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Diabetes Care Guidelines for Older Adults

 
When a loved one has been diagnosed with diabetes, you naturally want to do everything you can to ensure their continued good health and quality of life. But where do you begin? What should you know? How do you start?
To help provide you with the answers you need, the American Geriatrics Society has developed an understandable set of guidelines for improving the care of elderly loved ones with diabetes.
Specifically designed with the needs of the seniors with diabetes in mind, these guidelines take into consideration that older people with diabetes:
  • Experience higher rates of premature death and mental and physical disability
  • Are more prone to develop coexisting illnesses, including high blood pressure, heart disease and stroke
  • Have an increased risk for several common conditions associated with the aging process, such as depression, reduced mental function, urinary incontinence, harmful falls, persistent pain and overmedication.
Knowing the associated risks of diabetes is one of the most important things you can do to make certain your loved one receives proper care at all times. Another vital component of care is customization. As emphasized by the guidelines, no two people are alike and every person needs a customized diabetes care plan. What works for one individual may not be the best course of treatment for another, since some people are fairly healthy and can manage their diabetes on their own while others may have one or more diabetes complications. Still others may be frail, have memory loss and have several chronic diseases in addition to diabetes.
After talking with your loved one and evaluating their medical history, your doctor will assess whether tight blood sugar control or some other treatment approach is appropriate. Depending upon the doctor’s recommendations, keep in mind that:
  • Tight blood glucose control can lower the risks of diabetes-related blindness and kidney disease caused by small blood vessel damage.
  • The risk of heart attack or stroke can be diminished with proper blood pressure and cholesterol management.  
To learn more, review the Summary of Guidelines below and be sure to talk with your loved one’s doctors. By becoming as informed as possible, you can ensure a high quality of life for your family member and a peace of mind you will both enjoy.

Summary of Guidelines
1.  Unless there are special circumstances where it could be harmful, 81 to 325 mg of aspirin per day is recommended for older adults to lower the risk of stroke and heart attack.
Clinical studies have shown that aspirin use can reduce the risk of heart attack and other heart disease in older adults with diabetes. The aspirin dose in these studies ranged from 75 mg. to 325 mg.
2.  Older people with diabetes who have high LDL cholesterol should be given diet and exercise changes or put on cholesterol-lowering medication.
Several studies have shown that lowering LDL cholesterol reduces the risk of heart attack and stroke in older people with diabetes. Older adults with normal or nearly normal LDL cholesterol and low HDL or elevated triglycerides should be offered medicine in addition to nutrition education. Nutrition education, increased exercise, and weight loss also improve cardiovascular health in older adults with diabetes.

3.  High blood pressure should be treated gradually to avoid complications, with a target blood pressure of less than 130/80 mm Hg if it is tolerated.
There is strong evidence from a number of clinical studies that drug therapy for blood pressure management reduces death from heart attack and stroke in middle-aged and older people.  Because older adults may have less tolerance for blood pressure reduction, it should be treated gradually to avoid complications. 

4.  The blood glucose A1c target should be individualized. The American Diabetes Association target of 7% or less is a reasonable goal for relatively healthy adults who function well.  8% is a more realistic goal for frail older adults and others in whom the risks of tight blood glucose control outweigh the benefits.
Clinical studies of people in late middle age with type 2 diabetes found that a 1% reduction in A1c was associated with a 37% drop in small blood vessel complications and a 21% drop in the risk of other diabetes-related complications.  Therefore, older adults who are in reasonably good health, or those who already have some small blood vessel damage can benefit from tight blood sugar control.
Frail older adults are at higher risk for serious low blood sugar (hypoglycemia), so if they take certain medications, they may need to check their blood glucose more often.  Their doctor will take the hypoglycemia risk into account when setting their A1c target.

5.  Encourage the person and caregivers to receive diabetes education and make them aware that it is a covered benefit under Medicare.
Studies show that education on medication use, blood glucose monitoring, and recognizing high and low blood sugar can greatly improve a person’s blood glucose control.
For many people, especially those with diabetes complications, one-on-one counseling or group classes with a diabetes educator can improve diabetes control. Yearly diabetes self management training is a covered benefit under Medicare Part B (http://www.medicare.gov)

6.  Older people should have regular eye exams, foot exams, and tests of kidney functioning. 
Studies show that early diagnosis and treatment of diabetic retinopathy2 reduces the risk of blindness.
All people with diabetes should have a foot examination at least once a year.  Regular foot exams allow early diagnosis of diabetic neuropathy3 and injuries which might turn into ulcers and lead to amputation.
A test for the presence of microalbumin4 in the urine should be done at the time of diagnosis in people with type 2 diabetes, and once a year afterward. Kidney disease can be avoided or its progress slowed by keeping your loved one’s blood glucose at normal levels and treating their high blood pressure, if applicable.
7.  People who smoke should be helped with counseling and medications to quit smoking.
Among people with diabetes, smokers have a higher risk than nonsmokers of premature death from heart disease.  The good news: in just 2 to 3 years after quitting smoking, the risk of coronary heart disease falls to levels similar to those of people who never smoked.
8.  Screen and treat for the following age-related conditions that are more common in older people with diabetes: depression, harmful falls, urinary incontinence, forgetfulness and other mental problems, and persistent pain.
  • Older people with diabetes have a higher risk of depression.  Family doctors have a number of routine screening surveys that can help them to judge if a patient is depressed.
  • Older people with diabetes have a higher risk of falling and seriously hurting themselves.  Diabetes-related causes include physical disability, vision problems, nerve damage in the feet and legs, low blood sugar, or drug interactions and side effects.
  • Older women with diabetes are at higher risk for urinary incontinence than men. It may be due to high blood sugar, but many other health problems can also lead to loss of urine control, so ask the family doctor to test for the cause.
  • Failing memory and other losses of mental ability make it harder for the older person to check their blood sugar, feed themselves properly and remember to take their meds on schedule.
  • Older adults with diabetes can experience pain from nerve damage, and those with pain are often under-treated.
9.  Older people with diabetes should be evaluated at each doctor visit for drug side effects and drug interactions. 
  • Older adults with diabetes are at high risk for drug side effects and drug interactions, because they may take several drugs each day to manage blood sugar, cholesterol, blood pressure, and other conditions. The doctor should review every prescription and over-the-counter drug, ointment, and supplement being used by the patient at every visit and check that the person is taking each medicine properly.
  • Examples of adverse drug reactions in diabetes care:

    • People with poor kidney function should not use metformin because of the increased risk of lactic acidosis, a rare but serious complication.
    • The diabetes pill chlorpropamide lasts a very long time in the body, particularly in older adults. It is associated with increased risk for low blood sugar, and this risk increases with age.
    • Some high blood pressure medications such as ACE inhibitors can cause kidney failure as a side effect, so it is important to check kidney function 1-2 weeks after starting the meds, with each dose increase afterward, and at least once per year
Insulin Use by Older Adults
Insulin is an important medication for the control of diabetes and can be safely used by people of all ages. If you provide care for an older adult with diabetes, consider the following when insulin has been prescribed for diabetes management:
  • Individuals with type 2 diabetes may begin insulin therapy by using oral diabetes medications with meals and long-acting insulin injections at bedtime.
  • If more blood glucose control is needed, your doctor may replace pills with insulin. At this stage, many doctors like to start with two daily injections of premixed short and intermediate-acting insulin in a “70/30 or 75/25” combination. Examples are Humalog® 75/25 Mix and Novolog® 70/30 Mix.
  • For ”younger” seniors in relatively good health, the doctor may suggest three to four insulin injections a day: long-acting ”basal” insulin at bedtime, plus short-acting ”bolus” insulin at each meal. This ”basal/bolus” regimen requires more effort, but it results in more lifestyle flexibility for the person, and better blood glucose control. This type of regimen can greatly lower the A1c level and improve the person’s wellbeing in just a few short months. However, taking insulin this often increases the risk of low blood sugar, so it is important to do blood glucose testing several times a day.
Diabetes Meal Planning for Older Adults
Eating a healthy, well-balanced diet is essential throughout all stages of life. However, seniors with diabetes are more likely to suffer from nutritional deficiencies, especially in the vitamins B1, B12, C and D and folate, calcium, zinc and magnesium.
Warning signs such as a weight loss or gain of more than 10 pounds in six months, can indicate that your loved one is not eating properly.
To ensure your family member with diabetes is receiving the best nutrition possible, bear in mind that dietary considerations change with age. In particular:
  • Older adults generally need 20-to-30% fewer calories than they did when they were younger and more active.
  • Protein should account for 10-to-20% of caloric intake. Individuals who have an infection, wounds that are healing or other health stresses may need to eat greater amounts of protein and calories.
  • When it comes to carbohydrates, the total amount is more important than the source. Foods that contain sugar can substitute for other carbohydrates in the meal plan.
  • To decide how much fat an individual can eat, the dietician will weigh the risk of heart disease against the risk of malnutrition. If a low-cholesterol diet is recommended, the restrictions should be limited to the American Heart Association Step One guidelines.
  • The American Dietetic Association’s recommendation of 20-to-35 grams of fiber per day may be too high for some seniors. Too much fiber for people who are bedridden or dehydrated can lead to serious digestive problems.
  • Sodium restrictions should be carefully evaluated. Older adults tend to have reduced taste perceptions, so if their foods do not contain enough salt, they may not eat enough and become malnourished.
  • The alcohol limits recommended for younger individuals with diabetes do not necessarily apply to seniors, as alcohol tolerance tends to decrease with age. To maintain optimal glucose levels, alcohol use may need to be significantly restricted or eliminated.
  • If your loved one cannot meet their nutritional needs with a normal solid food diet, then pureed foods and/or supplements may need to be added to the meal plan.
What a caregiver can do
Because of the close relationship you have with your loved one, you play an important role in making good nutrition a priority. Listed below are some of the steps you can take to ensure proper eating habits are established and maintained:
  • Ask your doctor to prescribe one or more sessions with a registered dietician to create a customized meal plan that is not only in balance with your loved one’s diabetes medicines, but also designed to accommodate their food preferences and any other medical conditions they may have.  Meeting with a registered dietitian is a covered benefit under Medicare, but your doctor will need to request it.
  • If your family member with diabetes lives alone, consider preparing and freezing a week’s supply of balanced, portion-controlled meals that can be reheated as needed.
For individuals who do their own grocery shopping, make a shopping list that includes the basics they’ll need for several days’ worth of meals. If they are on a restricted diet, this list can also remind them to choose low-fat or low-salt versions of  favorite foods. 
Exercise for Older Adults with Diabetes
It’s no secret that exercise is good for you and it’s especially important for older adults with diabetes. In fact, according to the National Institutes of Health website NIHSeniorHealth.gov, emerging research shows that people of all ages and physical conditions benefit from exercise and physical activity.
Did you know, for example, that muscle strength declines by 15% per decade after age 50 and 30% per decade after age 70? 
  • By regularly participating in strength-building exercise, however, muscle tissue and strength can be restored.
  • What’s more, exercise also makes it easier for older individuals to maintain their strength, balance, flexibility and endurance — all of which are important for staying healthy and independent.
  • Lastly, exercise improves insulin sensitivity and can improve a person’s response to blood glucose medications.
The American Academy of Family Physicians also reports that exercise is safe for most adults aged 65 and over. Moreover, even individuals with heart disease, high blood pressure, diabetes and arthritis can safely enjoy regular exercise. Exercise actually improves many of these conditions!
Types of exercises
There are different exercises for each part of the body and the first step in determining any exercise regimen is to consult with your loved one’s doctor. Once their doctor has given the go-ahead, the person’s exercise program should include balance training because there is evidence that this can help to reduce the risk of falls.
  • Balance exercises like side leg raises and knee flexions can help decrease the risk of falls. A variety of balance exercises can be done, as some build up the leg muscles, and others, like briefly standing on one leg, improve balance. Now widely popular, Tai Chi may be of some benefit to older adults, but its effects have not been greatly studied in seniors.
  • Flexibility, or stretching, exercises lengthen the muscles and tissues that hold the body’s structures in place. Over time, regular flexibility training may help keep the body limber, speed recovery from injuries and prevent future injuries and falls.
  • Strength, or ”resistance,” exercises using light weights, balances and elastic bands can not only help build up leg and arm muscles, but also improve balance. However, this type of exercise may not be appropriate for individuals who have diabetic retinopathy (eye disease).
  • Endurance exercises, like walking, jogging, rowing or swimming improve the health of the heart, lungs and circulatory system. They may also delay or prevent colon cancer, heart disease, osteoporosis, stroke and other serious diseases.
Remember that successful exercise programs are those that last 10 weeks or longer. Help your loved one make exercise a success by setting small, achievable goals and encourage them to make their chosen form of physical activity a regular part of their daily routine.
What a caregiver can do
Although you can’t do the exercise for them, there are things you can do to help your loved one get the physical activity they need to stay healthy. For example:
  • If your family member has “couch potato” tendencies, remind them that exercise can increase their feeling of well-being by improving their insulin sensitivity. You may also want to mention that exercise is encouraged for all older adults who are considered able to participate by their doctors.
  • Call the local gyms to find out where exercise programs specifically designed for older adults .Your local hospital may also be able to provide information about senior fitness programs in your area.
  • If your family member lives in a nursing home, assisted living or long-term care facility, ask the staff what exercise program they offer for residents and enroll your loved one. To increase the odds that they’ll go, consider enrolling one of their friends for companionship.
  • Most importantly, before your family member begins any exercise program, schedule a physical check-up and discuss with the doctor which types and frequency of exercise are best for your family member.

    • Depending upon your loved one’s condition, certain forms of exercise may need to be avoided. Individuals with diabetes-related eye disease (retinopathy) may need to avoid or limit resistance exercises (free weights ,weight machines and rubber exercise bands)because these types of physical activities can elevate blood pressure and cause bleeding in eyes

Diabetes Care Guidelines for Older Adults

 
When a loved one has been diagnosed with diabetes, you naturally want to do everything you can to ensure their continued good health and quality of life. But where do you begin? What should you know? How do you start?
To help provide you with the answers you need, the American Geriatrics Society has developed an understandable set of guidelines for improving the care of elderly loved ones with diabetes.
Specifically designed with the needs of the seniors with diabetes in mind, these guidelines take into consideration that older people with diabetes:
  • Experience higher rates of premature death and mental and physical disability
  • Are more prone to develop coexisting illnesses, including high blood pressure, heart disease and stroke
  • Have an increased risk for several common conditions associated with the aging process, such as depression, reduced mental function, urinary incontinence, harmful falls, persistent pain and overmedication.
Knowing the associated risks of diabetes is one of the most important things you can do to make certain your loved one receives proper care at all times. Another vital component of care is customization. As emphasized by the guidelines, no two people are alike and every person needs a customized diabetes care plan. What works for one individual may not be the best course of treatment for another, since some people are fairly healthy and can manage their diabetes on their own while others may have one or more diabetes complications. Still others may be frail, have memory loss and have several chronic diseases in addition to diabetes.
After talking with your loved one and evaluating their medical history, your doctor will assess whether tight blood sugar control or some other treatment approach is appropriate. Depending upon the doctor’s recommendations, keep in mind that:
  • Tight blood glucose control can lower the risks of diabetes-related blindness and kidney disease caused by small blood vessel damage.
  • The risk of heart attack or stroke can be diminished with proper blood pressure and cholesterol management.  
To learn more, review the Summary of Guidelines below and be sure to talk with your loved one’s doctors. By becoming as informed as possible, you can ensure a high quality of life for your family member and a peace of mind you will both enjoy.

Summary of Guidelines
1.  Unless there are special circumstances where it could be harmful, 81 to 325 mg of aspirin per day is recommended for older adults to lower the risk of stroke and heart attack.
Clinical studies have shown that aspirin use can reduce the risk of heart attack and other heart disease in older adults with diabetes. The aspirin dose in these studies ranged from 75 mg. to 325 mg.
2.  Older people with diabetes who have high LDL cholesterol should be given diet and exercise changes or put on cholesterol-lowering medication.
Several studies have shown that lowering LDL cholesterol reduces the risk of heart attack and stroke in older people with diabetes. Older adults with normal or nearly normal LDL cholesterol and low HDL or elevated triglycerides should be offered medicine in addition to nutrition education. Nutrition education, increased exercise, and weight loss also improve cardiovascular health in older adults with diabetes.

3.  High blood pressure should be treated gradually to avoid complications, with a target blood pressure of less than 130/80 mm Hg if it is tolerated.
There is strong evidence from a number of clinical studies that drug therapy for blood pressure management reduces death from heart attack and stroke in middle-aged and older people.  Because older adults may have less tolerance for blood pressure reduction, it should be treated gradually to avoid complications. 

4.  The blood glucose A1c target should be individualized. The American Diabetes Association target of 7% or less is a reasonable goal for relatively healthy adults who function well.  8% is a more realistic goal for frail older adults and others in whom the risks of tight blood glucose control outweigh the benefits.
Clinical studies of people in late middle age with type 2 diabetes found that a 1% reduction in A1c was associated with a 37% drop in small blood vessel complications and a 21% drop in the risk of other diabetes-related complications.  Therefore, older adults who are in reasonably good health, or those who already have some small blood vessel damage can benefit from tight blood sugar control.
Frail older adults are at higher risk for serious low blood sugar (hypoglycemia), so if they take certain medications, they may need to check their blood glucose more often.  Their doctor will take the hypoglycemia risk into account when setting their A1c target.

5.  Encourage the person and caregivers to receive diabetes education and make them aware that it is a covered benefit under Medicare.
Studies show that education on medication use, blood glucose monitoring, and recognizing high and low blood sugar can greatly improve a person’s blood glucose control.
For many people, especially those with diabetes complications, one-on-one counseling or group classes with a diabetes educator can improve diabetes control. Yearly diabetes self management training is a covered benefit under Medicare Part B (http://www.medicare.gov)

6.  Older people should have regular eye exams, foot exams, and tests of kidney functioning. 
Studies show that early diagnosis and treatment of diabetic retinopathy2 reduces the risk of blindness.
All people with diabetes should have a foot examination at least once a year.  Regular foot exams allow early diagnosis of diabetic neuropathy3 and injuries which might turn into ulcers and lead to amputation.
A test for the presence of microalbumin4 in the urine should be done at the time of diagnosis in people with type 2 diabetes, and once a year afterward. Kidney disease can be avoided or its progress slowed by keeping your loved one’s blood glucose at normal levels and treating their high blood pressure, if applicable.
7.  People who smoke should be helped with counseling and medications to quit smoking.
Among people with diabetes, smokers have a higher risk than nonsmokers of premature death from heart disease.  The good news: in just 2 to 3 years after quitting smoking, the risk of coronary heart disease falls to levels similar to those of people who never smoked.
8.  Screen and treat for the following age-related conditions that are more common in older people with diabetes: depression, harmful falls, urinary incontinence, forgetfulness and other mental problems, and persistent pain.
  • Older people with diabetes have a higher risk of depression.  Family doctors have a number of routine screening surveys that can help them to judge if a patient is depressed.
  • Older people with diabetes have a higher risk of falling and seriously hurting themselves.  Diabetes-related causes include physical disability, vision problems, nerve damage in the feet and legs, low blood sugar, or drug interactions and side effects.
  • Older women with diabetes are at higher risk for urinary incontinence than men. It may be due to high blood sugar, but many other health problems can also lead to loss of urine control, so ask the family doctor to test for the cause.
  • Failing memory and other losses of mental ability make it harder for the older person to check their blood sugar, feed themselves properly and remember to take their meds on schedule.
  • Older adults with diabetes can experience pain from nerve damage, and those with pain are often under-treated.
9.  Older people with diabetes should be evaluated at each doctor visit for drug side effects and drug interactions. 
  • Older adults with diabetes are at high risk for drug side effects and drug interactions, because they may take several drugs each day to manage blood sugar, cholesterol, blood pressure, and other conditions. The doctor should review every prescription and over-the-counter drug, ointment, and supplement being used by the patient at every visit and check that the person is taking each medicine properly.
  • Examples of adverse drug reactions in diabetes care:

    • People with poor kidney function should not use metformin because of the increased risk of lactic acidosis, a rare but serious complication.
    • The diabetes pill chlorpropamide lasts a very long time in the body, particularly in older adults. It is associated with increased risk for low blood sugar, and this risk increases with age.
    • Some high blood pressure medications such as ACE inhibitors can cause kidney failure as a side effect, so it is important to check kidney function 1-2 weeks after starting the meds, with each dose increase afterward, and at least once per year
Insulin Use by Older Adults
Insulin is an important medication for the control of diabetes and can be safely used by people of all ages. If you provide care for an older adult with diabetes, consider the following when insulin has been prescribed for diabetes management:
  • Individuals with type 2 diabetes may begin insulin therapy by using oral diabetes medications with meals and long-acting insulin injections at bedtime.
  • If more blood glucose control is needed, your doctor may replace pills with insulin. At this stage, many doctors like to start with two daily injections of premixed short and intermediate-acting insulin in a “70/30 or 75/25” combination. Examples are Humalog® 75/25 Mix and Novolog® 70/30 Mix.
  • For ”younger” seniors in relatively good health, the doctor may suggest three to four insulin injections a day: long-acting ”basal” insulin at bedtime, plus short-acting ”bolus” insulin at each meal. This ”basal/bolus” regimen requires more effort, but it results in more lifestyle flexibility for the person, and better blood glucose control. This type of regimen can greatly lower the A1c level and improve the person’s wellbeing in just a few short months. However, taking insulin this often increases the risk of low blood sugar, so it is important to do blood glucose testing several times a day.
Diabetes Meal Planning for Older Adults
Eating a healthy, well-balanced diet is essential throughout all stages of life. However, seniors with diabetes are more likely to suffer from nutritional deficiencies, especially in the vitamins B1, B12, C and D and folate, calcium, zinc and magnesium.
Warning signs such as a weight loss or gain of more than 10 pounds in six months, can indicate that your loved one is not eating properly.
To ensure your family member with diabetes is receiving the best nutrition possible, bear in mind that dietary considerations change with age. In particular:
  • Older adults generally need 20-to-30% fewer calories than they did when they were younger and more active.
  • Protein should account for 10-to-20% of caloric intake. Individuals who have an infection, wounds that are healing or other health stresses may need to eat greater amounts of protein and calories.
  • When it comes to carbohydrates, the total amount is more important than the source. Foods that contain sugar can substitute for other carbohydrates in the meal plan.
  • To decide how much fat an individual can eat, the dietician will weigh the risk of heart disease against the risk of malnutrition. If a low-cholesterol diet is recommended, the restrictions should be limited to the American Heart Association Step One guidelines.
  • The American Dietetic Association’s recommendation of 20-to-35 grams of fiber per day may be too high for some seniors. Too much fiber for people who are bedridden or dehydrated can lead to serious digestive problems.
  • Sodium restrictions should be carefully evaluated. Older adults tend to have reduced taste perceptions, so if their foods do not contain enough salt, they may not eat enough and become malnourished.
  • The alcohol limits recommended for younger individuals with diabetes do not necessarily apply to seniors, as alcohol tolerance tends to decrease with age. To maintain optimal glucose levels, alcohol use may need to be significantly restricted or eliminated.
  • If your loved one cannot meet their nutritional needs with a normal solid food diet, then pureed foods and/or supplements may need to be added to the meal plan.
What a caregiver can do
Because of the close relationship you have with your loved one, you play an important role in making good nutrition a priority. Listed below are some of the steps you can take to ensure proper eating habits are established and maintained:
  • Ask your doctor to prescribe one or more sessions with a registered dietician to create a customized meal plan that is not only in balance with your loved one’s diabetes medicines, but also designed to accommodate their food preferences and any other medical conditions they may have.  Meeting with a registered dietitian is a covered benefit under Medicare, but your doctor will need to request it.
  • If your family member with diabetes lives alone, consider preparing and freezing a week’s supply of balanced, portion-controlled meals that can be reheated as needed.
For individuals who do their own grocery shopping, make a shopping list that includes the basics they’ll need for several days’ worth of meals. If they are on a restricted diet, this list can also remind them to choose low-fat or low-salt versions of  favorite foods. 
Exercise for Older Adults with Diabetes
It’s no secret that exercise is good for you and it’s especially important for older adults with diabetes. In fact, according to the National Institutes of Health website NIHSeniorHealth.gov, emerging research shows that people of all ages and physical conditions benefit from exercise and physical activity.
Did you know, for example, that muscle strength declines by 15% per decade after age 50 and 30% per decade after age 70? 
  • By regularly participating in strength-building exercise, however, muscle tissue and strength can be restored.
  • What’s more, exercise also makes it easier for older individuals to maintain their strength, balance, flexibility and endurance — all of which are important for staying healthy and independent.
  • Lastly, exercise improves insulin sensitivity and can improve a person’s response to blood glucose medications.
The American Academy of Family Physicians also reports that exercise is safe for most adults aged 65 and over. Moreover, even individuals with heart disease, high blood pressure, diabetes and arthritis can safely enjoy regular exercise. Exercise actually improves many of these conditions!
Types of exercises
There are different exercises for each part of the body and the first step in determining any exercise regimen is to consult with your loved one’s doctor. Once their doctor has given the go-ahead, the person’s exercise program should include balance training because there is evidence that this can help to reduce the risk of falls.
  • Balance exercises like side leg raises and knee flexions can help decrease the risk of falls. A variety of balance exercises can be done, as some build up the leg muscles, and others, like briefly standing on one leg, improve balance. Now widely popular, Tai Chi may be of some benefit to older adults, but its effects have not been greatly studied in seniors.
  • Flexibility, or stretching, exercises lengthen the muscles and tissues that hold the body’s structures in place. Over time, regular flexibility training may help keep the body limber, speed recovery from injuries and prevent future injuries and falls.
  • Strength, or ”resistance,” exercises using light weights, balances and elastic bands can not only help build up leg and arm muscles, but also improve balance. However, this type of exercise may not be appropriate for individuals who have diabetic retinopathy (eye disease).
  • Endurance exercises, like walking, jogging, rowing or swimming improve the health of the heart, lungs and circulatory system. They may also delay or prevent colon cancer, heart disease, osteoporosis, stroke and other serious diseases.
Remember that successful exercise programs are those that last 10 weeks or longer. Help your loved one make exercise a success by setting small, achievable goals and encourage them to make their chosen form of physical activity a regular part of their daily routine.
What a caregiver can do
Although you can’t do the exercise for them, there are things you can do to help your loved one get the physical activity they need to stay healthy. For example:
  • If your family member has “couch potato” tendencies, remind them that exercise can increase their feeling of well-being by improving their insulin sensitivity. You may also want to mention that exercise is encouraged for all older adults who are considered able to participate by their doctors.
  • Call the local gyms to find out where exercise programs specifically designed for older adults .Your local hospital may also be able to provide information about senior fitness programs in your area.
  • If your family member lives in a nursing home, assisted living or long-term care facility, ask the staff what exercise program they offer for residents and enroll your loved one. To increase the odds that they’ll go, consider enrolling one of their friends for companionship.
  • Most importantly, before your family member begins any exercise program, schedule a physical check-up and discuss with the doctor which types and frequency of exercise are best for your family member.

    • Depending upon your loved one’s condition, certain forms of exercise may need to be avoided. Individuals with diabetes-related eye disease (retinopathy) may need to avoid or limit resistance exercises (free weights ,weight machines and rubber exercise bands)because these types of physical activities can elevate blood pressure and cause bleeding in eyes

 

 



 

 

 

 

 



 

 

 

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