• Medical or healthcare power of attorney (POA)—This legal document, which may also be called a Durable Power of Attorney, designates an individual (referred to as your healthcare agent or proxy) to make medical decisions for you if you are unable to do so. (Note: This is different from a power of attorney authorizing someone to make financial transactions for you.)
• Do not resuscitate (DNR) order—This is a written request to forgo cardiopulmonary resuscitation (CPR) if your heart stops or you stop breathing. Advance directives do not have to include a DNR, and you aren’t required to have advance directives in place to request a DNR. Your physician can put a DNR order in your medical chart. It’s important to note that many states require a separate DNR form, which is state-specific and bears the signature of a physician (see chapter 5 for more details).
These legalities may seem overwhelming or even a bit depressing to consider, but they are necessary to ensure that your end-of-life wishes are carried out and help your loved ones during an already difficult time. While most of these documents are readily available online, consulting an attorney or, more specifically, an attorney who specializes in elder law is highly recommended, as laws and terminology differ by state. These professionals can walk you through the process, explain your options, and answer questions along the way. They can also help you plan for all the “what ifs” that you may not have considered before. The cost of preparing these documents is generally very affordable. However, if fees are a concern, many communities offer free or low-cost legal resources to help you draft these important documents. The National Elder Law Foundation (nelf.org) can help you find a local attorney. If possible, select a certified elder law attorney, which is considered the gold standard in the industry.
Keep in mind, documents don’t replace conversations! Simply stashing these documents away in a safe deposit box somewhere doesn’t help anyone. It’s vital to have open, honest conversations with your spouse, adult children, or other family members who may be involved in future caregiving or decision making. Share these documents with them (all parties should have a copy) and explain your wishes in person, if possible. Before appointing a POA, be sure that individual understands your requests and is willing to accept the responsibility. It’s also a good idea to review these documents every year or so, as things change.
If you are finding it difficult to initiate these conversations with aging parents or adult children, as the case may be, the Conversation Project offers some tips for getting started at www.theconversationproject.org. Groups such as the AARP and the Area Agencies on Aging are also good resources for how to get started and what topics to consider. Many people note that once the end-of-life subject is broached, this conversation can be one of the most meaningful talks they’ve ever had with their loved ones.
Health Factors
Prevention Is the Best Medicine
As discussed, many of the illnesses that were once associated with aging are largely avoidable and can be successfully treated. The keys are prevention and early diagnosis. Quite simply, the choices we make in our 50s regarding our health can greatly affect the quality of life in our late years. Even if you’ve neglected your health up to this point, it’s never too late to make improvements. Now is the time to take control.
Smoking
Let’s start with the culprit behind most preventable causes of death and disease in the United States—smoking. You may be familiar with the warnings regarding emphysema, bronchitis, and lung cancer, but did you know that smoking is also linked to heart disease and stroke? In fact, more smokers die from heart attacks than respiratory problems, and among those under 50, cigarette smoking is the number one risk factor for cardiovascular disease. Smoking damages the walls of your arteries, making them more susceptible to atherosclerosis (narrowing and hardening of the arteries), decreases circulation, increases blood pressure, reduces oxygen levels in the blood, and ups your chances of developing blood clots. Evidence also suggests that smoking contributes to unhealthy cholesterol levels.
And it’s not just cigarettes that are cause for concern—chewing tobacco and other products containing nicotine, such as smokeless cigarettes, can also be detrimental to your health. If you’re a tobacco user, the best thing you can do to improve your health is to stop, now! Even if you’ve smoked for many years, the health benefits of kicking the habit are immediate and improve over time. Within 20 minutes of your last cigarette, nicotine stops constricting blood vessels, your heart rate slows down, and your blood pressure decreases. After 8 to 10 hours without lighting up, your circulation begins to improve, carbon monoxide levels in your blood drop, and oxygen levels increase (your organs will thank you). After 24 smoke-free hours, your heart attack risk is reduced, and the body continues to heal with each passing day. Studies show that after a year of quitting, cardiovascular risks related to smoking are cut in half.
Of course, giving up tobacco is not easy. Nicotine is as addictive as heroin, and it often takes repeated attempts for folks to kick the habit for good. The good news is there are many tools available to help you succeed, such as nicotine replacement gum, lozenges, and patches. Though many of these aids are available over-the-counter, the best place to begin is with your healthcare provider, who can guide you in the process and possibly prescribe medications that reduce cravings and withdrawal symptoms. It’s important to follow directions carefully when using these products to avoid potential complications such as nicotine poisoning and interactions with other medications. To get started, you can find tips and support on websites such as www.smokefree.gov and the American Lung Association’s www.lung.org/stop-smoking.
Diet
Adopting healthy eating habits in your 50s is more important than ever in order to counteract changes that naturally occur with aging. For instance, both blood pressure and cholesterol levels tend to increase with age, so maintaining healthy ranges with diet and exercise is vital. When it comes to a healthy diet, there have been volumes written on the subject, with wide variations in advice. However, most experts agree that following a heart-healthy diet is your best bet. Eating a heart-healthy diet can lower blood pressure, reduce cholesterol, prevent diabetes, and keep weight in check. In fact, good eating habits are more effective against disease than medications.
You can ask your healthcare provider for healthy eating guidelines or find heart-healthy diets online on websites such as www.heart.org (The American Heart Association). In general, a heart-healthy diet includes:
• Reducing sodium to prevent hypertension (high blood pressure). Take the salt shaker off the table and check labels on prepared foods for sodium content—you might be surprised by what you find. Recommended guideline for sodium intake for healthy adults is 2,300 milligrams or less per day. However, older adults, African-Americans, and those with a diagnosis of hypertension should lower their daily intake to 1,500 milligrams or less. (On average, Americans consume double and even triple those amounts!)
• Reducing saturated fats, which are found in red meat, poultry skin, full-fat dairy products, butter, and cheese.
• Avoiding trans fats, which are artificial fats used to extend the shelf life of various packaged and processed foods, such as margarine, crackers, and bakery goods. Many deep fried and fast foods also contain trans fats.
• Adding more “good” fats (monounsaturated and polyunsaturated), which are found in foods such as avocados and nuts and some cooking oils (olive, canola, and sunflower).
• Including omega-3 fatty acids in your diet by eating fish, particularly deep-water, fatty fish (salmon, herring, trout, sardines, mackerel, and albacore tuna) at least two times per week.
• Increasing fiber with whole grain, high-fiber foods, such as whole grain breads and cereal, brown rice, couscous, quinoa, lentils, beans, nuts, oat bran, and