Cataract Surgery: Then and Now

Cataracts are a common eye problem, especially in seniors. In fact, according to the National Eye Institute, more than 50% of Americans have had at least one cataract by the age of 80. A cataract’s main symptoms include blurry vision, sensitivity to light and poor night vision due to the build up of protein which cloud the lens in the eye.

Today, cataract treatment is relatively simple. According to Dr. Alan Mendelsohn, cataracts treatments began to change significantly in the 1980s, shifting from in-patient to out-patient procedures.

“For the next decade, those of us on the “cutting edge” of cataract surgery in Hollywood were doing cataract surgery by a procedure called Extracapsular Cataract Extraction,” Dr. Alan Mendelsohn explains. This procedure was a step above the old methods, but it still required significant stitching and a long rest period throughout recovery.

“While moving cataract surgery to an out-patient basis was considered revolutionary at the time,” he continues, “an even bigger milestone transpired with the transformation of cataract surgery in the mid to late 1990’s to a highly improved technology called Phacoemulcification (phaco).” Phaco allows for only tiny incisions to be made at the surgery site, eliminating the need for stitches. As a result, recovery is much quicker and the risk of infection lower.

According to Dr. Mendelsohn, technological advances in cataract surgery are rapid. The playing field changed again over the last ten years with the “arrival of the multifocal ReStor IOL. With the ReStor IOL, we can generally correct most patients’ cataracts and enable them to see near, far, and everywhere in between without the aid of glasses or contact lenses.” In fact, Mendelsohn underwent such a surgery himself in 2014, and has been living without glasses since.

“Of course, I practice what I preach and always wear sunglasses with UV400 blocker and polarization outdoors during daylight hours for ocular protection!” he says.

IMPAT – Improving Elder Care

elderlyIMPACT (a group of 27 faith congregations around Central Virginia) convened at its yearly 11th Assembly on Community Problems.  It was there that a presentation was given on how the community is joining forces to improve care for seniors, given that the focus of IMPACT last year was enhancing eldercare for 2016.

Peter Thompson, director of the Senior Center addressed the interfaith group discussing future plans it has to joint together to improve services and amenities including: civic and community engagement, housing and transportation, all of which are relevant to the lives of seniors.  Given that the aging issue is known as “the No. 1 demographic issue our commonwealth faces” (as specified by the University of Virginia’s Weldon Cooper Center for Public Service).  This sentiment was echoed by Catholic Church of the Incarnation Pete Kashatus, who explained that “last year, we learned that on average, [the cost of elder care services is] one-and-a-half times what the average person over 60 brings home in a year,”

A few months ago the agencies in the community were approached by IMPACT to improve coordination and thus identify the size of the “affordability gap” in order to set up a plan to make senior care services more affordable in the region.

In other news relating to improving the quality of life for seniors, thanks to the National Joint Powers Alliance (NJPA)., many seniors may soon be able to get a hot meal each day in Minnesota. The building will be at the former Eagle Valley High School ag/shop location and has received a donation of $100,000 from the NJPA toward the $1 million price tag of the project.  Rick Hest, President of Eagle Bend Senior Center pointed out that by providing meals to seniors it gives them a greater chance of being able to “stay healthy and to stay in their homes for as long as possible.”  Ultimately the Hilltop Regional Kitchen will be helping respond to the most basic needs of hundreds of seniors, while at the same time, repurposing a vacant building in the community.  The grand opening is slated for June 1, 2017.

International Day of Older Persons

older-personsAround the world people are increasingly recognizing not only the contribution the elderly are making, but also the extent to which they are keeping up with the times.

First, in Scotland it appears that there has been a huge increase in the number of elderly becoming comfortable with the Internet.  The most recent Scottish Household Survey found that, while the number of Internet home users was unchanged from 2014 to 2015 (80 percent) what had changed was how that number was broken up.  The increase of those over 75 using the Internet was significant; a further 6 percent of this demographic have started using the Internet.

The UN-organized International Day of Older Persons is marked around the world each year on October 1.  Apart from creating awareness of the contribution the elderly make and the respect they deserve, negating stereotypes about older persons and aging.  The UN Strategy on this comprises the Madrid International Plan of Action, whereby member states reaffirmed their commitment to human rights and dealing with age discrimination.  It also encourages continuing education for all age groups, especially the elderly.

In Ghana the day was also marked.  Joining the international voice in applauding the older persons who have contributed – in various ways – to the wealth of the nation.  The theme for this year’s celebration is: “Take a Stand Against Ageism” and the government in Ghana has been doing that through its dedication to enhancing various systems and structures that will improve the quality of life for the elderly.  One example of this is the Ministry’s dedicated desk which has been instituted for the sole purpose of addressing issues of older persons.  In addition, the National Ageing Policy (NAP) that was recently endorsed with the hope of ensuring that the “socio-economic development and human rights of the aged persons are protected and guaranteed.”

Increasing awareness, developing respect and understanding the differences of older persons is crucial if society is going to continue to evolve with its increasingly elderly population.

Aging Process: Forum

elderlyIn a couple of weeks’ issues senior citizens often have to encounter will be put on the table at a community forum in Ridgefield.  The aging process brings with it – as many of us know – a whole slew of new challenges, but getting the know-how ahead of time can facilitate this process.  Families of the elderly are encouraged to participate in ‘The Next Step…Senior Solutions’ as well.

At the event – held at the Ridgefield Visiting Nurse Association (RVNA) Center on Governor Street – senior services providers will be accessible and a Q&A session from the audience will take place.  RVNA Director of Community Health and wellness, Barbara Newland explained the reason for the event which is to: ‘take an in-depth look at the decisions seniors face and the choices available to help them maintain their highest level of independence in our community.”

Then there are the efforts to help the elderly live in their homes as long as possible, maintain as independent a lifestyle as possible.  There are many technological advances going on in this area (most notably vis-à-vis at-home monitoring), but in addition there is Bardstown at Home – a local non-profit which trains individuals on giving home care for elderly.  According to its founder, Suzanne Reasbeck, since people “fight to keep [their] independence as long as [they] can [it makes sense that] the movement is toward home care. If we would spend time learning more about how to do some of the basic care tasks that people need.”

The non-profit – which has been in operation for close to 7 years now – offers help with everyday tasks like transportation to appointments, grocery shopping and wellness checks, trying to meet the basic needs of the elderly demographic which is almost-independent. The organization has developed a ‘Plan of Care’ which looks into the person from a holistic point of view, covering the following areas: “diagnoses, medications, limitations, needed equipment, dietary needs, developing detailed care instructions and knowing available services or assistance.” That data is then recorded and made accessible to those assisting the elderly.

There are many ways to tackle the issue of aging.  The first is knowledge and recognition; once that is accomplished it facilitates the rest.

Whitehorse Health Meet

meetingLast week Premiers from 13 Canadian provinces and territories met up to discuss a whole range of socio-economic topics, but one that was glaringly amiss was the issue that keeps causing problems: a healthcare system incapable of providing adequate care on a viable budget.

Ultimately the simple fact is, the nation is aging.  As such, health care now takes up 50% of provincial revenues.  According to Statistics Canada, there are more Canadians 65+ than children under 15.  Indeed, there is  more than 16 percent in that age group which by 2051 will increase to one in four.

What this means is that the hospitals are too crowded because there are just not enough senior facilities or services for the elderly.  Because of this, people who need to be in the hospitals for surgery and stuff are waiting longer than should be the case.  In other words, alternatives need to be found for aging Canadians that a) are more appropriate for their needs and b) don’t waste the valuable resources being used in hospitals for patients who actually need them.

Thankfully though, things are changing.  In the news is the story of the near-completion of the Killarney Seniors Centre, and at the same time, Vancouver has plans for a second such facility.  According to Raymond Louie (who presented the idea for the first center), it is now up to a vote from the Council and a commitment to the anticipated $9m expenditure required.  It is hoped that both the federal and provincial government will take part in this.

“R U OK?”

elderlyFor the elderly living alone in Clark County, there is a new program being put into practice which will make them feel less alone.  Law enforcement officers will be able to check in on these individuals via the “R U OK? Senior Safe and Sound Program.”  According to Gene Kelly, Clark County Sheriff, this is “another program that will allow seniors to stay in their homes.  What we’ve found in our research of this program is that seniors really appreciate it and their families really appreciate it.”

This is a great option for individuals who are 65 and over along with their caretakers.  Program participants can decide what time to receive the daily call and then if they do not answer, someone on a list of people close to them can be contacted in the case of a problematic issue.  As Kelly pointed out, “the family can rest assured that someone will check on their loved one. If there’s no response, we’ll put things into action.”

This program could go part of the way to addressing the issue of the disturbingly low amount of geriatricians in the country. As Associate Professor of Medicine at Durham’s the Duke University School of Medicine, Dr. Heather Whitson said: “We are not prepared as a nation. We are facing a crisis. Our current health care system is ill equipped to provide the optimal care experience for patients with multiple chronic conditions or with functional limitations and disabilities.”  According to the AGS, the country needs approximately 17,000 geriatricians to care for the around 12 million American seniors.  Right now there are only 7,500 now.


Initiatives Nationwide for Seniors

seniorsDepending on where you are located throughout America, there are various levels of activities, locations and resource centers available for the elderly.  In Bridgewater for example, a new wellness center was opened for seniors.  Set up by the Somerset County Board of Chosen Freeholders, this Main Street location was opened at a ceremony that coincided with Older Americans Month.  According to Patricia Walsh, the Director of the Freeholders, “With its proximity to the Adult Day Center, the opening of this center completes the vision Somerset County has had for a senior campus that serves the needs of residents as they go through the various stages of aging.”  Indeed, this was not just a metaphorical but also a literal statement of fact since the construction of the pedestrian bridge forms a link between the Adult Day Center and the Senior Wellness Center.

Bonne Terre seniors can also enjoy some improvement in their facilities.  The current address for the Bonne Terre Nutrition Center and Senior Center is changing due to expansions.  According to Jim Eaton, the institution’s City Administration, it will be set up as follows: a nutrition center that will focus exclusively on diet, supplements and food guides and then a separate senior center to manage all other activities.  Given that there will be apartments as well, this will provide a great opportunity for the city to use different organizations.

So these are two great examples of where life is good for seniors. Now, if only seniors in Brunswick County were privy to this kind of treatment and resources.  Unfortunately though it is not the case. Instead, seniors meet twice a week at the Town Creek Park in a place that is not theirs at all.  They may share a meal together and play games but thereafter they have to fold up all the tables and chairs and store them; in fact everything needs to put away, even the kettle! This is more than just frustrating as one of the seniors, Sandra Tyner explained: “We want something of our own so we don’t have to do all this getting out and putting away. We just need a place that we can call home.”

And it’s not for want of trying.  Indeed, over the last few months a group of dedicated speakers have been active at county commissioner meetings, politely reminding county leaders they want a senior center in the Bolivia/Town Creek area.  Thankfully something finally seems to be moving as a local church recently committed to donating some land for the purpose of building a senior center and now the county is investigating capital funding for a building.

It seems only right that there should be some kind of more equal distribution of resources for the elderly around the country so hopefully within the very near future, the Bolivia/Town Creek area will become more like Somerset County and Bonne Terre.

Fluctuation in Life Expectancy

diabetesAmericans are living significantly longer than they used to. While that is great news, financially it is becoming increasingly burdensome for the state. What happened many years ago was that social security was set at 65, as, at that time, life expectancy for US males was 68 and for women, three or four years more. Also statistically back then, most people actually passed away before having the opportunity to collect a lot of the money. So funding this was not so burdensome. Things have changed a lot since then. Life expectancy has now increased to late 70s, and along with it, the burden of social security funding.

Today there is increasingly more we can do to prevent premature death and also enhance quality of life. Preventing diabetes and heart disease (major causes of death) can be done via lifestyle changes. Keeping in shape and avoiding obesity are the main methods. Quitting smoking and cutting out drinking are two key ways to do this as well.

And of course, with an improved quality of life, medical expenditure diminishes and the state becomes less burdened. There is no reason for the elderly to stop moving. They can slow down, yes, but walking, swimming, and all sorts of gentle exercise are absolutely vital for maintaining a decent quality of life. In fact, some seniors even find weight lifting rewarding and the more they do this, the more accustomed to it they become. Weight lifting, Pilates and Yoga are particularly good for balance which tends to become more problematic later in life.

When it comes to life expectancy and quality of life for the ageing, there is a lot we can control.


Helping the Elderly Feel Young Again

QueenOften, feeling old, is just a matter of that…feeling it.  So if one makes a mental switch to feeling young again, sometimes that can be very positive.  One thing that is proving to be helpful to people moving into their golden years according to a study by Optegra Eye Health Care, is seeing famous people continue to lead full lives despite their age.

Some of those such individuals who are seen as inspiration today include: The Queen of England (approaching 90), David Attenborough (approaching 90), Dame Judi Dench (81), Dame Helen Mirren (70) and Joanna Lumley (70).

Indeed a survey found that 68 percent of adults feel younger than their age and are not letting old age or retirement stop them from living full, active lives.

And for those who need a little more help in the way of feeling younger, there is always Alfierobot. This “robot” is currently being created in an effort to help elderly people stay independent and active for longer. Nicknamed by those trying it out as Alfie, ENRICHME  (ENabling Robot and assisted living environment for Independent Care and Health Monitoring of the Elderly) is developing this in conjunction with the UK’s University of Lincoln.  Research is being undertaken to develop and test robots’ capacity to support seniors with ‘smart home’ technology to provide 24/7 feedback to seniors, caretakers and health professionals.

New Insights into Casts & More

bandageIn recent news, the AO Foundation, a medically guided nonprofit led by surgeons, has a new book for surgeons and others to use. Professor Geoff Richards is the Director of the AO Research and Development and Editor in Chief of the eCM Journal.

Called Casts, Splints, and Support Bandages—Nonoperative Treatment and Perioperative Protection, the book offers an overview of the history, techniques, methods and principles for applying modern plaster and synthetic casts. It has three sections about casting and guidelines for non-operative treatment.

The book also has a step-by-step instructions for 55 individual cast, split and bandaging techniques. This text and instructional video project will certainly be of interest to a large range of people in the medical community.

AO Education Institute is certainly proud to have been part of the project. Members like Professor Geoff Richards work tirelessly to help with the efforts of the AO Foundation and to assist surgeons in every way possible. As they say on their website, “It is the ideal resource for any busy hospital or orthopedic/trauma practice.”