By Judy O’Gorman Alvarez
“There’s living well and there’s living long,” said Dr. Steve Swartz, an internist specializing in geriatric medicine in Middletown.
“You want to live well. You want to age gracefully but you want to age in a way that gives you a quality of life,” he said.
According to Swartz, there are several stressors in life, including physical, medical, financial and emotional. What he tries to impress on patients, and those who attend his talks for Meridian Health System, is how to balance or overcome those stressors and achieve that quality of life.
Swartz points out that there are certain catastrophic issues in life that you cannot change, but there are many hurdles in aging that you can control, with regular doctor visits, exercise, eating well.
“That’s all good, but it doesn’t necessarily give you a good quality of life … As you get older, you still need short- and long-term goals,” said Swartz, who is also the medical director at Care One at King James Rehabilitation in Atlantic Highlands. “That’s the key. You need friendship, hobbies, and you need to live each day as if it’s your last day.
“You want to make each day important and meaningful, not just to you, but to other people,” he said. “The most important aspect is you don’t want to be empty or feel loneliness.”
He said it’s important to treat any medical problems and abide by preventive measures, such as getting colonoscopies, shingles and pneumonia vaccines. “You need to treat medical problems and correct the things you can correct.”
Although growing older may mean making adjustments to diet, and physical activity, staying active is important to well being.
Eating healthy, however, may not be as easy as following the pyramid food guidelines that applied when people were younger.
For example, all those years of being told to eat your veggies may not be the advice to follow for patients recently started on Coumadin, an anticoagulant, who shouldn’t have fresh vegetables or green leafy salads, as they interfere with the Coumadin level.
The same thoughts apply for the age-old advice about exercising and keeping healthy. “That’s the other caveat,” Swartz said, “some people have diabetes or shortness of breath, heart or lung problems and they have difficulty walking.”
Swartz encourages those patients to try walking just a short distance or a few minutes at a time and then slowly increasing it over time.
“Water aerobics is wonderful for people with osteoarthritis or who are overweight,” he said. “It’s good for ankle, knee and back problems. Exercising in water is great.”
Swartz tries to help people deal with their medical situations –such as orthopedic or cardio issues. “You can have an impairment or you can have a disability,” he said.
“Someone can have impairment with a leg, but can get through the disability by using a walker or crutches.”
Shri Pagay, who was diagnosed with Parkinson’s disease, takes the Arthritis Foundation Exercise Class at The Community YMCA, Red Bank Family Health & Wellness Center on Maple Avenue, once a week. “It keeps me moving,” he said of the class that works on stretches, range of motion exercises and light weights. “It’s important for people with Parkinson’s and people with movement disorders.”
Pagay also attends the Y’s chair yoga classes, which helps with balance, and walks on the treadmill as often as he can.
Geriatric physicians look at all aspects of the patient. “If someone has a hip fracture, you can rehab them and send them home or figure out what could be their best bet,” Swartz said. “The medical problems and financial problems and emotional problems are more complicated from a geriatric point of view and family issues can be hard to get through.”
Making sure a senior citizen is not in danger or distress often falls to family, friends or neighbors. “It’s difficult when you’re dealing with someone who’s living alone, independent and has no support,” Swartz said.
If the patient has been hospitalized, social workers and case managers can help after they’re discharged. But sometimes Swartz realizes during a regular office visit that a patient is in need of help and will call on social workers or even a patient’s neighbors. Visiting physicians, who make house calls, are especially helpful for those living by themselves and housebound.
Most times “family and friends have to motivate people,” he said. “They have to take them out, get them to activities.”
Lois Ashall of Middletown goes to the Middletown Senior Center for the Senior Shape-Up session three times a week for a workout.
“I got into it after my husband passed away almost 18 years ago,” she said. “I have high blood pressure and the doctor said exercise was good.”
She and a core group of up to 15 women – and a few men – attend regularly and currently are following a Richard Simmons for seniors 40-minute videotape. “It’s easy to follow and we really enjoy it. In bad weather, we really miss it.”
Ashall makes a point of keeping busy almost every day. For many years she read to children at a nearby elementary school and belongs to a couple of senior citizens groups.
“I also knit for St. Mary’s Church and I knit for the senior center,” she said. “I try to keep active every day.”
Swartz said staying active mentally and physically is important. “At the end of life, someone can say ‘I made a difference to other people’ s lives. In some way I’m fulfilling my short- and long-term goals,’” the physician said. “Doing that and doing all the other things you should do, will give you a good quality of life.”