Friday, July 26, 2013

Jonathan Kay: Canadian doctors explain why so many of us die badly


Last week, I wrote a column about the problem of “unwanted care,” a term used to describe the aggressive, invasive, often debilitating heath treatments that are imposed on dying patients — frequently when they are senile or unconscious — during their last weeks or months of life. The example I provided, courtesy of Atlantic magazine author Jonathan Rauch, was of a 94-year-old man dying from internal bleeding and kidney failure in a U.S. hospital. Instead of providing palliative care, the doctors tried to get authorization to remove the man’s colon and put him on dialysis. “We are spending billions on health care that no one wants, and which often has no real effect except suffering and indignity,” I argued.
I ended by asking Canadian doctors and nurses to share with me their thoughts about the issue. Many did. And, with the authors’ permission, I will quote from some of their responses in the space below.

For the full story,  click the link below.


http://fullcomment.nationalpost.com/2013/07/11/jonathan-kay-canadian-doctors-explain-why-so-many-of-us-die-badly/

Monday, July 8, 2013

Exercise and Health and Wellbeing


It's been widely accepted that if you have problems sleeping, notice your moods vary or that your anxiety is a bit high... you may not getting enough exercise! Regular exercise doesn't just improve your frame of mind; research also confirms it decreases anxiety, improves rest and raises ones self-esteem. According to the American Senior Fitness Association, 60 percent of mature adults are inactive and as a consequence many suffer from these symptoms. With heart disease, cancer and strokes serving as the leading causes of death for mature adults, staying physically active not only helps to prevent many illnesses, it can improve the health of people who already have debilitating diseases or disabilities.

As the countries 78 million baby boomers have begun aging, "...there is a trend toward activities that are moderate in intensity and not so pounding on the body," says Richard Cotton, an exercise physiologist who is a spokesman for the American Council on Exercise. Comfort and lower injury risk are the major forces that have driven the switch to low-impact activities. "Because older adults are more prone to musculoskeletal injury, low-impact exercises are ideal for them," Cotton says. In addition, it has been documented that mature adults are much more likely to stick with a less grueling routine over the long haul.

The American Sports Data Corporation, an organization which tracks exercise trends, also agrees that the hottest exercise trends for mature adults are those that demand less "power" yet still burn a significant number of calories. The ASD's latest survey of 15,000 mature adults shows that although gym membership amongst the 55+ crowd has increased -- especially among women -- joint-jarring activities like aerobics and kickboxing are giving way to gentler pursuits such as pilates, yoga, tai chi, elliptical trainers and exercise bikes.

Pilates
Originally designed to give dancers muscle strength without bulk, Pilates was largely ignored by the general public for almost a century. Only two years ago, fewer than 10 percent of gyms offered classes in mat Pilates, a blend of stretching and calisthenics designed to enhance alignment, increase flexibility, and firm abdominal and back muscles. Currently almost 40 percent of facilities offer Pilates as a regular exercise class. Pilates is a body conditioning system made up of various exercises that help mature adults build strength by improving flexibility, agility and economy of motion. Pilates can even help alleviate chronic ailments and back pain -- all without building excess bulk. It has also been noted that with this type of fitness program there is often a marked improvement in posture and an increase in joint stability.

Yoga
Americans first turned to the 5,000-year-old stretching and relaxation technique in the 1960s, looking for a way to get "high" without drugs. Now, the yoga/tai chi category boasts over 11 million followers, almost double the 5.7 million who participated in 1998. Yoga helps mature adults maintain a fitter body, calmer mind and feel more relaxed. Recent studies have shown that Yoga can normalize your blood pressure and even balance your nervous system all while using breathing techniques to cleanse your air passages; this cleansing also helps mature adults prevent respiratory ailments.

Elliptical Trainers and Recumbent Bikes
More than 10 million Americans currently use elliptical trainers, a knee-friendly cross between a stair climber and a cross-country-ski machine. That's a surge of 177 percent over the 1998 level of 3.9 million -- and a sign that elliptical trainers have passed the litmus test of health club acceptance. More than 10 million Americans now recline while they pedal using recumbent bikes, an increase of about 50 percent since 1998. Not only are these machines more comfy than ordinary exercise bikes for mature adults, they also alleviate considerable amounts of stress off achy lower backs.

Tai Chi
Tai Chi is an ancient Chinese martial arts program that is said to help mature adults improve their balance and potentially avoid falls. According to Mayo Clinic research one of out every three adults 65+ is involved in an accident resulting in a fall. The slow, gentle and soothing movements of Tai Chi help older adults develop stronger muscles, improve balance control, enhance concentration and stabilize psychological well-being. The movements and philosophy of Tai Chi also teach one to relax, slow down, coordinate the mind and body and improve posture.

Fitness experts warn that by itself, any one of these low-impact exercises is not enough to stay fit. I recently posted a video interview with the founder of the International Council on Active Aging, Colin Milner, about the benefits of exercise and staying active as we age. While aging boomers are fueling the exercise trend toward kinder, gentler workouts, experts say that anyone who wants to stay fit -- particularly beginning exercisers -- should also consider incorporating low-intensity activities into their routine. The ideal routine combines the strength, flexibility and balance training of yoga and pilates with an aerobic activity such as brisk walking. Whatever exercise program you decide to embrace, remember to always check with your physician before you begin.

Alexis Abramson, PhD: