type and any medical concerns and not just how many calories you consume or achieving an ideal weight. For example, older people who don’t get enough of the right nutrients can be too thin or too heavy. Some may be too thin because they don’t get enough food, while others might be overweight partly because they get too much of the wrong types of foods. Likewise, people with certain medical conditions might find it necessary to limit certain types of foods or follow a specific diet (e.g., no concentrated carbohydrates, low sodium, low fat, low cholesterol, low potassium).

Problems with Malnutrition

Malnutrition is a real problem for older adults. A recent study showed that more than half of American seniors seen at emergency departments are either malnourished or at risk for malnutrition. Of those who were malnourished, more than three-quarters said they had not been previously diagnosed with malnutrition, the study authors found (HealthDay News). Malnutrition, which can be caused by eating too little food, too few nutrients and digestive problems related to aging, can lead to fatigue, depression, weak immune system, anemia, weakness, and digestive, lung and heart problems, as well as skin concerns.

Older adults may eat less often or eat only those foods with a distinctive or strong flavor. As we age the intensity of taste and the ability to identify different tastes diminishes. While older people tend to maintain the ability to detect sweet taste, we have more difficulty detecting sour, salty and bitter tastes. Other factors that affect taste include dentures, medications and smoking, while problems with digestion and medication interactions can also affect our diet.

As we get older, calorie needs change due to more body fat and less lean muscle. Less activity can further decrease calorie needs. The challenge for older adults, especially for those who are overweight, is to meet new and higher nutrient needs than when younger yet consume fewer calories. For example, older adults require increased calcium to stay bone healthy. The answer to this problem is to choose foods high in nutrients in relation to their calories. Nutrient-rich foods supply vitamins, minerals, protein, carbohydrates, fats and water and keep your muscles, bones, organs and other parts of your body healthy.

Beyond getting enough nutrients, eating the right foods may reduce the risk of heart disease, stroke, type 2 diabetes, bone loss, some kinds of cancer and anemia. If you already have one or more of these chronic diseases, eating well and being physically active may help you better manage them. Healthy eating may also help you reduce high blood pressure, lower high cholesterol and manage diabetes.

As we get older, digestive secretions diminish markedly. Adequate dietary fiber, as opposed to increased use of laxatives, will maintain regular bowel function and not interfere with the digestion and absorption of nutrients, as occurs with laxative use or abuse.

How Many Calories a Day?

The National Institute of Health (NIH) provides guidelines for how many calories an older adult should consume.

A woman over age 50 should consume daily about:

• 1,600 calories if her physical activity level is low (only performs activities associated with typical day-to-day life)
• 1,800 calories if she is moderately active (walks the equivalent of 1.5 to 3 miles a day at 3 to 4 miles per hour)
• 2,000 to 2,200 calories if she has an active lifestyle (walks the equivalent of more than 3 miles a day at 3 to 4 miles per hour)

A man over age 50 should consume daily about:

• 2,000 to 2,200 calories if his physical activity level is low (only performs activities associated with typical day-to-day life)

• 2,200 to 2,400 calories if he is moderately active (walks the equivalent of 1.5 to 3 miles a day at 3 to 4 miles per hour)

• 2,400 to 2,800 calories if he has an active lifestyle (walks the equivalent of more than 3 miles a day at 3 to 4 miles per hour)

Best Foods to Eat

People of all ages need more than 40 nutrients to stay healthy. With age, it becomes more important that diets contain a sufficient amount of calcium, fiber, iron, protein and vitamins A, C, D and folic acid. Because no one food or pill provides all of the nutrients, it’s best to eat a variety of foods to get the full spectrum of nutrients. (Colorado State University Extension.)

The NIH provides a diet that is a mixture of nutrient-dense foods that are low-calorie. It contains vitamins, minerals, complex carbohydrates, lean protein and healthy fats.

Vegetables, Fruits and Grains

Vegetables, fruits and grains offer important vitamins and minerals to keep your body healthy. Most of these foods have little fat and no cholesterol. They are also a source of fiber, which can help with digestion and constipation, and may lower cholesterol and blood sugar.

They also provide phytochemicals—natural compounds such as beta-carotene, lutein and lycopene—that can promote good health and reduce the risk of heart disease, diabetes and some cancers. In addition, vegetables, fruits and grains contain antioxidants, including vitamins C and E, which can protect cells in the body from the damage caused by oxidation. Antioxidants are thought to promote health and to possibly reduce the risk of certain cancers and other diseases.

Vegetables. Healthy choices include broccoli, spinach, turnip and collard greens, as well as other dark, leafy greens. Aim for lots of color on your plate as a way to get a variety of vegetables each day—for example, tomatoes, carrots, sweet potatoes, pumpkin, red peppers or winter squash.

Fruit. To make sure you get the benefit of the natural fiber in fruits, choose whole or cut-up fruits. Choose fresh, frozen, canned or dried fruits and go easy on fruit juices.

Grains: Any food made from wheat, rice, oats, cornmeal, barley or another cereal grain is a grain product. Approximately one ounce of grain foods counts as a serving. This is about one slice of bread, roll or small muffin. It also equals about one cup of dry flaked cereal or a half-cup of cooked rice, pasta or cereal. At least half (3 ounces) of the grain foods you eat per day should be whole grains, which are a major source of energy and fiber, rather than refined.

Other whole grains include popcorn, brown rice, wild rice, buckwheat, bulgur and quinoa.

Protein

Protein helps build and maintain muscle and skin. As we age, protein absorption may decrease, and our bodies may make less protein. However, this does not mean protein intake should be routinely increased, because of the general decline in kidney function. Excess protein could unnecessarily stress kidneys.

Sources of protein include meats, seafood, beans, nuts, seeds, and tofu. When buying meats, which also provide B vitamins, iron and zinc, choose lean cuts or low-fat products, because they provide less total fat, less saturated fat and fewer calories than products with more fat.

For instance, 3 ounces of cooked, regular ground beef (70% lean) has 6.1 grams of saturated fat and 230 calories. Three ounces of cooked, extra-lean ground beef (95% lean) contains 2.9 grams of saturated fat and 164 calories—and more protein, too, 19.46 grams of protein vs. 21.94 (from the U.S. Department of Agriculture’s Agricultural Research Service).

Beans, including pinto beans, kidney beans, black beans, chickpeas, split peas and lentils, tend to be low or lower in saturated fats, and provide fiber. Another source of protein is nuts and seeds.

One egg, one-fourth cup of cooked dry beans or tofu, one tablespoon of peanut butter or a half-ounce of nuts or seeds equals 1 ounce of meat, poultry or seafood. Be aware that peanut butter and nuts are very high in fat, though mostly good fat, so should be eaten in moderation.

Dairy products

Older adults need 1,200 mg of calcium a day. Low-fat or fat-free dairy products, including milk, yogurt and cheese, provide calcium and vitamin D to help maintain strong bones, as well as protein, potassium, vitamin A and magnesium. Nondairy sources of calcium include broccoli, almonds, kale, canned fish such as salmon and sardines, and calcium-fortified tofu or soy beverages.

Choose sweet dairy foods with care. Flavored milks, fruit yogurts, frozen yogurt and puddings can contain a lot of added sugars—empty calories that provide little in the way of nutrients.

Salmon, sardines and tuna provide vitamin D, while some cereals and juices are fortified with extra calcium and vitamin D.

Fats

Your body needs some fats for energy and for healthy organs, skin and hair. Fats also help your body absorb vitamins A, D, E and K and provide essential fatty acids, which your body cannot make on its own.

On the other hand, fat contains more than twice as many calories as protein or carbohydrates, and increases your risk of type 2 diabetes, heart disease and other health problems, so you should aim to limit fats to 20 to 35 percent of your daily calories. For instance, if you eat and drink 2,000 calories daily, only 400 to 700 of the calories should be from fats.

The number of calories from fat in a serving of packaged foods is listed on the Nutrition Facts label of the package (see sidebar, “How to Read the Nutrition Facts Label”).

The best fats are polyunsaturated and monounsaturated fats from vegetable oils such as soybean, corn, canola, olive, safflower and sunflower. Polyunsaturated fat is also in nuts, seeds and fish.

The worst kinds are saturated fats and trans fats, which increase the risk for heart disease. You should consume less than 10 percent of calories from saturated fats, which are found in red meat, milk products, including butter and palm, and coconut oils. Common sources include regular cheese, pizza, grain-based desserts such as cookies, cakes and donuts, and dairy desserts, such as ice cream.

Processed trans fats are found in stick margarine and vegetable shortening and are often used in store-bought baked goods like pastries, crackers and candy and in fried foods at some fast-food restaurants.

To help you choose the right foods, MyPlate for Older Adults offers examples of good food choices and physical activities for older adults who want to stay healthy.

Sources

“Eating Well Over 50,” Helpguide.org

Nutrition and Aging,” Colorado State University Extension

“Malnutrition Threatens Many U.S. Seniors Seen at ERs,” August 13, 2014, Medline Plus

How to Read the Nutrition-Facts Label

The U.S. Food and Drug Administration requires a Nutrition Facts label on all processed foods. This label gives the percentage of Daily Value—which means the percentage of the recommended daily amount of a nutrient in a single serving of the food, based on the nutritional needs of a person eating 2,000 calories a day. It also lists the gram amounts for fats, cholesterol, sodium, potassium, carbohydrates and protein plus

• the serving size (i.e., how large one serving of the food is)
• how many servings of the food are in the container
• how many calories are in one serving of the food
• which kind of fats
• which nutrients (vitamins, etc.) the food provides

For example, on a label for macaroni and cheese, the Percent Daily Value for total fat is 18 percent. This means that one serving of macaroni and cheese (1 cup) will give you 18 percent of the total amount of fat you should allow yourself each day, assuming you eat about 2,000 calories daily.

Keep in mind that the calories, nutrient amounts and percentages listed in the Nutrition Facts are for one serving only. The package might contain two or more servings. If you eat two servings, you would consume twice the calories, fat, sodium, carbohydrates, protein, etc., as you would for one serving.

http://www.optimumseniorcare.com/services/alzheimerscare.php

http://optimumseniorcare.com/blog/

https://www.facebook.com/OptimumseniorcareIL