Frailty Is A Thing?
00:00:00 – 00:05:17
Have you ever wondered why an older adult who seems perfectly healthy and suddenly has all kinds of health issues. I’m sure you’ve heard the term frail but did you know that frailty is a medical conditions. Frailty has stages and thankfully there are ways to avoid becoming frail if someone we love has already started having frailty issues. There are ways to manage their condition so not to get worse. That’s the topic of my first episode with guest host. Dr elena mucci. Dr mucci is a gerontologist and she will be chatting with me monthly about all things aging well. Future topics are going to include loss of balance what to do about it continents delirium and wyatt so serious late stages of dementia and your favourite how to prevent dementia. This episode is brought to you by caregiver. Chronicles and eight week online course covering everything from diagnosis through hospice for more information. Use the link in the show. Welcome to fading memories. A podcast with advice wisdom and hope from caregivers who have lived the experience and survived. Tell the tale. Think of us as your caregiver. Best friend. I am excited today to introduced to you dr mucci. She has the coolest instagram page. That you’re ever gonna wanna watch so her pages linked in the show notes and we are going to discuss. Frailty today which. Until i ran into her even know an actual medical thing. So thank you for joining me. Have i so i just thought frailty meant you know i have a very good definition of frailty. I just thought it meant that you started losing the ability to move freely. And then you’ve told me that there’s actual stages and it’s a medical thing so why don’t you start by telling everybody what frailty actually is to a medical doctor a right. Thank you very much for the kind introduction jets and so frankly is very commonly used announced a fabulous look after all people and they just say oh mommy’s a bit freia and she slowed down a little bit out. Of course they chum failty in medical world as means completely different thing and their definition official definition knees highly if they reduce physiological reserves allocco physiological reserves. Will this means. And why is it important to understand while this happens. As a result of amalgamation wolf three major factors as a result of aging process amalgamated with age related diseases we accumulate over the life span as less side effects of medications. Let me give you an example. What this means. So recent example for my clinical practice beatrice is ninety two year old lady. She’s quite fit. Well lead independently. She before the lockdown. Actually it was running classes in a swimming pool oval senior citizens so very engaged with her community and leaving a beautiful life with quote a good quality of life however there is ninety two and in the lost two three years. Should he’d have a few medical problems into stroke clinic with couple of meanest strobes diagnoses on. Jain ah should also has a little bit okay. High blood pressure. Some kidney disease muggles problems. None of them are actually bad. Enough to impact on. Have day to day functioning. She takes madison’s will these conditions. She is on block thin as full day mini strokes or cholesterol tablets. So she’s functioning will and then one day should develops really a bad kid named action or you’re north talked infection and it was bad enough for her to be a stylized in hospital and what happened. She became very confused. Deal various and rather than spending just two three days in hospital For intravenous antibiotics shea had two weeks admission in hospital because have confusion was resolving and of course what happens told their doubts if they spend a lot of time in in bed completely condition muscles wasted away by them. Homeless mission is keen. Swimmer could not stand to go into a rehabilitation facility and it was good two months before she actually returned home and she was not back to normal cell sure required carrozza assistance required Family to help.
00:05:18 – 00:10:04
And that’s what frailities. It’s their amalgamation. She did not know that. Race frail have family did not understand why mom sophie to while swimming the day before teaching her class next day hunterston agen and actually swearing which Merited before in. How confused state why this will happen into. It was very traumatic for the families. And that’s what i said. I explained frame because of course as a result of a previous mini strokes should have reduced brain reserves and urinary infection. Eat infection there are toxins in the body which up poisoning the brain. Now in you. And i we might not have a major program but had strokes if so bring presents lou and should develop a confusion shays ninety two age related changes to the boogie moss and muscles. Do you know on net. After the age of fifty we use about one to two percent muscle mass every year. So just imagine when you come to ninety two remember. She’s actually switch. It wasn’t bad But you can’t go against the nature so there you go mini strokes causing reduced brain reserves. Shays ninety two year old with reduction in her muscle mass spending two weeks hostile bat eligible kidney problem on the background and of course urinary tract infection led to deterioration bad and have completed different individual at the village and that’s frailities the compound ethnic of life and illness all coming together in a negative way. Yeah me can you making you Very vulnerable making you very vulnerable and it’s not until an acute medical problem comes along. Such has urinary infection omeday heart attack in some individuals just could be even the vaccination sometimes can precipitate all depends on how vulnerable you are what your background is like. And let’s not forget the side effects of medications as well so it. As i said it’s amalgamated. Age related changes disease related changes as well as our huntsville exposure to sign Medications had taken for these diseases so she was unblocked Fools a yeah. She was on cholesterol comrades. And guess what she was given antibiotics which interacted with cholesterol tablets stockton’s and that made her muscle problems. Even worse one thing led to another. It always amazes me when. I hear dr talk about that. My dad was on twenty five different prescriptions. And i just shook my head like they don’t even know what these all how these are all interacting with each other. Oh you reminded milk a storage gen. When i had a very compliant Lady in her late eighties. She came to our clinic. And a she said doxa. My general practitioner grab told me to take medicines one hour so they don’t interact between each and but dr around death many hours in a day on thirty two medicines won’t shy dude. My gosh you can imagine shellacked my clinic with just Than those medicines. Iztok most of them. Anyway that’s good. ’cause i seriously think people rely on medication instead of lifestyle changes kind of brings me back to the frailty. You said there are ways of avoiding it preventing it somewhat anyway. Do we want to talk about the different stages of frailty or how to avoid it. I i’m not sure which is most logical well. Now that we’ve started talking about batteries. I will talk about this stages freely so people that are carrying this can recognize they stages and can prepare themselves. How bad things will become wet. Mom does develop that. You’re in retracted action. And may i referred to walkway universally used. In medical world quality roque will frame disco. Whoa it has pictures on it and we use it on. The basis of it is very easy to use even for family members for caregivers in calf facilities.
00:10:04 – 00:15:14
And if you look at the pictures they eat you can include the picture zo with this faster than people that there are nine stages stage one. Two and three is when people might have minor problems. The accident on stage four is when there is a little bit robotic problems now causing some impact on the quality of life will be individual and they require maybe some minor health with activities of daily living Free frail or rated mild friendly team. This stage five six is the frailities saturn and the individual is requiring care support. Amalie support support with activities of daily ribbon and maybe a help is washington dress and at that stage alley individual is very vulnerable. Indeed it is very easy from stage. Five and six or freely to scale to go deteriorates so fast that individual has to go into a and nursing home for example and they’re unable to return home and medically it is the stage. Full five six where we need to away catch the individuals do all interventions as geriatricians as if he’s thirty so conditional therapists try to give the one stock up get that individual from stage five into fool maintain that independence for long however stage. Seven or eight or nine is when they fraility is a reversal. And he’s the message for caregivers. They have to be realistic. If you’ll locked one is already. Heaven staged seven eight or nine on the fraility as score and they signed vigil. Swab milk walkin. The either will chair bound or bed. Bound requiring care round. The clock can do verily tougher themselves this individuals have such a wolf is a wonderful reserves. They don’t need much at tiny little chest. Infection would be enough to lead to such a deterioration in their health that it probably will be pushing that into the last stages of their life into end of life said stages over have to plan accordingly the stages. You don’t recognize if we have the unrealistic expectation that everything can be back to mobile then. We’ll have the individual suffering in the middle unnecessary investigations unnecessary hospitalizations on necessarily treatments. And the day. Sometimes it’s our guilt which is pushing us to do these things for our loved ones by today. We have this individuals friend. I completely agree one of the reasons. I became interested in this topic. One was everybody knows that my mom fell and broke her leg and that was the last straw for her robotic. Couldn’t take anymore but not long after my mom passed my grandmother who is one hundred to almost one hundred and three who is mostly blind from glaucoma and very hard of hearing in the last almost two years. She went from being able to function on her own at home although she should not have been living on her own to like. You said being hospitalized and then she was in a that wasn’t respite a Rehabilitation facility for a short time. I not sure what the reasoning for taking her out was but now she has to live in a care home just like you said she needs help up and down of the chair. She can walk a little bit with a walker braces. I think you guys know you don’t call embraces. Those are suspenders. And she can do very little for herself. And i was kinda shocked that she went from reasonably okay especially for one hundred to two not okay like it seemingly overnight now. She’s not on very many medications at all. Like very low dose blood pressure medication drops for her eyes mean for something in her advanced age. She’s on very few medications. So how in your i mean. Obviously you’ve never met her or seen her. But what do you suspect happen that she just had like underlying issues or was it the visual stimulation and audio stimulation. that just. i’m trying to figure out what compound with her where she ended up in the state that she’s in now well. It’s at a motivational everything. Jim i think the rapid decline observed is exactly what it was she had no reserves will know his reserves left in have to xing sing and impatience.
00:15:14 – 00:20:02
Lack mareb You rented as i said. You really don’t need much and a few digital constipation. Sometimes is enough for them just to be going down through independent individual or function or case in touch with us save dependency just a few days. Couple of days of constipation is enough. And that’s because the null reserves to hide anything and We see that all the time with with emphatic. Genetic rep the safe for these patients. They actually survive longer. If we’re void. Frustrations what i observed in my clinical practice as a geriatrician. The families yet from sound mambas doing right yesterday today shades confused. Let’s take tov and guess what happens in hospital. They get even more confused on a busy. Michael ward with confused patients. Sharpton screening lights owner. No other faces. People come on different schedules and shits. That confusion gets who has And there is a slight chance to recover from those acute episodes. It is in that environment surrounded by the lovely cash over as some stole tests harassed wherever down their own environment is the best place for them. And i’d say when you own that rope would fraley school scale If you are seven eight or nine the hospital is the last place you need to take your log onto. So that’s the kind of information that we all need because we’re trained for lack of a better term. There is an physical medical type. Emergency rush limbaugh to the hospital and for many of us those of us. That aren’t one hundred and two almost one hundred and three. That might be the right choice but with my dad. I knew it wasn’t the right choice although he ended up in the hospital for thirty two days because once they’re there it’s kind of hard to extract them at least over here in the united states until the problem is fixed while my dad’s problem wasn’t going to get fixed. You know obviously the same thing with my grandmother. She’s one hundred and two hundred and two. That’s a law. I mean. I’m going to do apart from making confusing even higher hostile Digital might never recover. You reminded me over. Not the case manage the day and that’s a patient rates dementia. Let’s william dark. As derek is actually a young patient he in his seventies and i’ve known him for five years i died. This is the main been looking off to him. All these years and in the last of years dimension deteriorated significantly. He’s lovely wife. who can’t ramal. This time should couldn’t do it anymore. So he is now in accountable and about each weeks ago she asked me to visit because you deteriorated and at that stage we agreed that really something will come his way will be Of some sold at some stage whether it’s a heart attack or stroke whatever and we decided that event day comes there is nothing hostile can do to improve his life to turn the clock around. He’s in the last stages of his dementia even though he’s completely mobile allsteel eating and drinking but quoted debris very bad dementia were made a decision. Multiple will still transfers and keep him comfortable and guess what you told me today in saying that he’s a cab home ease foreign point ambulance to transfer him to hospital. He has been having record seizures. So that’s the problem you see you. Now what will come your way. a in. His case eats seizures. he had he has been having full. He bent his had these seizures and the cattles will important on the. She’s impact ghosts and i spent whole afternoon. Forty eight in his cash. Who’ll and hayes primary care. Physician and lenient honestly putin everyone sport and saying well. What am i going to do for him in hostile even if he had a full even if he had a bleed on the brain or he had a stroke will whatever reason he’s having seasons. I’ve ivonne find a you. Resurgent operator him. It’s not in his best interest. Hump fusion will make you more computer.
00:20:03 – 00:25:04
Coastal will make him reviews. Let’s keep him comfortable. he’s time has come. That’s what the wife wanted. That’s what we agreed eight weeks ago. Let’s stop this time. And it was a huge accurate. And i can see why people end up in house channel. It took two or three hours of my time. What would you can. His amongst many healthcare professionals each should be this difficult. We make decisions eight weeks ago yet when the time has come cavill perfect for novels. So we have that issue out there where we have to work with our cameroon. Snus in all healthcare providers educating about doing kaplan’s to avoid this unnecessary traumatizing of the individual. Yeah and the family is. That’s what happened with my dad. If i hit known he had a donated kidney and he didn’t take good care of it and we showed up at their home to put up holiday decorations and spend time with them. This was november twenty nine. Th two thousand sixteen. Had i known what was going on with him in had. I had enough foresight to know who to call. I wanna call hospice that day. I didn’t know what was wrong with him. I had to deal with him and mom and their dog and it was. It was the most stressful horrible thing and he was in the hospital for thirty two days. His nephrologist which were those those of you who are not doctors. That’s a kidney doctor. Kept saying what’s we get enough dialysis. It’ll clear up. Toxins out of his system in his memory should get better because he went from being what i thought was mentally okay to thinking it was nine hundred ninety eight. I’ve looked back now and saw that. There were signs that his cognition was not. Great is not as good as i thought. But compared to my mom like everybody’s better so or at the time everybody was better he was in the hospital for thirty two days he ended up with delirium he was released. He knew he had a gap in his memory. He was very anxious to fill that gap. My sister was very super positive which is her personality. My personality is like yellow. Let’s see how long this lasts. Unfortunately my negative attitude was the right one because after three days he had no clue. He was fighting with the caregivers. He didn’t need help. Didn’t understand why they were there then. He how in up in a different hospital mostly. Because i didn’t want him going back to the first one and that’s when we discussed hospice but it was just an tobacco up half a step. His personal nephrologist told me i was going to have to sit. I was going to have to transport him back and forth to dialysis. And i was going to have to sit with him every single time because he kept trying to pull out the needles and when i looked at her and i said you know this isn’t what he wants. This is against his medical directive. I said i think we need to call hospice. She hung up on me. Oh i’m sorry. I’m sorry to hear that and you raised another important issue. And that’s the work we have to do between geriatricians in politics care physicians and single nationals and. I spent a lot of time explaining to my parents of families. At although things. I get busted but if you are looked after by a cardiologists hotdog fat will lund dr. Ot needle they are looking at their specialists. And they’re obsessed about keith. Nay or the heart and they give the medicines in their arrival. They actually look at other medications all think about this in long jumper abuses and things like that. And i think joint cam by no means i’m saying let’s dismissal. This single ovid’s nationalists in frame people absolutely not. I worked very closely with my own leaks but we need to work together and there is plenty of evidence out that whilst doing active care for someone who is really afraid and we don’t know whether they will be reached direction they will be born. There is no harm in involved in participating teams enya and control in whatever symptoms. We have as we’re less carreno with active treatment. And if they don’t work at least their family has already been given some realistic expectations. The politika team is battle ready. And they’re transitional. Cash can be very smooth rather than. Let’s it when onto the dialysis. Edible go into whatever you want. And that’s that’s an important issue you see in understanding frailty jam if families can see that had your loved one is stage six seven eight.
00:25:05 – 00:30:06
You’ll need to understand that. The reserves running low that the next chest infection dramatic decline. Why don’t we discussed a possible decline. Now what we’re gonna do for. What our contingency plans rather than headed a knee jerk reaction cooling ambulances shifting them to the nearby spital. Let’s work a contingent supplants where we can’t immobile. He in britain in united kingdom. We have crisis response team for example. These saw senior nurses who go into people’s houses and our minister. Intravenous antibiotics so we do that here. We can give treatments at home. They’re so that needs to be a clear plan. Treatments can administered at home The family needs to think maybe leads going to family. Men bustle cares. Or maybe an nearby cabin facility any central win the transferred to will show and also the contingent surprised should go further and whoopi mom doesn’t respond. What is going to be the next. He should stay in that careful or we’re going to organize a large package. And she’s gonna stay at all so planning planning plume if they owned that stage six seven eight planning needs to be started now definitely planning ahead. A lot of people don’t want to discuss our end you know. We don’t wanna talk about dying. I know in the united states. i’m sure britain is the same. We kind of feel like dinosaur the failure which is dumb because as my maternal grandfather always said nobody gets out of this life alive and then he usually had some quickly statement relating to the conversation. But you know we don’t get out of this life alive so if you plan ahead and you say this is how i want the end to be. This is like i knew. My dad didn’t want to be on dialysis so if he just told me. I think i’m at the stage where i might be needing it again so we could have called hospice then. Or if i had known about palliative care you know. Six seven months prior. I could have said. I think you need to have palliative care just so that you know to manage whatever’s going to happen and then when the time comes will do hospice and then we wouldn’t have spent thirty two days in a panic thirty two days where my poor mom went from her home to my sister’s home to my home back to her home. I mean even. The dog was getting anxiety. I mean it was just horrible horrible for everybody and now i want you to think about it. The last month that he was not on hospice was horrible. Horrible no we don’t want horrible so plan plan plan. I e planner. Twenty twenty was really really hard. Because i couldn’t plan anything but we still did our trust and our medical advanced directives. And you know what it’s done. I don’t have to worry about it. Mar rotary club was talking about those exact types of plans at yesterday’s meeting. And i’m like i’m all done. Listen i’m so good and it made me feel really good. Because i’m like where we got it all planned out so it reduces anxiety to know that you have a plan in place so when something scary happens and your immediate reaction is you can take a step back and take a deep breath and go wait. We discussed this. We planned it my want even write it down or tell your best friend so that they can grab you by the back of the shirt. Say no this is what you guys planned on doing this. What you’re going to do i’m holding you to it. You asked me to hold it too. Yeah it’s not a failure. Planning ahead reduces anxiety and stress and scary stuff so this how do we prevent getting into those later states. My favorite kicked ways. I did my weight’s today’s i’m good. Good good well. Now that we know definition of frame ut and we have an understanding of one pocket it was age related changes to the body which we can’t do much about the muscle mass will go down that bone density will go down. Td yet all these things are happening. So the key ease jan is healthy lifestyle because whereas we cannot avoid easterly de changes to the body what we can avoid is damaging our body with other things so when we get into our seventies we have good reserves. Good enough to we the problem. So let me give you a few good examples on how we can prevent things that we can get in our seventies engaged. Eight is strong enough to have this major complications that accelerated frankly to wear one day.
00:30:06 – 00:35:02
You live at whole next day. You wanna campbell facility. Lifelong exercise has shown to slow down the reduction in muscle mass andrew. Our listeners off thinking of a presence there all the loved ones please. Give them a how do bells just said to ground with Ram dumbbells to train the upper boarding the strength training of who’s yeah in the middle of a pandemic and there has been abrupt stop to exercise classes to our older people. Get out that. Having the community walks together and things like that we don’t have any but that shouldn’t stop us are there any other ways of exercise Mcadoo than dumbbells the can do just i say. Walk walk in your own flat. I instruct my patients on every hour. Stand up and will for five ten minutes and that leads me to the next advice as we grew older bef- few well. I’m retired now. I can slow down now. You can look slow down. let’s Being you want to do because as you are older you’ll muscles your news in your muscles faster so in fact when you’re an older person you’ll need to move even more do your walks Subscribe to the gym. Do your exercises. Also our families and children are so helpful they want to do. Everything was no no. I’ll do that for you. I’ll get your show mall. Don’t allow them. If you’re able do not allow them to do anything for you. Do not go into the latest state. As long as you can do your own thing dude. I heard on the radio reading. Nice program of this grandma. Recycling herself jan. I laughed at that story. Hell own grandchildren now. Grown up and should an ad in the local cafe. Saying that i’m looking for a great child. Everyone thought it was a joke but it. It’s a small village where everyone and these working. Mum found her. Spend my time with my daughter after school. And so she is. Grandma will say recycling myself as grandma. Why not going with this. Ten year old after school collecting warmth walks doing things. So that’s a major thing. Do not slow down do things so this is yet The next thing is vitamin d so throughout our adult life. When need to make sure that all ways have enough vitamin d between d r. It’s soaps fool in breaking bones makes our muscle stronger as well saw especially in the areas where you are at risk if you already in our facility. I don’t see much sun. Your united kingdom where the reserve lethal song. Especially when you need to be on supplements and contact your gp maybe half the levels dumb soul between the What else do we have. High protein died in all the citizens have shown to reduce the law so muscle so easy going to depart. Protein shakes or high protein diets supplements try to increase the protein in the diet on. What else will be cereals. Try to lose weight even overweight. It’s all to do with the propulsion if we need to remember with aging is trying to take over muscle as it is as an aging process. But if we’re aging already over wade proportionally heaven. Move at them. The muscle there will be very little muscle to carry ass around the now. Eight is ninety. So if you and your food is fifty sixties. Now try to lose that weight and do your dumbbells and build up the muscle. So if you have enough muscle and you get into your seventies league is stop using your muscles. Physiology create that you have you know way not reserves to news you bet makes sense does these meaning interventions good nutrition with exercise exercise do more slowdown in retirement. Will two things. I love the recycled grandma because that benefits her the child the mom and also gives her a purpose in life which is important for brain health. Yeah antle house jim. That’s an important one. I actually The you reminded me. Mental health is actually important to all above.
00:35:02 – 00:40:04
You have to be a heaven. It really good mental health to have that designed to exercise designed to eat designed to get on the juice in so a mental house is very very important. And i mean we can talk about mental health day contrary bought is especially during the pandemic p. Up death food and just cool anyone talk known. You still get yourself a crochet. Sad all stock in awe. There’s a little older. Adults are now know how to operate computers so the new skill to of read e communicate nature yet. If you are. You’re lucky enough to get out. There embraced fresh air. It’s so so impetus mental health. Should’ve come number one because it’s important for everything else isn’t it. That is very true. The other thing and it’s interesting because you talked about losing weight. I lost one hundred pounds like seven years ago and then we hit menopause and some of its comeback. Twenty twenty was not kind at all. I didn’t put on weight. But i realized that all of my workouts were basically dog walking and bike riding. Bike riding is good. It’s out in the sun. We go for a couple of hours so burns a lot of calories but there was more eating and it just so you know the start of this year. I realized i needed to get back on. You know the really intense exercise and training routine. I used to have which thankfully my husband bought a peleton. And i’m loving that. Like i said i did the resistance band strength training this morning and that took some brain power because i had to figure out how they were doing certain things with the bands but one of the things that i learned during that weight loss journey. My personal trainer was fifteen years older than me. She’s late sixties. At this point is maintaining balance. She would always have us doing exercises. That helped maintain your balance. Because if you’re getting a little unsure and you fall over putting on your pants or getting up out of a chair well no falling is really bad for us. So lots of things you can do to your balance two sides right harry. Good point john. That’s an excellent point because while the age related changes which happen to our brain it’s doug missiles Over ninety percent of patients on the age of eighty already have a degree. Or baron hartnell no blood vessels on the brain in medical terms. We call it small vessel disease. You don’t even have to have stroke. So transient ischemic attacks. Just that age related change is what lead into poor bounds as we age and you are so right. Doing the balance exercises along the resistance. Training is very important to maintaining. Our bottles will to extend that. So one thing i’ve learned in this podcast. If you wanna maintain your brain health you have to eat right and exercise. It gets sunlight and proper sleep. No magic pill. I’ll talk on some medical things. John i think in terms of prevention of Windy to remember especially as we get on kosovo. I spoke about provincial Before people who are currently in the fifties and sixties by defy talk about individuals who are in their late sixties seventies. donald Are talking about provincial for them. Their cruelty already have a few medical problems. That probably already on a number of medications would they need to remember is f- age the targets for various controls. Change the blood. Sugar level control changes their blood pressure control levels change so they have to review those medicines. The medicines if you are on a few full five medicines. You have discussed with your promises so emily practitioner at every six months. Do you still need that. Those do you still need this madison. Maybe it has to be changed to something else maybe discontinued. Maybe you need something which your mobile ready Blood pressure for example people who on blood pressure medications at sixty seventies they get into the age is a ninety s and. I don’t know whether you knew general not as grow old. The blood pressure starts going down a bit. Naturally it stops reducing if nobody reviews your blood pressure medications and your own the same blocks in your eighties. As in your sixties s. Sure enough. Your blood pressure will be over treated. It will be too low. You’ll have dizzy spouse fool fracture your hip and next thing you find yourself in the nearest care.
00:40:05 – 00:45:11
So medicines review constantly. Check the liberal. Send update your medicines. Let sounds important since. I’m not on any medications. It’s not something that i i think of immediately. So that’s my first goal in life. It has been a goal for ever since adults. Lezama thirties probably is to avoid being on medications. If at all possible and i understand the importance for some of them but sometimes we can lose weight and reduce your blood pressure. We can learn mindfulness to learn reduce blood pressure after this last year. Once we’re through this pandemic because as we’re recording it is january twelfth twenty twenty one britain is in. I don’t know like complete lockdown california’s practically in the same boat. So we’re not there yet but we’re getting closer sciences blessed us with vaccines we just gotta get all rolled out. Is there anything else we should discuss about. Frailty before we sign off today. I think we’ve covered most of it. I think we’ve covered most when you were talking about the national bloc pressure you forgot to mention alcohol and all our discussion about fraility was somehow did not mention alcohol. It’s also maybe. I will squeeze within a couple of minutes our discussion and the point. I want to make in terms of walkable again guys. Don’t forget as we age liver. Function goes down with a bid. Live shrinks than liba circulation slows down. So it cannot alcohol of course processes. I live so you’ll live is not as good as process in europe will as it was in your fifties sixties so’s donald alcohol because drinking the santa moms will result in alcohol levels groin. So what you drunk the day before still will be in your blood next day. And then you have more dream alcoholic drink. And that’s the levels will accumulate in. You think you haven’t got much but actually you’ll drive in and somebody breast has serum levels. Might actually dangerous ohi. That’s a good point a drink tea in water. So that’s why i don’t think alcohol. I have enough fondness for food and sugar. Which i learned ten years ago how to reduce that. I just have made a choice not to drink most of the time because too many calories and then i’d have to do more exercise and that interferes with my new hobby. I picked up during the pandemic of making greeting cards. so i learned something. New near is a pandemic. That’s what i was saying than you steal. it will occupy you. It will train your brandon. Of course learn new skill in your fifties sixties has schule now by research to slow down or actually prevent dementia. So then go gay for me. Because i’m not sure i mentioned to you. But by maternal great grandmother had dementia. My maternal grandmother likely had vascular. Dementia from an aneurysm met leaked for three months and my mom obviously had alzheimer’s for twenty years. So you know my family. History is not so great. So i do. When i started the weight. Loss and exercise journey it was to avoid the diabetes. That is on my dad’s and luckily for me. Doing that also has helped prevent possible alzheimer’s. So you know you might not think that you like exercise or you really like that fatty juicy steak with the butter on top which is kind of easy. Because i personally cannot eat that much fat anymore. But ask yourself if this sugary treat or this fatty meat is worth potentially not being able to take care of yourself later on Puts it puts making a healthy lifestyle into perspective. I have to exercise or become homicidal actually went to the gym way back when during the journey back when we could go into gyms and i literally walked in the door her a gun on the bike of telling and the trainer. I told you about a minute ago. Chemo. virtue is everything. Okay mic wilby in an hour and we us an after an hour. It was like okay. The world is safe. I’m not homicide anymore. I don’t even remember what bothered me. I just remember how. I felt when i walked in which was. Don’t get in my face. Because i might hurt you and when i walked out you know. The the butterflies of the birds were chirping around my head. I was like i’d have same feeling. It feels good. And i get really great creative ideas when i’m exercising so that was the thing that made me realize that my exercise wasn’t you know it wasn’t up to par because it wasn’t getting ideas like the blood wasn’t going through the brain fast enough to get all the ideas so just start out slow.
00:45:11 – 00:48:41
Don’t make massive changes right away. It’s you can do it. If i can lose one hundred pounds and keep most of it off for seven years. You guys can do it to jenny as i am. As i’m originally from russia i have no idea what hundred pounds needs. Can you tell me what is in kilograms. No me think. I’ll give it a lot. It’s about the weight of a ten year. Old child right significant. Sounds like it could be about thirty kilograms. It’s possible yeah. When i was a kid we learned half of the metric system in half of the english system and so i never learned either one of them very well so i know kilograms hundreds and i think thirty is probably close so as long as you ask me in stones because that one. I don’t know at all. But this has been fantastic. And dr elena is going to be back monthly with other really great tidbits of information. All of this bet. More than it’s there’s a big. And i really appreciate you kinda gave me a list and we will be back again together next month. Yeah thank you. I hope this conversation cleared up some of the mysteries. You’ve probably had about why someone goes from seemingly fine to completely not fine almost overnight. I was curious about this because of personal experiences. And when dr mucci suggested that we have a chat about it i was excited to learn more. Definitely check out her instagram page. She has healthy aging tips every friday. One of my goals with this podcast in addition to giving you caregiver advised for caring for your loved. One is also to give you advice and things to do so that you can age well and hopefully avoid many of the problems that you’re living through with your loved one do both of us a favor and share this show with anybody you know that wants to age well and there’s always i’ll be in your ears again next tuesday. I’ve got your attention. Let me tell you about the modules in the eight week online course from caregiver. Chronicles it starts out with. What is a caregiver then. Educating yourself on the diagnosis caring for a loved one and observing your loved ones religious beliefs. How to live a healthy lifestyle as a caregiver navigating the medical professionals understanding medication super important legal matters also important. The decision maker insurance community resources durable medical equipment when a caregiver is needed finding a caregiver placement in the skilled nursing facility or memory care. Residents family dynamics challenges and conflicts learning how to navigate. That is probably worth the entire fee. Then there’s home health hospice than planning for your loved ones transition. Be sure to check out. Their weekly live asked. Dr yvette anything. The link for that is also in the show notes.