How to be the best you can be
Growing old is part of life. Most older people live at home independently and make a positive contribution to the community. Their skills and wisdom are an important resource which society needs. While people do change as they get older, old age is not a time of inevitable mental and physical decline. Many of the so-called age related declines can be slowed down or even prevented by positive lifestyle changes.
This booklet focuses on the physical aspects of keeping yourself healthy and safe as you grow older.
The key topics discussed in this booklet are:
- The senses: hearing, sight, smell
- Oral hygiene
- Foot care
- Skin care
- Screening for cancer
- Bladder control
- Drugs – medicines, alcohol, smoking
- Sexual relations
- Keeping warm in winter
- Safety and security in and outside the home.
Financial security, independence, personal health and safety are certainly factors that determine the lifestyle you have at any age. But the quality of life you have as you get older will also depend on your approach to ageing:
- how well you can adapt and respond to changes
- whether you can maintain confidence in yourself as an individual
- whether you can maintain a sense of humour and fun
- how active you are physically, mentally and socially.
But it is also important for your total health to think about how you can continue to develop the mental, emotional, social and spiritual aspects of your life.
Plan for the future, live in the present.
Regardless of age, regular physical activity keeps you fit and makes you feel good. Because exercise increases the heart rate, the heart muscle is strengthened and the oxygen supply to the body increases. This means muscles and joints are more likely to be nourished and strengthened and therefore able to work more efficiently. The spin-off is that you have greater mobility, feel more energetic, look better and possibly have more fun.
If your body is not used, then it starts to lose fitness and flexibility. Because of age related decline, older adults probably benefit more from exercise than any other age group, but it should be tailored to you personally. If you have any medical problems, check with your doctor before beginning an exercise programme.
Tips for fitness
- Be physically active every day. Try ‘snacking’ on exercise to keep fit.
- Start exercising slowly and gradually increase the time to around 30 minutes most days of the week.
- Practise good posture by distributing the weight evenly on your feet, pulling in your tummy and imagining yourself growing tall. Relax your shoulders and breathe evenly.
- Make your own gentle exercise programme.
- Join or form an activity group and enjoy socialising at the same time as exercising. Popular choices are:
- line dancing
- kiaido ryu.
At the start of the day
Repeat each of these exercises several times while lying down, before getting out of bed.
- Move your feet up and down at the ankles.
- Circle them round in both directions.
- Bend your knees one at a time toward your shoulders.
- Raise your bottom up while keeping your feet flat and knees bent.
- Stretch your arms outwards and upwards over your head.
When you are up, practise walking along a straight line to improve your balance.
For sore backs
Sore and stiff backs can be painful and limiting. You can strengthen the muscles which support your spine by the following exercises done twice a day.
- Stand with feet shoulder width apart, breathe out while bending back, supporting your back with your hands at your waist and holding your neck straight.
- Lie on your back with your hands out at the side, bend both knees and lift them to your chest, roll to left and hold then to right and hold, keeping your shoulders on the floor.
- Lie flat on your back and raise one leg at a time as far as you can without straining. Hold for about 20 seconds before repeating with the other leg.
Also check that your mattress is firm enough to support your back.
Protecting your back when you are lifting
- Keep the load as close to your body as possible.
- Use your legs by placing your feet apart, toes forward and knees bent.
- Keep your back straight.
- Pause between each phase, ie, lift (pause), carry (pause), lower (pause).
To find out about physical activities available for older people in your area, contact your local Citizens Advice Bureau, gym, pool, community/recreation centre, or look on your library noticeboard.
Your metabolic rate slows down as you get older and you probably use less energy than when you were younger. You therefore need fewer calories to maintain the same weight. A balanced, varied diet is essential to give you energy, keep your body strong, and provide protection against illness.
- Eat food from each of these four food groups each day:
- at least three servings of vegetables and at least two servings of fruit
- at least six servings of breads and cereals, eg, 1 cup cornflakes, 1 slice bread, 1 roll, 1 cup cooked rice, 1 muffin, 2 plain biscuits
- at least three servings of milk and milk products, eg, 1 glass of milk, 2 slices of cheese
- at least one serving of meat, poultry, seafood, eggs or meat alternative.
- Drink at least eight cups of fluid each day – water is the cheapest and the best.
- Have plenty of high-fibre foods such as wholemeal bread, breakfast cereals such as porridge, vegetables and fruit to help prevent constipation.
- Chew food well, and do not have a heavy meal late at night if you want to avoid indigestion. If indigestion persists, talk about it with your doctor.
- Limit the quantity of foods you eat that are high in fat and sugar (eg, cakes, biscuits, jams, sweets, fried foods).
- If you are overweight, increase the amount of exercise you do and reduce the amount of fatty and sweet food you eat.
- If you are underweight, eat more than three meals a day. Check with your doctor.
- Plan interesting meals, especially if you are cooking for yourself.
- Take opportunities to eat meals with other people. You may like to try a new recipe and invite others over to share it with you.
- Cut visible fat off meat and use lower-fat foods.
- Don’t add extra salt to foods.
- Keep an emergency supply of foods that will not spoil (eg, tinned and frozen foods), in case you have a period of time when you can’t get out.
- Try preparing more food than is needed for one meal, dividing the leftover into meal size portions and freeze. Make sure you label with the date and rotate your supply.
The amount of sleep needed varies from person to person. Most experts agree we need less sleep as we get older, probably six and a half hours per night after age 60 is enough for most of us. Some people feel rested after four to five hours sleep while seven to eight hours is normal for others. It’s the quality of sleep that is more important than the quantity.
The normal sleep cycle is about one and a half hours and there are usually four or five sleep cycles during the night. Each one is made up of two different kinds of sleep.
- Non-rapid eye movement (nonREM) or quiet sleep usually occurs soon after you go to sleep and involves all the bodily functions including brain waves slowing down. The temperature of the body also drops. This type of sleep is important for physical health.
- Rapid eye movement (REM) or dreaming sleep comes at the end of each sleep cycle and involves a lot of brain activity with dreams, twitching, and irregular brain waves. This type of sleep is important for mental health.
Older people have reduced levels of melatonin – the hormone that governs the sleep-wake cycle, and so the time spent in deep sleep may lessen and REM sleep increase.
If you do not sleep well, here are some tips to help you get a good night.
- Keep regular hours – try to get up and go to bed about the same time each day.
- Have some physical exercise each day – even a short walk will help reduce tension and being outside in the sunlight can improve the quality of your sleep.
- If it suits your lifestyle, eat your main meal in the middle of the day and have a light meal at night.
- Avoid tea, coffee, alcohol, cigarettes and other stimulants in the evening.
- Unwind at the end of the day by enjoying something quiet, like listening to music or reading a book.
- Try to set aside cares and worries that haven’t been dealt with during the day. Imagine putting them into an envelope to be opened another time.
- Breathe slowly and deeply a few times when you’re in bed, then slowly tighten and relax all your muscles.
- Try not to focus on the fact that you are not asleep.
Sleeping pills are only helpful in the very short term and should not be thought of as a solution to a sleep problem. They can alter your mood, cause loss of concentration and interact with other drugs. You may also find you come to depend on them.
If you are worried about your lack of sleep (insomnia) talk about it with your doctor. You may be referred to a sleep clinic. Insomnia can also be an indication of anxiety or depression, which can be treated.
Many older people experience a gradual hearing loss due to ageing changes in the inner ear. The effect of this is a loss of loudness and clarity. Communication with others will be made easier by reducing background noise, having good lighting and keeping a clear view of the face of the person speaking.
Hearing loss can also be caused by other factors, so tell your doctor and have your hearing checked if you have any of these warning signs:
- difficulty with picking out words especially at a distance or when there is background noise
- high notes increasingly hard to hear
- needing to have the television or radio turned up too loud for others
- not always hearing the telephone or doorbell
- ringing or hissing noises continually present.
A hearing aid, if you need one, can be fitted by a qualified audiologist to suit your kind of hearing loss. Today’s hearing aids are highly sophisticated technical devices which can help with a lot of problems. It may take a little time to get used to wearing a hearing aid, but it can make a lot of difference to your quality of life.
Most of us notice a gradual decline in sight as we get older and need to wear glasses for reading and close-up work. Hardening of the lens reduces sharpness of sight, and it may become more difficult to distinguish shades of colour. Older people also have reduced night vision, and this makes it harder to drive at night.
Report any problems with your eyes to your doctor. This includes:
- any heavy discharge from the eyes
- redness or swelling in or around the eye
- loss of sight
- dimness or double vision
- blind spots
- narrowed field of vision.
It’s a good idea to get your sight tested and eyes examined every two to three years. Eye diseases, such as glaucoma, cataracts and macular degeneration that may otherwise go unnoticed can then be treated early. People with diabetes need to be extra careful to manage their condition and should have regular eye screening.
The sense of smell decreases with age and you may find you miss out on many aromas and scents you used to enjoy. As well, you may not notice unpleasant or dangerous odours such as:
- ‘off’ food
- gas leaks
- body odour.
When you can’t rely on your sense of smell:
- Make sure you always check use-by dates on your food.
- Get smoke alarms fitted to give you warning of fire.
- Check batteries monthly.
- Have any gas equipment you use checked regularly.
- Be extra careful about personal hygiene and ventilation.
Teeth are important for chewing food in preparation for digestion. Whether you have your own teeth or dentures, it is important to keep them and your gums in good condition. A build-up of plaque (a sticky, invisible film containing bacteria) can irritate and infect the gums resulting in loss of teeth. Regular brushing and flossing and an annual check with your dentist are the keys to good oral hygiene.
See your dentist if you have any of these signs of a gum infection:
- your gums frequently bleed when you brush your teeth
- the colour or shape of your gums changes
- you have persistent bad breath or an unpleasant taste in your mouth
- your teeth start getting loose.
Dentures which fit well will enable you to chew better and look better.
- Have your dentures checked every five years as they may need adjusting or replacing.
- See your dentist if your dentures are uncomfortable or are making your mouth sore.
- Clean regularly with a brush and denture cleaner or toothpaste.
- Place dentures in a mug of water if you prefer to take them out at night.
For more information about emergency dental care and assistance for people on low incomes contact your local District Health Board (listed in the phone book) or Work and Income office.
Healthy feet are important for a full and active life. Many common foot problems result from disease, long years of wear and tear, ill-fitting shoes, poor circulation to the feet, or toenails that have not been cared for.
To maintain healthy feet podiatrists suggest:
- washing your feet daily and dry well especially between the toes
- trimming your toenails straight across so they are even with the ends of your toes
- inspecting your feet daily for redness, swelling, cracks in the skin or sores
- using a plain moisturiser to keep the skin soft and supple
- resting your feet by putting them up while reading or watching television
- wearing well-fitting supportive shoes
- wearing a clean pair of socks each day
- exercising your feet and toes regularly
- warming your feet slowly if they are cold and protecting them from direct heat
- wearing warm socks or stockings during cold weather, particularly if you suffer from chilblains
- seeing your doctor or a podiatrist if you have an ingrown toenail, any discharge from a nail or corn, or if you cannot easily cut your own toenails.
For more information about foot care, look under ‘Podiatrists’ in the Yellow Pages.
As your skin ages it loses its resilience and elasticity and damages more easily. Dry skin, brown patches or broken veins may appear. These changes may be more rapid if you have had long exposure to the sun over many years.
Ways to help keep your skin in good order:
- Use a bland moisturiser regularly on any dry skin.
- Avoid any soaps, shampoos or cosmetics that act as irritants to your skin.
- Use warm rather than very hot water for baths.
- Protect your hands by wearing gloves when gardening.
- Use an approved sunblock (SPF30+ or more) when exposed to the sun.
- Wear a sunhat to shade your face when outside.
- Get any unexplained rashes or patches of rough skin checked out.
- Report any changes in moles to your doctor. If cancerous, early treatment is more effective.
- Exercise daily to maintain healthy tissue.
- Drink at least eight glasses of water a day.
Having regular smear tests every three years is the best way of finding and treating abnormal cell changes and preventing cervical cancer from developing. All women should:
- Have a smear test from age 20 to 69 if you have ever been sexually active. At 70, if all your previous tests have been normal, you do not need to have further smear tests.
- Check with your smear taker (doctor or nurse) if you’ve had a hysterectomy (removal of the uterus) – to see if you still need to continue with smear tests.
- Check with your doctor if you have unusual symptoms at any age.
The chance of women developing breast cancer increases with age. A breast X-ray (mammogram) can detect unusual changes in the breast often before a lump can be felt. This can then be checked to see if it is cancer. Treatment is more likely to be effective if the cancer is found when it is very small.
- If you are 45–69 you are eligible to have free two-yearly screening mammography within the national screening programme, BreastScreen Aotearoa.
Loss of bladder control (incontinence) is not a normal part of ageing. However, it may indicate problems, eg, an infection, constipation, medications, slack muscles, concentrated urine. Whatever the cause, it can mean embarrassment, discomfort and an unpleasant odour.
Ways to maintain good bladder control:
- avoid going to the toilet ‘just in case’
- hold on until you really need to go
- drink plenty of fluids, especially water.
Some of the more common bladder problems are:
This is when a small amount of urine leaks from the bladder with sudden movement (eg, jumping, sneezing, coughing). Women are more likely to be affected than men as there is often a weakness in the pelvic floor muscles after child bearing. The muscles concerned can be strengthened with specific exercises.
Some people have irritable bladders that want to empty frequently. A retraining programme can get the brain to take control again.
Men can have urinary problems from the enlargement of the prostate gland, which can cause difficulty passing urine or controlling the flow. For men over 50, it is advisable to have the prostate checked, even if there are no symptoms. Ask your doctor for a test.
Don’t be afraid to ask for help if you have a continence problem. Careful assessment to sort out the cause and find the best solution can mean a real difference to quality of life. Incontinence can nearly always be managed or treated.
Talk to your doctor or practice nurse about exercises to improve bladder control and your pharmacist for further information about continence support.
Drugs – medicines, alcohol and smoking
As you get older your body processes what you put into it differently. This means that you will be more affected by drugs than you were when you were younger. This includes alcohol and tobacco as well as medicines.
Older people are more likely to have side effects from both prescribed and over-the-counter drugs. There may also be interaction between alcohol, medicines and other drugs. Sometimes this can lead to falls, depression, confusion.
- Make sure you know what medicines you’re taking, why you need them and whether to expect any side effects.
- Follow instructions on the label and take the amount prescribed.
- Try a ‘pill organiser’, available from your pharmacy, for keeping a check on your daily tablets.
- Check whether you should avoid alcohol or other drugs while taking the medicine.
- Report any possible reactions to medicines, eg, dizziness, indigestion, rashes, to your doctor.
Older people are more susceptible to alcohol-related problems. You’ve probably noticed that as the body ages it is less able to deal with the effects of drinking. The liver is less able to process alcohol. This often means higher blood alcohol concentrations and stronger reactions to heavy consumption. One or two glasses of alcohol occasionally are not likely to be harmful. However, it is not advisable to drink every day.
Heavy drinking can cause diseases of the liver, heart, stomach, and kidneys and problems such as depression, insomnia, forgetfulness, confusion and shakiness. Drinking also increases the likelihood of accidents and falls.
Remember for all of us, regardless of age:
- It is not safe to drink and drive.
- Drinking can affect relationships with other people.
- Alcohol is no substitute for food as it is high in calories and low in nutrients.
- Alcohol can alter the effect of medicines and cause unwanted reactions.
We all know tobacco contains chemicals that damage the body and can cause death and disease. The risk of developing tobacco-related diseases is greatest for those who have smoked heavily for a long time. Smokers have a far greater risk of:
- heart attack
- lung cancer
- mouth and throat cancers.
Giving up smoking at any age can significantly enhance your health and reduce your risks of heart disease and stroke. Many older people have also made the decision to give up smoking to protect the health of those they live with or see regularly.
You can get information and help to break the habit if you are a smoker. A national toll free Quit line is available for help and advice: 0800 778 778.
Both male and female interest in sex may undergo changes in older age, but most older people can lead an active and satisfying sex life if they want to. As at any other age this is a matter of individual circumstances and preferences.
After the menopause in women, the vagina loses some of its natural lubricant and may feel dry and sore during intercourse. If this happens, ask your doctor to prescribe a hormonal cream. Fear of becoming impotent is sometimes a worry for older men. Talk to your doctor if this is a problem for you.
For good relations with your partner:
- Keep lines of communication open.
- Talk through any problems when they occur.
- Remember touching can give pleasure, but does not have to lead to intercourse.
- Try to make your sex life fun, not routine and boring.
Keeping warm and well in winter
Older people are at greater risk of hypothermia due to reduced activity, less awareness of cold and the effects of some drugs. Living in a cold environment also increases the risk of heart attack, stroke and pneumonia. Influenza can be avoided or at least reduced in severity each winter by having an influenza vaccination in autumn.
- Keep the main living areas at a comfortable temperature between 18 and 22°C. Use a wall thermometer or a thermostat on your heater.
- Make sure you have a supply of fuel.
- Consider putting insulation in ceiling spaces and sealing windows and doors for draughts.
- Regard heat as a health matter and not as a luxury.
- See your doctor about influenza vaccination each autumn.
Safety in and outside the home
Like the very young, older people are at increased risk of injury compared with other age groups. Falls are the most common cause of injury for older people in and around the home. Fire and smoke related injuries are also too common.
Some of the reasons for being injured are:
- your bones are more brittle and can break more easily
- impaired co-ordination and balance can mean you are unsteady on your feet
- changes in hearing and eyesight can affect your awareness of hazards.
Many accidents are predictable and can therefore be prevented if you:
- Maintain good physical and mental health, eg:
- exercise up to 30 minutes most days
- have your eyes tested regularly and wear glasses when prescribed
- take care with medications and limit alcohol intake.
- Keep aware of hazards and risks and practise commonsense safety habits, eg:
- wear shoes that have non-slip soles and low heels
- avoid long loose sleeves or skirts that can cause you to trip.
- Avoid trailing cords by having enough power points for your electrical appliances.
- Get rid of worn or torn carpets and lino.
- Tack or tape down loose edges of carpets and secure loose rugs.
- Make sure your floor surfaces are non-slip and mop up any spills immediately.
- Store chemicals where they won’t spill in containers that will not break. Label contents carefully.
In the kitchen
- Use an electric jug that automatically turns itself off.
- Turn saucepan handles in when heating on the stove.
- Try to have the things you use most in cupboards you can reach.
- Make sure that anything you stand on to reach high things is stable.
In the bathroom
- Use non-slip mats in the bath and shower.
- Install grab rails by bath, shower and toilet.
- Turn on cold water first in shower or bath.
In the bedroom
- Check that you have a quick, safe exit from your bedroom in case of fire.
- Never smoke in bed.
- Get your electric blanket checked before the start of winter.
- Turn on a light or use a torch if you have to get up in the night.
- Make sure you have sufficient lighting on outside entrances and pathways.
- Paint a white line on the edge of outside steps so that they are easy to see at night.
- Have moss cleared from steps and paths. Consider installing non-slip edging.
- Make sure your exits are kept clear, so you can leave quickly in case of fire.
- Have your chimney swept regularly to eliminate the risk of fire or carbon monoxide poisoning.
- Be careful about putting clothes to air close to a fire or heater.
- Dress and undress well away from any heaters or fires.
- Get smoke detectors installed and keep a fire extinguisher handy.
- Cross main roads only at pedestrian crossings – no jay-walking.
- Wear bright colours and attach reflective tape if walking on a country road.
- Watch out for slippery surfaces on pavements – some tiles can be a hazard.
- Recognise your reflexes may be a little slower and this can increase the risks of walking and driving in traffic.
- Drive carefully and pull over to let faster traffic pass.
- Enrol for a ‘Safe with Age’ or a defensive driving course to update your skills.
- Take plenty of rest breaks on long trips.
- Check carefully before backing your car out of the garage or carport.
- Be aware that some medications may make you drowsy.
While it is obviously sensible to take special care of hazards as we get older, it is also important to balance this with getting out and about and being part of life.
Safety at home
- Consider having your house fitted with security lights and an alarm system.
- Get a chain for the doors and a peephole.
- Do not let unknown people or people without identification into your house.
- Join a neighbourhood support scheme.
- Have a list of emergency phone numbers in large print handy to the telephone.
- Wear an alarm bracelet or necklace if you have a medical condition that may require immediate help.
- Make sure your telephone is accessible from the floor.
- Arrange a signal with your neighbour if you need help, eg, blind not up by 10am means all is not well.
- Keep an up-to-date first aid kit.
- Keep a ‘Life tube’ in your fridge, available from your local Age Concern branch.
Don’t be afraid to ask for help.