Readiness to Retire 3 Financial readiness (money) Lifestyle readiness (time) Substitution preparation for job satisfaction, socialization, intellectual stimulation, challenge, routine etc HEALTH !! Both assume your HEALTH !!
Lecture Limitations 5 This presentation is not intended to provide specific individual medical advice. The nature of this presentation is general guiding principles and not individual advice. If individualized advice is needed or desired, please see your primary health care provider.
Objectives 6 As a result of this session, participants will : Know what their expected lifespan is 1.Know what their expected lifespan is 2.Learn the secrets of living to 100 years old 3.Increase their odds of dying healthy 4.Understand how to age healthy 5.Take more control of their health and care 6.Identify your next action steps for “health now and in retirement”
How many years are YOU going to live ? 7 Why is this important? Don’t want to outlive your money For 1000’s years life expectancy = 25 yrs 1800’s = 37 yrs 1900’s = 48 yrs 1950’s = 65 yrs Exercise
8 Round 1. What age and cause of death did you pick ? Round 2. Why do you think you picked those ? Round 3. What things could you change right now in your lifestyle that would likely result in an increased age at death and/or change your cause of death ?
Our “SMART” Goal H 9 To die at _____ years of age and To die of ______________
Predicted Life Expectancy - Birth 10 Average Men Women 83.1 Stats Can 2008 data last modified 09/27/2011
Predicted Life Expectancy - Birth 11 Average Provincial Range (6 years) Men – 79.2 Provincial Range 72.5 – 79.2 (7 years) Women – 83.6 Provincial Range 78.5 – 83.6 (5 years) Stats Can 2008 data last modified 09/27/2011
Predicted Life Expectancy - Birth 12 Average 80.9 ON 81.3 Men ON 79.0 Women ON 83.4 Stats Can 2008 data last modified 09/27/2011
Predicted Life Expectancy - Age Combined = 85.0 (+ 4.1 years ) 83.3 Men = 83.3 (+ 4.8 years ) 86.5 Women = 86.5 (+ 3.4 years ) 3.2 year gap between W > M (- 1.3 years gap) Stats Can 2008 data last modified 09/27/2011
Ray Kruzweil - Futurist 14 IT doubling every yr in exponential manner 1960s computer = ½ MIT 2010 cell phone = 1,000 x powerful, 1m x cheaper and 1 m x smaller = 1b x improved price/performance 2037 (25 years) = 1 b x more powerful and 100,000 x smaller = size of a blood cell
Ray Kruzweil - Futurist (2) (27 years) = reverse engineer brains = A.I (33 years) = “Singularity” Technology > Human brains Will need to amplify our brains with technology Will spend majority of life in VR (38 years) = extension of life Human aging and illness will be reversed World hunger and poverty will be solved We will “cure” death – “immortality medicine”
Ray Kruzweil – Futurist (3) 16 Within the next yrs (?) Genetics (biotechnology) reprogramming our biology for disease or death Nanotechnology keeping us healthy from the inside out Robotics combined with Artificial Intelligence
How many years are YOU going to live ? 17 For 1000’s years life expectancy = 25 yrs 1800’s = 37 yrs 1900’s = 48 yrs 1950’s = 65 yrs 1980’s = 75 yrs 2000’s = 80 yrs 1 in 6 alive today will live to be 100 Born in 2007 = 104 yrs - Lancet Journal and What age are you going to use for your financial planning ?
Our “SMART” Goal 18 To die at _100__ years of age How can I increase my How can I increase my odds of doing that ?
Objectives 19 As a result of this session, participants will : 1.Know what their expected lifespan is 2.Learn the secrets of living to 100 years old 3.Increase their odds of dying healthy 4.Understand how to age healthy 5.Learn how to take more control of their health 6.Identify your personalized next action steps for a “healthy now and in retirement”
Live to 100 = Centurions 20 In Okinawa, Japan studies show Low-stress lifestyle A diet that heavy on grains, fish, and vegetables light on meat, eggs, and dairy. Emphasis on walking and gardening. Older adults not isolated within community, taken care of and continue to work Spiritual sense of purpose Santrock. Physical Development and Biological Aging.
Live to 100 = Centurions 21 In Okinawa, Japan studies show Mind: Low-stress lifestyle Body: A diet that heavy on grains, fish, and vegetables light on meat, eggs, and dairy. Emphasis on walking and gardening. Social/Spirit: Older adults not isolated within community, taken care of and continue to work Spiritual sense of purpose Santrock. Physical Development and Biological Aging.
New England Centenarian Study 22 Centenarians handle stress better (resilient). If gave birth > 40 yrs old = 4 x chance of living to 100 Few are obese. Men are especially lean. Smoking history rare. Most have at least one old 1 st degree relative. Many children of centenarians (age ) follow parents’ footsteps - low rates heart disease, diabetes and mortality. 1 in 3 = no changes in their thinking abilities.
Predictors for Male Centurions 23 Are married Are not overweight Have low blood pressure Strong grip ( overall strength and fitness) Have high education level Have low blood sugar Avoids heavy drinking Do not smoke Have a low cholesterol. – JAMA Nov 2011
Keys to living real old (100) H 24 Diet: low meat, fish, high vegetables Lifestyle: education, don’t smoke, limit drinking, thin, active, marriage, don’t be poor Stress: low or well managed stress Social: Have lots of close friends, be a believer Purpose: family, community, work, volunteer Don’t get chronic disease (cardiac or cancer) Move to Japan and have really old parents Take and make changes !www.liveto100.com
Objectives 25 As a result of this session, participants will : 1.Know what their expected lifespan is 2.Learn the secrets of living to 100 years old 3.Increase their odds of dying healthy 4.Understand how to age healthy 5.Take more control of their health and care 6.Identify your next action steps for “health now and in retirement”
Our “SMART” Goal H 26 To die at _100__ years of age and To die of ____?______
27 1. Cancer H 29.6 % 2. Heart Disease H 21.3 % 3. Stroke H 5.8 % 4. Lung Disease 4.6 % 5. Accidents 4.3 % 6. Diabetes 3.8 % 7. Alzheimer's 2.8 % 8. Flu/Pneumonia 2.3 % 9. Kidney Disease 1.6 % 10. Suicide 1.6 % Sources: Statistics Canada, 2008 data, Last modified: Total (all causes of death)
Total (all causes of death) 29 CANADA 1. Cancer 2. Heart Disease 3. Stroke 4. Lung Disease 5. Accidental 6. Diabetes 7. Alzheimer's 8. Flu/Pneumonia 9. Kidney Disease 10. Suicide *Accidental – cars, drugs, guns, poison, drowning, falls UNITED STATES 1. Heart and Stroke Disease 2. Cancer 3. Accidental * 4. Lack of Health Insurance 5. Suicide 6. Infections (Sepsis) 7. Alcohol induced 8. Homicide 9. HIV 10. Hepatitis (liver disease) Statistics Canada, 2008 data Last modified: US data (2010)
Increase Odds of Dying Healthy Source: US data 2000 Wikipedia 30 DO NOT DO NOT: % of deaths 1. Smoke Have poor diet & be inactive Abuse alcohol Get infectious diseases Expose to Toxicants (Pollution) Have traffic accidents Have firearms accidents Get STDs.8 9. Abuse drugs.7__ %
Our “SMART” Goal H 31 To die at _100__ years of age and To die of natural causes “old age”
Objectives 32 As a result of this session, participants will : 1.Know what their expected lifespan is 2.Learn the secrets of living to 100 years old 3.Increase their odds of dying healthy Understand how to “age healthy” 4.Understand how to “age healthy” 5.Take more control of their health and care 6.Identify your next action steps for “health now and in retirement”
What is “Age” ? 33 Chronological – age based on birthday Biological H – age based on body (US) Must do a sign in Sends you personalized action plan Let’s you update scores / determine priorities Translates your data to a “Doctor’s Visit Plan” Yes your age can get “younger next year”
What is “Health” H ? 34 What does “health” mean to you ? How do you define it ? How do you decide if you have it ? Or don’t have it? How do you decide if someone else has it ? “Disease is gender specific, health is not”
Self - Rating of Health 35 22% excellent - 38% very good (60 %) 29% good - 11% poor health (40 %) No significant difference by sex More good - poor with age (+55) Varies with provinces Best health in NL and AB Sources: Statistics Canada ( 2005 data) Last modified:
Define “Health” ? 36 A person’s mind, body and spirit, being free of illness, injury or pain (Wikipedia) The level of functional or metabolic efficiency of a living being (Wikipedia) A state of complete physical, mental, and social well being and not merely the absence of disease or infirmity (WHO) Brain’s perfect adaptation of your body to the world it thinks you live in (YNY)
“Age Healthy” Pre-Requisites 37 An individual must be able to identify and to realize aspirations, satisfy needs, and change or cope with their environment. - Peace - Shelter - Education - Food - Stable eco-system - Equity - Social justice- Income - Sustainable resources WHO’s “Ottawa Charter for Health Promotion” 1986
How To Age Healthy 38 You may have to chronologically age but you can get “younger next year” biologically Key is to remember: “An ounce of prevention is worth a pound of cure”
39 Prevent cancers, BP, heart disease, stroke, lung disease and just about everything else... Men 24.3% Women 18.9% Best thing to improve your health... QUIT TODAY DrivenToQuit.ca contest open until Feb 29 H Quit for month of March and can win a Ford Fusion Second hand smoke effects – other adults, kids, pets Kids 300 x > asthma, ear infections “Smoking is the only form of socially acceptable suicide” Don’t Smoke H
Eat Right H 40 Prevent heart, diabetes, obesity, BP, dementia Use “Eat Right Ontario” dietician line Heart and Stroke Vegetables > White meat/fish > Red meat Fresh > Steamed > Broiled > Frozen* > Can* > Fried > Deep Fried No white sugar, flour, rice Mediterranean diet Accountability partners
Use of Supplements 41 Omega 3 Prevent heart, depression, dementia, cancer, arthritis Fortified food, 1 gm fish oil, algae Vitamin D Prevent cancer and arterial diseases 400-1,000 IU / day
NPN Supplements (2) 42 Health Canada: 8-digit Natural Product Number (NPN) on bottle Natural Health Products Database license if safe, effective and high quality If not licensed No pre - market evaluation or testing No specific disease prevention or treatment claim No manufacturing consistency assurance
Exercise, Exercise, Exercise 43 Prevents heart, obesity, BP, dementia, falls Improves energy, bones, muscle mass, self- confidence, increased independence Cardio, flexibility, balance and strength Even 5 minutes a day is better than zero Can still catch up if starting “late” in life Walking min most days will do it Key is find something you like to do
Limit Alcohol 44 Prevent Disease and Death Liver, pancreas, respiratory, immune > disease in women with > 1 drink/day Cognitive loss, depression, addiction Car accidents, falls, drowning, suicide 1/3 motor vehicle deaths alcohol related Average 9.8 Litres per person (Rank 46) Screen for addiction Men 5x > Women
Prevent Infections 45 Get vaccinations Influenza “flu” (Annually) Tetanus (every 10 years) Herpes Zoster “Shingles” (age 60 ) Pneumococcal “Pneumonia” (> age 65) Tropical Diseases (if traveling) Yellow Fever Meningococcal Hepatitis A and B Typhoid
Prevent Dental Decay 46 Screen for oral cancer, neurological issues, gum disease, TMJ, grinding (stress), nutritional deficits Prevent lung and heart disease, stroke and diabetes. Decay is from neglect not age. Floss daily Brush after meals, sweets, before bed Power brush or change out soft brush 3 months Use antiseptic mouthwash Have exams every 6-12 months (9 months PSHP) Canadian Dental Hygienist
Prevent Dementia Work out your brain – Stay curious Read Attend educational classes Learn a new hobby, skills or language Numbers/math games “Sudoku “ Laugh – 9 belly laughs a day Play an instrument Sense of mastery and control in something 2.Stay hydrated (brain > 70% water) - > 50 yrs thirst reflex decreased 3. Diet, Exercise, Socialize
Get Enough Sleep 48 Sleep is an active state not a passive one Regenerative, releases hormones Get 8 hours a night Same hours every day, 7 days a week Between pm and 6-7 am Sleep Hygiene No TV in bedroom Keep room very dark Have a “step down” time before bed
Take Smart Risks 49 Prevent Vehicle Accidents Use seat belts Drive within the speed limit Use bicycle helmets Follow boat safety training Prevent STDs Use condoms Prevent accidental weapons discharge Have weapon safety training and use lock up Prevent accidental overdoses Get rid of old pills Don’t mix pills and alcohol Don’t share/take other people’s pills
Develop Stress Resilience 50 Stress impacts life expectancy /health > 80% of Dr visits are stress related No one accepted definition yet Fight/ flight “stress” reaction Needs to go “on” and “off” appropriately Stress resilience is a learned skill set Positive Attitude, Thought Patterns, Exercise Sense of belonging, Meditation, Prayer, Gratitude
Emergency Preparedness (1) 51 CPR - You may have learned it... But has everyone around you ? 60% trainees did not feel confident to use CPR in an actual emergency New 2010 guidelines... Call 911 Start chest compressions – 2 inches deep Do to the beat of “Staying Alive” $35 kit/video from Teach your family, friends, and community 20 minutes
Emergency Preparedness (2) 52 Discuss the hard stuff now with your family 1. Organ Donation or Service Ontario 2. Living Will Advancecareplanning.ca 3. Power of Attorney - Personal Care 4. Funeral Plans
Emergency Preparedness (3) 53 Insurance Coverage Extended Health Care and Dental Travel Out of Country /Province Disability Critical Illness (need to get while healthy) Long Term Care Healthy Life Expectancy 73.0 (Ranks 20)
Emergency Preparation (4) 54 Primary Health Care Provider Family Doctor / Walk in Clinic Nurse Practitioner / Physician Assistant Naturopath Osteopath Chiropractor Podiatrist Psychologist Optometrist Dentist
Alternative Medicine Practioners 55 Unlicensed - No professional body oversight No standards or code of ethics No one to complain to if things go wrong Red Flags : Say THEY can heal you, vice helping YOU heal you Fear mongering against Western medicine Not interested to work with your doctor/team You need to go more often, not less to them over time You feel uncomfortable alone with them
Check for Age and Sex Specific Cancers 56 Breast H Prostate Colon Cervix Skin (Melanoma) Order more documents from form at back of binder H Or go to (province specific)www.cancer.ca
Check Blood Pressure 57 Prevent “silent killer” Heart disease and stroke. Get checked at least once a year Know your numbers If high at first, check at different times of day over at least 3 days Diet, exercise, stress reduction should be considered prior to medications.
Check Cholesterol Levels 58 Prevent heart disease and stroke Not everyone needs to... Men > 40 Women > 50 or postmenopausal People who have diabetes, BP, smoke or obesity Family hx premature heart disease or stroke People with physical signs of high cholesterol (fatty deposits under the skin; xanthoma or xanthelasma) People with vascular or coronary artery disease
Check if you are Obese 59 Negative health impact on about everything 28.4% M (Rank 27) and 29.5% W (Rank 65) Rates 2 x higher then 1980 BMI ( > 30 kg/m 2 ) Waist Circumference Pear verses Apple 40”/102 cm Men : 35”/ 88 cm Women “To feel fit as a fiddle you must tone down your middle.” ~Author unknown
Check for Diabetes 60 Not recommended for routine screening ! Only if high BP and/or Cholesterol (“Fair”) Overweight (BMI > 25) and signs of intolerance Lifestyle interventions (“Good” ) Metformin or acarbose (“Fair”) Canadian Diabetes Association Screen at 40 and every 3 years
Self-Check for Depression 61 2 weeks or more: Persistent sad, anxious or empty mood Feelings of hopelessness and pessimism Feelings of guilt, worthlessness or helplessness Loss of interest or pleasure in hobbies and activities Screening quiz - CMHA.ca Moodgym.anu.edu.au – educational modules (free)
Screen for Suicidal Ideation Canadians took own lives in 2010 7662 died of colon cancer and 5105 breast cancer Most are men aged Men 4x more successful then women Use more lethal means and have less warning signs Many have seen their doc in month ahead Many overdose on alcohol and prescribed drugs Know when, where and how to get help dcottawa.on.ca or Canadian Family Physician Vol 57 Feb 11 p 148
Age Healthy H 63 Don’t smoke Exercise Eat right Supplements Limit alcohol Get sleep Take Smart Risk Reduce Stress Cancer Screen BP Screen Cholesterol Screen Obesity Screen Depression Screen Suicidal Screen Prevent dementia Prevent infections Dental Care Emerg Preparedness
Objectives 64 As a result of this session, participants will : 1.Know what their expected lifespan is 2.Learn the secrets of living to 100 years old 3.Increase their odds of dying healthy 4.Understand how to age healthy 5. Take more control of their health and care 6.Identify your next action steps for “health now and in retirement”
Take control of your health and health care Keep a shadow medical file Keep journal of doctors, dates, tests, findings, symptoms 2.Internet Research Find support groups – social and often best info Best medical team and location Critical appraisal skills required 3.Understand the Canadian health care system Know how to navigate and advocate
Medical Files – who’s is it ? 66 Personal Health Information Protection Act (PHIPA) Doctor OWNS the records (Supreme Court). Must keep for 10 years after last entry (College Regulation) 30 years if occupational health practice related Doctor or Clinics = HEALTH INFORMATION CUSTODIAN (HIC) Gather, create, holds personal information as part of their job HIC/owner relationship is contractual Patient has right to ACCESS from owner or custodian. Access must be free, copying rarely is.... Ontario Medical Review Mar 2011
Internet Research - “Trust No One” 67 Critical Appraisal Skill Sets H What country ? Who is paying for the site ? Author’s Credentials ? Advertisements ? Type ? Selling Products ? Advertisements ? Last time page updated ? HonCode designation ? Prioritize using: Canadian Government, National Health Associations, Medical Institutions, Support Groups
Understanding the Health Care System 68 Medicare – SK – hospital “tertiary” care Health care system not on health or health care Rising costs #1 drugs and #2 salaries Taking from Peter to pay for Paul Need education, housing, poverty addressed too... Money isn’t going to solve this problem We need more “health” and less “health care”
Health Care System Health Transfers Agreement Will the system be restructured ? National vice provincial approaches Patient centric outcome measures Human Resource Management of caregivers
Need a “Seniors’ Health Policy” 70 Need Public Engagement (2014 PHA) Palliative care Home care City Planning Recreation for Seniors Transport for Seniors Social support for Seniors Public health programs for Seniors Long Term Care options and facilities Eldercare options
CARP (www.CARP.ca) 71 National, non-partisan, non-profit ‘New Vision of Aging (+45) for Canada’ promoting social change that will bring financial security equitable access to health care and freedom from discrimination Free newsletters on $, health, lifestyle, advocacy $15/yr membership open to all Free membership to partner (same address) Over 300,000 members to date Many benefits
CARP Health Wizard 72 Canadian Health Care Guide Finding care: health care provider, facility, program Managing your health: decision making, tests, treatments, caregivers Healthy living: workplace, nutrition, lifestyle, travel Health and Wellness Age specific screening guides Health conditions Medications (OTC, natural and prescription) Directories Community, groups, associations, provincial guides
CARP Health Wizard 73 Novus Health “leader in Canadian Health Navigation, delivers innovative online and telephone support solutions for today's complex health care environment”. “empowers the member to navigate the health care system and provides the trusted health information that they need to make informed health decisions”. Offered by insurance, employee programs etc Basic level free (higher levels for $)
Take control of your health and health care Keep a shadow medical file Keep journal of doctors, dates, tests, findings, symptoms 2.Internet Research Find support groups – social and often best info Best medical team and location Critical appraisal skills required 3. Becoming an “E-Patient” Understand the Canadian health care system Know how to self-navigate and self-advocate Advocate for a patient centric system
Health “Let Patients Help” 75 Health care, e-Health and Web 2.0 together Epatient (TED.com) = Epatientdave.com Empowered, Equipped, Engaged, Enabled, Equals, Emancipated and Experts Epatients.net “Health Care Providers Can’t Do It Alone” ParticipatoryMedicine.org Society of E-patients and Health Care Providers
Objectives 76 As a result of this session, participants will : 1.Know what their expected lifespan is 2.Learn the secrets of living to 100 years old 3.Increase their odds of dying healthy 4.Understand how to age healthy 5.Take more control of their health and care 6.Identify your personalized next action steps for a “healthy now and in retirement”
Retire Right (2009) Dr. Fraunfelder MD 77 Financial planning is not as important to a fulfilling retirement as many think- the psychological experience is just as crucial. The happiest retirees shared 8 key traits: 1. Plan ahead 2. Keep a healthy lifestyle 3. Engage in leisure activities 4. Lean on their support network 5. Maintain a positive attitude (of gratitude) 6. Accept change 7. Have a sense of purpose 8. Enjoy some expression of spirituality These are all skills. Skills can be strengthened, even learned from scratch.
I commit to not living like I will never die 2.not dying with my music still in me 3.considering more then just finances when deciding my retirement date 4.using 100 for my financial planning life expectancy 5.finding out my chronological life expectancy 6.finding out my present biological age
I commit to self-rating my health as excellent 8. never starting to smoke 9. not exposing myself to second hand smoke 10. cutting back on my smoking 11. sign up to driventoquit.ca and Quitting ! 12. annual medical check ups 13. annual dental visits 14. doing my age / sex specific medical screening
I commit to keeping a “healthy” waist circumference 16. “working out” my brain daily 17. learning a new instrument, skill or language 18. laughing every day 19. doing a daily act of random kindness 20. developing an attitude of gratitude 21. learning CPR with my family and friends 22. volunteering in my community 23. spending more time nurturing relationships 1.
I commit to becoming an organ donor 25. making a living will and POA - Personal Care 26. researching critical illness and LTC insurance 27. defining my own “medical team” 28. knowing the signs and symptoms of strokes 29. knowing the signs and symptoms of heart attack 30. knowing the signs and symptoms of depression 31. knowing where to find help for depression
I commit to shopping for healthier food 33. cooking in a more healthy manner 34. eating more at lunch and less at dinner 35. having breakfast every day 34. walking for min most days 35. starting exercise for 5 min a day (if at 0 now) 36. checking my stress levels quizwww.cmha.ca 37. finding a new “stress buster” strategy
I commit to learning to meditate 39. knowing my blood pressure numbers 40. limiting my alcohol intake 41. screening myself for alcoholism 42. always wearing my seat belt 43. joining FSNA for the travel insurance 44. joining CARP for the health wizard 45. joining FSNA/CARP for the advocacy
I commit to making my own medical file/chart 47. critically appraising all internet health research 48. learning more about the health care system 49. becoming an e-patient 50. becoming engaged in the 2014 health care accord.... My life is my health and my health is my life... I am going to live to 100 and die of natural causes I am going to live to 100 and die of natural causes !
I “SMART” commit to
Feedback 86 (1) What worked (2) What didn’t work (3) What would you like to see changed for the next lecture? How can it be improved ? me: Talk to me: at break Course Critique Course notes will be posted within 24 hours to