Caring for the Elderly – From Tip to Toe

As your elderly family members enter their golden years, there is much that can be done to help them do so with comfort, grace and dignity.

Growing old, for most, is challenging as the later years can bring with them a wide variety of health conditions, ranging from Alzheimer’s disease and depression to backache and bunions, that can make life downright miserable, stressful and uncomfortable.

There are, however, many therapies and remedies available to restore vitality, health and happiness to an elderly and vulnerable person. Let’s start at the head and work our way down to the toes!

HEALTHY EYES AND A WONDERFUL WORLD

‘I see trees of green, red roses too; I see them bloom for me and for you; and I think to myself what a wonderful world.’ – The opening lines of Louis Armstrong’s famous song remind us just how precious our eyesight is. Imagine what it would be like to live in a colourless world. The thought is inconceivable, but all too often it is a potential reality as we advance in age.

According to the late Professor WJ Serfontein, there are four major age-related eye diseases: cataracts, diabetic retinopathy, glaucoma and macular degeneration. The risk of these conditions increases with age, becoming significant after 50 years of age – for example age-related macular degeneration (AMD) is the leading cause of blindness in people over 55.

Eye care

Nutrients for good vision

Omega-3 fatty acids, lutein, zeaxanthin, zinc, and vitamins C and E may help ward off age-related vision problems such as macular degeneration and cataracts. These nutrients are found in:

  • Green, leafy vegetables such as spinach, kale and collards
  • Salmon, tuna and other oily fish
  • Eggs, nuts, beans and other non-meat protein sources
  • Oranges and other citrus fruits or juices.

Visit your eye doctor regularly Certain age-related eye diseases, such as glaucoma, have no symptoms so it is wise to have regular eye tests to nip eye problems in the bud and make them easier to treat.

Either an optometrist or an ophthalmologist (medical doctor specialised in eye care) will provide a comprehensive eye exam.

COGNITIVE FUNCTION AND DEPRESSION

Living a long, happy and healthy life depends very much on a state of mind – on both a physical and a psychological level. It goes without saying that as we age we will suffer from varying degrees of memory loss, and maybe even dementia and Alzheimer’s disease. In addition to this, the elderly often have to contend with depression.

Cognitive care

According to integrative practitioner, Dr Bernard Brom, there are a variety of nutrients that may prove useful in combatting memory degeneration as well as depression:

  • Phosphatidylserine (PS) is a naturally occurring phospholipid found in high concentrations in the brain. PS can slow down, halt and even reverse age-related degeneration of brain tissue and function.¹ It protects cell membranes and is responsible for nerve growth regulation, improving memory and concentration. It is also used to relieve depression. A good starting dose is 200 to 300 mg/day with a maintenance dose of 100 mg/day.
  • Acetyl-L-carnitine is linked to mitochondrial function and energy production and can cross the blood-brain barrier efficiently. Studies have shown an improvement in memory and emotional state in mentally impaired elderly persons using this nutrient. ² It may also slow down the progression of Alzheimer’s disease and even achieve considerable improvement.³ The recommended dose is 1 000 to 2 000 mg per day in two divided doses.
  • Ginkgo biloba enhances blood supply to the brain and is therefore useful for the elderly in improving short-term memory and depression. It also relieves dizziness, headaches and AMD. The recommended dose is 240 to 320 mg per day (using a 24% concentration of the extract).
  • Bacopa monnieri, also known as Brahmi, is an ancient Ayurvedic herbal medicine known to improve memory, learning and concentration; it also enhances cognitive function in the elderly as well as relieving stress and anxiety. Research has shown that Bacopa monnieri may enhance memory, speed of recall and improve overall learning in children aged 10 to 19.Studies suggest that Bacopa monnieri significantly improves memory in older people 5 and research is ongoing to determine its potential as a treatment for managing memory neurological disorders, including Alzheimer’s disease.6

BONE MASS LOSS AND HIP FRACTURES

According to naturopathic physician, Dr Benita Perch, ‘Our ageing population is affected by an increased incidence of osteoporosis. This serious and disabling disease is characterised by decreased bone mineral density (BMD) and thinning of bone tissue, which lead to bone fragility and fracture.’

According to the Centers for Disease Control and Prevention, approximately nine out of 10 hip fractures occur in people over the age of 60.

Caring for ‘dem bones’

Dr Perch recommends routine screening with a DEXA scan (dual-energy X-ray absorptiometry) at age 65 and older. This scan measures BMD and calculates fracture risk. A scan after menopause is recommended so that there is an initial baseline to work from.

Thereafter conventional treatment may be used which includes bisphosphonates, oestrogen receptor modulators, and hormones (teriparatide and calcitonin). It is best to avoid hormone replacement therapy.

Dr Perch warns that: ‘Caffeine intake can accelerate bone loss, and alcohol can result in decreased bone formation when more than two drinks a day are consumed; however, a low intake of alcohol is associated with increased BMD in women and a decreased risk of hip fracture.’

She also recommends the following supplements:4

Calcium: 1 000 mg a day before menopause. A healthy diet provides about 500 to 600 mg a day, so 400 mg should be supplemented. In the elderly, up the dose to 1 200 to 1 500 mg. Calcium bisglycinate (chelated) and citrate/malate/aspartate (bound complex) are better choices.

Magnesium is an important component of bone, and 400 to 700 mg a day is recommended. The best forms are the soluble ones such as malate, citrate and glycinate, and the worst the insoluble ones such as chloride, carbonate and oxide.

Vitamin D3. A review of women with osteoporosis hospitalised for hip fractures found 50% to be deficient in vitamin D. Get tested early, the testing of children is even recommended. A blood test will tell you how much you need to supplement with.

Vitamin K2 is required for the production of osteocalcin, the protein matrix on which mineralisation occurs. The dosage is 45 mg a day.

B vitamins play a number of roles, especially vitamin B6 and folic acid in homocysteine metabolism.

Boron 2 to 3 mg a day reduces urinary excretion of both calcium and magnesium.

Silica, manganese and phosphorus are thought to aid calcium uptake into the bone.

Zinc helps with calcium assimilation. Take 20 to 40 mg a day.

Isoflavones. Synthetic isoflavone (ipriflavone 600 mg a day) helps bring calcium into the bones.

Essential fatty acids increase calcium absorption in the intestines and reduce calcium excretion.

Strontium increases BMD and has been shown to reduce the incidence of fractures by more than 40% over a three-year period. The dosage is 680 mg a day in divided doses. It needs to be taken at a separate time to calcium but with magnesium, calcium and vitamin D to be safe for bones overall.

OSTEOARTHRITIS

There are over 100 identified different types of arthritis and osteoarthritis (OA) is the type that affects most people. Grim statistics pinpoint OA as a health burden for about 90% of all people before they reach the age of 80.5 OA is largely associated with age as it is related to the wear and tear of joint cartilage.

Supplementing for relief

According to the Arthritis Foundation, the following supplements may be beneficial in treating pain and inflammation for arthritic conditions:

Glucosamine sulphate is derived from the shells of shellfish or some vegetables and is a major component of bone cartilage. It may slow down the deterioration of cartilage, improve joint mobility and thereby relieve OA. The recommended dosage is 1 500 mg per day.6

Chondroitin occurs naturally in the body’s connective tissues and is an important component of cartilage. Supplementing with chondroitin sulphate, which is largely derived from beef cartilage, may prove beneficial for OA by stimulating the repair of damaged cartilage. The recommended dosage is 800 to 2 000 mg, either in a single dose or two or three divided doses daily, for up to three years.7

MSM is another effective source of sulphur. The recommended dosages are: 1 000 to 3 000 mg of glucosamine sulphate and 600 to 2 000 mg of MSM daily. The lower doses will support joints and prevent degeneration, while the higher doses will maximise recovery.8

Turmeric (Curcuma longa) has been found to improve pain and function in the long term in patients with knee OA.12 A 2015 study, published online in Clinical Nutrition, suggests that curcumin, when added to the diet, may lower inflammation. In the eight-week trial, researchers found significant reductions in signs of inflammation, such as C-reactive protein (CRP) and other blood markers.

‘Curcumin is the active ingredient of the famous spice turmeric and has a long history of culinary and medicinal use in the Asian countries,’ said the study’s senior author Amirhossein Sahebkar from the Mashhad University of Medical Sciences in Iran.

Curcumin’s two main therapeutic effects lie in its strong antioxidant and anti-inflammatory properties. The recommended dosage for OA is: Capsule, typically 400 mg to 600 mg, three times per day.12 One of the biggest challenges for using curcumin therapeutically is the poor rate of absorption. Ensure that your supplement is bio-available. BCM-95 was developed to overcome the bio-availability challenges faced by curcumin supplements and has been clinically proven to do so.13

Caution: Turmeric used in high doses can cause blood thinning. Do not use turmeric if you are on blood thinners such as warfarin or about to have surgery or are pregnant.9

Omega-3 fatty acids, in supplement form or fresh from a healthy diet rich in fish such as salmon, tuna, mackerel and herring, fight the painful inflammation associated with arthritic conditions. For OA supplement with up to 2.6 g twice a day.10

BUNIONS

When bunions interfere with a daily ramble it can be very bothersome as mobility is important to help maintain overall health in an older person.

Bunions occur as swellings below the base of the big toe. They are commonly caused by ill-fitting shoes. They can also be hereditary and in the elderly are caused by arthritis, loss of the fat pad or cushion beneath the foot, and the wasting away of muscles and ligaments.

Care for bunions

Ultrasound, foot soaks, massages and foot pads and toe separators may help in the short term. In severe cases pain medication may be required and in some cases surgery. It should be noted however that surgery does carry a risk for the elderly person and this option should be carefully considered.

CONCLUSION

When caring for an elderly person, listen carefully to what they say, and never hesitate to seek the help of a qualified medical practitioner the moment you are in doubt about any aspect of their health. Remember, also, to take care of yourself – looking after an elderly person is hard work, both physically and emotionally.

References

  1. Kidd PM. ‘Phosphatidylserine’, the nutrient building block that accelerates all brain functions and counters Alzheimer’s. A Keats Good Health Guide, USA: Keats Publishing, 1998.
  2. Salvioli G, Neri M. L-acetylcarnitine treatment of mental decline in the elderly. Drugs Exp Clin Res. 1994;(20):169-76.
  3. Bowman B. Acetyl-L-carnitine and Alzheimer’s disease. Nutr Rev. 1992;(50):142-144.
  4. Perch B. Bone density and bone strength. Natural Medicine. 2012;(84):79.

 

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Caring for the Elderly – From Tip to Toe

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