Aging: Everybody's Doing It
I've Had It with Counting Sheep!
I can still hear my mom telling me to come in from a great game of hide 'n' seek because it was bedtime. “But Mom, …” and she'd retort with, “You need your eight hours of sleep.” Now, I'm here years later with a teenage son who needs 10 hours (I just wish it wasn't during school). Growing bodies do need a good amount of sleep to recharge those Energizer Bunny bodies of theirs. But the older body sleeps less soundly. On average it will take Dad longer to fall asleep and he'll sleep lighter than he did in his younger days. He might nap more, but it's light sleep that he's getting.
One reason for this drop in restful, restorative sleep is that there are fewer brain cells in charge of deep sleep. There are five stages of sleep, with the deep, restorative stages being the third and fourth stage. Older people seem to get less of this. They also tend to experience less R.E.M. (rapid eye movement) sleep, which is the fifth stage—the kind that has your eyes flickering while you're dreaming. All that flickering causes an increased blood supply and the flow of some mighty fine brain chemicals. You can thank these guys for that restored, I'm out to conquer the world feeling when you wake up. (Really, Starbucks doesn't deserve the credit.)
It's a myth that older people need less sleep. Adult sleep needs, according to the National Sleep Foundation, remain constant throughout most of our lives. Most of us will require seven to nine hours of sleep throughout our lifetime. It's the stages of sleep that will undergo change.
When the body ages, there's less melatonin, the hormone that's been found to regulate sleep. If Mom is in her 70s or 80s the levels may be barely traceable. Besides these physical changes, getting little exercise, drinking caffeine, and smoking all contribute their fair share in robbing your parents of a good night's sleep.
Your parents might not be too happy with their new sleep patterns. If they stubbornly stay in bed until they get a full night's sleep they'll never win. The key is to find ways to make sleep more effective and wake up feeling refreshed. Mom or Dad might have to invest more time and care in making this happen.
Here are some tips to help your parents get a good night's sleep:
- Develop a regular, soothing routine for going to bed, such as listening to music, reading, or visualizing a favorite place like the beach. This is a great time for a massage, a warm bath, or putting on skin lotion.
- Stick to the same bedtime and naptime every day. A consistent schedule helps set Mom and Dad's biological clocks and cues their bodies that it's time to sleep.
- Exercise in the early afternoon, not right before bedtime.
- Drink hardly any fluids a few hours before bedtime so there's no need to go to the bathroom in the middle of the night.
- Stay clear of coffee, tea, cola, and other caffeine-laden drinks or foods eight hours before bedtime.
- Keep daytime napping limited to afternoons, not late in the day, and no longer than an hour. Watch out for dozing off in front of the TV.
- Avoid heavy meals close to bedtime especially those that are spicy. Dinners around 5:00 P.M. give adequate time for digestion.
- Ask the doctor about the side effects of certain prescription drugs, which can cause sleeping problems. Perhaps the dosage or time of day to take the drug can be changed.
- Don't smoke. Besides a zillion other reasons not to smoke, nicotine plays havoc with sleep.
- Avoid alcohol at bedtime. Although it may appear to put you to sleep, Mom or Dad will actually awaken early without feeling restored.
Even though there are normal changes with sleep patterns as Mom and Dad age, don't dismiss your Dad's complaints of not getting enough sleep. If he isn't feeling rested when he gets up in the morning there may be other problems, such as coronary artery disease, lung disease, thyroid problems, depression, anxiety, or dementia. Side effects of medications are another culprit. Don't brush off sleeping problems as just “part of the package” with old age. Your dad should describe his sleeping problems to his physician, who will then explore all of the possibilities behind Dad's sleeping problems. Don't let him simply walk out of the doctor's office with sleeping pills in hand thinking the problem is solved.
Taking sleeping pills for the long haul can cause daytime sleepiness, anxiety, cognitive (thinking) decline, and falls. Getting off the drug must be done very carefully. If this is the case for your parent, work with a physician to gradually and safely oversee your parent's withdrawal of the drug.
Let's talk about sleeping pills for a moment. When I was Secretary of Aging for the state of Pennsylvania, I was responsible for a prescription program for about 400,000 elderly. After a national television show exposed the side effects of the drug Halcion, a popular sleeping pill, we did some research of our own. We discovered that thousands of our cardholders had been taking sleeping pills for years. Now, any good doctor will tell you that sleeping pills are meant to be taken for only a very short period of time—we're talking days, maybe a week or two. Even the drug companies that manufacture the pills recommend temporary usage. Yet despite all the cautions against it, 40 percent of all patients in this country who are taking hypnotic drugs to sleep are over 65 years. Yet, your parents' age group makes up only 12 percent of the population. Yikes. Plenty of research has backed up the National Institute of Aging's claim that “hypnotic medication should not be the mainstay of management for most of the causes of disturbed sleep.”
The Hot and Cold of It
The brain's thermostat starts to lose its sensitivity to picking up temperature changes as we age. Folks in their mid-80s find this especially troublesome. Complicating this are circulatory problems and medications that can throw your parents' thermostats out of whack. You also lose your ability to sweat in old age, so now your parents are left without nature's protective cooling system.
Your parents probably grew up without air conditioning and it was a badge of honor to be able to “take the heat.” So there's your mom out in the garden in 80 degree heat and your dad pushing the lawn mower. Not a good scenario. During my stint as Secretary of Aging, we were hit with a heat wave in Philadelphia and more than 100 people more than 60 years of age died of heat-related deaths due to hyperthermia. Many were found in their homes with their windows shut because they were afraid of people breaking in, or they kept the AC off to avoid high utility bills. We learned from that experience and launched a prevention program with senior centers and the Area Agency on Aging. It's made a great difference in Philly, but every year with more heat waves throughout the country, thousands of elderly people are overcome with heat stroke. During a heat wave, be sure to check on your parents.
Hyperthermia means a body temperature that is dangerously high, while hypothermia means a body temperature that is dangerously low.
Here are some tips for helping your parents cope with the heat:
- Make sure they're drinking plenty of fluids.
- Make sure they keep the air conditioning on, but older people should not be sitting right in front of it—their bodies could cool off too much and then they'll suffer hypothermia.
- If they're using a fan, make sure a window is open to create a draft rather than simply circulating hot air in a closed room like an oven.
- If they don't have air conditioning, suggest they spend the day at the mall. Or how about buying your parents an air conditioner and arranging to pay for the extra electricity?
- Suggest they take a lukewarm bath or shower; it's one of the best ways to cool off.
- Call or visit twice a day—if Mom or Dad starts acting confused, has a headache, is dizzy, or is nauseous, your parent is showing signs of a heat stroke. Call for medical help.
- Suggest Mom or Dad keep a cool cloth around the back of the neck.
On the other hand, your mom and dad are also vulnerable to becoming too cold and can lapse into hypothermia. Of course, this is a more likely problem in the winter but they can also become victims by sitting in front of an air conditioner. Room temperatures lower than 65 degrees can induce hypothermia. During cool nights make sure your parents have warm bedclothes and blankets because they are more likely to lose body heat while they're sleeping.
Both hyperthermia and hypothermia are medical emergencies. The weather can pose a real danger to your parents—watch out for them.
Now, Why Did I Go to the Store?
Billions of the brain's nerve cells bite the dust between adolescence and old age. The brain also becomes smaller and lighter. By the time Mom has reached 90, as much as half of her original nerve cells are lost. It sounds pretty dismal, but it's not. I like to think of it as clearing out some space on my hard drive. Who needs 85 years of files, anyway?
What's normal is that she might be more forgetful than she ever was and she may be a bit slower. But in no way does that mean she has lost her intelligence. When you look up a number in the phone book, close it, and then dial, you're using short-term memory. Without much fanfare, you decided that you weren't going to store it in your head. It's that kind of memory—the kind that you have in mind for the short term—that older folks have more difficulty retaining. And if they want to store this new information into long-term memory, they have to work a little harder than the rest of us to retrieve it. Retrieving stored data is going to take more time. Your parents shouldn't panic if they experience short-term forgetfulness or if they aren't slamming the buzzer as fast as they used to playing along with Jeopardy.
Even though you might find Mom or Dad calculating a waiter's tip slower than he or she did before, or not making a quick decision when there are multiple choices, don't go off making the same mistake you did as a teenager—they really are pretty smart people. And they can get smarter. Just like your aerobics instructor yells out, “Use it or lose it,” keeping mentally active can help Mom and Dad stay mentally fit—as in, “He might be old but his mind is as sharp as a tack.” Hey, one of the fastest-growing groups on the Internet is more than 60!
More on: Aging Parents
Excerpted from The Complete Idiot's Guide to Caring for Aging Parents Â© 2001 by Linda Colvin Rhodes, Ed.D. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Alpha Books, a member of Penguin Group (USA) Inc.
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