This surprisingly simple everyday habit makes a big difference for bone health

 With your risk of falling stronger bones means less likely to break. Which is another reason to do stairs constantly.

Two and a half years ago I bought a 4 level condo, 7 steps per level, that is what will keep me travelling to Europe for decades to come. Not doing steps is tantamount to giving up on life.

This surprisingly simple everyday habit makes a big difference for bone health

How often do you choose the stairs over an escalator or elevator? If the answer is rarely, you might want to reconsider. Bone density naturally declines with age, but for women, that process accelerates after menopause, according to Betsy Grunch, MD, a board-certified neurosurgeon specializing in spinal surgery. Fortunately, you can do something about that. “Bones are living tissue. They’re constantly remodeling and adapting to the forces placed on them,” Grunch explains.” And one simple way to do that is by taking the stairs. Read on to find out why that helps.

Why Taking the Stairs Is Good for Your Bones

Bones are similar to muscles in that they get stronger when you use them, explains Pasha Ehsan, M.D., a physiatrist board-certified in physical medicine and rehabilitation with Providence St. Jude Medical Center in Fullerton, California. “Bones respond to stress and impact,” Ehsan says. “When you put force through a bone, such as stepping firmly on a stair, the bone cells sense that pressure. This triggers the body to build more bone tissue and make the bone stronger over time.”

You want to be careful not to pound too hard, warns William Workman, a board-certified orthopedic surgeon at DISC Sports & Spine Center and adjunct clinical associate professor in the department of orthopaedic surgery at Stanford University. “Excessive pounding can irritate joints and potentially lead to overuse injuries like stress reactions or stress fractures if the body doesn’t have time to recover,” Workman says. “Just taking the stairs instead of the elevator adds the kind of weight-bearing activity that helps keep bones strong.” 

More Tips for Keeping Bones Healthy

Taking the stairs is a simple way to get in weight-bearing activity, but it isn’t a replacement for regular exercise. “Stair impact can be a helpful supplement to other exercises, but it can also be a good starting point for people who don’t have a regular workout routine,” Ehsan says. “It’s accessible, quick, and doesn’t require equipment.”

 Related video 1 exercise to boost leg strength in seniors (Bob and Brad) 

Grunch says even 10-15 minutes of stair climbing or light jumping three to five times a week can help stimulate bone remodeling. 

I can't jump at all, not even an inch off the floor, which is bizarre since my left leg still has massive power!

However, she stresses the importance of incorporating strength training to help maintain muscle mass as well. “The stronger your muscles are, the better they protect and stimulate your skeleton,” she says. What's more, healthy bone tissue also relies on overall healthy habits, like not smoking and getting enough protein, vitamin D, and calcium. “The big takeaway is this: bone health is built over years, not weeks. Small, consistent stresses like taking the stairs add up,” Grunch says.

Read the original article on Real Simple

I'm a trainer and here are 4 stair exercises to help strengthen your knees after 60

 To keep living in your own home and travel in Europe your competent? doctor better write these up as EXACT PROTOCOLS! 

Can't do that; PURE INCOMPETENCE!

I'm a trainer and here are 4 stair exercises to help strengthen your knees after 60

1. Supported Step-Up

Step-ups are one of the most direct ways to build knee strength because they train the same pattern you use on stairs. One leg pushes, the knee tracks well, and the hip helps finish the movement. The railing lets you practice with support, so you can focus on clean reps instead of fighting for balance. Start with a low step and make the working leg do the climb.

Muscles Trained: Quads, glutes, hamstrings, calves, core.

How to Do It

1. Stand facing the stairs.
2. Hold the railing lightly.
3. Place your right foot fully on the first step.
4. Press through your right foot and step up.
5. Bring your left foot to the step.
6. Step back down with control, then repeat before switching sides.

Recommended Sets and Reps: Perform 2 to 3 sets of 6 to 10 reps per side.

Best Variations: Lower step-up, slower step-up, step-up with a brief pause.

Form Tip: Keep your whole foot on the step.

2. Supported Stair Toe Tap

Lowering is where many knees feel the most unsure. A stair toe tap helps you train that control in a small range before moving into bigger step-downs. The leg on the step does the work as the other foot taps the floor. This builds confidence because you can use the railing, shorten the range, and keep every rep smooth.

Muscles Trained: Quads, glutes, calves, hamstrings, core.

How to Do It

1. Stand on the bottom step with your right foot planted.
2. Hold the railing lightly.
3. Let your left foot hover near the floor.
4. Bend your right knee and tap your left toes to the floor.
5. Press through your right foot to stand tall again.
6. Complete your reps, then switch sides.

Recommended Sets and Reps: Perform 2 to 3 sets of 5 to 8 reps per side.

Best Variations: Smaller-range toe tap, supported step-down, slower toe tap.

Form Tip: Bend the standing knee slowly.

RELATED: 3 Simple Exercises That Rebuild Bone Strength Better Than Calcium Supplements After 60

3. Stair Calf Raise

The calves help your knees more than most people realize. They support your ankles, help control each step, and make walking or climbing feel steadier. A stair calf raise gives you a simple way to strengthen the lower legs with the railing close by. Use a controlled lift and lower so the calves do real work through each rep.

Muscles Trained: Calves, ankles, feet, quads.

How to Do It

1. Stand on the bottom step while holding the railing.
2. Place the balls of your feet on the edge of the step.
3. Let your heels lower slightly.
4. Press through the balls of your feet and lift your heels.
5. Pause briefly at the top.
6. Lower with control.

Recommended Sets and Reps: Perform 2 to 3 sets of 10 to 15 reps.

Best Variations: Floor calf raise, smaller-range stair calf raise, single-leg assisted calf raise.

Form Tip: Lift and lower without bouncing.

4. Supported Stair March

A stair march keeps the movement basic while adding balance and hip control. One foot stays on the step as the other knee lifts, which makes the standing leg work harder to keep you steady. This helps the knee because strong hips and better balance reduce the wobble people often feel on stairs. Keep the railing close and move at a pace you can control.

Muscles Trained: Quads, glutes, hip flexors, calves, core.

How to Do It

1. Stand facing the stairs.
2. Place your right foot on the first step.
3. Hold the railing lightly.
4. Press through your right foot and lift your left knee.
5. Lower your left foot back to the floor.
6. Repeat your reps, then switch sides.

Recommended Sets and Reps: Perform 2 to 3 sets of 6 to 10 reps per side.

Best Variations: Lower knee lift, slower stair march, step-up march.

Form Tip: Stand tall before each knee lift.

RELATED: 7 Daily Drills That Keep Your Mobility Decades Younger After 60

5. How to Build Knee Strength on Stairs After 60

Stair training works when the reps stay controlled, and your knee feels supported through the whole range. Use the railing, start with the lowest step, and stop a set before your form gets sloppy. The goal is steady progress, not rushing into a higher step before your legs are ready.

• Use the railing every time: Support lets you train the knee without turning each rep into a balance test.
• Start on the bottom step: A lower height gives your quads and hips a better chance to control the movement.
• Slow down the lowering: Step-downs and toe taps build more knee control when you slow down.
• Watch your knee path: Keep the knee pointing in the same direction as your toes.
• Train both legs evenly: Give the weaker side the same number of reps, even if the range has to be smaller.
• Stop if pain changes your movement: Muscle effort is fine. Sharp pain, limping, or shifting away from one leg means you need to stop the set.
• Practice a few days per week: Two to four short sessions give your knees regular strength work without overloading them.

References

• Park, Soo Yeon et al. "Aging-related changes in knee flexor muscle strength and cross-sectional area." Medicine vol. 101,42 (2022): e31104. doi:10.1097/MD.0000000000031104
• Solan, Matthew. "Strength Training Tied to Smaller Risk of Knee Osteoarthritis and Pain Later in Life." Harvard Health Publishing, Harvard Medical School, 1 Feb. 2024, www.health.harvard.edu/diseases-and-conditions/strength-training-tied-to-smaller-risk-of-knee-osteoarthritis-and-pain-later-in-life. Reviewed by Howard E. LeWine.

A simple stair workout for longevity, recommended by a personal trainer

 Did your competent? doctor and therapist get you recovered correctly in climbing stairs by pointing out EXACTLY how it should be done? Like  this? 

With this series of images from Nathan Nicholson I finally got the understanding that you don't just lift the foot straight up, you  engage your hamstring to pull your leg up behind you at the same time pointing your toes down(plantarflexion) to clear the lip of the step. I have to plan this all out on my own since most of my premotor cortex is dead. This currently is a very slow process. My therapists DID NOTHING for me on this!
1. Engage the hamstring
2. Point the toes down - plantarflexion
3. Clear the step
4. Dorsiflexion to lift the toe up
5. Straighten the leg 

NO, SO PURE INCOMPETENCE? Haven't you gotten them all fired yet?

A simple stair workout for longevity, recommended by a personal trainer

• Why this matters: VO2 max measures how effectively your body uses oxygen during exercise. Stair climbing can improve your VO2 max.
• What you can do: Start with one or two sessions per week. Alternate four minutes of hard effort with a slow recovery period.
• The payoff: Higher levels of cardiorespiratory fitness are associated with a lower risk of premature death.

The stairs don’t have to be just something to get you from one place to another. They can also be a really effective workout tool—one that boosts your VO2 max. VO2 max measures the maximum amount of oxygen your body can use during exercise. Turns out, VO2 max is also a predictor of longevity. The higher your VO2 max, the more likely you may be to live longer. Here’s what you need to know about a stair workout so you can start increasing your VO2 max and, in turn, your longevity.

How To Do the Workout

There are different stair-related methods to increase your VO2 max, but a simple one you can implement is a 4x4 interval. Here’s how it works: 

1. Climb stairs for 4 minutes straight: The key is to do it at a pace that leaves you near exhaustion by the end. You can approximate this pace by asking yourself, “Could I keep going at this pace for more than four minutes?” If the answer is no, you’re on target. 
2. Recover for 4 minutes: Walk slowly on a flat surface or slowly climb the stairs. 
3. Repeat: Once you again complete four minutes at the fast pace and four minutes at the recovery pace, you’re done.

How Often Should You Do It?

For most adults, two 4×4 interval sessions per week is the best starting target for improving VO2 max. Research comparing weekly frequencies suggests that two to three sessions can improve VO2 max, but there is no clear extra benefit from doing three instead of two for recreational exercisers. Classic 4×4 studies often used three weekly sessions, but that volume may be harder for you to recover from.

 Related video: Study finds strength training sweet spot for longevity (KYTX-TV Tyler-Longview)

How To Progress

As you get comfortable doing your stair climbing workouts, a practical progression might look like the following:

• If you’re new to intervals: Once weekly for two to three weeks
• If you exercise regularly: Twice weekly
• If you’re well-trained and recovering well: Up to three times weekly, provided these are your only very hard cardio sessions

How To Adjust the Workout

Everybody has different physical needs and health implications, so by no means do you have to follow this prescription exactly to improve your VO2 max using stairs.

If using stairs hurts your knees or other lower body joints, feel free to do a 4x4 workout on a more suitable tool. You can still replicate four minutes on and four minutes of recovery using a workout tool of your choice, such as a stationary bike or elliptical. The key is to work at a strenuous pace for four minutes, recover slowly, and repeat.

If four minutes is too challenging, you can shorten the interval as needed to match your current capacity, then work up from there.

Stair Workout Safety Tips

Before starting a stair climbing exercise routine, keep these three safety points in mind:

• Warm up: Especially with interval work, warming up beforehand is a good idea. Take a few minutes to loosen up and get the blood flowing before starting your first interval.
• Stop if you feel unwell: If you develop chest pain, dizziness, faintness, or an irregular or pounding heartbeat when you start your intervals, stop immediately. 
• Talk with your doctor: Check with a healthcare provider before trying vigorous stair intervals if you have heart or lung disease, frequent falls, unexplained dizziness, a recent injury or surgery, or joint symptoms that make stairs difficult. Adults with chronic conditions should consider how those conditions affect their ability to exercise safely.

How Much of an Impact Can the Workout Have?

Stair climbing should be part of a larger fitness plan. But workouts like it that target VO2 can have a big impact on health over time.

A 2018 study showed that participants with extreme cardiorespiratory fitness—which VO2 measures—had a lower risk of all-cause mortality compared to people of any other level of cardiorespiratory fitness.

You don’t have to be an elite athlete with extreme cardiorespiratory fitness to get the benefits. The study also showed that improving cardiorespiratory fitness from low to even just below average was associated with a 50% reduction in all-cause mortality. When you go from low to above average, the risk reduction is about 70%. The results suggest that the better your cardiorespiratory fitness, the longer you may be able to live. Stair climbing may be able to play a part in this.

Read the original article on Health

Taking the stairs could cut risk of early death

 Two and a half years ago I bought a 4 level condo, 7 steps per level, that is what will keep me travelling to Europe for decades to come. Not doing steps is tantamount to giving up on life.

Taking the stairs could cut risk of early death

Taking the stairs will help you live longer – according to new research from the University of East Anglia and the Norfolk and Norwich University Hospital.

A major new study published today reveals that climbing the stairs significantly reduces the risk of dying from cardiovascular disease.

Over the course of the study, people who regularly climb stairs were 39 per cent less likely to die from heart-related problems and 24 per cent less likely to die from any cause - compared with people who don't climb stairs as often.

The study also reveals that people who climbed the stairs were less likely to develop major cardiovascular conditions such as heart attack, stroke and heart failure.

Prof Vassilios Vassiliou, from UEA’s Norwich Medical School, said: “Cardiovascular disease is the leading cause of death worldwide - with cases nearly doubling between 1990 and 2019.

“But it is largely preventable through a healthy lifestyle - including regular physical activity, a heart-healthy diet, not smoking, maintaining a healthy weight, and managing blood pressure, cholesterol, and diabetes.

“Taking the stairs is a practical and often overlooked way to build physical activity into daily life. 

“We wanted to better understand how this everyday activity could have life-saving potential.”

Strong evidence from large-scale analysis

The research team investigated whether climbing stairs could play a role in reducing the risks of cardiovascular disease and premature death.

After reviewing nearly 1,900 studies, they analysed data from more than 480,000 participants across nine high quality studies with a median follow-up period of 14 years.

The study population included both healthy participants and those with a previous history of heart problems. Ages ranged from 35 to 84 years old and 53 per cent of participants were women.

Dr Sophie Paddock, also from UEA’s Norwich Medical School and a cardiology specialist registrar at the NNUH, said: “After pooling results from over 450,000 participants, we found a consistent association between stair climbing and lower risk of both cardiovascular death and overall mortality.

“Unlike going to the gym or doing a workout, climbing the stairs is something you can easily fit into your day at home, at work or when you're out. It's a good option for people who don't have much time or easy access to exercise.

“So if you have the choice of taking the stairs or the lift, go for the stairs as it will help your heart.

“Even brief bursts of physical activity have beneficial health impacts, and short bouts of stair climbing should be an achievable target to integrate into daily routines.”

Previous research cited in the study showed that just minutes of stair climbing several times a week can improve cardiorespiratory fitness and lower cholesterol. 

One large cohort study included in the analysis suggested that climbing around six flights of stairs per day may deliver the greatest benefit, although researchers say the optimal “dose” requires further investigation.

Dr Paddock said: “Some of the studies we looked at showed that the more stairs climbed, the greater the health benefits. But even small changes had a measurable impact.”

A simple step forward

The findings reinforce broader evidence that even short bursts of physical activity can have meaningful health benefits.

Prof Vassiliou said: “With more than a quarter of adults worldwide failing to meet recommended activity levels, choosing to take the stairs offers a realistic, scalable intervention. 

“Encouraging people to take the stairs in workplaces, public buildings and homes could form part of a wider strategy to reduce cardiovascular disease at population level.”

Not for everyone

While the benefits are clear, researchers caution that stair climbing may not be suitable for everyone - particularly those with mobility issues or joint conditions. 

They also highlight the need for future research using wearable technology to measure activity more accurately and determine optimal recommendations.

‘Evaluating the Impact of Stair Climbing on Cardiovascular Risk Reduction: A Systematic Review and Meta-analysis’ is published in the American Journal of Cardiovascular Drugs. 

Regular Stair Climbing May Reduce Heart Disease Risk and Boost Longevity: Study

 Just bought a 4 level condo, 7 steps to each level. Absolutely do not believe in removing steps in living quarters. Don't do steps at home, won't be able to travel to step laden places like Machu Pichu or restrooms anywhere in Europe!

Regular Stair Climbing May Reduce Heart Disease Risk and Boost Longevity: Study

If you're over 65 and can still do these 12 things with ease, you're aging wonderfully

 

If you're over 65 and can still do these 12 things with ease, you're aging wonderfully

You can walk long distances without losing your balance 

Not a problem, for days in Italy I kept up with the group, thru the Vatican, Colosseum, Sorrento, Capri Island

Being able to walk for several minutes without feeling unsteady is one of the strongest signs of healthy aging. Good balance reduces the risk of falls and helps you remain independent when carrying out everyday activities such as shopping, taking walks, or visiting family and friends. Walking also strengthens your muscles, joints, and cardiovascular system.

If you are over 65 and can comfortably walk several blocks without needing frequent breaks, your physical condition is likely in very good shape. This ability also reflects strong coordination between your muscles, vision, and nervous system, all of which are essential for maintaining an active lifestyle for years to come.

You can climb stairs without much effort 

easy! And because I just bought a 4-level condo with 7 steps to each floor I'll have enough practice doing steps, I'll still be doing them at age 100(currently 70). One level living means you didn't plan early enough to keep doing steps. Which means you can't travel to Europe since most bar/restaurant bathrooms are in the basement with no railings.)

Climbing stairs requires muscular strength, cardiovascular endurance, and good coordination. When an older adult can do this without experiencing excessive fatigue, it is often a sign that they have maintained good physical fitness and mobility for daily life.

Although it is perfectly normal to move at a slower pace as you age, preserving this ability shows that your legs, heart, and lungs are still working efficiently. Continuing to perform strength-building exercises can help maintain this important skill over time.

You maintain a healthy memory

Remembering appointments, names, recent conversations, or daily tasks is part of having a healthy memory. Occasional forgetfulness is completely normal, but maintaining the ability to organize and recall information suggests that your brain continues to function efficiently.

Reading, solving puzzles, learning new activities, and having regular conversations all help stimulate cognitive function. These habits support memory while promoting mental sharpness as the years go by.

You can stand up from a chair without assistance (I can do this from kitchen chairs, but couches and Adirondack chairs require scooting to the edge to get my feet under me and then still use my right arm to push me up. I consider my efforts in this excellent.)

Standing up from a chair without relying heavily on your arms reflects good strength in your legs and core muscles. Although it seems like a simple movement, healthcare professionals often use it as an indicator of mobility and independence in older adults.

Maintaining this ability makes many daily activities easier, from getting out of bed to using public transportation. Regular strength-training exercises can help preserve this skill while reducing the likelihood of future mobility limitations.

You maintain an active social life 

(Sunday is music at Red Cedar, Tuesday is music at Moriarties, Thursday is trivia at Moriarties; all are bars, so alcohol is involved, there will be no condemnations of that.) All part of my plan to exponentially expand my social connections to prevent dementia. Alcohol will be involved and there will be no naysaying of that. 

Spending time with family, friends, or participating in community activities supports both emotional and cognitive well-being. Social connections help reduce isolation while stimulating memory, communication skills, and self-confidence.

Women who maintain meaningful social relationships often cope better with the natural changes that come with aging. Conversations, group classes, volunteer work, and recreational activities all contribute to improved emotional well-being and a greater sense of fulfillment.

You enjoy learning new things Learning lots of new research on stroke which your incompetent? doctor doesn't know about. How long will you allow incompetence before you get them fired?

The ability to learn does not disappear with age. Whether you're learning how to use new technology, taking a class, or developing a new hobby, your willingness to learn demonstrates that your brain continues to adapt and grow.

Besides stimulating cognitive function, learning new skills boosts confidence and keeps curiosity alive. It also encourages the formation of new neural connections that help support long-term brain health.

You have good coordination 

It's pretty good for not having a useable left hand

Being able to perform tasks that require precise movements, such as cooking, sewing, writing, or handling small objects, shows that communication between your brain and muscles remains strong. This ability is essential for maintaining independence.

Practicing balance and coordination exercises helps preserve these important skills. Maintaining manual dexterity also allows you to continue enjoying hobbies and everyday activities that require precision and focus.

You sleep well on a regular basis

Getting seven to eight hours of quality sleep each night helps your body and mind recover properly. Good sleep supports your immune system, improves memory, and helps maintain steady energy levels throughout the day.

Although sleep patterns often change with age, consistently getting restorative sleep remains an excellent indicator of overall health. Keeping a regular bedtime routine can improve sleep quality and overall well-being

You stay positive when facing challenges I'm the poster child for this; stroke at 50, fired at 56, divorced at 58. Never been depressed a day in my life! Life is great, having superior fun all the time!

 

The ability to adapt to change and approach difficult situations with optimism is an important sign of emotional well-being. Resilient people often find solutions more easily and maintain a positive outlook despite everyday challenges

Developing hobbies, practicing relaxation techniques, and maintaining healthy relationships all contribute to emotional balance. This positive mindset supports a better quality of life and helps make the aging process more enjoyable.

You can handle household tasks without difficulty Of course they are difficult, I only have one useable arm/hand. Try vacuuming with an electric corded vacuum and not run over the cord. My solution, no carpeted floors. 

Cooking, cleaning, organizing your home, and running errands require coordination, strength, endurance, and planning. Being able to complete these activities independently reflects a healthy combination of physical and cognitive abilities.

Beyond preserving independence, household chores also provide regular physical activity. These everyday movements help maintain mobility while strengthening multiple muscle groups.

You eat a balanced diet When you provide AN EXACT PROTOCOL, I'll consider doing this, but until then; fuck off!

Preparing nutritious meals and making healthy food choices demonstrate a commitment to your long-term well-being. A diet rich in fruits, vegetables, lean proteins, and whole grains supports your body's functions throughout every stage of life.

Staying properly hydrated and limiting highly processed foods are equally important. These healthy habits help preserve energy, strengthen bones, and support a well-functioning immune system.

You Enjoy Your Independence

I can't see getting married again, it would severely limit my traveling and social connections.  I'll take my chances considering how much fun I'm having being single.

Being able to manage your daily activities, organize your schedule, and make decisions confidently is one of the strongest indicators of healthy aging. Independence supports self-esteem and allows you to continue participating actively in everyday life.

Maintaining independence does not mean doing everything alone; it means having the confidence and ability to take care of yourself while knowing when to ask for help if needed. This balance between self-reliance and well-being is one of the clearest signs of a high quality of life after age 65.

Adapting a Home to Age in Place: An Age Well conversation with Lakelyn Eichenberger, Ph.D.

I'll be living here for a long time

And because I just bought a 4-level condo with 7 steps to each floor I'll have enough practice doing steps, I'll still be doing them at age 100(currently 69). One level living means you didn't plan early enough to keep doing steps. Which means you can't travel to Europe since most bar/restaurant bathrooms are in the basement with no railings.)

Adapting a Home to Age in Place: An Age Well conversation with Lakelyn Eichenberger, Ph.D.

At a Glance

• Adapting homes for physical challenges involves practical modifications in high-risk areas like bathrooms and kitchens, along with thoughtful solutions for stairs and improved lighting throughout the home. 
• For individuals experiencing cognitive decline, specific home adjustments such as specialized shower heads, automatic stove shutoffs, and various alarm systems can significantly enhance safety and manage daily challenges. 
• Successfully aging in place also relies heavily on a strong support system, encompassing social connections, community resources, professional home care services, and proactive planning for evolving needs. 

Lakelyn Eichenberger, Ph.D., is a gerontologist and spokesperson for Home Instead, an organization providing home care services for older people. Based in Omaha, Neb., she is a frequent public speaker and has appeared on programs including the Dr. Oz and Dr. Phil shows. We spoke with Dr. Eichenberger recently about ways people can adapt their homes as they age to make living in them safer and more manageable.  

 

The idea of aging in place — continuing to live independently in one’s own home in later years — is appealing to many people. What do you think drives that? 

It is a very popular sentiment. In fact, 90% of people would prefer to age in place at home. I think that correlates very directly to their perceived quality of life and happiness. 

Often they’ve lived in their homes for many years. Perhaps they raised their children there. Their home holds a lot of their memories. They also usually feel tied in various ways to their community. They have a local bank and grocery store they always go to. They may be involved in a faith community. They know their neighbors. All of that creates a social support network for them that they rightly want to retain.  

I think, too, that staying in one’s home can be important just from an emotional standpoint. It’s a symbol of independence and for some, leaving a home behind feels like admitting defeat. 

With that said, many homes aren't necessarily set up for aging in place, so there are some things people need to consider changing in order to stay home. Given the benefits, it's worth thinking about investing a little bit of money into just making sure your living environment is meeting your needs as you get older. 

 

Pictured: 

Lakelyn Eichenberger

If you’re looking at what you can do to stay in your home longer or help your parents or other family members stay in theirs, it seems like the steps would be quite a bit different for addressing physical issues versus cognitive issues. Can you talk about each of those a bit? 

Taking the physical challenges first, I think there are four key areas that people should be thinking about. The first is adapting the home for safety. The second is minimizing the risks. Third is bringing in outside help, and fourth is making a plan which involves all of that.  

Begin by taking a look at which areas of the home you use most frequently. Are you experiencing any challenges in those areas? You may want to adopt some safety measures.  

Bathrooms and kitchens are where most falls occur. In a bathroom, adding things like grab bars can make a huge difference. Some people get concerned about the resale value of a home outfitted with things like that, but I say safety far outweighs that concern. Besides, the hardware can always be removed, so that’s not something to stress about. 

You should also make sure you have a secure mat outside the shower or bath that has a rubber backing to reduce tripping hazards. More significantly, cost-wise, you might consider converting a tub into a step-in shower to get more easily in and out and lessen the risk of slips and falls. It takes some advanced planning, obviously, but it’s an adaptation many people have found essential. 

Looking at the kitchen, if arthritis is starting to impact your dexterity and your ability to prepare meals for yourself, there’s a vast array of arthritis-friendly products, from jar grippers to large-handled utensils to reachers. If you have a rug in front of the sink that’s easy to trip over, consider getting one with a rubber backing or using double-sided tape to tape your current one to the floor.  

In the living room, do you have a favorite chair that’s getting harder to get in and out of, perhaps because the cushions have sunk in? Maybe it’s time to invest in a new comfortable chair to make watching TV more enjoyable and to improve your mobility.  

Small things like that can go a long way toward minimizing risks. 

What about stairs, and the reality that many people live in multi-story homes? 

Not only do most homes have multiple stories, but many of them don’t have a full bedroom and bathroom on the first floor. That is something to think through. If a person were no longer able to get up and down the stairs, is there a room on the main floor that could be temporarily converted into a bedroom, or would it be possible to build out a full bath if there is currently only a powder room or a half bath?  

If navigating stairs is still possible but becoming challenging, at the very least a staircase should be very well lit, with a light switch at the top and the bottom. Perhaps consider installing handrails on both sides for added stability. It can also be helpful to put a piece of colorful duct tape on the edge of the final stair at the bottom, just to provide a visual queue that it’s the end of the staircase. (Yep, my place has handrails on both sides, will need to re-install some of the brackets since they didn't drive them into studs.)

It would be wise, if climbing stairs is becoming difficult, to avoid carrying armloads of things up and down them — awkward laundry baskets, for instance. Very often, laundry rooms are in the basement or on the main floor while the bedrooms are all upstairs. So a couple of things could be considered here. Most simply, perhaps you switch from a basket to a laundry bag so you’re grasping just one little handle. As a pricier solution, some folks will have a stackable washer/dryer installed in a closet in the master bedroom or a hallway.  

There are lifts that you can install in a staircase, whether the staircase is straight or turns a corner. Split-level homes are an interesting challenge, because they’ll often have two or more short stairways. I’ve seen people install multiple lifts in those houses, but obviously that adds expense. 

There are several ways to manage issues with stairs, but I want to reemphasize lighting. People underestimate good lighting in places like hallways and stairs, and people of certain generations worry about their electricity bills, so they don’t keep a lot of lights on in the home. I understand where they’re coming from, but the great news is, we have a lot of very efficient light bulbs now, and having that light — especially at dusk and dawn — can prevent a lot of unnecessary falls and accidents. 

In addition, a motion-sensor nightlight by your bed can light the way to the bathroom at night, which is a very common time for serious falls. 

Can you share some adaptations to help people experiencing cognitive decline? 

There’s a lot to consider. One simple bathroom modification would be to install a detachable shower head that allows you to control where the water goes. People with dementia can become agitated when there’s water on their head or face. 

Kitchen safety is another source of concern for those living with cognitive impairment. An automatic stove shutoff can be installed that turns burners off after a certain length of time. Instead of having a knife block on the counter, maybe you move all the knives to a drawer just for safety. You should consider securing chemicals — for instance, a bottle of laundry soap could be mistaken for a jug of milk. 

Oftentimes, people living with cognitive impairment experience something called late-day agitation, or “sundowning.” Their circadian rhythm is disrupted, they become more agitated in the early evening hours and they sometimes are wakeful during the night at certain points. In those cases, it can be helpful to install a bed alarm underneath the top sheet or on the floor next to the bed to alert family if they’ve gotten up in the middle of the night. That may prevent falls or keep a person from wandering. 

If your loved one has wandered, or if you’re concerned that they may, putting alerts or alarms on the doors that lead to the exterior of the house to notify a family member can be helpful. Some phones and other personal emergency-response devices have GPS monitoring, as well. 

 

Aside from cognitive decline, isolation can have a negative impact on mental health too, correct? 

Oh, for sure, and that’s why a support network is so important. Who are the friends and family members? A lot of families have kind of dispersed nowadays, so you might not have a direct family member within driving distance, within the same state or even in the same country. If there isn’t family around, it’s important to figure out who you can lean on. Maybe it’s your faith community — many have volunteer programs. Maybe it’s tapping into your Area Agency on Aging. Look into things like senior centers — a lot of area agencies on aging have senior centers or community centers or multigenerational programming that you can get involved in. Do a self-audit of hobbies and activities you enjoy, and how you might do them in a social setting to continue those interactions and connections. 

We tend to see that when somebody has to stop driving themself, especially in communities where there's not great public transport, isolation starts to take root. So, if somebody does have to stop driving, it's really important to also come up with a plan on how they’re still going to be able to connect with those that they find enjoyment connecting with or getting to their social activities or to their appointments, because the last thing we want somebody to do is have to give up their keys and then become totally isolated. So, coming up with options and things to look forward to — maybe it’s a monthly or weekly family dinner, or continuing to go to a faith service on the weekend and having a volunteer come pick them up. Those kinds of things are really important to make sure that people aren't isolated, because we know that isolation can lead to a lot of health concerns — physical, mental and emotional. It can even increase the risk for cognitive decline.  

 

“We know that isolation can lead to a lot of health concerns — physical, mental and emotional. It can even increase the risk for cognitive decline.”

Lakelyn Eichenberger

What other steps should people consider to improve their ability to stay at home? 

Even though there are a lot of tools and conveniences to help you age in place, your own health, strength and mobility obviously impact your ability to stay home. So I think it’s extremely important to stay physically active as you get older in whatever way works for you that has your doctor’s approval. Keeping up your strength and mobility can help you move about your environment better and live in it more safely. 

 

Practically speaking, there comes a point when you just can’t do all the things you once did. So part of aging in place inevitably has to include having help around the house, doesn’t it? 

Yes, most of the time. A lot of people think, “Oh, my family will just help out,” and many family members do want to jump in and help. But we’re seeing more adult children in that “sandwich” generation, raising their own kids and helping to look after their older loved one while still working, and that limits the amount of time that they could be there to provide support. I think it’s important again to start thinking ahead about who’s in your support network, and while that can perhaps include family and neighbors that you know, professional support can really be an important supplement. 

 

When you’re talking about professional support in-home, you’re not talking about health-care issues, but more about things like cleaning, cooking, doing chores around the house? 

Yes. Home health care is what a lot of people know of as a service that comes into the home, and those folks do more of the medical tasks. Home care is a very complementary service to home health care. To your point, they can help with meal preparation, laundry, running errands and transportation to appointments. Of course, there are also service providers that can help with snow removal, lawn care and other things like that. And especially in more metropolitan areas, delivery services are available from pharmacies and grocery stores. 

Sometimes local governments provide services. For example, a lot of local fire stations will come and install fire alarms or will change out the batteries on an annual basis for older adults. 

So there are plenty of support options around you that can be helpful in prolonging your ability to stay in your home. 

You mentioned fire alarms. On the topic of alarms and sensors generally, what about wearable alarm systems? 

They’re abbreviated as PERS, for personal emergency response systems. I think that those are a great option for individuals, especially if they live alone. A lot of older adults don’t want to wear them because they’re not fashionable, or because they’re kind of an outward expression that you’re getting older. But iPhones and iWatches now have fall-detection technology, and so do a lot of other smart watches and fitness monitors. PERS companies, too, are starting to make their devices less conspicuous, looking more like watches than pendants.  They really can be lifesaving for many people, often at pretty low cost. 

 

So, with the right combination of products and services and adaptations, aging in place is something that really is achievable for many people. 

Yes, and I would also add the other critical piece that I mentioned at the outset — having a plan. I cannot overstate the importance of thinking through, as best you can, when and how your needs are going to change. I have so many examples of people who have done this successfully with the right planning and support, and they experienced high levels of happiness and fulfillment. You can make it work!