Keep Moving

For baby boomers, maintaining mobility is a key healthcare goal.

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Bette McNeely recently biking in Maine

On a bright morning in May, a little white Corvette with the license tag “OLDLDYZ” sped down Prince Avenue. It raced right past a bus stop, blew by Athens Piedmont Hospital, and barely beat a red light. I imagined older versions of Thelma and Louise were in the front seat, hatching defiant plans as they drove toward the dawning of a new day.

The moment was rife with symbolism as I was working on an article about mobility.
Cinema-worthy defiance aside, most people reach a point in their lives when they can no longer take their mobility for granted. According to a Harvard Health Publication, “Mobility and Independence,”mobility limitations affect one-third to one-half of adults ages 65 and older. Since living well depends on your ability to move, safeguarding your mobility is a key healthcare goal.

“Most people, no matter what their health problems are, will tell you they’re doing O.K. as long as they are getting around,” says Bette McNeely, a retired geriatric nurse practitioner.
“People usually define their health by their mobility.”

“Getting around” sounds much simpler than it actually is. That process that most people take for granted requires muscle power, balance, working joints, vision, hearing, cognitive strength and a safe environment. Maintaining mobility means taking care of all of these things.

Health + Mobility

Any healthcare provider will tell you that exercise and a healthy diet are most important in maintaining your mobility and independence, no matter your age or health status. The
U.S. Department of Health and Human Services recommends 150 minutes of exercise a week. Load bearing exercise has the potential to worsen joint pain and injuries, but swimming, water aerobics, tai chi, yoga, stationary biking or using an elliptical trainer are all good alternatives.

While exercise is key to maintaining mobility, even the healthiest baby boomers need to slow down. McNeely, now 78, says she’s always been an athlete. But a smashed elbow and tendon tears in both feet taught her to “lower the bar.” For her, that meant playing
tennis with people in her own age group and shortening the number of hours she worked in her garden.

“You can be content with your aging and your function if you realistically lower the bar,” she says.

Even eye doctors will tell you to keep exercising. Gus Sams, an ophthalmologist with Athens Eye Doctors and Surgeons, says that preventative checkups, routine eye exams, a healthy diet rich in antioxidants, and regular exercise are the greatest measures you can take to maintain your vision, a key component in mobility.

Sams says that cataracts, macular degeneration, diabetic retinopathy, and glaucoma are the most common causes of vision loss in the aging population. These vision impairments can
dramatically limit your daily activities, but there are treatment options available. Cataracts can be corrected with surgery; glaucoma with surgery, drops or lasers. There’s no treatment for “dry” macular degeneration, but antioxidant vitamins can slow its progression. For “wet” macular degeneration, intraocular injections can reverse or slow the progression. Diabetes should be treated systemically, and the subsequent vision problems can be corrected with lasers or injections.

While vision is the most obvious sense we need for getting around, hearing is also an integral part of the neural processes that support perception and cognition. About one-third of people in their 60s and more than 80 percent of those over 85 have some level of hearing loss, according to Harvard Health.

Lawrence Crockett, an audiologist and clinic director of ENT of Athens, says the primary factors that lead to hearing loss are age, genetics and exposure to loud noise. Today’s world is noisier than it used to be, and Crockett says that if you’re using a machine, and you have to turn that machine off to talk to a person, you need to be wearing ear protection.

Damage to the inner ear can affect balance, but Crockett says that hearing loss, itself, is the problem that really affects mobility. “People start avoiding situations simply because they can’t hear,” he says.

Most people, no matter what their health problems are, will tell you they’re doing O.K. as long as they are getting around”
Bette McNeely, a retired geriatric nurse practitioner.

If you detect hearing loss, get an exam. Crockett says he’s been fitting hearing aids for almost 40 years, and “nowadays they are much better at helping people utilize the hearing they have left.”

Home + Mobility

Age-related health issues put people at increasingly greater risk of falling, and falling can pose a serious threat to future mobility. In fact, falls are the leading cause of death from injury in people over age 65. Each year, one in three people in this age group falls, according to Harvard Health.

“Once you fall, things go downhill,” says Pamela Turner, Associate Professor and Extension Housing Specialist with the College of Family and Consumer Sciences.

Safeguarding yourself from falling begins at home. Turner says that baby boomers should clear out clutter to keep from tripping. “That’s not always easy for this generation. They tend to have a lot of stuff,” she says.

Falls are the leading cause
of death from
injury in people over age 65.

Secondly, Turner recommends making sure you have enough light to see. Her mother added an energy efficient nightlight in the bathroom and now carries it with her when she travels. Turner also recently installed motion-activated solar lights along the walkways and stairs outside her mother’s home.

Finally, Turner says, “Don’t ever climb to change a light bulb or retrieve something from a high shelf when you are by yourself. Anybody could fall, but your balance isn’t as good as it used to be.”

Turner’s department has published an extensive home safety checklist. You can find it online at www.fcs.uga.edu/docs/Home_Safety_CheckList.pdf.

Occupational Therapist Tracy Young
Athens Piedmont occupational therapist Tracy Young uses this piece of equipment
(on the floor) to precisely measure brake response time.

Driving + Mobility

For most people, mobility means more than moving safely around the house. For those like the women in the little white Corvette, mobility means driving … sometimes even fast.

Remember the sense of dignity and independence you felt when you first got your driver’s license? After a lifetime of driving, the action seems almost automatic, but it’s far from that.
Driving requires coordination of the senses, brain, and body.

When Tom McNeely’s diabetes began to affect his fine motor skills and reaction time, Bette gently confronted him with her concerns about his driving. She knew, based on years
of experience as a geriatric nurse practitioner, that her husband would need time to accept the fact he could no longer drive. “It’s not an easy process, and it can’t be dumped on somebody. You really have to prep them for the idea,” says McNeely.

She knew that Athens Regional Hospital (now Piedmont) offered a driving assessment, so she negotiated a deal with her husband. He agreed to a trial run of allowing her to drive him wherever he needed to go until he completed his driving assessment.

Once it was time for the assessment, McNeely and her husband met with occupational therapist Tracy Young, whom McNeely describes as “the most professional, empathetic health care professional I’ve ever worked with.”

Young explained every test before she administered it and let her patient know whether he had passed or failed and why. “Driving is very complex,” Young explains. “There are
many memory, thinking and multi-tasking skills involved. The clinical evaluation pulls apart all of those abilities and tests them.”

The clinical driving assessment at Athens Piedmont Hospital takes one and a half hours. If a patient passes all of Young’s clinical tests, she arranges an on-the-road driving evaluation. Depending on a patient’s performance, Young might recommend therapy to improve driving skills or modifi cations such as driving to local areas or only driving during daytime hours.

Based on McNeely’s husband’s performance in the clinic, Young advised him to stop driving altogether but gave him the option of taking the on-the-road test. “My husband surprised her by saying no,” says McNeely. “Tracy said, ‘Can I hug you?’ because not everybody has that reaction.”

Most people consider driving a physical act, but Young says that’s the least of it. “You don’t need a lot of strength to move a power steering wheel,” she says. “The cognitive part
of driving is what takes people out of driving way before the physical, generally.”

Therefore, Young advises baby boomers to add mental challenges to their aerobic exercise regimen. “Part of aging is decreased attention and multi-tasking skills. Go to classes, pick up a hobby, learn a language. Research shows those things keep us sharp,” she explains.

Most importantly, plan ahead. Statistics show that most people have to retire from driving the last 5 to 7 years of their lives. “I have to tell a lot of people that based on their testing, they have to retire from driving,” says Young. “And then we address, how are you going to get around in the community?”

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