Vitamin supplements: Do we need them as we age?

Dr. Jim House, researcher who lectured in the Senior Lecture series sponsored by the University Of Manitoba, began his presentation with Mahatma Ghandi’s quote: “Live as if you were to die tomorrow; Learn as if you were to live forever”.

He then invited us to consider how vitamins and scientific knowledge about vitamins have effected the treatment of such diseases as pernicious anaemia. In 1925, as many of us learned in Downton Abby, pernicious anemia was a fatal disease. Since 1956, when the structure of vitamin B12 was revealed, the disease can be treated.

We learned the difference between water soluble (vitamins B & C) and fat soluble (A, D, E, K) vitamins. We learned that vitamin B12 supplement is recommended as we age because the Intrinsic Factor (IF) needed to absorb vitamin B12 decreases as we age. The other important vitamin supplement to take as our bodies age is Vitamin D. Most healthy adults, who follow the recommended dietary amount (RDA) of food should not need supplements.

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Deliberate Dialogue: Facing Death

Deliberate Dialogue: Facing Death

How do we confront life’s final and inevitable challenge?

Dr. Harvey Chochinov opened his seminar, part of the University of Manitoba Alumni Senior Lecture Series, with a short video: from birth we begin our flight, flying through calm skies, turbulent headwinds, and then landing, sometimes softly but often with a hard bump. His work involves finding ways to soften the hard bump of landing that we all face.

His presentation referred to the notion of the will to live. Questions about whether the strength of our will to live is related to the level of pain we experience led to inquiries dying with dignity. Studies from the BenLux region of Europe indicate that 60% of those who seek assisted death cite loss of dignity as a reason for their choice, whereas only 5% cite pain as the reason. For many, losing dignity is associated with vulnerability, our notions of how others value and need us. When my mother talked about the end of her life, her greatest fear was becoming a burden to her family. So long as she could cook for her family, help with the care of her grandchildren or sew and knit for them, she felt needed. Her self of self, her personhood, involved the notion of helping and giving to others. When her family moved away and when her grandchildren no longer needed her, she began to lose her notion of self. She feared that people began to see her as needy. Escher image of agedThe Escher picture shows what the eye of the beholder sees. Chochinov and his colleagues maintain that those who work with the ill, aged or dying should see the individual and try to find out what has been and remains important to them. He differentiated between health care, which is knowledge-based and technically proficient, and health caring, which includes caring for the individual as well as knowledge and technique. When the needs of patients and families are not met by what the system offers and delivers there is patient dissatisfaction with the care but also an elevated incidence of professional burn-out since caregivers feel unable to offer what patients need.

The psychology of illness is the psychology of loss. When prolonged illness occurs, personhood is under assault. We viewed slides showing data gathered through questions about “Dignity Model”. Questions about feelings of worth, not feeling that the person had made a meaning or contribution, feeling a lack of control over one’s life, feeling a burden to others, and not being treated with respect or understanding were important to more than 80% of individuals. The rates for learning of distressing symptoms, wondering how life might end, uncertainty regarding the illness, and feeling depressed and anxious ranged between 40-70%.

An interesting study in progress involves caregivers speaking to patients and asking them: “What should I know about you as a person to help me take the best care of you that I can?” After patients had read and revised their responses, they were asked: “Can I put this on your chart?” these two questions enabled patients to explain what is important to them, who they are as individuals, and allows caregivers to learn about the individuals in their care.

Chochinov concluded the presentation by reminding us to hold end of life conversations, to name a health-care proxy and provide advance directives. HE also recommended q website with additional information: the Virtual Hospice.

Alzheimer’s and Age-Friendly Communitites

 

 

In the space of one week I attended two lectures and viewed a film, all related to Alzheimer’s and aging. Both lectures, part of Senior Seminars at the University of Manitoba, highlighted the importance of healthy living in ‘age-friendly communities.’ Most of us have read and understood the importance of a balanced diet, daily exercise and a supportive environment for people of all ages. Babies sleep to consolidate their learning. If we, as older individuals (read seniors) do not get enough sleep any new learning will disappear. Neurogenesis still occurs, despite advancing years IF we eat a healthy, balanced diet that we enjoy, exercise our bodies, exercise our brains, sleep, and choose to be happy.

The film, entitled “Remember’ follows a widower who suffers from dementia on a lengthy journey to find and kill the guard who had murdered his family at Auschwitz. We watch him as he receives assistance from fellow travellers, consults the letter that provides him the details of his trip, and interacts with those he meets. He manages to cope with several false leads that require his problem-solving skills to help him sort through his options. We also watch him when he is not able to cope with the journey. We rejoice at the kindness of strangers, often children, who help him when he is lost in time and space—a blank slate.

Active Aging encompasses one’s health, one’s participation in daily activities, and one’s sense of security. The World report on Aging and Health (WHO, 2015) outlines a framework for action to foster Healthy Aging built around the new concept of functional ability. Making these investments will have valuable social and economic returns, both in terms of health and wellbeing of older people and in enabling their on-going participation in society. A fact sheet about ageing is also available at http://www.who.int/mediacentre/factsheets/fs404/en. In Canada, we know that those aged 65+ outnumber the youth and by 2020 will outnumber children 5 years and younger.

The diversity among the elderly with a range from independent to various levels of dependency needs to be considered when planning for the future and involves looking at transportation, social participation, housing, outdoor spaces and buildings, community support and health services as well as collaboration among agencies and information about services.

In the last few years, studies have demonstrated that active living, including a wide range of activities can enable individuals to maintain their independence for many years. That message is one that is important for those of us who are baby boomers—we can take steps to change some habits and include physical activity and mental stimulation in our daily lives. My grandmother died at 74 years; my mother lived to 96 but her last 5 years were lived in ever decreasing concentric circles and increasing isolation as her once active mind lost its flexibility. These losses are not inevitable.