Senior Toronto blog

November 30, 2017

Seniors and marijuana

In Canada, access to medical marijuana has been legal since around 2001, and access to recreational marijuana will become legal in July 2018. This is good news for seniors. I’ll tell you why, but first we need a little detour into the past.

Marijuana (also called cannabis) packs a double punch: it has medicinal properties, and it produces a high. For centuries, cultures around the world have woven it into their healing practices, customs and religious rites. But in the West, especially in the United States, the legal history of marijuana has taken a sinister turn. It has been repeatedly vilified by powerful individuals and groups in the service of political, racist and business agendas. The history of marijuana in America is sordid but fascinating. If you want to get your toes wet you can start here or here. The upshot is that the research evidence is sparse and uneven, and patients are missing out.

Here is the best evidence available to date. This is a nerdy list, but I want to be unbiased and thorough. First, here are the conditions that marijuana can treat.

Conclusive or substantial evidence:

  • Treatment of chronic pain in adults
  • Treatment of chemotherapy-induced nausea and vomiting
  • Improving multiple sclerosis spasticity symptoms

Moderate evidence:

  • Sleep disturbance associated with certain disorders

Limited evidence:

  • Increasing appetite and reducing weight loss associated with HIV / AIDS
  • Improving symptoms of Tourette syndrome
  • Improving anxiety symptoms
  • Improving symptoms of post-traumatic stress disorder

Here are the possible adverse effects.

Substantial evidence:

  • Statistical association between cannabis smoking and worse respiratory symptoms in respiratory disease with long-term cannabis smoking
  • Increased risk of motor vehicle crashes
  • Development of schizophrenia or other psychoses, with the highest risk among the most frequent users
  • Statistical association between increases in cannabis use frequency and progression to developing problem cannabis use

Moderate evidence:

  • No statistical association between smoking cannabis and incidence of lung cancer
  • Impairment in cognitive domains of learning, memory and attention (acute cannabis use)
  • Small increased risk for development of depressive disorders
  • Increased risk of suicide ideation and suicide attempts with a higher incidence among heavier users
  • Increased incidence of social anxiety disorder with regular cannabis use
  • Being male and smoking cigarettes are risk factors for the progression of cannabis use to developing problem cannabis use
  • Major depressive disorder is a risk factor for the development of problem cannabis use

Limited or no evidence:

  • Increased risk of acute myocardial infarction
  • Statistical association between cannabis smoking and developing chronic obstructive pulmonary disease
  • Statistical association between cannabis use and death due to cannabis overdose

Obviously there are plenty of research gaps, but with increasing public acceptance and more and more jurisdictions legalizing marijuana, hopefully the research will soon follow. Meanwhile, what stands out for me is the evidence for chronic pain, an issue of pressing concern for many seniors. It’s an obvious and very welcome alternative to opioids. So if you have chronic pain or any of the other conditions listed above as having evidence support, and you’re not satisfied with your current treatment, consider discussing marijuana with your doctor. Remember that medical marijuana comes without the kick. Just take the lowest possible dose, use in moderation, and eat it instead of smoking it.

Some doctors are uncomfortable prescribing marijuana, given the spotty knowledge base, lack of evidence for dosing levels, lack of standardized medication, and tentative, limited guidance from the College of Family Physicians of Canada. All in good time. If your doctor won’t prescribe it, then just wait until next July, have a candy and see what happens. Peace, man.

October 29, 2017

Elderfitness

Aging in place, managing in our own home for as long as we can -- that’s what most of us want. We’re in no hurry to go into care. But as we get older, it gets harder and harder to climb the stairs, do housework and yard work, shop for groceries, walk to the bus stop. Fitness is the key. We can’t stop the clock from ticking, but we can try to maintain or maybe even increase our ability to function, bearing in mind our porous bones and wonky hearts and aching, swollen joints. So how do we do it? Many senior centres run fitness programs, but they are mostly geared toward older seniors and are too gentle for seniors who are still active. So I searched through the evidence-based literature to try to come up with a formula that we could try at home, without hiring a personal trainer or buying expensive equipment. I’m no fitness guru, so do this at your own risk, and check with your doctor first. Don’t forget to warm up and cool down.

Endurance

  • 20 minutes every day of moderately intensive aerobic activity: energetic continuous movement that makes your heart beat faster and makes you feel warm.
  • Examples: low-impact aerobics, aquafitness, brisk walking, bicycling, dancing.

Interval training

  • Short bursts of intense activity, 2 days a week
  • Examples: Take a walk. For the first 10 minutes, walk at an easy pace. For the next 15 minutes, do a hard walk for 1 minute, then a medium walk for 1 minute, then an easy walk for 1 minute. Repeat 4 more times. Finish with a 5-minute easy walk. Or, if you have an exercise bike: warm up at an easy pace for 5 minutes, then cycle for 20 seconds at high intensity, cycle slowly for 90 seconds, repeat 4 – 6 times, cool down with 2 minutes of light cycling and 2 minutes of walking.

Muscle strengthening

  • 2 days a week, exercises that strengthen all the major muscle groups, upper and lower body.
  • 8 to 12 repetitions per activity, or until it would be hard to do another repetition. If they get easy, do another set.
  • Examples: squats, one-arm row with hand weights, bicep curls with hand weights, using resistance bands, wall pushups.

Balance

  • A few minutes a day.
  • Examples: walking backward or sideways, heel walking, toe walking, standing from a sitting position, standing on one foot.

Flexibility

  • A few minutes a day.
  • Examples: arm and leg stretches, yoga.

This is all very sketchy and you need to fill in the details by finding examples and routines on the internet. YouTube is full of great free workouts; you can exercise in front of your computer. Use keywords like “20 minute” and “low impact”. Keep searching until you have a nice collection of varied workouts so you’re not doing the same ones every day. Check out some pregnancy workouts; they work well for seniors because they’re safe, and careful about balance.

If you would like to read up on guidelines or get some background information, go to:

September 30, 2017

Majority of one

She stares out the window, watching people pass by on the street. In a little while she’ll warm up some soup, then watch television. From time to time she casts a wistful glance at the telephone, which never rings.

It runs so deep in our culture, that image of the senior on her own, lonely and forgotten, a figure of pity and contempt. The older we get, the more likely we are to be on our own: for women over 65, it’s 33%. By the time we reach 85, it climbs to 43%. But our society tilts heavily in favour of marriage and family life: tax breaks, insurance benefits, travel, grocery packaging, entertainment, media, and on and on. So people on their own get short shrift.

But then along comes Statistics Canada with some startling news from the 2016 Census. For the first time in Canadian history, the number of one-person households has surpassed all other types of living situations. They accounted for 28.2 per cent of all households in 2016, more than the percentage of couples with children, couples without children, single-parent families, multiple family households and all other combinations of people living together. Living on your own is the new normal. But our cultural values and social arrangements haven’t caught up yet.

Ah, you say, but what about loneliness? What about belonging? What about quality of life? It turns out that a lot of the research has bought into the prevailing cultural values, assuming marriage and family life to be the norm, and equating solo living with loneliness. Discard those assumptions, and a new picture emerges. Here’s a sampling from some recent research:

  • Women who get married get fatter.
  • Women who have always been single have better overall health than currently married women.
  • People who have always been single are more attentive to friends, family and neighbors than people who are married.
  • Single people have a more diverse set of confidants than married people do.
  • Single people are more likely to volunteer for civic organizations than married people are.
  • Single people have less debt than married people do, even when the married people do not have kids.
  • Single people are less materialistic than married people are.
  • The more self-sufficient single people are, the less likely they are to experience negative emotions. For married people, the reverse is true: the more self-sufficient they are, the more likely they are to experience negative emotions.
  • Single people are more likely than married people to have regularly looked after someone who was sick or disabled or elderly, for at least three months.
  • Solitude brings many rewards to those who value it. People who are single, particularly those whose first choice is to be single, seem especially likely to value solitude and benefit from it.

This is not to devalue the very real challenges that seniors face who age on their own, or the pain of losing a long-time spouse. But don’t take on any excess baggage by buying into stereotypes and received ideas. Emotionally and intellectually, it’s richly rewarding to be alone. Take an inward journey.

August 29, 2017

Fun Guide follies

If you are a fairly fit, active senior who wants to stay that way, you probably have a date in early August marked in your calendar. That’s when the Parks Forestry and Recreation (PFR) Fun Guides get posted online, and you can start planning your fall and winter activities. When we were younger, many of us thought of the Fun Guides as one-stop shopping for fitness and recreation, but now that we’re seniors, how well do they stack up?

Suppose you have osteoporosis and want to find an osteo fitness class. PFR lets you search for programs by entering terms in a search box, but no matter how you word it – osteo fit, osteo fitness, osteofitness, bone – you get no hits. You can try drilling down through the listings instead, so you click on Fitness, and then what? Is it under Cardio? Muscle conditioning? Other? I eventually found it under Cardio – Older Adult. But if you don’t want to play guessing games, you may as well just download the Older Adult brochure for your district and scroll through until you find listings for what they call Osteo Fit. You’ll find some classes, but they’re pretty unevenly distributed. Lots of choice if you live in Etobicoke or Scarborough, but there’s only one location for all of North York, and three for Toronto / East York. If the locations or times aren’t convenient, what do you do now?

It turns out that there are lots of organizations that provide fitness, recreational and other programming for seniors, but aren’t listed in the Fun Guides, because they aren’t funded by PFR. Consider these:

  • Partially funded community centres. These ten community centres get some of their funding from the city, but not through PFR, and have to raise the rest themselves. Most of them have senior programs. Unlike the community centres in the Fun Guides, these have their own websites. You can find the list here, though this page doesn’t provide links to their websites.
  • Neighbourhood centres. These organizations try to build strong communities and promote social participation and inclusiveness. Seniors are a vulnerable group, so these centres offer programming for us. You can see the list of them here.
  • Community health centres. They take a broad view of health, looking at the social, economic and environmental factors that affect how healthy we are. So their senior programs include fitness and social activities, as well as health promotion and education and more. You can find a local one here.
  • Senior centres, of course. Actually, PFR runs seven senior centres, six in Etobicoke and one in Scarborough, so they’re in the Fun Guides, but most senior centres get their funding elsewhere. It’s tricky trying to get a list of the Toronto senior centres. The best way I could find is by going through the resource lists for the Local Health Integration Networks (LHINs). Torontonians might belong to any of five LHINs, so first find your LHIN, then click Seniors and then Seniors’ centres. These listings are maintained by a not-for-profit organization; it’s not a paid advertising directory. It’s pretty thorough, too.

Got a headache yet? Feeling a little dizzy? Frustrated? Exasperated? Well, there’s a cure for that. Come on over to Senior Toronto. In the site search box, type “osteo fitness” (without the quotes). Check out the 25 hits. Seven of them are not in the Fun Guides: two partially-funded community centres, one neighbourhood centre, one community health centre and three senior centres. Piece of cake. Senior Toronto is your one-stop shop.

July 30, 2017

The fine art of doing nothing

The Italians call it “il dolce far niente”, the sweet do-nothing, and they have perfected it down to a fine art. Not hard to get the hang of it when you can sip wine on a terrace in an ancient Tuscan town and gaze out over the valley all afternoon. It’s a little trickier over here, where we pride ourselves on how busy we are. But free time is one of the most precious gifts of retirement, and I think it’s worth learning how to enjoy the extravagance of wasting some of it. First, we have to tussle with some notions that our culture has ingrained in us: that we have to be useful, that we have to achieve goals, that time is money. If we’re tied to our gadgets, we have to set them aside for a while. We have to eliminate all distractions, everything that fills up our minds, including reading and listening to music. But no meditation either; we’re not trying to empty our minds. We’re going to let our minds drift.

I’m new at this myself, so I’m trying out some short experiences first. Once I get comfortable with those, I’m going to try longer ones. Here are some ideas:

  • Lie down outside somewhere. I dare you. Watch the clouds roll by.
  • If you have a dog, go to the park and play together. Roll around in the grass.
  • Find a bench. It’s especially fun to be sitting still when there’s a lot going on around you. Try the boardwalk along the Beach; a bus stop; Philosopher’s Walk; a local park where kids are playing baseball or skateboarding or romping through a splashpad.
  • Eat chocolate. It has to be good chocolate, of course. No gobbling. If you need lessons in savouring chocolate, you can get them here.
  • It’s hard to believe, but some people don’t like chocolate. So eat an orange; they’re delicious too. Don’t like to get your hands sticky? Eat it in the shower.
  • Take an afternoon nap. It doesn’t have to be long; 20 or 30 minutes will do. You’ll feel like a new person. Call it a siesta.
  • Try some purposeless walking.
  • Go to a cafe with an outdoor patio. Order a cold drink or a coffee. See how long you can make it last.
  • Take a bath. Add Epsom salts or bath oil or bubbles. Rubber ducky optional.
  • Take a long bus or streetcar or subway ride. Pick a route you don’t normally take. The streetcar routes are especially colourful, but you can have a good time just watching the people around you. Don’t stare.

June 30, 2017

Summer in the city

Retirement often feels to me like a permanent vacation. No bosses nipping at your heels, no impossible deadlines. Lots of deliciously slow, leisurely days. I rarely feel the urge to travel. But every once in a while, especially in the summer, I want a little break from my familiar routine. You too? Here are a few outings that can transport you to a different place and time, all for the price of a local transit ticket:

  • Allan Gardens Conservatory. Built in 1910, the Allan Gardens Conservatory is an elegant glass-domed gem, worth seeing in its own right. Inside you’ll find a permanent collection of exotic plants, and four seasonal flower shows a year. Admission free. On the south side of Carlton St between Jarvis St and Sherbourne St. From College subway station, take the 506 Carlton streetcar east to Jarvis St.
  • Black Creek Pioneer Village offers an opportunity to explore 19th century buildings, heritage-bred farm animals, and beautiful gardens. Admission $12 for seniors. At 1000 Murray Ross Parkway, near Jane St and Steeles Ave. From Finch subway station, take the Steeles 60 West bus to Murray Ross Parkway.
  • Islington Village Murals. Stroll along Dundas St West between Kipling Ave and Islington Ave and view the 26 murals that depict actual local people, places, and events from the early 1900s. Beautifully painted by professional artists along a lively stretch of Dundas West. Download the brochure from the website. From Islington subway station, walk north on Islington Ave a short distance to Dundas West.
  • Mount Pleasant Cemetery has one of the finest collections of almost every tree and shrub that can grow in eastern North America. Many are labelled so that you can easily identify them. Buried here are many prominent figures from 19th and 20th century Toronto, including Timothy Eaton, William Lyon MacKenzie King, Hart Massey, Egerton Ryerson, and Garfield Weston. Download the map from the website. Between Yonge St and Bayview Ave, and Moore Ave to Merton St. From St Clair subway station, walk north on Yonge St a short distance to the entrance.
  • Niagara Falls. On Fridays, Saturdays, Sundays and holidays in the summer, the GO train goes directly to Niagara Falls. It leaves Union Station at 9:00 am, and arrives in Niagara Falls at 11:05 am. Gawk at the falls, mingle with the tourists, eat fudge. If you don’t have a Presto card, ask for a senior day pass.
  • Patio by the Lake. Just sit, have a meal or a drink, enjoy the view, and pretend you’re in Muskoka. I’ve given you a link to a useful list that was compiled in 2016.
  • Port Credit. A lively, picturesque waterfront with a resort-town atmosphere. Enjoy the shops and restaurants along Lakeshore Road. Meander along the lakefront trails. Take the GO train to Port Credit; if you don’t have a Presto card, ask for a senior day pass. The waterfront is a short distance from the GO station.
  • Redpath Sugar Museum. The Redpath Sugar Refinery is one of the few remaining manufacturers on the Toronto waterfront. Their museum is a fascinating excursion into Toronto’s industrial history. Contact them in advance to arrange your visit. At 95 Queens Quay East, between Yonge St and Lower Jarvis St. From Pape subway station, take the 72 Pape bus southbound to the Queens Quay East at Lower Jarvis St West Side stop.
  • Riverdale Farm occupies 7.5 scenic acres along pathways through wooded areas, around ponds, and past flower and vegetable gardens on the edge of the Don Valley. It recreates an early 20th century Ontario farm in the heart of Cabbagetown. Admission free. At 201 Winchester St. From Castle Frank subway station, take the 65 Parliament St bus south to Winchester St, then walk east along Winchester St to the end.
  • Self-Guided Walking Tours. The City of Toronto lists about 40 on their website. They cover everything from history and architecture to ravines and the waterfront. Some offer online interactive versions. They all have downloadable printable guides. There’s something for everyone.