Staying Fit: A Routine Matter
Getting into and remaining in good physical shape doesn’t have to be difficult. Two seniors who reaped the benefits of an exercise regimen share their simple routines and the satisfying rewards. Click here to view article.

Staying fit doesn’t have to be difficult or complicated. You don’t have to join a gym where everyone is 20 years old and wears body-fitting shorts and tops, or join the kind of hiking club where the group starts at 6 a.m. to get to the top of the mountain by noon.

There are several easy exercises that can keep you healthy; some can even be done at home using a chair or wall. A fitness regimen can include activities you do as part of your daily life, such as gardening or dancing. Many find joining a class with other seniors gives them structure, motivation and a way to meet others. The key is to maintain a schedule that becomes routine.

Benefits of Exercise

The National Institute on Aging (NIA) lists several benefits for exercise and physical activity. They can help:

• Maintain and improve your physical strength and fitness
• Improve your ability to do everyday activities
• Improve your balance
• Manage and improve diseases like diabetes, heart disease and osteoporosis
• Reduce feelings of depression and may improve mood and overall well-being

Two Seniors Reap the Rewards

Two older adults who maintain a regular fitness schedule add another benefit: improving your social network. Georgiann Ash, of West Virginia, has participated in Silver Sneakers exercise classes five days a week for more than five years. She enrolled in Silver Sneakers, a national fitness program for older adults, through her Humana HMO. The program is available through Medicare health plans, Medicare Supplement carriers and group retiree plans. Classes use chairs, hand-held weights, elastic tubing with handles, balls and kickboards for a gentle-on-the-joints workout.

Doing cardio and strength exercises, the 78-year-old has become strong enough to do her own housework, laundry and yard work, while lowering her cholesterol and triglyceride levels. In the class, Ash also found a group that emotionally supported her during a difficult time when her daughter and son had health crises.

“As you get older, you lose friends and family,” she says. “Sometimes you don’t feel like going to the Y and have to push yourself. But you go anyway and are glad you did because of the exercise and morale.”

Ash’s doctor was so impressed with her physical improvement that he started recommending the Silver Sneakers program to other elderly patients. ”He calls me the queen of Silver Sneakers,” she jokes.

Similarly, Frank “Ted” Redman is part of a group of seniors who walk together three days a week and are fortunate enough to enjoy a scenic place to exercise: along the river that flows through Boise, Idaho, where they often encounter deer. “We walk in winter, rain or shine,” he says, although some of the group prefers the mall on cold days.

Redman, 77, started walking after he had back surgery for sciatica and his doctor told him to “walk, walk, walk.” Since he’s started his walking program, he has had no problems with his back. He also suffers from emphysema, so three other days of the week, he and his wife, Barbara, attend a Silver Sneakers program, also through Humana, that emphasizes muscle strength, balance and cardio.

Since they started the program, his emphysema has not progressed, while Barbara has lost 60 pounds and “feels great, healthy.”

The couple will celebrate their 50th wedding anniversary in December. “We started together because we figured we needed to be doing something [about our health],” says Barbara, 75.

“I wish everyone could do what we are doing—keep active,“ she says. In addition, echoing Ash’s comments, “People tend to be isolated, so this keeps us in contact with people.”

Four Types of Exercise

The NIA breaks down exercise into four types, although some of them overlap: endurance, strength, balance and flexibility. Most of us focus on one type, but combining them provides a comprehensive insurance policy for our health and body.

Endurance, or aerobic, exercise increases your breathing and heart rate. Activities include brisk walking, yard work, swimming, dancing, biking or climbing stairs or hills. By keeping your heart, lungs and circulatory system healthy, endurance activities delay or prevent many diseases common in older adults such as diabetes and heart disease. Building your endurance makes it easier to carry out many of your everyday activities.

Strength exercises make your muscles stronger. Even small increases in strength can make a big difference in your ability to stay independent and carry out everyday activities such as climbing stairs and carrying groceries.

Balance exercises, such as standing on one foot and tai chi, help prevent falls, a common problem in older adults. Many lower-body strength exercises will also improve your balance.

Flexibility exercises, such as yoga and stretching, can help your body stay limber. Being flexible gives you more freedom of movement for other exercises as well as for your everyday activities.

Simple Exercises

You can do these exercises at home (from “Basic Exercises for Seniors,” eHow.com and “11 Easy Exercises You Can Do Today,” Everyday Health).

Strength: For strengthening leg muscles, stand upright with legs shoulder-width apart. Place your hands on your hips. Starting with your right foot, step forward about 18 inches. Bend your right knee slightly, then step back with your right foot to the standing position. Step forward with your left foot. Repeat five to 10 lunges for each leg.

You can modify traditional push-ups by doing wall push-ups. Face a blank wall while standing about arm’s length away, lean forward and press your palms flat against the wall. Bend your arms and slowly bring your upper body toward the wall, hold for a moment and push yourself back until your arms are straight again. Do a set of 10, rest and repeat another set.

Arm curls will strengthen the muscles involved with everyday activities such as lifting ordinary objects like a suitcase or a gallon of water. Either seated or standing, hold hand weights down at your sides with palms facing up and elbows tucked in, then bend your elbows and lift the weights toward your chest. Hold each repetition for about 1 second, then slowly lower the arms. Do a set of 10, rest and repeat another set.

For lower body strength, squat in front of a sturdy chair. Keep your arms in front of you and bend to an almost-sitting position. Hold the position for a few moments, then raise yourself back to a standing position. Take a breather and repeat for two sets of 10 repetitions.

Flexibility: Focus on arm and chest muscles by standing with your feet shoulder-width apart and your arms at your sides, then bring both arms behind your back and grasp hands. With your shoulders pulled back, hold the move for about 30 seconds, release and repeat.

Another helpful stretch starts in the same standing position, but this time clasp your hands in front. Turn your hands so the palms face the ground and bring your arms up to shoulder height. Press your palms outward, away from the body, and hold the move for about 30 seconds, release and repeat.

To stretch your quadriceps, start by standing behind a chair and grabbing it with your right hand. Bend your left leg behind you and grab your foot with your left hand. Hold the stretch for about 30 seconds, or long enough that you feel the stretch in the front of the thigh. Release the foot and repeat on the other side.

Balance: Start in a seated position in an armless chair. Keeping your back and shoulders straight, extend your arms parallel to the ground and slowly stand up, without using your hands. Sit down and repeat the move 10 to 15 times. Rest and then complete another set of 10 to 15 repetitions.

Another balance exercise is to stand upright and raise both arms straight out to your sides at shoulder height. Focus on a spot on the wall ahead of you to help you stay steady. Stepping slowly, put one foot in front of the other. When you take a step, lift your back leg slightly off the floor and hold it for a count of one before taking the next step. Begin with 10 steps and then increase the amount.

Following an Exercise Program

The National Institute on Aging offers an exercise program, Go4Life, designed to make exercise and physical activity a routine part of your life. The program offers exercises, motivational tips, an exercise video and an interactive website.

An interactive tool helps you fill out your base activity level, recording how much time each day you exercise or are physically active. From your base level, you can set goals. From there, identify your long-term goals, focusing on where you want to be in six months, a year or two years.

An exercise plan can help you stick to your goals. Go4Life’s My Exercise Plans interactive tool keeps track of your exercise and physical activity plans. Once you’ve put your physical activity plan into action, keeping track of your progress will help you stay with your plan and ensure you’re including all four types of exercise (endurance, strength, balance and flexibility) on a regular basis.

You can use the site’s My Progress Reports interactive tool to see how far you’ve come and whether you need to update your goals. Each month, you will likely see an improvement.

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Kristofferson says he has memory issues but remains active

Actor and Grammy Award-winning country singer Kris Kristofferson says he’s losing his ability to remember — except for song lyrics. Like country legend Glen Campbell, who revealed that he has Alzheimer’s disease but still released music and went on tour, Kristofferson’s memory loss isn’t slowing him down.

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Alzheimer’s disease may have an effect on your relationships

While your abilities may change over time with Alzheimer’s, your ability to live well with the disease depends on how you continue to be a partner in your relationships. Establishing and maintaining meaningful relationships throughout your Alzheimer’s experience can enhance your ability to stay both physically and emotionally healthy.

Alzheimer’s may affect your relationships. While your abilities may change over time, your ability to live well with Alzheimer’s depends on how you choose to continue to be a partner in your relationships.

• How Alzheimer’s affects relationships
• Role changes
• How to keep your relationships positive
• Intimacy and sexuality

How Alzheimer’s affects relationships

It is crucial to remember that you are still the same person you were before the diagnosis. However, after sharing your diagnosis, you may find that others are uncertain about how to respond. Some individuals may shy away, while others may be eager to stand by you and provide support. You may find that people with whom you once had a close relationship are now uncomfortable talking to you or asking you about how you are coping.

It can hurt to realize that certain family and friends you thought would be there for you can’t meet your expectations now. They may have discomfort about your diagnosis, as it stirs up fears about their own futures. People who can’t be a part of your support circle now may join later once they have had time to adjust to your diagnosis.

You may find it difficult to participate in social activities or interactions that were once enjoyable for you. Anxiety, frustration or loss are common emotions that you may experience about changes in your ability to follow a conversation, stay focused with competing background noise, or have enough energy to participate in social activities. For many, these changes in relationships can lead to isolation, withdrawal and depression, which can have a negative impact on your physical and emotional well-being. Learn how others are coping with Alzheimer’s and changing relationships by joining our message boards and seeing Tips for Daily Life.

Establishing and maintaining meaningful relationships throughout your experience with Alzheimer’s can enhance your ability to stay both physically and emotionally healthy.

Role changes

As your abilities change, there will be changes in your roles and responsibilities with family and friends. As a result, you may feel:

• Excluded from conversations about long-term planning and other important decisions.
  1. – Family members may have conversations or make plans for the future without
       your presence or feedback.
• Loss of independence or specific functions that were your primary responsibility.
  1. – Those close to you may feel the need to make the decision for you about when to
       stop driving.
  2. – You may experience a loss of employment or a loss of your role as a bread-winner.
  3. – Others may feel that you should no longer make financial decisions.

• Fear of burdening others with a caregiving role or other responsibilities that you once managed.
• Becoming more dependent on spouse, family or friends.

All of these issues and feelings can affect your relationships. You may find that those closest to you have good intentions, but may provide help that feels invasive or unnecessary at times.

It can be difficult to do, but adapting to changes and accepting help from others can be a way to acknowledge the value their assistance brings to your life. The more you can be involved, the fewer negative feelings you may have.

How to keep your relationships positive and productive

• Be open about your feelings.
  Share your experience living with the disease.
• Be specific about how you would like to continue relationships and how you would like to be treated.
  Let others know what social activities you feel most comfortable doing and the best ways to share time together.
• Learn how to ask for help.
  Tell others how they can help and your expectations for support.
• Strengthen trusting relationships.
  Focus on those relationships which are supportive, and show your gratitude for the people you love and appreciate.
• Reevaluate relationships.
  Don’t dwell on people unable to support you at this time or are unable to have a positive presence in your life. Give them the time to adjust to your diagnosis. Try not to take their pulling away personally.
• See yourself as unique and human.
  You have much left to experience.

Intimacy and sexuality

Throughout your life, your need for physical and emotional closeness and your sexuality and how you experience it, undergo changes. Some of these changes come with maturation, while others reflect changes in life circumstances, such as a diagnosis of Alzheimer’s. The disease may affect sexual feelings and behavior. Take your needs and expectations for intimacy into consideration as the disease progresses.

If you have a sexual partner, openness about sexual changes is a key part of maintaining closeness. The more open and honest you can be with each other, the more you can avoid assigning blame, feeling guilty or lowering the self-esteem of either partner. It is important to educate yourself and your partner about the changes that occur and how to respond appropriately.

Your interest and expression of intimacy and sexuality may be affected by Alzheimer’s in the following ways:

Changes in roles and responsibilities: You may experience uncertainty, frustration or reduced confidence because you need help with things you once managed on your own. These emotions may lead to stress and changes in feelings toward your partner. Your partner may experience some of these same feelings and may need to make adjustments if there is uncertainty about your comfort level with sexual contact or activities that were once pleasurable for you.

Medical issues: Depression can lead to a loss of interest in sex. Speak to your doctor if you or others have expressed concern about your emotional health. Some medications may have side effects that alter your sexual desire. As the disease progresses, you may experience significant increases or decreases in your sexual behavior. Speak with your doctor if these changes are problematic for you or a partner.

Tips for coping with changes in intimacy and sexuality:

• Accept that changes in your intimate and sexual relationships will occur over time.
• You may want to explore new ways to express sexuality and obtain satisfaction. This may include non-sexual touching or sharing memories about intimate moments.
• Communicate with your partner. Discuss new ways to connect and express closeness in ways that are mutually enjoyable.

Download Sexual Relationship Changes and Alzheimer’s

TIPS FROM PEOPLE WITH ALZHEIMER’S

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Handling relationships

1. Remember that your care partner or others close to you did not ask to be put in this situation either. They have fears and frustrations too. Working together may make the situation much better.
2. If longtime friends shy away, remember your best and real friends will stay with you. Invest your time and energy in them.
3. When you feel a loss of equality in a relationship, let the other person know what he or she did and how it made you feel.

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Speaking more than one language may lower dementia risk

In the largest study to date on the link between language skills and dementia, people who spoke two languages staved off the disease years longer than people who only spoke one language. Researchers said that speaking more than one language may lead to better development of the areas of the brain that handle executive functions and attention tasks, which may protect against dementia. More research is needed in this area to confirm and expand on these intriguing findings.

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Sharing your Alzheimer’s diagnosis is an important step

Talking openly with those you trust is a powerful way to educate those around you about your Alzheimer’s disease diagnosis and to engage their support. You may be hesitant to share this information given the impact such a disclosure may have, but keep in mind that Alzheimer’s is not your fault.

Sharing Your Diagnosis

Sharing your diagnosis with others is an important step toward integrating Alzheimer’s disease into your life. You may be hesitant to share your diagnosis with some people, given the impact such a disclosure may have for you. Keep this mantra in mind: Alzheimer’s disease is not your fault.

• Why tell
• Deciding who to tell
• How to share your diagnosis
• Tips from early-stage individuals
• Responses to diagnosis

Why tell others about your diagnosis

As the disease progresses, you will need the support of those who know and understand you. Concealing or denying your diagnosis will limit your ability to cope with the challenges ahead. While some relationships may be tested by what you are revealing, other relationships may be strengthened.

It is normal to experience fear or discomfort about sharing your diagnosis. However, talking openly with those you trust is a powerful way to educate those around you about the disease and to engage their support.

Deciding who to tell

Some individuals choose to share their diagnosis with just their closest family and friends, while others may be comfortable sharing their diagnosis with a broader group of people. Assess your personal comfort level before making this decision. You may feel more supported sharing your diagnosis with close friends and family first before telling others.

Consider the relationships in your life and determine who should be included in your disclosure:

• Who are the people I feel closest to?
• Who will continue to support me with this diagnosis?
• Who I am responsible for telling (spouse, partner, friends)?

How to share your diagnosis

After deciding to share your diagnosis, consider when to tell your news. You may want to tell others about the diagnosis as soon as you get it. Or you may want to wait until you have had time to come to terms with your diagnosis.

“I found after sharing my diagnosis that my friends have a depth to them that I didn’t know they had.”
Ellen M., person living with Alzheimer’s

To increase the likelihood of a comforting reaction when you tell your friends or family about the diagnosis, find a time when you can be alone and relaxed together. Give some thought to the conversation — what do you want to say? Consider writing your thoughts on paper and bringing that with you.

When you share your diagnosis, you may want to talk about planning for the future or about how family and friends can help; you also may wish to explain more about Alzheimer’s.

Help those closest to you come to terms with your new situation by considering these questions:

• How do I think this person will react? If the reaction is something unexpected, how might I feel? What can I do in response?
• How do I want this person to treat me? The diagnosis represents a big change, but it’s only gradually that my needs will change. What do I want from this person right now?
• What does the person need from me now? What can I provide that will help?

Tips from individuals in the early stage

• Go slowly.
  You don’t need to talk about everything in one sitting if the person is having a reaction that is difficult for you.
• Let the person know that both of you will be having different reactions about this over time.
  You both can continue to talk about your thoughts and feelings throughout your relationship.
• Provide educational brochures about the disease.
  You can also direct him or her to alz.org for additional information.
• Let the person know that you are still you.
  Even though you are now living with this diagnosis, who you are and what has made you close to each other continues unchanged. Continuing your commitment to the relationship you have can be comforting to both of you.
• Let people provide assistance when it makes your life easier.
  Just like it helps you to feel useful and needed, helping may make them feel better, too. Accepting help is not an all-or-nothing proposition, and letting others help is not the same as being helpless. They are trying to make life easier for you, and it may help you to let them do that when it feels appropriate.

Responses to diagnosis

Consider how you felt after hearing your diagnosis for the first time. Just like you, the people with whom you share your diagnosis will likely experience similar reactions including fear, anger or relief that there is an explanation for symptoms. You may encounter unexpected or negative reactions. Family and friends may react with denial, or with comments or behavior that reflect their misconceptions about Alzheimer’s disease. Responses may include, “But you seem to be fine” or “You’re too young to have dementia.”

Denial is a common response to the disclosure of a serious illness; it provides distance from overwhelming feelings. Stigmaor misconceptions about Alzheimer’s may exist due to a lack of information. These reactions reflect the person’s need for more time and/or education before they can respond to you in helpful ways. Allow your family or friends time to digest your news so everyone can move forward together in a positive way.

Your first conversation about your diagnosis may grow into an ongoing dialogue about your experience living with Alzheimer’s. Honest communication about your experience and your expectations of each other can help strengthen your connection. Learn ways you can help your family and friends adjust to your diagnosis.

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