Senior Toronto blog

January 30, 2018

Why ageism won’t go away

I went to the drugstore the other day to buy a birthday card, and it made me want to head straight over to the headache remedies. Card after card full of jokes about sagging body parts, leaky plumbing, failing memories, and being over the hill. They wouldn’t dare write like this about women or ethnic groups. But here we are in 2018, and ageism still gets a free pass. It’s everywhere: media, entertainment, fashion, cosmetics, public services, workplace, medical care, long term care, and among our own nearest and dearest. In this era of political correctness and righteous indignation, why can’t we put an end to ageism?

You don’t have to be a psychologist to recognize that much of it is fear. When we’re young, we don’t want to think about our own decline and death. That’s not going to happen to me! So younger people find ways to distance themselves from us seniors. They view us through negative stereotypes, patronize us, treat us as weak and needy, a burden on society, undeserving. We get that; after all, we used to be them. But they haven’t figured out that someday they’re going to be us.

Closer to home, ageism may take a different shape. Family members, especially adult children, may wonder aloud about our ability to look after ourselves, offering help we don’t need, planning our future without asking us what we want. Obviously, some of that is driven by their real concern for our welfare. But sometimes their real concern is for their own peace of mind. They might like to see us tucked away safely in care so that they don’t have to worry about us or help us out at home. And we don’t want to cause them worry, so we might end up going into care or living in their granny flat when that’s not what we really want.

Here’s an uncomfortable fact: sometimes the stereotype is true. Aging is a tough slog. Most of us will eventually experience chronic illness and physical decline. Some of us will suffer mental decline and dementia. When young people see us standing in a crowded subway car, how can they tell which of us is on his way to a ravine hike and which of us has severe arthritis and needs to sit down? When staff see us at Home Depot, how can they tell which of us is building her own deck and which of us can’t figure out what light bulb to buy? So they decide it’s safer to assume we need help.

I don’t think we can wipe out ageism, but as seniors we do have to deal with it. If you relish a good fight, by all means call out the ageists on their most egregious behaviour. Gently but firmly stand up for yourself with your family members, letting them know that you try to exercise good judgment in your life decisions, just like they do, and will call on them when you need help. Don’t fall into the stereotypes, not even when you’re with other seniors. Don’t call yourself an old codger, don’t label a moment of forgetfulness a senior moment, don’t buy anti-aging cream. But take the seat on the subway – you’ll make that young person’s day.

December 29, 2017

My wish list for seniors

Well, Santa’s come and gone for 2017. But I figured I should submit this wish list now, because Santa’s going to need a head start to get through it. Not sure he’ll get it all done by next Christmas.

  • Enough long term care for all who need it, so we don’t have to languish in hospital beds or die on the wait list. And affordable assisted living or home support, so we can age in our own homes and stay out of institutions as long as possible.
  • Someone to please sell some decent clothes for seniors.
  • A ban on anti-aging products. Stop flogging all that snake oil, just let us age naturally.
  • Strong senior representation in neighbourhood associations, to make our local neighbourhoods senior-friendly.
  • A single umbrella group with clout that represents and advocates forcefully for seniors’ needs and interests to governments, businesses and service agencies.
  • Appropriate social and recreational programming to cater to seniors of different ages, needs and abilities.
  • Professional financial trustee services, for people who can’t manage their finances themselves anymore and don’t have anyone to do it for them. Trust companies currently make these services available only to millionaires.
  • Affordable glasses, hearing aids, dental care, wheelchairs and smart phones.
  • Enough geriatricians and gerontological nurses and social workers to meet the burgeoning demand.
  • An end to widespread public acceptance of ageism, a form of discrimination that still gets a free pass in our society.

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.
  • 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.