Town&Style

Aging Gracefully

Caring for your mental and physical health will help you enjoy your retirement years. Read advice from local experts about keeping your spirits high and your feet and teeth in good shape.

[at a glance]

Keeping anything running smoothly once it’s a ‘classic’ can be summed up in two words:
preventive maintenance. That includes ourselves. If we started long ago, we’re more likely to be in good shape as we roll through our senior years. But it’s never too late to get that tune-up.

Keep up with regular dental maintenance, like checkups, brushing and flossing. Repair anything that needs it immediately.
Avoid tobacco, sweets, caffeine and alcohol. But if you indulge, and can’t brush, wash out your mouth with water immediately afterward.
Drink plenty of water to keep the mouth hydrated.
Wear orthotics to support the arches; even inexpensive ones are better than going without.
Wear supportive shoes with good arch and heel support, as well as roomy toe boxes.
Briefly ice your feet if they are sore after activity. If you tend to suffer from foot pain, use a prescription topical anti-inflammatory before activity.
Consider death and grief to be normal parts of life, and turn to loved ones for support.
Talk to family members and friends about end-of-life plans and feelings.
Keep active and productive to make your days enjoyable and meaningful.

[living with loss]

“Loss is a part of everyday life. As we get older, time amplifies the opportunities for that to happen,” says Rachel Hasper, M.A., LPC, of Rachel Hasper Therapy in Webster Groves. “When we reach middle to late adulthood the losses start to build,” agrees Priscilla Bass-Timmerberg, Ph.D., LPC, of Life Transitions Counseling in Webster Groves. “We lose parents, maybe a sibling, then maybe contemporaries. Those connections are important to us.”

Loss will be experienced not only from death; we may personally face limitations in mobility or health, Hasper adds. Many of us eventually will be forced to move from our homes, maybe to distant cities, cutting ties to friends, hobbies and favorite places. And, notes Bass-Timmerberg, we also will be saddened by the health issues of friends and relatives. “You are going to know a wide range of people who are very healthy to very ill,” she says. “In your group somebody is going to have Alzheimer’s disease or dementia.”

How do we make the best of these years of loss? “The conversation has to be about how we learn to carry grief and how we mourn in a healthy way,” Hasper advises. “Death is almost a taboo topic. We need to feel safe enough to talk about it.”

“Teenagers think death is a random thing, but we know as we age that death will touch us,” adds Bass-Timmerberg. “We can prepare by talking to our families. I am talking to my kids about how I want the end stage of my life to be.” Both counselors stress the power of relationships and activities as sources of energy during dark times.

“Over time you really begin to cherish the relationships you have left,” says Bass-Timmerberg. “It will come down to the point where you are all adults who no longer have parents. The people who make the easiest transitions have close relationships as well as some religious or spiritual belief in which they find comfort.”

“Take care of yourself,” Hasper emphasizes. “Stay active, exercise, keep yourself engaged with people who remain. Have a sense of purpose. Wake up in the morning and have a reason to be there. Being productive helps you have a good outlook on life and keeps your mind sharp. Finding ways to carry on traditions also is helpful and comforting.”

People who are grieving should not hesitate to reach out to close friends and relatives. “Asking for help is a difficult thing,” Hasper says. “Many don’t want others to be bothered by their sadness. But reaching out is a gift to people on the outside—people who care about you want to help but might not know what to do.”

Grief is a normal and necessary part of life, Hasper points out. “Sharing old stories with friends is a way to keep memories alive. We can become comfortable enough to enjoy those rememberings after we have gone through the sadness,” she says.

Confronting death in a healthy way also can clear a path toward our own passing, adds Bass-Timmerberg. “In the last stage of life, you can focus on making sure you have done what you wanted to do and handled the things you can make peace with.”

[comfort first]

You know that famous quote about death and taxes? Well, it should be revised to read, three things are inevitable in life: death, taxes and sore feet.

A lifetime of pounding the pavement, along with the aging of tissues, leads to a number of irritating possibilities; the National Institute on Aging’s website lists no fewer than 10 significant foot problems that could become part of your life once you pass middle age.

“As everybody gets older, the structure of the foot starts to break down,” says Dr. Richard Lehman, founder and medical director of the U.S. Center for Sports Medicine in Kirkwood. “Your arch starts to collapse, so your foot becomes a little flatter. That starts to overload the tendons and muscles that support the inside of your foot.”

The foot becomes longer and wider, requiring evolving sizes of shoes. This degeneration also can cause arthritis—inflammation of the skeletal joints—and most significant, bunions, those swollen and tender joints at the base of the big toes.

An additional pain source can be hammertoes caused by shortening of tendons that control toe movements. This pulls toes backward, making joints larger
and stiffer to the point where they can rub painfully against shoes. “As you lose your arch and get some bunions and a little arthritis, you can have pain, stiffness and swelling, usually on the ball of the foot,” Lehman says.

His recommendations for dealing with foot pain do not include less exercise. “You want to remain as active as you can be,” he points out. He does, however, advise stretching exercises for the Achilles tendons and middle of the foot prior to exercise.

The first line of treatment for old feet is supportive shoes and an orthotic arch support, Lehman says. “I put all my patients in an orthotic. You don’t need to spend a lot of money—just go to the pharmacy and get one made by Dr. Scholl’s.”

The prototypical supportive shoe will have support for the arch and heel, a deep toe box and a bit of sideways give, he notes. Shoes should have enough arch support to make you feel taller when you put them on, he adds. “That support also stabilizes your knees and back.” Major brands of sports shoes differ in approaches to the toe box. “Some have really good toe boxes and others are kind of narrow. A wider shoe may not look as good but it will be more comfortable,” Lehman says. Whatever style you buy, he suggests, “the more laces the better. For loafers, they say one size fits all, which means one size doesn’t fit anybody.” If your feet are sore after a long day of activity, he suggests icing them for five to 20 minutes.

People with severe foot pain after activity should ask their primary care physician about a prescription for a topical anti-inflammatory, he says. “If you know you are going to be walking or gardening for two or three hours, you want to use the anti-inflammatory an hour before you go out.” Topical anti-inflammatory medications are becoming the standard of care, he adds. “We’ve gotten away from the oral medications due to their side effects.”

If you really care about your feet, they should be pampered even around the house. “You should never go barefoot in your home,” Lehman says. “It doesn’t seem like much, but after an hour on a tile floor you could easily feel pain in the heel or bottom of the foot.” In medical terminology, that means plantar fasciitis, the straining of the ligament that connects the heel bone to the toes.

 [terrific teeth]

A healthy smile is important at any age. Even if we’ve managed to get to retirement with a full set of pearly whites, oral health care is far from over.

“Teeth are the subject matter of a grand masterpiece—your smile—that should radiate beauty throughout life,” says Dr. Peter J. Pagano of Artistic Dentistry in Creve Coeur. The teeth, gums and lips, he says, “have to be maintained to create facial beauty and a non-aged look on the face.”

The challenges of oral care can increase with age, adds Dr. Stuart D. Waite, whose practice, Dr. Waite and Associates, is based at Mercy Hospital in Creve Coeur. “Our mouths are always more susceptible to disease due to the bacteria that live there,” he points out. “Due to the aging process, medications and diet changes, sometimes our mouth can become dry, and as you suffer from dry mouth, you are more susceptible to a host of problems ranging from gum disease to tooth decay.”

Consistent, daily oral hygiene is a must, Waite says. The American Dental Association (ADA) recommends that seniors brush twice daily with fluoride toothpaste, floss once a day and regularly visit the dentist for checkups and cleanings. More attention also should be paid to the consumption of alcoholic or caffeinated beverages and sweets, he says. “The liquids we sometimes prefer to drink because they taste better than water can desiccate, or dry, the oral membranes of the mouth. Then the bacteria have the advantage.”

Instead of always having a sweet dessert, consider tempering that with some fresh fruit, Waite suggests. “The cup of coffee that gets us started in the morning or the glass of red wine at dinner don’t have to be avoided, we just have to know they have an impact. Having a glass of water after them to rinse the mouth is a minimum fix for rehydrating the tissues and cleaning the teeth.”

The ADA includes tobacco products in its list of what to keep out of the mouth—these can cause oral cancer, tooth discoloration, gum disease or tooth loss. “The ingredients in tobacco create a constriction of blood vessels, which prevents tissues from being fully oxygenated,” Pagano explains. “Toxins build up in these tissues because they aren’t carried off properly. That leads to generally unhealthy tissues that can become dried out, inflamed and discolored. The idea is to retard the effect of time on the body, but smoking accelerates the aging process.”

Gum disease and tooth decay take the sparkle right out of your smile. “If the gums are pink, tight and healthy, that looks great,” Pagano says. “If the gums are red, puffy and receded, they can create black triangles between the teeth. Receded gums make the teeth look longer and we can see the exposed roots.”

It’s unusual to reach retirement age without a bridge, implant or dentures in your mouth to replace destroyed or lost teeth. For replacing individual teeth, bridges can be less expensive but implants are likely to be more lasting, Pagano says. “Because a bridge is difficult to floss, there can be decay. A high percentage of bridges fail by the 10-year mark,” he says, “while implants are 98 percent successful and look the most like your natural teeth.”

Decades of dental wear may create another sign of aging, Pagano adds. “The distance between the chin and nose shortens as we get older, due to tooth wear or the loss of teeth. As the chewing tables wear, the teeth become shorter. We can rebuild the biting surfaces of the teeth to counter that.”

Oral health should never be overlooked—no matter your age. It takes lifelong discipline, but we’re rewarded with a mouthful of teeth that will serve us well—and a smile that can keep us looking younger and feeling happier.

by Rick Stoff

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