The Importance of Vitamin D by Dr. Sarah Brewer

Dr. Sarah Brewer is a medical nutritionist, nutritional therapist and the author of over 60 popular health books. We are excited about her guest blog post on this vital topic. 

At one-time, vitamin D was all about ensuring good calcium absorption from the diet to maintain healthy bones. Researchers now realize this important vitamin does a lot more than that and has beneficial effects all over the body.

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What is it?

Vitamin D, or calciferol, is the collective term for five different, fat-soluble vitamins. The most important for human health is vitamin D3 (cholecalciferol) which we can make in our skin to some extent. Vitamin D3 is also obtained from animal-based foods such as liver, oily fish, meat, eggs, and dairy products and is added to some fortified foods. We also obtain small amounts of vitamin D2 (ergocalciferol) from a few plant foods such as mushrooms.

What does it do?

As well as regulating the absorption of calcium and phosphate from the diet, and helping to maintain strong bones, vitamin D helps to stimulate immune cells to reduce the susceptibility to infections such as pneumonia. It’s no coincidence that sun exposure was once a leading sanatorium treatment for tuberculosis before antibiotics were available.

Vitamin D helps to reduce calcium deposition in arteries, is involved in memory and mood, and has a strengthening effect on muscle fibres that improve stability and help reduce falls.

Studies have also found associations between good vitamin D status and reduced risks of:

  • breast cancer[i]
  • type 2 diabetes[ii]
  • depression[iii]
  • Alzheimer’s disease and Parkinson’s disease[iv]
  • stroke[v].
The difficulty with making vitamin D

Even in youth, it’s difficult to make all the vitamin D3 you need, which is why it is classed as an essential micronutrient. Its synthesis depends on the presence of a cholesterol-like building block (7-dehydrocholesterol) in the skin, and exposure to sunlight when the UV index is greater than 3.

People living at a latitude of 52 degrees N (which passes through the center of the UK and Canada) are not exposed to enough UVB radiation to make vitamin D between October and April. Those living at a latitude 42 degrees N (which forms the northern limit of Spain and part of the border between Canada and North America) are unable to synthesise vitamin D3 between November to February.

Low vitamin D levels are frequently seen in people living at northern latitudes, especially in those who cover up in the sun, use high factor sun protection, or who stay indoors most of the time – which includes many older people, especially those who are frail or relatively immobile.

People who are taking a statin drug are also at risk of vitamin D deficiency as they produce less of the cholesterol-like precursor in their skin.[vi]

Skin synthesis falls with age

Over the age of 50, the ability to synthesise vitamin D3 reduces so that skin concentrations fall by at least half between the ages of 20 to 80 years. One study showed that people aged 62 and over synthesised four times less natural vitamin D than those in their 20s.[vii]

Due to a combination of less sun exposure, and less ability to make vitamin D3 even when the sun is shining, vitamin D deficiency becomes more common with increasing age.

Vitamin D3 deficiency has wide-ranging effects on health

In older people, lack of vitamin D is associated with the bone diseases, osteomalacia and osteoporosis, and has been linked with muscle weakness, falls and bone fractures.

In the Health, Aging and Body Composition study, involving 2,099 older people (average age around 75 years) who were initially well-functioning, a low vitamin D level was associated with increased risk of developing mobility limitation, disability and poor physical function. [viii]

In the United States, the CDC Injury Center estimates that the number of fatal falls in older people will rise to 100,000 per year by 2030, but that these future fatal falls could be reduced by nearly a quarter through screening for fall risks, reviewing medications, and recommending Vitamin D supplementation.[ix]

Vitamin D deficiency may also play a role in constipation and increase the risk of common age-related conditions such as type 2 diabetes, arterial calcification, hypertension and heart disease as well as some cancers.

What’s the answer?

Despite the limitations mentioned, it’s important to encourage the elderly to spend time out of doors, to obtain some sun exposure, and to eat food sources of vitamin D regularly. The most important intervention, however, is to offer them a vitamin D3 supplement.

Elderly lady using a walker in the garden standing on a pathway with buildings in the background smiling at the camera.

What’s the best dose?

Opinions vary, with recommendations ranging from 10mcg to 50 mcg vitamin D3 per day. Some researchers have found that the United States, for examples, studies show that an intake of 100 mcg (4000 IU) is needed to maintain vitamin D levels in all older women. [x] This intake is equivalent to the currently suggested EU Upper Safe Level.[xi] If in doubt, blood tests can predict the best dose.

Safety

Intakes above 100mcg vitamin D3 are best taken under medical supervision. Excess can lead to side effects associated with high calcium levels, such as demineralization of bone, kidney stones, headache and weakness.

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Read more about vitamin D and health here: https://drsarahbrewer.com/a-z-of-vitamins/vitamin-d

Subscribe to my newsletter to get a FREE 46-page PDF Do You Need A MultiVitamin? at nutritionupdates.subscribemenow.com

For more information on diet and supplements, visit my Nutritional Medicine website at www.DrSarahBrewer.com.  Read my general health articles at www.MyLowerBloodPressure.com and www.ExpertHealthReviews.com @DrSarahB  

References

Senior Social Media Training for Senior Health

A new study out of England and Italy finds that when the elderly are trained in the use of social media as well as Skype and email, they perform better cognitively and experience improved health.

During a two year period, 120 seniors in the UK and Italy aged 65 and above were given specially designed computer training and were compared against a control group that did not received any. Among those that used these tools, the mental and physical capacity improved as opposed to a steady decline experienced in the control group.

Hypotheses asThinkstockPhotos-453532787 to why this occurred include: “Human beings are social animals,” as stated by Thomas Morton who led the study out of the University of Exeter’s psychology department. It is amazing how satisfying our basic social needs can have synergistic effects for our overall health. One woman reported feeling “invigorated” rather than “slipping into a slower pace” and caring more about her appearance and losing weight. Three quarters of the test group with computer training found email and Skype useful, but fewer than half liked Facebook as much.

The Office for National Statistics in the UK reports that the elderly over 65 have increased their internet use from 9% in 2006 to an astounding 37% in 2013. With the elderly population in Europe set to grow from 17% to 30% by 2060, marrying their well being with this ever growing usage of technology can have dramatic effects on their quality of life.

Those in the eldercare field feel that the computer, and even the use of that word, could be a barrier to entry for many of the elderly. Shifting the focus of technology adoption from the computers to tablets might be more effective since tablets tend to be more user-friendly.

Being that a major problem of the elderly is a devastating feeling of loneliness and isolation, encouraging new technology adoption as an avenue for its alleviation is a winning solution. Keeping in touch with old friends and relatives as well as keeping current with the events of the day could help the elderly remain feeling vital. The counter intuitive marriage of the elderly with technology might be the perfect antidote to what ails them.

David York Home Healthcare Agency is very sensitive to the potential of feeling isolated and makes every effort to send caring and compassionate home health aides into the client’s home. David York Home Agency (DYA) is well versed in the problems of the elderly and all factors related to eldercare services. DYA provides certified home health aide services for the elderly in their home and is abreast of all the latest guidelines and trends for seniors.  We would be happy to discuss your case with you.  Please call for a free consultation today at (718) 376-7755 or visit our website.  You can also follow us on FacebookTwitter, or LinkedIn.

 

Elder Self-Neglect: Most Common Form of Elder Abuse

The Geriatric Care Manager shows up to check on her 78 year old client. She notices the elderly man is gaunter and noticeably thinner than when she started the case. From week to week, the piles of mail seem to grow and the dishes seem to wait all week for the once per week cleaning woman to come. The apartment has an unpleasant odor signaling the need for more help than agreed to by the client. Sadly, all these are signs of elder self neglect, a growing problem among the elderly.

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According to the National Association of Professional Geriatric Care Managers (NAPGCM), elderly self-neglect far exceeds any physical or sexual abuse or neglect by others such as their assigned caregiver. Geriatric Care Managers report as follows: 92% say they encounter this in their community; 52% of them say it is a growing problem, and 76% of them say it is the most common form of elder abuse/neglect that they encounter in their practices.

The warning signs of elder self-neglect are:

  1. Poor personal hygiene with respect to bathing and grooming.
  2. Poor medical management as defined by forgetting doses or refusing to take medications and refusing medical treatment.
  3. Signs of dehydrations and malnutrition.
  4. Unsanitary living conditions.
  5. Signs of unpaid bills, bounced checks and/or utility turn-offs.
  6. Weight loss and a shortage of food in the house.

While it is important to be able to recognize the signs and symptoms of elder self-neglect, it is even more important to take a look at possible underlying causes. These include:

  1. Depression which is so common in the elderly.
  2. Increased physical and/or mental deficits or dementia.
  3. Undiagnosed illness that might be causing extreme fatigue.
  4. Medications with side effects that cause lethargy.
  5. Continuation of a lifelong pattern of slovenliness.

If you think someone you know or love is suffering from elder abuse or elder self-neglect, you can contact The National Center on Elder Abuse for a state by state listing of resources that can help.

When you can’t be there, David York Agency is with skilled home health aide services for the elderly in their home. We are fully acquainted with all factors related to eldercare services and always available to set up a senior homecare plan taking the whole patient into account. David York Agency is abreast of all the latest guidelines for seniors and we would be happy to discuss your case with you. Please call us at (718) 376-7755 or visit our website. You can also like us on Facebook or follow us on Twitter, Google+ or LinkedIn.

 

 

Failure: Screening & Reporting Falls in Elderly

There seems to be a big gap with respect to caring for the elderly – reporting and screening for falls. The responsibility for this failure falls to both the elderly experiencing the falls as well as their caregivers and healthcare providers.

453263573A study out of the UCLA Center for Health Policy Research shows 12.6% of
California’s elderly population fall more than one time a year and most do not report it to their medical provider. When they do report the event, the healthcare professional treating them seem to neglect counseling them on fall prevention in 40% of the cases.

Fall prevention is critical to the elderly since it is the leading cause for injury and hospitalization among those 65 and older and the risk only increases as they age. One in 5 people 85 and older report falling more than once a year versus 1 in 10 of those between 65 and 74. The outcomes of a fall in the elderly are often fatal or, at best, have long term consequences for performing their activities of daily living.

While it is incumbent on healthcare professionals to provide counseling to all their elderly patients, these providers must also be informed of any falls by those they treat. Elderly patients must be encouraged to report any falls so that they can be counseled how to prevent falls and to elder proof their surroundings. Also, they need to warn them about certain medications that can exacerbate their lack of balance which naturally declines as they age. Those medications include*:

  • anti-seizure drugs (anticonvulsants)
  • hypertensive (high blood pressure) drugs
  • sedatives
  • tranquilizers
  • anxiolytics (anti-anxiety drugs)
  • aminoglycosides (a type of antibiotic)
  • diuretics
  • vasodilators
  • certain analgesics (painkillers)
  • certain chemotherapeutics (anti-cancer drugs).

*From NIH Senior Health: Balance Problems: Causes and Prevention

 

At David York Home Healthcare Agency, we could provide direction to caregivers as to how to manage the total care of your senior loved one. David York Agency provides skilled home health aide services for the elderly in New York in their homes and is abreast of all the latest guidelines for seniors.  Our home health aides are certified and fully trained on how to safely care for the elderly. We would be happy to discuss your case with you.  Please call us at (718) 376-7755 or visit our website.  You can also like us on Facebook, or follow us on Twitter or LinkedIn.

 

 

 

 

Prescribed Drugs: Possible Risk to the Elderly

A study out of Brown University finds that doctors in the U.S. are prescribing drugs to the elderly that can have harmful side effects and the problem is even more acute in the south.

122422920Many drugs such as valium are harder for the elderly to metabolize so they stay in their systems a lot longer and this lingering effect can cause lightheadedness in an older person. This compromised physical state can very well lead to falls which we all know can have deadly consequences for the elderly.

Furthermore, a problem now termed as polypharmacy seems to be taking hold as a public health issue. This relates to the fact that the average senior citizen’s treatment plan includes four prescription drugs at the same time opening endless possibilities for harmful interactions which are suspected to be responsible for almost 33% of all hospital admissions.

The elderly and their caretakers need to review their medications regularly to make sure they know all associated risks, possible side effects and negative interactions. This link from Merck can be a handy reference.

David York Home Healthcare Agency provides skilled home health aide services for the elderly in their home and is abreast of all the latest guidelines for seniors.  We would be happy to discuss your case with you.  Please call us at (718) 376-7755 or visit our website.  You can also follow us on FacebookTwitter or LinkedIn.

Home Health Aides – Providing Quality Care

Need a little assistance caring for an elderly loved one at home? A home health aide can provide much needed care when it comes to caring for an aging parent or spouse. Home health aides provide in-home care with many activities of daily living (ADL) which include personal care, bathing, dressing, toileting, grooming, and mobility.

A home health aide can also help with grocery shopping and meal preparation.Carer and elderly woman They can take into account any special dietary requirements and make sure that your loved one is getting healthy meals regularly.

If your loved one can no longer navigate outside the home by themselves, a home health aide can escort them to important doctor visits or other appointments. The home health aide will ensure that their elderly client gets back and forth safely.

David York Agency provides high quality skilled home health aide services for the elderly and infirm with the highest degree of personal service. We can provide full-time or part-time professionals depending on your needs. We have Certified Home Health Aides (HHA), Certified Personal Care Aides (PCA), Registered Nurses (RN), and Licensed Practical Nurses (LPN). All of our aides are certified and specially trained. All of our aides are thoroughly screened, fingerprinted and checked for criminal background. We regularly check credentials and maintain valid references for our aides. You can be sure that the highest caliber health aides are caring for your loved ones.

When home healthcare becomes necessary, David York Agency would be happy to answer all your questions. Visit our website at David York Agency. Please like us on  Facebook or follow us on Twitter, Google+ or LinkedIn.

Getting Important Documents Assembled for the Elderly

So often, when crisis hits, a family can be caught unawares by this emergency situation. Adult children are blindsided by not knowing where to find critical documents necessary for deciding on the care for their elderly parents and they feel handcuffed by not having access to important assets or documents that are needed. However, it is never too early to start that ‘just in case’ file.

While the holidays are a wonderful time for family sharing and bonding, it is also an opportunity for adult children to help organize essential information for their elderly parents. I think that in addition to feasting and spreading joy this holiday season, all of us, whether we be seniors, caregivers or potential caregivers, should take the opportunity to get some ‘ducks in a row’ and organize those all important documents and bits of information. David York Agency has compiled a handy checklist and a small packet of worksheets to assist in this task. Both are accessible through these links or on the Caregiver Resources page of the David York Agency website.

Essential Documents & Emergency Information Worksheets (pdf version)

Essential Documents & Emergency Information Checklist (pdf versionDec newsletter

  • Professionals List – All Contact Information for:
    • Doctors: Primary Care and Specialists
    • Accountant
    • Attorney
    • Financial Advisor
    • Insurance Brokers
  • Important Documents Packet (Originals and/or Copies):
    • Social Security Card
    • Birth Certificate
    • Driver’s License
    • Marriage Certificate
    • Divorce Certificate
    • Passport
    • Medical Information
      • Allergies
      • Medications
      • Treatments
      • Major Operations
      • Immunization Records
    • Medicare/Medicaid/Insurance Card
    • Life Insurance Policies
    • Military Discharge Papers
    • Deeds
    • Titles
    • Tax Returns for last 6 years
    • Instructions on Location of all files
  • Financial Accounts List – All Contact Information and Account Numbers for:
    • Bank Accounts
    • Investment/Brokerage Accounts
      • Stocks
      • Bonds
      • CDs
    • Credit/Debit Cards
  • Financial Assets List:
    • Car Ownership
    • Mortgage Documents
    • Real Estate Holdings
    • Loans Owed or Owed to them
    • Tax Returns
    • Insurance Policies
      • Home
      • Auto
      • Health
      • Long Term Care
      • Life
    • Original Invoices for Important Possessions
    • Partnership Documents
    • Jewelry and Valuables
    • Safe Combination and Directions
    • Location of Safety Deposit Key
  • Sources of Income:
    • Annuities
    • Social Security
    • Pensions
    • Annual Distributions from Retirement Accounts
    • VA Benefits
    • Disability Payments
  • Recurring Bills:
    • Mortgage
    • Loans
    • Utilities
      • Telephone
      • Electric
      • Gas
    • Insurance Premiums (monthly & quarterly)
    • Car Lease
    • Annual Expenses (i.e. home alarm)
    • Deliveries (i.e. newspaper, milk)
  • Computerized Information:
    • Email Accounts and Passwords
    • Password for Computer
    • Recurring Online Billing
  • Estate Planning Documents:
    • Will
    • Special Instructions regarding personal property
    • Durable Power of Attorney
    • Advanced Healthcare Directive/Living Will
    • Healthcare Proxy
    • Do Not Resuscitate (DNR) Order
    • Retirement Plans
    • Disability Plans
    • Governmental Benefits for which they are eligible
  • End of Life Arrangements:
    • Cemetery Plot Ownership
    • Pre-Planned Burial Papers
    • Personal Statement regarding burial services

Most important is that all this information be easily accessible clearly labeled and a trusted person know its location. Also, if you choose to keep this all stored on a computer, make sure a back up is made and a print out is kept in a location known to a close friend or relative. Healthcare decisions are often quite pressing, so knowing where to find medical records and decision makers in time can be crucial. With respect to assets, at times the government takes possession of unclaimed assets and while you might be able to get a hold of something belonging to you that was overlooked, it is not always an easy process. It is best not to get into that situation and have everything organized ahead of time.
When home healthcare becomes necessary, David York Agency provides skilled home health aide services. David York Home Healthcare Agency can satisfy all your questions and would be happy to give you more information and discuss your case with you. Visit our website at David York Agency – providing healthcare professionals to the elderly and infirm, with the highest degree of personal service. Please like us on Facebook or follow us on Twitter, Google+ or LinkedIn.

Preventing Falls in the Elderly

We are often so consumed with the symptoms and treatments of the diseases endemic to the elderly that we fail to see how a simple fall can have catastrophic effects. These falls can lead to disabling conditions, extended hospital stays and even death. To the elderly, commonplace activities like walking, shopping and socializing become dreaded events.  Their physical realities combined with their fears mean that the elderly come to view themselves as fragile which exacerbates their isolation and depression, all too common conditions among this group.

Ten things you can do to prevent falls include (The National Institute on Aging has a handy tip sheet):487709591

  • Regular exercise, especially those that work on balance like yoga and tai chi, can help steady the elderly adult. Weight-bearing exercises that slow bone loss and lower-body strengthening exercises are especially helpful.
  • Physical therapy may be useful for improving balance and walking confidence.  Your doctor or health care provider may be able to make that referral.
  • Stand up slowly from a seated or lying position.
  • Wear rubber soled shoes to avoid slipping.
  • Make regular eye and hearing check-ups to ensure they are fitted with glasses with the optimal prescription for clear vision.  Interestingly, even wearing bifocals while walking or on steps may blur the vision enough to cause falls.  Proper hearing can ensure no cues are missed.
  • Elder proofing a home taking elderly needs and deficits into account much as we do for babies is often neglected.  (See article below.)
  • Regular dizziness may indicate an underlying medical condition with respect to blood pressure, circulation, or sensory issues which should be checked out by a physician.
  • Have the doctor or pharmacist review all medications to identify those most likely to cause dizziness and drowsiness.
  • Limit the amount of alcohol consumed.
  • Get enough sleep.
    Source: National Institute on Aging: Go4Life: Preventing Falls

David York Home Healthcare Agency  provides skilled home health aide services for the elderly in New York in their homes and is abreast of all the latest guidelines for seniors.  We would be happy to discuss your case with you.  Please call us at (718) 376-7755 or visit our website.  You can also follow us on Facebook, Twitter, or LinkedIn. At David York Agency, we could provide direction as to how to manage the total care of your senior loved one.

Too Old To Drive?

With all the free spirited Baby Boomers aging, it might be hard for them to think of giving up a big part of their vehicles of freedom – the car keys. According to the National Highway Traffic Safety Administration, the past 10 years has seen about a 20% increase in licensed drivers over 65 years old on the road. As their children see more and more physical signs for concern and feel awkward about broaching the subject with their aging parents, a new area of expertise has come on the scene –  Driving Rehabilitation Specialists. These are occupational therapists that specialize in assessing and even correcting some of the problems seniors may experience as their driving skills age with them.

too old to driveIt’s all about keeping everyone safe. According to the AAA, the highest fatal car accidents occur in two distinct age groups – teenagers and those 75 and older. However, while teenagers are more of danger to others, senior citizen drivers are more of a danger to themselves. They are more fragile and don’t bounce back from injuries well at all.

On the other hand, up until the age of 65, the accident rates of older adults mirror those who are middle aged. In order to ensure that this younger senior citizen group is driving safely for as long as possible, various safeguards can be employed. Organizations such as AAA & AARP have online screening assessment questionnaires. After that, you might want to get an ‘on-the-road’ driving assessment which can be scheduled through a rehabilitation center or driving school. Finally, driving rehabilitation specialists can be called to look for things like flexibility, reflexes and range of motion in the neck and shoulders. This option can be pricey ranging anywhere from $200 – $1,000 depending on the state and the depth of analysis and instruction involved. The  American Occupational Therapy Society can help you locate someone in your zip code.

At David York Home Healthcare Agency, we are very in tune with the quality of life issues pertaining to the elderly. Our home health aides are keenly aware of the needs and issues of senior citizens as their skills decline.

David York Agency provides skilled home health aides for the elderly and ill. We provide skilled home health aide services for home healthcare and could assist you in mapping out and managing the total care of your senior loved one. Please call us at (718) 376-7755 or visit us on our website to become acquainted with all we offer. Please like us on Facebook or follow us on Twitter or  LinkedIn.

MediSafe Project: Never Forget to take Medications

Managing medication compliance keeps getting easier. At David York Agency, we are excited about the MediSafe Project, one of the latest technological innovations to help ensure that you and your loved ones never skip or take the wrong dose of a prescribed medication or supplement. MediSafe is a user friendly app that you can download for free at their website and use to set alerts to remind you to take your various medications or supplements. This new award winning mobile pillbox technology is also a way for supportive families, friends and caregivers to identify when patients have taken medication and be alerted when they did not.

mediSafeFor those who don’t have smartphones, caregivers and relatives can download the app and track the medication compliance for the patient. Also, beginning in 2015, the system will become accessible to people without smartphones via an automated phone system and text messaging. Patients will be able to record medication doses via touchtone and caretakers will be able to receive alerts via incoming, automated calls.

Medication non-adherence is a pervasive and costly problem in terms of time, money and health. This problem tremendously impacts health outcomes and even causes fatalities. Whether they are elderly, diabetic, or suffering from another illness, adherence is critical to patient health. In fact, the National Community Pharmacists Association estimates that it adds $290 billion to healthcare spending annually.

In the elderly, impediments to adherence include dementia and lack of adequate support from caregivers. Though a child, spouse, or senior caregiver is usually taking some level of responsibility for their daily routine, it’s hard for everyone to remember every medication on time.

MediSafe’s mission is to solve the problem of medication non-adherence and increase the power of family & friends to achieve positive, healthy outcomes for each other on a daily basis by delivering personalized medication reminder notifications specific to each patient & medication. It tells you when it’s time to take a medication; then you enter that you have taken it so the software can record that for you. It is the first-of-its-kind cloud-synced mobile medication database management system with an iOS and Android mobile app. Here is a quick video to show you how it works.

David York Agency is expert at the care and management of various diseases endemic to the elderly. Our home health aides are fully aware of the problem of missed medication doses and most of them have smartphones that could be utilized for MediSafe if the family desires.

David York Home Healthcare Agency provides skilled home health aide services for home healthcare and could assist you in mapping out and managing the total care of your senior loved one. Please call us at (718) 376-7755 or visit us on our website  www.davidyorkagency.com to become acquainted with all we offer.
Please like us on  Facebook or follow us on Twitter or LinkedIn.