Senior Toronto blog

February 29, 2024

Normal aging

It seems like every other day my body comes up with some new problem. And every time it happens, I wonder whether I should go to the doctor, or whether it’s just another symptom of normal aging. How am I supposed to know? I’ve never been old before. I wish I had a tricorder like the medical officers on Star Trek had. They’d just swipe it over the patient and get an instant diagnosis. Failing that, I thought I’d check out what the experts tell us to expect. I’ve pulled this together using reliable sources, like MedlinePlus, the Mayo Clinic and the Merck Manual. It’s a long list, but if you’re a senior, you probably won’t be surprised. This is not a formula; different changes happen to different people at different times. Many age-related changes creep up slowly. Whatever changes you’re going through, remember that there’s a lot you can do to mitigate many of them and go on enjoying your life.

Bones and joints

  • Bones become less dense, leading to osteopenia and osteoporosis, risk of fractures
  • Vertebrae become less dense, making the spine shorter
  • Cartilage thins, leading to osteoarthritis
  • Ligaments become weaker and more rigid, making us less flexible
  • Exercise; take vitamin D and dietary calcium

Brain and nervous system

  • Blood flow to the brain decreases
  • Reaction time slows
  • Vocabulary, short-term memory, the ability to multitask, learn new material, and recall words may be reduced
  • Balance is compromised by changes in the inner ear
  • Some red flags for dementia are the inability to learn and retain new information; the inability to complete tasks you are familiar with; disorientation in time or place
  • Don’t worry too much about forgetfulness if it is not interfering with your daily life
  • Stay mentally and socially active; challenge yourself

Digestive system

  • Digestive process slows, sometimes leading to constipation
  • Increased likelihood of developing lactose intolerance
  • Liver may be less able to remove drugs from the body; drug effects last longer
  • We may react differently to medications, may need lower doses
  • Eat a healthy high-fibre diet; exercise

Ears

  • Reduced perception of high-pitched sounds
  • Trouble hearing in groups or loud environments with background noise
  • Have your hearing checked periodically

Endocrine system

  • Insulin production diminishes and is less effective, increasing the risk of prediabetes and type 2 diabetes
  • Have regular blood tests

Eyes

  • Reduced near vision
  • Increased sensitivity to light
  • Need for brighter light
  • Changes in colour perception
  • Cataracts
  • Floaters
  • Dry eye
  • Schedule regular checkups; test for glaucoma and macular degeneration

Heart and blood vessels

  • Blood vessels stiffen, making the heart pump harder
  • Buildup of plaque in artery walls, obstructing blood flow
  • Blood pressure tends to increase
  • Eat a healthy low-sodium, cholesterol-lowering diet; manage stress; get enough sleep
  • Maintain regular aerobic activity, even just brisk walking

Immune system

  • Immune system acts more slowly
  • Cancer is more common among seniors
  • Vaccines are less protective
  • Infections like pneumonia and influenza are more common and more severe among seniors
  • Get all the regular vaccines

Kidneys and urinary tract

  • Bladder can hold less urine, resulting in more frequent urination
  • Urinary sphincter is less able to close tightly, sometimes leading to urgency or incontinence
  • In men, prostate gland may enlarge and obstruct the flow of urine
  • Do Kegel exercises

Lungs and the muscles of breathing

  • Breathing muscles weaken
  • Lungs become less elastic, deliver less oxygen
  • Exercising may be more difficult
  • Lungs become less able to fight infection
  • Try to build up endurance gradually through exercise

Mouth and nose

  • Reduced ability to taste and smell
  • Dry mouth
  • Receding gums
  • Nose lengthens and enlarges
  • Schedule regular dental checkups; brush and floss twice a day

Muscles and body fat

  • Muscle mass, strength, stamina and flexibility decrease
  • Percentage of body fat increases, fat distribution changes
  • Diet and exercise can minimize effects

Skin

  • Skin loses underlying fat, becomes thinner, drier, less elastic, more wrinkled
  • Reduced sensitivity to pain, pressure, temperature
  • Number of sweat glands and blood vessels decreases, making the body less able to cool itself
  • Increased risk of heat-related disorders
  • Skin bruises more easily, heals more slowly
  • Less protection against ultraviolet radiation; age spots
  • Use sunscreen, mild soap, moisturizers

Sleep

  • Sleep becomes fragmented
  • It may take longer to fall asleep, and seniors sleep more lightly, awakening more in the night
  • Don’t eat, drink or exercise within two to three hours before bedtime
  • Follow a regular bedtime routine

January 29, 2024

Prediabetes

Last summer, after a routine blood test, I learned that my blood sugar had gone up into the prediabetic range. I was surprised, because I thought that my diet was pretty healthy. But I sure didn’t want to add diabetes to my growing list of ailments. So I cut out white carbs, starchy vegetables like potatoes and corn, cheese, and anything with added sugar. I discovered chickpea pasta, farro and yu choy, stopped feeling hungry between meals and lost five pounds. Now my bad numbers are going back down.

When younger people get prediabetes, it’s a red flag. They have to make lifestyle changes, or they’re on their way to diabetes. But when seniors get prediabetes, it’s a different story. Guess what proportion of seniors have prediabetes: it’s 48.8%. That’s right: almost half of us. And it happens even to seniors who exercise regularly and eat healthy diets. That’s because many seniors produce less insulin and process it less efficiently than younger people. But we’re not at the same risk as younger people of going on to develop diabetes. A recent study of seniors with prediabetes showed that, over a 12-year period, most of the study subjects remained stable or reverted to normal. In fact, more people regressed back to normal than proceeded to diabetes. If you would rather read a layman’s version of the study, check out this New York Times article. But prediabetes still increases the risk of heart disease, and it may progress to diabetes in some seniors. So if we’re given a diagnosis of prediabetes, we probably shouldn’t blame ourselves for negligence, but we should keep exercising and maintaining a healthy diet.

It's simply a fact of life in old age: we have to keep pedalling faster just to stay in place.

December 29, 2023

Pedometers

I’m enrolled in a research project involving cardiac rehab patients. I had to fill out a detailed questionnaire about my sleep habits, diet and mental health. The researchers also sent me a simple pedometer, and asked me to record my steps every day for seven days. I stared at the number for the day and had no idea what it meant. Was it high? Low? Average for my age? I normally do a 20 to 30 minute aerobics video every morning, rotating through a dozen or so that I have bookmarked. The next day, I decided to add an extra 10-minute routine, just to see what difference it made. To my surprise, my total was lower than on the day before. That really got me wondering. What does a pedometer measure? What good is the information? Is it a useful tool for seniors?

I started watching the pedometer while I did my aerobics routines. It worked fine when I was stepping forward or back. But most other moves, like step-touch, grapevine and hamstring curls, didn’t register at all. A simple pedometer measures only regular steps, one foot in front of the other as we shift our weight from side to side. We could be working full tilt doing weight training, balance routines, yoga, chair exercises, cycling or aquafit, and the pedometer would think we were taking a nap. Many of us seniors have mobility issues that restrict our walking, like spinal stenosis, hip or knee arthritis, balance disorders or neurological problems. So we can’t walk as much as younger people, and our fitness routines often include many modalities besides walking. That’s why researchers have not been able to set meaningful step-count standards for seniors: they’re not a reliable indicator of our activity levels, and generic goals may not be achievable for many of us.

So what good is a pedometer for seniors? I can think of two worthwhile applications. It’s still useful to measure walking. Walking is not just another exercise move: it’s an essential life skill. We want to be able to go shopping, go to the park, meet friends at a restaurant. No matter what our health issues are, we want to push ourselves to do as much walking as we can. A pedometer is excellent for this. We can use the numbers to compete against ourselves, see if we can up the stats just a little bit. But we have to make sure we don’t overemphasize walking to the detriment of other forms of exercise, just because walking is easy to measure. We need to maintain a balanced program.

A pedometer can also be useful simply as an activity motivator, encouraging us to raise our numbers. We tend to get more sedentary as we age, and may underestimate how much time we spend just sitting there. Too much sedentary time is dangerous for us. This issue is now beginning to be addressed in fitness guidelines for seniors, for example the ones from the Canadian Society for Exercise Physiology. I think guidelines like these are the best way to monitor our overall activity, and the pedometer can be added in as a handy little prod, reminding us to get off the couch.

November 30, 2023

Decluttering for seniors

After my mother died, it fell to me to clear out the house she had lived in for over fifty years. All the cupboards and drawers were crammed full of paper: utility bills, drugstore coupons and greeting cards going back to the 1950s. The bedroom cupboards were full of ratty, worn-out clothes. My parents simply never threw anything out. At first I was appalled. Then I had to confront the fact that apparently neither of them was capable of making the simplest decision about what was valuable and what was not. Finally came the anger, that they knowingly left this mess for their daughter to clean up. It took me months to finish the job, and the experience tarnished my memories of my parents ever after.

So there’s the first good reason to declutter your home: so you don’t dump a big job that’s really your responsibility onto someone else. Don’t leave it to family members, no matter how you feel about them, and don’t leave it to your executor. You don’t want to be remembered as a deadbeat. It’s worthwhile to declutter no matter what your future plans may be. If you’re planning to move into a smaller home, you’ll be ready to roll. If you’re not planning to move, your home will be more spacious, safer and easier to clean. You’ll get a demanding, stressful task out of the way while you can still handle it yourself. And once you’ve gotten rid of things you no longer need, what’s left will be the things that really matter.

So why haven’t you done it already? Well, there’s no question that decluttering is a daunting task. It can be physically demanding: crawling around on the floor, reaching up to high shelves, packing, moving boxes and disposing of them. It’s emotionally demanding too. That stuff is the story of our lives. As we handle our belongings, they will evoke powerful memories. We may find ourselves less and less mobile over time, and take comfort from having our familiar things around us, to help us feel secure, so it may be hard to let them go. The task can seem overwhelming. It takes motivation, stamina, self-discipline and organizational skills. But we have to do it anyway, because we’re not deadbeats.

Luckily, there are lots of guides and checklists to help us declutter our homes, for example here and here. Read through them, make a plan, go slowly. Start small, maybe focussing on an area with no sentimental baggage, like the bathroom. Take time to reminisce. Take pictures of important items or make a journal. If you have valuable items you want to keep, add a memorandum to list them in your will, so your executor knows who they should go to, and there won’t be squabbles. Get help from family, friends or professionals if you need to.

Decluttering is hard work, but it can be liberating. It’s part of healthy aging: letting go of what no longer serves us, and focussing on the life we’re living now.

October 29, 2023

Fall vaccines

It’s more complicated for seniors this year. There are four kinds of vaccines you can get, and some of them cost money.

Covid

  • The fall 2023 vaccine has been updated to cover the currently circulating variants
  • You’re eligible to receive it 6 months (24 weeks) after your last vaccine or Covid infection
  • Access has been priorized first for high-risk groups, then it’s available to all beginning October 30
  • You can safely get a flu shot at the same time
  • You can book an appointment through the provincial booking system, a local pharmacy and some family doctors
  • Free

Flu

  • Access has been priorized first for high-risk groups, then it’s available to all beginning October 30
  • There are three types of flu vaccines this year. The standard-dose vaccine protects against 4 virus strains. The adjuvanted vaccine protects against 3 strains and adds a substance to boost immune response, and the high-dose vaccine protects against 4 strains at higher doses. These last two vaccines are available to people aged 65+. Research shows little difference in effectiveness between these two, so just take what’s available
  • If you want just a flu shot, you can book an appointment on the Toronto Public Health website, a local pharmacy, or a family doctor
  • Free

Pneumonia

  • Also called pneumococcal vaccine
  • It used to be that if you had a pneumonia shot at age 65+, it was good for 10 years, but now there are new vaccines and the guidance is changing
  • If you’ve never had a pneumonia shot, you should get one
  • The newer versions are called PCV20 (conjugate) and PCV15 (conjugate). The older ones are called PCV13 (conjugate) and PPSV3 (polysaccharide)
  • PCV20 has been shown to offer greater immune response
  • The Ontario Immunization Advisory Committee now recommends PCV20 for all adults aged 65+. For patients who have had a previous pneumonia vaccine, they recommend PCV20 at least five years after immunization with PPV23, or one year after immunization with PCV13 alone. But the approval is recent, and both newer and older versions are being offered
  • You can apparently get the pneumonia vaccine at the same time as other vaccines, but use your own judgment about how many shots you want to get at once
  • There may be a charge for this vaccine

RSV

  • This is a new one
  • The vaccine, called Arexvy, prevents lower respiratory tract disease caused by RSV (respiratory syncytial virus). The disease is particularly dangerous for seniors
  • The publicly funded vaccine rollout is targeting seniors 60+ living in long term care homes and some retirement homes
  • If you are a community-dwelling senior, should you get the RSV vaccine? You’ll need to discuss this with your doctor
  • If you do want it, you have to arrange to pay for the vaccine through your healthcare provider
  • You need to wait 14 days between receiving Arvexy and any other vaccine

September 29, 2023

Senior recreation programs 2023-24

I've been working on updating Senior Toronto listings to include the latest offerings. When it comes to the listings from Toronto Parks and Recreation, this is harder than it used to be. Fall programs used to be announced in early August, but now they don't show up until nearly the end of the month, leaving us with little time to make decisions before registration day. And they no longer produce a Fun Guide in print or PDF. The Fun Guide was a clear, easy-to-use document that laid out all the programs for each organization. Now you have to search online. It's up to you to discover where to look. Registered programs and drop-in programs are listed separately, with very different interfaces. The drop-in programs were especially slow to update this year, with new information appearing in dribs and drabs over several weeks. There is no longer a separate heading for Older Adult programs; you have to sift through all the programs to find any with the subheading "older adult". So finding senior programs is harder than ever, and many seniors have expressed frustration trying to hunt them down.

What you do find is pretty disappointing. Many of the Centres that routinely run senior programs have cut back on their offerings, especially arts, dance, games and walking programs. I was pleased to find eight Centres offering senior programs for the first time or bringing them back after a hiatus. But there were also ten Centres that offered senior programs last year -- and some for many years before that --but are not offering any now.

I don't know how Toronto Parks and Recreation Community Centres decide which programs to offer. But I can't imagine that their senior programs aren't needed. After being stuck at home through four years of the pandemic, most seniors are eager to get back to being active and engaged and involved with other people. If you can't find programs that interest you through Toronto Parks and Recreation, remember that there are other organizations that also provide senior programming: community centres not run by Parks and Recreation, community health centres, neighbourhood centres and senior centres. In addition to fitness and recreation, many of these organizations also offer a variety of support services. They're all listed here on Senior Toronto.