A Guide to Being A Remarkable Human Being

Remarkability lies in the edges. The biggest, fastest, slowest, richest, easiest, most difficult. Not everyone wants to be remarkable most just want to be ordinary and they do not appreciate your efforts to be remarkable. So what? Most people are ostriches, heads in the sand, unable to help you anyway. Your goal isn’t to please everyone. Your goal is to please those that actually speak up. Here is a list of some of the ways remarkable people get and stay remarkable. Part Two is tomorrow.

Live Your Own Life: Embrace your uniqueness and live a life true to yourself, not one dictated by societal expectations or the opinions of others. Define your own path and make choices aligned with your values and passions.

Be Authentic: Authenticity involves being genuine and true to yourself. Avoid putting on masks or adopting personas to fit in. People appreciate authenticity, and it fosters genuine connections and relationships.

Come Up With Your Own Sayings:  Express your thoughts and ideas uniquely. Creating your own sayings or adopting unconventional expressions can set you apart and make your communication memorable.

Leave Others Better Than You Found Them:  Aim to positively impact the lives of those you encounter. Offer encouragement, support, or a helping hand. Leave a lasting positive impression through your interactions.

Help People Without Wanting Anything In Return:  Genuine acts of kindness without expecting reciprocation create a remarkable impact. Selfless giving builds trust, fosters connections, and contributes to a positive, supportive community.

Don’t Try To Be Perfect: Embrace imperfections and learn from mistakes. The pursuit of perfection can be paralyzing, hindering growth and innovation. Authenticity often emerges from the acknowledgment of imperfections.

Face Your Fears: Confronting fears leads to personal growth and resilience. It might involve stepping out of your comfort zone, taking risks, and overcoming obstacles. Remarkable individuals often face challenges head-on.

Take The Plunge:  Be proactive and take initiative. Whether it's pursuing a passion, starting a project, or initiating change, taking the plunge demonstrates courage and determination.

Question The Norm: Challenge conventional thinking and question established norms. Remarkable individuals often pioneer new ideas, challenging the status quo and contributing to innovation.

Start Your Own Tribe: Build a community around shared values and interests. Starting your own tribe involves connecting with like-minded individuals, fostering a sense of belonging, and making a positive impact collectively.

Say NO To Things: Prioritize your time and energy by saying no to activities or commitments that don't align with your goals or values. Setting boundaries allows you to focus on what truly matters.

You Are Enough: Cultivate self-acceptance and recognize your inherent worth. Being remarkable starts with acknowledging and embracing your unique qualities.

Dear Rheumatoid Arthritis Survivor a positive outlook,

 Dear Rheumatoid Arthritis Survivor, 

Greetings!

I want to introduce myself (with apologies to the "Stones)-I am Rheumatoid Arthritis. While I may have found my way into your life, I want you to know that there’s a brighter side to this journey. Let’s focus on the positivity within this challenging situation.

I’m like a hidden warrior within you, often not leaving a trace in your blood work. Others may not see or hear me, but it’s your body that senses my presence. Together, we can work on managing and living well despite my presence.

I might bring discomfort in various ways, but I also believe in your strength and resilience. Remember the days when you and energy were inseparable? I might have changed the rules, but we can still find moments of joy together, even if it’s in a unique form.

While I interrupt your sleep and make you forgetful and unsure, let’s think of the interruptions as more time to explore new ways of controlling these challenges. You can adjust to find strategies that work for you.

When I am in control, your body temperature will fluctuate, and I may cause swelling. It will help if you see this as a reminder of your body’s unbelievable flexibility and its ability to endure.

As we move along this path, you will experience emotional highs and lows, but remember, you are not alone. There are ways to manage your mood swings to find stability.

Your appearance might change, but it’s the beauty within you that truly matters. We can explore ways to accept these changes together.

Weight fluctuations may occur, but with the right support and guidance, we can work on finding a weight that suits you.

I may affect different parts of your body, but we can adapt and learn to manage each challenge that arises. Let’s focus on what we can do to keep you as healthy as possible.

We may face some challenges, but with determination, we can navigate this journey together.

You didn’t ask for me, but I believe in your ability to face and overcome any obstacle that comes your way. It’s your resilience that drew me to you.

I’ve heard you’re seeking help from doctors to manage me. Keep searching, to find a healthcare provider who understands and can assist you effectively. It may take time, but we will get there.

There might be moments when you feel misunderstood by those around you. So, find comfort in connecting with others who share similar experiences; they can be a beneficial source of understanding and encouragement.

While it might seem like a long journey ahead, know that you possess the strength to overcome each challenge. Your strong will and the care of your loved ones will bring more light to your journey.

Always here, but not in control,

Dear Rheumatoid Arthritis Survivor: a letter

As you may know, I have been diagnosed with Rheumatoid Arthritis, Soon after I received this news, I received an email from a friend that is below. In the next post, you will see that I rewrote the post to reflect a more positive outlook. 

Hi. 

My name is Rheumatoid Arthritis.

I’m an invisible autoimmune disease that attacks your body inside and out, making you want to scream sometimes and cry. I am now with you for life. I’m so sneaky—I don’t always show up in your blood work. Others around you can’t see me or hear me, but YOUR body feels me. 

I can attack you anywhere and anyway I please. I can cause severe pain or, if I’m in a good mood, I can just cause you to ache all over.  Remember when you and Energy ran around together and had fun? I took energy from you and gave you exhaustion. Try to have fun now.

I can take good sleep from you and in its place, give you brain fog and lack of concentration.

I can make you want to sleep 24/7, and I can also cause insomnia.

I can make you tremble internally or make you feel cold or hot when everyone else feels normal.

I can also give you swollen hands and feet, swollen face, eyelids, swollen everything. I can make you feel very anxious with panic attacks or very depressed. I can also cause other mental health problems. Do you know crazy mood swings? That’s me.

Crying for no reason? Angry for no reason? That’s probably me too. I can make your hair fall out, become dry and brittle, and cause rashes, and dry skin, the sky is the limit with me.

I can make you gain weight and no matter what you eat or how much you exercise, I can keep that weight on you. I can also make you lose weight.

I don’t discriminate.

I can invade your skin, your joints, your lungs, your thyroid, your brain, your liver and any other tissue, organ, or bones I wish.

Some of my other autoimmune disease friends often join me, giving you even more to deal with. The list of my friends is quite lengthy.  I probably have more friends than you do because I've taken most of yours away.

If you have something planned, or are looking forward to a great day, I can take that away from you too. You didn’t ask for me. I chose you for various reasons.

That virus or viruses you had that you never really recovered from, or that car accident, or maybe it was the years of abuse and trauma (I thrive on stress.) You may have a family history of me. Whatever the cause, I’m here to stay.

I hear you’re going to see a doctor to try and get rid of me. That makes me laugh. Just try. You will have to go to many, many doctors until you find one who can help you effectively. You will be put on the wrong medication for you, pain pills, sleeping pills, energy pills, told you are suffering from anxiety or depression, and given anti-anxiety pills and antidepressants.

There are so many other ways I can make you sick and miserable, the list is endless - high cholesterol, gall bladder, blood pressure, blood sugar, heart issues among others. That’s probably me.

Can’t get pregnant, or have had a miscarriage? That’s probably me too or the medication you take to try to escape from me.

Shortness of breath or “air hunger?” Yep, probably me. Are your liver enzymes elevated? Yep, probably me.

Teeth and gum problems? TMJ? Hives? Yep, probably me. I told you the list was endless.

You may be given ibuprofen, get massaged, and told if you just sleep and exercise properly, I will go away. You’ll be told to think positively, you’ll be poked, prodded, and MOST OF ALL, not taken seriously when you try to explain to the endless number of doctors you’ve seen, just how debilitating I am and how ill and exhausted you really feel.

In all probability you will get a referral from these ‘understanding’ (clueless) doctors, to see a psychiatrist. Your family, friends and co-workers will all listen to you until they just get tired of hearing about how I make you feel, and just how debilitating I can be.

Some of them will say things like “Oh, you are just having a bad day” or “Well, remember, you can’t do the things you used to do 20 YEARS ago”, not hearing that you said that you can't do things you used to be able to do 20 DAYS ago.

They’ll also say things like, “If you just get up and move, get outside and do things, you’ll feel better.”

They won’t understand that I take away the ‘gas’ that powers your body and mind to ENABLE you to do those things. Some will start talking behind your back, they’ll call you a hypochondriac, while you slowly feel that you are losing your dignity trying to make them understand, especially if you are in the middle of a conversation with a “normal” person and can’t remember what you were going to say next. You’ll be told things like, “Oh, my grandmother had that, and she’s fine on her medication” when you desperately want to explain that I don’t impose myself upon everyone in the exact same way, and just because that grandmother is fine on the medication SHE’S taking, doesn’t mean it will work for you.

They will not understand that having this disease impacts your body from the top of your head to the tip of your toes and that every cell and every body system and organ requires the proper amount and the right kind of medications for YOU. Not what works for someone else.

The only place you will get the kind of support and understanding in dealing with me is with other people who have me. They are really the only ones who can truly understand. I am an invisible illness. I am YOUR Chronic Illness.

Always and Forever

Before a cardiac arrest, men and women have different symptoms, study finds

 This is very important information about Cardiac arrest symptoms. The article is posted here The main points are below:

Of the more than 356,000 cardiac arrests in the United States each year, 90% are fatal.

While there are some known signs of sudden cardiac arrest, it usually occurs without warning.

Researchers from the Smidt Heart Institute at Cedars-Sinai Health System have found that half of people experiencing a sudden cardiac arrest also had a telling symptom 24 hours beforehand.

Scientists also discovered those warning symptoms are different between men and women.

The scientists also found differences in the sudden cardiac arrest warning symptoms between men and women.

Researchers found that the most prominent symptom for women 24 hours before cardiac arrest was shortness of breath. For men, chest pain was the preeminent telltale symptom.

More than 356,000 out-of-hospital cardiac arrests occur in the United States each year. Of that number, about 90% cause a fatality.

Although there are some known signs and symptoms of cardiac arrest — also known as sudden cardiac arrest — most times it occurs without warning.

Now, researchers from the Smidt Heart Institute at Cedars-Sinai Health System have found that half of the people experiencing a sudden cardiac arrest also had a telling symptom 24 hours beforehand.

The future of AI in healthcare

 The future of AI in healthcare is promising and holds tremendous potential to revolutionize the industry. As seniors I belwive we have a vested interested in making sure that technology is used properly in healthcare. After a review of the issues here are my (not expert) thoughts on where where AI is expected to have an impact:

AI algorithms can analyze large amounts of medical data, including medical images, lab results, and patient records, to assist healthcare professionals in diagnosing diseases more accurately and quickly. AI systems have demonstrated impressive capabilities in detecting various conditions, such as cancer, heart disease, and eye disorders, with high accuracy rates. Algorithms are only as unbiased as the data they are trained on. If the training data used to develop AI models contain biases, such as racial or gender biases, the algorithms can perpetuate and amplify those biases in healthcare decision-making. This could result in unequal treatment and exacerbate existing disparities in healthcare.

AI can help create personalized treatment plans by analyzing individual patient data, including genetic information, lifestyle factors, and medical history. This approach allows healthcare providers to tailor treatments to each patient's unique characteristics, leading to more effective and efficient care. However, the use of AI in healthcare raises important ethical considerations. For example, ensuring patient privacy and data security is crucial when dealing with sensitive medical information. If AI systems are not designed to protect patient confidentiality and comply with privacy regulations it will be difficult maintain trust in the healthcare system.

AI can accelerate the drug discovery process by analyzing vast amounts of scientific literature, clinical trial data, and molecular structures. It can assist in identifying potential drug candidates, predicting their efficacy and side effects, and optimizing clinical trial designs. This can potentially reduce the time and cost associated with bringing new drugs to market. AI systems heavily rely on data quality and algorithm performance. Technical limitations, such as data inaccuracies, algorithmic errors, or limited access to diverse and representative datasets, can affect the reliability and effectiveness of AI in healthcare. Thorough validation and ongoing monitoring are necessary to ensure the accuracy and safety of AI-driven solutions.

AI-powered devices and wearables can continuously monitor patients' health parameters, such as heart rate, blood pressure, and glucose levels. This real-time data can be analyzed by AI algorithms to detect abnormalities and provide timely alerts to healthcare providers. Telemedicine platforms can leverage AI to offer virtual consultations, enabling patients to receive medical advice and diagnoses remotely. AI systems excel at processing and analyzing vast amounts of data, but they may struggle with understanding the nuances of individual patient cases. The lack of contextual understanding and the inability to consider the full patient history and circumstances could potentially lead to inaccurate diagnoses or treatment recommendations.

The problem is that as AI systems become more involved in-patient care, there is a risk of reducing the amount of human interaction between healthcare providers and patients. The human touch, empathy, and personalized care that healthcare professionals provide are important aspects of the patient’s experience, and the overreliance on AI could potentially diminish these qualities.

AI can streamline administrative tasks, such as patient scheduling, medical billing, and documentation. Natural language processing (NLP) algorithms can convert spoken or written information into structured data, automating data entry and reducing the administrative burden on healthcare professionals. The introduction of AI in healthcare raises questions about liability and accountability in case of errors, malfunctions, or adverse outcomes. Determining responsibility in complex AI-driven decisions can be challenging, and clear frameworks need to be established to assign accountability and address legal and ethical concerns.

 AI-enabled robots can assist surgeons in performing complex procedures with enhanced precision and control. They can also be used for repetitive tasks, such as medication delivery or patient monitoring, freeing up healthcare staff to focus on more critical and complex responsibilities.

As AI becomes more integrated into healthcare, ethical considerations will be crucial. Ensuring patient privacy, maintaining transparency and explainability of AI algorithms, and addressing biases in data and algorithms are important challenges that need to be addressed to maintain trust and equity in healthcare AI systems.

Addressing these concerns requires careful regulation, transparent development practices, continuous monitoring, and ongoing research to mitigate risks and ensure the responsible and ethical use of AI in healthcare.

AI is not meant to replace healthcare professionals. Instead, it is designed to augment their capabilities, improve decision-making, and enhance patient outcomes. Collaboration between AI and human experts will be key to harnessing the full potential of AI in healthcare.

Life to years, not years to life

Last thoughts on subjective ageing. Modern medicine should be adding life to years; not just more years to life.  According to Stats Canada, there were over 861,000 people aged 85 and older counted in the 2021 Census, more than twice the number observed in the 2001 Census. The population aged 85 and older is one of the fastest-growing age groups, with a 12% increase from 2016. Currently, 2.3% of the population is aged 85 and older.

The lifespan of an 85-year­old man in Canada is 6.7 years and the lifespan of an 85-year-old woman in Canada is 8 years. The good news is that these surviving octogenarians are more likely to be active. For example, by the end of his life, the average 85-year-old man will have spent only 0.56 years in an institution, and the average 85-year-old woman will have spent 1.5 years.

Between ages 75 and 84, 73% of elderly people report no disability; and after age 85, 40% of the population remains fully functional. Over the last century, the number of years an individual spends in active retirement has increased 10-fold.

In order that successful aging not to seem like an oxymoron, the concept of aging must be viewed from three dimensions: decline, change, and development. The term "ageing" can connote decline, and decline is not successful. After age 20 our senses slowly fail us. By age 70 we can identify only 50% of the smells that we could recognize at 40. Our vision in dim light declines steadily, until by age 80, few of us can drive at night; by age 90, 50% of us can no longer use public transportation.

But the term "ageing" also conveys change, a relatively neutral meaning. Analogous to the transformation of trees from spring to winter, our hair changes from chestnut to white, our waistline becomes bigger, our eyes acquire crow's feet, and our frequency of making love shifts from three times a week to twice a month. At the beach, we pick up grandkids instead of sweethearts, but our capacity for joy is undiminished.

Finally, the term "ageing" also conveys development and maturation. Analogous to a grand vineyard wine evolving from bitterness to perfection, at 70 we are often more patient, more tolerant, and more accepting of the effect on ourselves and others. We are more likely to tolerate paradoxes, to appreciate relativity, and to understand that every present has both a past and a future. Finally, like age itself, experience can only increase with time.

When examiners used a global definition of successful aging at age 75, 80% of the Berlin Aging Study cohort were still considered in "good health" (cognitively fit, active, and involved in life) or in "average health" (relatively healthy, still independent, and satisfied with life). At age 95, this level of health was still maintained by 30% of the subjects. These figures would have been significantly better had those with "terminal decline" been excluded. For example, the average centenarian lives without major disability until age 97! 

The stats in this blog are from Stats Canada, and an article written in a 1998 article on Successful Ageing by George E. Vaillant, M.D. Kenneth Mukamal, M.D. published by Harvard Second Generation Studies.

Why engage a private patient advocate?

Listen up! If you want some peace of mind when dealing with the complicated world of healthcare, you have got to get yourself a patient advocate. Sure, healthcare providers may have their own advocates, but those guys work for the man. Your personal health advocate can monitor things while you focus on feeling better. Having a patient advocate enables you or your family to concentrate on health, knowing a professional is watching out for them. 

The advocate works with the staff to accomplish the goals of patient care. And, when necessary, can be assertive, pushing issues up the chain of command to get resolution. Taking on this role allows the family to concentrate on the patient and avoid being at odds with the staff. Private advocates work for YOU, and only you. They’re like your own personal tour guide through the maze of medical jargon and confusing treatment options.

And dealing with doctors and nurses can be stressful enough to give anyone anxiety. Even when the interaction is not life-threatening, most people experience anxiety when encountering healthcare providers. Anxiety impedes the ability to think, hear, form questions, to recall information. 

Having an advocate frees you or your family from these worries because the advocate will prepare questions, take notes, raise issues or concerns, be available to talk through the encounter and offer explanations. This does not mean that the advocate takes over or that you relinquish your autonomy. It simply means the patient can breathe a little easier knowing they are with someone who knows how the system works. 

The presence of an advocate usually has a positive impact on the staff. The staff seems to step up a little more, knowing that a professional is monitoring the care. They also appreciate speaking to someone who speaks their language and understands how the system works.

When there are problems, the advocate can address them free of the emotional charge that a family member might bring to the situation, as a professional, who can’t be intimidated. That’s where your advocate comes in, taking notes, asking questions, and just being a badass on your behalf. They’ll even step in and mediate family disagreements over treatment choices or end-of-life decisions.

So don’t be a hero and try to handle it all on your own. Get yourself a patient advocate and let them be your health BFF. I believe it is one of the best gifts you can give yourself with your health and recovery.

Our Immune System Weakens As We Age

 My Age Put Me At Greater Risk

This is from the Tri-Cities Seniors Action Society Newsletter, thanks to Ken for the information

“My wife and I recently retired and are looking forward to travelling and enjoying our leisure time. I heard the recommendations on the radio and TV to get vaccinated for influenza but I just never got around to it. Why should I? We both go to the gym regularly and are feeling fit. My wife got the Fluzone High-Dose vaccine that was recommended for those over 65—and she paid about $75 for it. I didn’t take the time to get the shot. One day, just before Christmas, I felt really lousy—very tired, with body aches, and sweating. I was in bed for about four days, didn’t have an appetite, and even had difficulty getting dressed in the morning. I started to have difficulty breathing so my wife called an ambulance and I was taken to the hospital. I was discharged from the hospital after four days—and then spent over a month recovering at home. I still am lacking energy and strength and balance. I am worried that I have had some long-lasting damage to my lungs.” Nick, 71 years old

Our body’s ability to fight infection decreases as we age because our immune system weakens over time. Adults over 50 have an increased susceptibility to infections, age-related diseases, cancer and an increased incidence of auto-immune disorders. More than 1 in 2 adults 50+ in Canada have a chronic condition putting them at higher risk of flu complications. (diabetes, asthma, heart disease, COPD, obesity, cancer, stroke, arthritis, depression, high blood pressure) Of the many people who are hospitalized by the flu each year, 70% of those are seniors and seniors account for 91% of flu-related deaths, according to the Centre for Disease Control and Prevention. 

How to Protect Yourself

The seasonal flu vaccine is the most effective way to reduce the risk of severe flu infection and prevent hospitalizations and other serious complications. For seniors, the Canadian National Advisory Committee on Immunization recommends the High Dose Quadrivalent Influenza vaccine over the standard dose vaccine for those 65+. (NOTE: This vaccine costs adults about $75 in BC although it is given free by most other provincial governments.)

Just to clarify to the many seniors who have, in fact, asked for the High Dose Quadrivalent vaccine in past years—there were many pharmacists who offered the free Fluad vaccine in spite of the senior asking for the High Dose Quadrivalent. If you received your Influenza vaccine for free, then you received the Fluad vaccine. Be sure to ask your pharmacist which vaccine is best for you considering your health conditions.

Vegatables that are good for arthritis

 There is some evidence to suggest that eating a diet rich in vegetables, including broccoli, cauliflower, and spinach, may be beneficial for people with arthritis. These vegetables are high in nutrients like vitamins C and K, which are important for maintaining healthy bones and reducing inflammation. These foods are an excellent source of vitamins, minerals, and antioxidants, which can help support overall health and well-being.

Inflammation is a key component of many types of arthritis, and a diet that is high in anti-inflammatory foods may help reduce inflammation and improve symptoms. There is some evidence to suggest that eating a diet rich in fruits and vegetables may have a protective effect against the development of certain types of arthritis, such as osteoarthritis. A study published in the American Journal of Clinical Nutrition found that people who consumed a diet high in fruits and vegetables had a lower risk of developing osteoarthritis of the knee compared to those who consumed a diet low in these foods.

It’s important to note that while these vegetables may have some potential benefits for people with arthritis, they are not a substitute for medical treatment. It’s always a good idea to talk to your doctor or a registered dietitian before changing your diet. They can help you create a healthy and balanced meal plan that meets your individual needs.

While a healthy diet can be beneficial for people with arthritis, it is important to note that there is no specific diet or type of food that can cure or prevent arthritis. 

Dry January for some?

I don't drink much anymore, but I do have a drink once or twice a week. When I was younger, I drank a lot, especially around the Christmas holidays. Dry January, also known as “Drynuary,” refers to abstaining from alcohol for the month of January. It did not exist when I was younger and had not heard about it until recently. The idea has gained popularity in recent years as a way for people to reset their drinking habits and improve their overall health and well-being.

There is some evidence to suggest that taking part in Dry January can have lasting effects on an individual’s alcohol consumption. A study published in the journal Addiction found that people who took part in Dry January reported drinking less alcohol and having fewer alcohol-related problems in the six months following the challenge. Another study published in the Journal of Clinical Psychology found that people who took part in Dry January had a lower risk of developing an alcohol use disorder in the following year.

However, it’s important to note that the effects of Dry January on an individual’s alcohol consumption may vary depending on the person’s individual circumstances and motivations for participating in the challenge. Some people may find that Dry January helps them to moderate their drinking long-term, while others may return to their previous drinking habits after the challenge is over.

It’s a good idea to consume alcohol in moderation and to be mindful of the potential negative effects of heavy drinking on your health and well-being. Suppose you are concerned about your alcohol consumption or are experiencing problems related to alcohol. In that case, it may be helpful to speak with a healthcare professional or a trained counsellor or therapist.

Adult Immuzization

 

What can I do about depression?

Get help: Depression deserves the same care and attention as any other medical condition. There is no shame in seeking help. Treatment options for depression include antidepressant medications, available from a doctor, and counselling. Both can be very effective. Older adults who are contemplating suicide should speak to their doctor or go to the nearest hospital emergency department.

There are also many things older adults can do on their own or with family and friends to prevent or lessen the effects of depression.

Be active: Exercising the body helps to lift the mood. Even taking a short stroll or joining a local aquafit class can help to make the world seem a brighter place.

Think positively: Instead of thinking about what you could have done differently in life, think about what you’ve done right. Remember your strengths and how you overcame challenges in the past.

Eat well: Food is your fuel. When you eat nutritious healthy foods in the right amounts, it can boost your strength and help you feel well.

Get involved: When you enjoy what you’re doing, you enjoy life. Rekindle your interest in activities you used to enjoy or find new ones.

Manage stress: Think back on stressful times in the past and how you got through them. Can you use the same techniques again, or is it time to try something new?

Avoid alcohol: Having a drink may seem to make you feel better for a short while, but alcohol can actually worsen depression. Being active, enjoying others and eating well can give you a natural high that won’t have negative effects.

Spirituality: Seeking answers about life and coming to peace with the past and the present can improve your perspective on life. Examining your faith can involve returning to your roots, finding fellowship in an organized religion or seeking understanding outside a traditional religion.

Where can I get help or get more information? Call your local crisis line.

For information and referral to mental health services available, contact the Canadian Mental Health Association, BC Division toll free 1-800-555-8222 or 604-688-3234. Call 911 for help right away.

Go to your local emergency room or in British Columbia you can call 1-800-SUICIDE (1-800-784-2433) for help any time of day or night, from anywhere across BC. It’s a free call.

 Article originally appeared at: https://www.camh.ca/ Author: The Centre for Addiction and Mental Health (CAMH)   

What are the signs of depression?

People often think that depression in older adults is a normal response to the losses of aging. When they say, for example, “It’s no wonder he’s depressed, he’s 82,” or “If I had arthritis, I’d probably be depressed too,” they may mean well, but depression is not normal.

An older adult may be severely depressed if he or she:

    does not get dressed

    does not answer the phone or the door

    loses interest in activities he or she used to enjoy

    expresses feelings of worthlessness and sadness

    has unusual outbursts of crying, agitation or anger, or shows little emotion

    sleeps poorly or too much

    eats more or less than usual

complains about physical symptoms that do not have a cause

lacks energy, is often tired

seems confused

has difficulty concentrating

has trouble remembering things

has trouble making decisions or following through with plans

spends more time alone 

Article originally appeared at: https://www.camh.ca/ Author: The Centre for Addiction and Mental Health (CAMH)   

Depression in Older Adults

If you have a sad, despairing mood that lasts for more than two weeks, it may be depression.

Depression is different from sadness, though it can be triggered by the sadness caused by loss (e.g., loss of a loved one, loss of hearing), stress or major life change (e.g., retirement, moving). Depression can also be caused by some medical conditions, such as chronic pain thyroid problems, stroke or Alzheimer’s disease. Certain medications and alcohol use can cause depression as well. Depression may also develop for no apparent reason.

People who are depressed cannot just “get over it.” Depression is a biological illness caused by a chemical imbalance in the brain. It affects thoughts, feelings, behaviour and physical health.

Older adults who are depressed may have had episodes of depression throughout their lives, or they may have their first episode late in life.

Depression can affect anyone at any age, but is often not recognized in older adults. This is because some signs of depression can be mistaken for signs of aging, and also because older adults who are depressed may not complain about feeling low. When left untreated, depression may continue for weeks, months or even years. Untreated depression is the main cause of suicide in older adults. 

Article originally appeared at: https://www.camh.ca/ Author: The Centre for Addiction and Mental Health (CAMH)   

Get your flu shot now

 For adults 65 years of age and older, the National Advisory Committee on Immunization (NACI) recommends that Quadrivalent High-Dose should be used over Quadrivalent-Standard Dose, given the burden of influenza A(H3N2) disease affecting older adults and the good evidence of better protection of Trivalent-High Dose compared to Trivalent-Standard Dose in adults 65 years of age and older.

Any of the available influenza vaccines would be preferable to remaining unvaccinated or requesting individuals to return for vaccine. Therefore, in the absence of a specific product, NACI recommends that any of the available influenza vaccines authorized for this age group should be used.

There is only one high-dose Quadrivalent Influenza vaccine currently authorized for use in Canada by NACI. (IIV4-HD or Fluzone High-Dose Quadrivalent)

There is good evidence that Fluzone High-Dose provides superior protection compared with standard-dose TIV in the elderly (Grade A Evidence); 2) there is fair evidence that the MF59-adjuvanted Fluad (that will be provided to those over 65 in BC) may be effective at reducing the risk of hospitalization for influenza and influenza complications in the elderly compared to unvaccinated individuals (Grade B Evidence).

Coles Notes Version:

• High-Dose Quadrivalent Influenza Vaccine has 4 times the antigen of a standard dose vaccine to account for “immunosenescence”. (weakening of the immune system over time)

• This superior protection (greater than 24% over the standard dose) increases with those much older than 65 and with pre-existing underlying chronic conditions. (protection for an 80 yr old is about 37% better than standard dose)

• The NACI recommends High-Dose Quadrivalent (IIV4-HD) compared with the standard dose for adults 65 years (2022/2023)

• Unfortunately, the BC government, is only going to offer a TRI-valent influenza vaccine (IIV3-Adj) (covering 3 strains) for seniors to be announced in October 2022. Other provinces: AB, SK, ON, NB, PE, YK will offer the recommended NACI High-Dose QUADrivalent (IIV4-HD) (covering 4 strains) for free for ALL those over 65 years of age. Again, seniors in BC are being short-changed in their health. Did our BC Ministry of Health not learn anything during COVID about caring for seniors?

Those seniors over 65 in long-term care or assisted living residences, or First Nations will receive the NACI-recommended High-Dose Quadrivalent (IIV4-HD) at no cost. (The Federal government is paying for it.) Those seniors still living on their own will have to pay between $75 to $90 for this vaccine as the BC government is only providing the Fluad Trivalent for free. In other words, most seniors throughout the province will be charged a fee to receive the NACI-recommended Influenza vaccine—or choose the free Fluad vaccine. If they lived in Alberta, Saskatchewan, or Ontario it would be FREE.

 

Give me your BEST shot! Seniors are worth it. Let’s keep seniors out of hospitals.

Here It Comes! Get Ready for Influenza Season

My thanks to the Tri-Cities Senior Action Society for this information.

What is Influenza and Why Is It Important for Seniors?

Influenza is a respiratory illness caused by the influenza A and B viruses in humans and can cause mild to severe illness, which can result in hospitalization or death. Certain populations, such as young children, older adults, and those with chronic health conditions, may be at higher risk for serious influenza complications such as viral pneumonia, secondary bacterial pneumonia, and worsening of underlying medical conditions.

Older Canadians suffer disproportionately from influenza-related morbidity and mortality. And account for about 70% of hospitalizations and 90% of deaths …due to Influenza.

In Canada, influenza generally occurs every year in the late fall and winter months

Potential complications of Influenza can include direct respiratory effects such as asthma & COPD exacerbations, ear & sinus infections, and bronchitis and pneumonia.

74% of Canadians report having at least one of the following chronic conditions: arthritis, asthma, cancer, chronic pain, depression, diabetes, emphysema or chronic obstructive pulmonary disease, heart disease, high blood pressure, a mood disorder other than depression and stroke.

Influenza contributes to mortality among patients with underlying lung or chronic heart diseases.

For persons aged 65 years and over, the risk for influenza-attributed death was

5X greater among those with chronic heart diseases

12X greater among those with chronic lung diseases

20X greater among those with both chronic heart and lung conditions

Pneumonia and Influenza are leading causes of catastrophic disability, behind stroke and congestive heart failure  

What was found over the last six months from the southern hemisphere? Looking to Australia for statistics and input helps researchers develop the best vaccine matches for the northern hemisphere.

97.4% of influenza A(H1N1) and 93.3% of influenza A(H3N2) were the main strains found.

This year, Influenza burden exceeded the 5-year average.

The typical peak of laboratory-confirmed influenza is August to September, but this year was EARLIER in May and June and was larger.

Influenza-related hospitalizations decreased in July which can probably be attributed to a good match of the Influenza vaccine.

Based on this early data, Canadians must receive their flu vaccines as soon as possible, preferably with vaccines with the most evidence for benefit. Usually the peak “flu season” in BC is December and January but can be expected to be in October and November. Why? Most people have let their guard down and are not wearing masks, not social distancing, and are not washing their hands as they were in early COVID times.

The added hospitalizations from influenza and influenza-related illnesses will put further stresses on health-care resources—hospitals and staffs—and will have further societal and economic consequences.

Vaccines don't save lives.

Vaccinations do.

They're safe, they're effective, and   they're rolling out now. Check with your health authority to see when you can book your flu shot.

Which Jar Opener works best?

When I was younger my wife would ask me to open jars from time to time now when I need a jar open, I ask her. I have arthritis in my wrists so opening a jar or bottle is sometimes difficult. I am not alone, many older adults often find opening jars and bottles and other containers hard, due to weakness in their hands, arthritis, or just reduced strength in their arms. We have a jar and bottle opener, and it works for us. The folks at Longevity Explorers at Tech Enhanced Life took a look at this problem. Here is what they found out:

There are many "gadgets" that have been developed to help overcome this difficulty. When you look on Amazon you see literally hundreds. But which one to pick?

The Explorers at several of our circles wanted to find answers to this question, and we engaged in a series of discussions and some hands-on evaluations to learn which jar opener would work best and for whom. Unsurprisingly, we found there was no such thing as a "best" jar opener. But there were definitely products that worked best for certain people.

Different opener types solve different problems

Broadly speaking there are three things these jar openers are designed to "help" with: Grip; the need for two strong hands and arms; and strength & leverage.

In the absence of a gadget to help, opening a jar requires the following.

·         Grip: One hand needs to grip tightly the jar lid. If the lid is slippery or if one's grip is not very strong, then the hand will slip, and it will not be possible to turn the jar lid.

·         Two strong hands: The other hand needs to grip the jar itself. If the jar is big or slippery this can be hard for anyone. If one's grip is not super strong in the second hand, or if one has small hands, or the jar is slippery, this second-hand grip can also fail, and the jar will not open.

·          Strength & Leverage: Even if both hands grip well on the jar and the jar lid, one needs adequate strength to turn the lid and jar in opposite directions and break the seal. This can be hard for anyone, and harder still for people who are frail or who have arthritis.

Some of our Explorers cared mainly about grip, some cared more about the need to have two strong hands, some needed leverage or strength, and some needed help with all three of these things.

Here is a link to their: Most Popular Jar Openers

 

 

Life expectancy in Canada and the US compared

 National Center for Health Statistics reported that life expectancy at birth in the United States declined nearly a year from 2020 to 2021, according to new provisional data from the CDC’s National Center for Health Statistics (NCHS). That decline – 77.0 to 76.1 years – took U.S. life expectancy at birth to its lowest level since 1996. The 0.9-year drop in life expectancy in 2021, along with a 1.8-year drop in 2020, was the biggest two-year decline in life expectancy since 1921-1923.

In Canada life expectancy has been on the rise for the past five years. In 2018 our life expectancy was 82. 07 years while in 2022 our life expectancy is 82.81 years, a 0.18% increase from 2021, Over the past five years, the life expectancy of Canadians has increased by 0.18% a year. Not a big increase but better than a drop in life expectancy as our neighbours to the south are experiencing.

Their data featured in a new report, “Provisional Life Expectancy Estimates for 2021.” shows that non-Hispanic American Indian-Alaskan Native people (AIAN) had the biggest drop in life expectancy in 2021 – 1.9 years. AIAN people had a life expectancy at birth of 65.2 years in 2021 – equal to the life expectancy of the total U.S. population in 1944. AIAN life expectancy has declined by 6.6 years from 2019 to 2021.

Non-Hispanic white people in the United States had the second biggest decline in life expectancy in 2021 – one full year from 77.4 in 2020 to 76.4 in 2021. Non-Hispanic Black people had the third biggest decline, a 0.7-year drop from 71.5 years in 2020 to 70.8 in 2021. Life expectancy at birth in 2021 was the lowest for both groups since 1995

Life expectancy at birth for women in the United States dropped 0.8 years from 79.9 years in 2020 to 79.1 in 2021, while life expectancy for men dropped one full year, from 74.2 years in 2020 to 73.2 in 2021. The report shows the disparity in life expectancy between men and women grew in 2021 from 5.7 years in 2020 to 5.9 years in 2021. From 2000 to 2010, this disparity had narrowed to 4.8 years, but gradually increased from 2010 to 2019 and is now the largest gap since 1996.

The numbers show that our approach to the pandemic was more effective than our neighbours. While life expectancy went up in Canada, the declines in life expectancy in the United States since 2019 are largely driven by the pandemic. COVID-19 deaths contributed to nearly three-fourths or 74% of the decline from 2019 to 2020 and 50% of the decline from 2020 to 2021. An estimated 16% of the decline in life expectancy from 2020 to 2021 can be attributed to increases in deaths from accidents/unintentional injuries. Drug overdose deaths account for nearly half of all unintentional injury deaths. The most recent data reported by NCHS showed more than 109,000 overdose deaths in the one-year period ending in March of 2022.

Other causes of death contributing to the decline in life expectancy from 2020 to 2021 include heart disease (4.1% of the decline), chronic liver disease and cirrhosis (3.0%), and suicide (2.1%). For men, the one-year decline in life expectancy was attributed primarily to mortality from COVID-19 (49.5% of the decline), unintentional injuries (19.1%), suicide (3.6%), chronic liver disease and cirrhosis (3.4%), and homicide (2.5%). For women, the 0.8-year decline in life expectancy was attributed mainly to mortality from COVID-19 (51.2% of the decline), unintentional injuries (14.8%), heart disease (5.7%), stroke (3.5%), and chronic liver disease and cirrhosis (2.4%)

While Canada is doing well it is only 15^th in the world for life expectancy with Japan at number 1 with a life expectancy of 85.16 years. The United States is 40^th in the world. Both countries have a long way to go to increase life expectancy. If you want  to check your counties ranking go here: https://www.worldlifeexpectancy.com/japan-life-expectancy 

Today is World Suicide Prevention day

I had a young cousin that committed suicide. The fallout of his action lasted for years. Suicidal thoughts are complex. The factors and causes that lead to suicide are complex and many. No single approach works for everyone. What we do know is that there are certain factors and life events that may make someone more vulnerable to suicide and mental health conditions such as anxiety and depression can also be contributing factors.  People who are suicidal may feel trapped or like a burden to their friends, family and those around them and thus feel like they are alone and have no other options. The COVID-19 Pandemic has contributed to increased feelings of isolation and vulnerability. By creating hope through action, we can signal to people experiencing suicidal thoughts that there is hope and that we care and want to support them.

You can help give someone hope by showing that you care. All of us can play a role, no matter how small. We may never know what we do that makes a difference. We all can reach in and ask somebody. You do not need to tell them what to do or have solutions, but simply making the time and space to listen to someone about their experiences of distress or suicidal thoughts can help. Small talk can save lives and create a sense of connection and hope in somebody who may be struggling. The International Association for Suicide Prevention is dedicated to preventing suicide and suicidal behaviour and alleviating its effects. IASP leads the global role in suicide prevention by strategically developing an effective forum that is proactive in creating strong collaborative partnerships and promoting evidence-based action in order to reduce the incidence of suicide and suicidal behaviour.

The World Health Organisation (WHO) estimates more than 700,000 people die due to suicide each year and that almost 77% of all global suicides occur in low and middle-income countries (LMICs). For every suicide there are many more who attempt suicide or have serious suicidal ideation. Suicidal behaviour profoundly impacts families and communities and remains a universal challenge with millions impacted. The reduction of suicide mortality is of global importance and a vital public health consideration. Here is a link to resources that might help. 

https://www.iasp.info/wspd/resources/ 

Please share this film Creating Hope Through Action film to raise awareness of suicide prevention.

Palliative care

 A friend of mine has been fighting a number of issues for the past year and finally, his family decided to follow the doctor's advice and put him into palliative care. The decision was made after my friend had a bad fall, which aggravated his health. A few weeks after the fall, I was told that he had pneumonia and was rushed to the hospital. He is having trouble eating, drinking and swallowing. It is unlikely that he will get to go home. His wish was to have palliative care at home. Due to his current condition that is unlikely to happen.

My friend like most patients requiring palliative care support is known to have complex health services needs and to be a high health system user in the last months of life. Research has shown that referral to specialized palliative services, and the application of a palliative approach by primary care services even when still receiving curative treatments, can lead to a reduction in aggressive intervention at the end of life, reduced emergency room visits and hospitalizations, thereby increasing the quality of life.

Patients often express their wish to have end-of-life care at home. They want to die peacefully in their own home surrounded by their loved ones. However, if they experience acute symptoms such as shortness of breath, inability to eat or drink, or delirium, their caregivers may call 911. In my friend's situation, it led to patients being transferred to the emergency room. In some jurisdictions in Canada, paramedics and palliative care programs allow paramedics to treat those acute symptom needs, avoid transfer to the hospital and ensure continuity of care with the community team. This allows the patient to get the right care, in the right place at the right time. Ultimately, it honours the patient’s wishes for a peaceful death at home.

Palliative care for many is not understood and so people are reluctant to use this service. The earlier a person can take advantage of palliative care the better. The goals of palliative care are to provide comfort and symptom relief when faced with a life-threatening or life-limiting illness. Primary care clinicians are well placed to identify and work with those who may need palliative care, and many regions have palliative home care community programs to support palliative patients and their caregivers. However, both primary and palliative care community programs are often unable to provide urgent care 24/7 and do not have immediate access to resources such as medications. Expansion of the primary health care team to include service providers outside clinical settings and structured hours of care, with the goal of improving access to palliative care services, is needed.