Ask HN: Best Preventative for Aging Parents? | Hacker News Reader

Ask HN: Best Preventative for Aging Parents?

51 pointscaddddr79 comments

Could people with aging parents / older people make recommendations for others? Just wondering if there any simple actions I could suggest to help them healthwise mentally / physically.

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Daily exercise + healthy nutrition + good sleep + social involvement.

If your parents are farther along, then be sure you create a care plan so you can continue to help them.

I maintain a free open source care plan template:

https://github.com/joelparkerhenderson/care-plan

Everyone should be into exercise, nutrition, sleep and social interactions.

It does not matter how old you are. You can build a foundation right now that is going to help you have a good quality of life for decades.

I only skimmed your list, but I didn't see anything about cataloging assets (e.g. bank accounts, 401-ks, real estate, treasury bonds, loans) and debts. If I die tomorrow, the executor of my estate is going to have a job finding all my assets.

Also maybe list something about pets and where they should go.

Great point. What do you think would be good to add, in more detail?

You can email me joel@joelparkerhenderson.com or do a GitHub issue or PR. Any help you can provide is very much appreciated!

> Great point. What do you think would be good to add, in more detail?

The Archdiocese of Toronto has a pretty good estate planning PDF with decent checklists and boxes to fill out with information: individual, spouse, children/dependents, real estate (principal residence, rec property, rental units), bank accounts, safety deposit boxes, vehicles, assets/investments, insurance policies, advisors (lawyer, physician, accountant), will/trustees, desired beneficiaries, power of attorney, funeral/burial:

* https://www.catholic-cemeteries.ca/wp-content/uploads/2024/0...

Thank you. I'll add all those areas this week.

The Houston SPCA had a very good presentation on Estate Planning and Your Pets. It covered the basics of estate planning, and then covered the specifics about pets. The speaker also addressed planning for incapacity.

[0] https://youtu.be/kPt9B8_shwQ?t=1370

Thank you. Great video. I added info for pets. I also emailed the speaker to invite his help.

> Daily exercise

For some possible motivation, some fitness instructors that are 80 years old:

* https://toronto.ctvnews.ca/i-m-a-super-lucky-healthy-person-...

* https://www.dallasnews.com/news/healthy-living/2016/09/27/th...

second person posts to her instagram where you can track her progress 7 years later: https://www.instagram.com/p/CxtNiI6pM49/

> Daily exercise

This can simply be walking a lot, especially if you're in a more urban area, where you don't have to drive everywhere (either figuratively or literally).

See "The Gym of Life":

* https://www.youtube.com/watch?v=KPUlgSRn6e0

Strength training is probably the number one predictor of long-term quality of life. I wish I could recall where I read it so I could offer more than anecdote, but essentially the ability to carry weight is a predictor of your ability to balance and not fall. Lifting weights also increases your bone density which lowers the risk of falls.

In many cases a bad fall precedes deteriorating health and lowered quality of life until the person is ultimately rendered unable to move on their own.

Life heavy things. Don’t overdo it. Try to life heavier things with time. The earlier you start, the better off you are.

VO2 Max is the number one predictor not "strength training".

Strenght training is corellated with increased bone density and slowing down muscle loss as you age. It's really important.

Also, strength training does not necessarily mean benching 3 plates. Also it does not mean 0 cardio.

Absolutely. I just wanted to get the facts straight that VO2 max is absolutely the most important thing. No reason to not just do everything however. Reaching the point of diminishing returns for VO2 max and strength training is not that difficult and is even easier to maintain than it is to gain.

> Reaching the point of diminishing returns for VO2 max and strength training is not that difficult

wondering why do you think so about VO2 max? This is my focus, and I see slow but linear growth over many years.

The point of diminishing returns for benefits to longevity is reached after exercising a couple hours a week for a few years consistently. Then you just need to maintain that. VO2 Max itself can still improve over time but the effect on longevity is not as significant.

I am wondering what is actual curve in that study.

When body will start fading, and maintaining will be harder, then developed buffer may start playing more significant role.

I have been incredibly out of shape and overweight most of my life. In the last year I've managed to lose a lot of weight and I started weight training about 8~ months ago. I saw my VO2 go from 33 to 39 (which is still quite low) at a very steady rate and then all of a sudden just plateau at 39. Was absolutely annoying because I thought I had only a month or two left before I hit that 50%/Absolute Average point for my age :(

Sadly (for me), I think this means I actually have to start doing cardio.

This is oversimplified. Strength training and VO2 max are not mutually exclusive from each other.

overlap is small though

agreed wrt falls and, moreover, being stronger/better balanced also mitigates the damage for the falls that do happen.

I’d recommend StrongLifts 5x5 as a good starting point for anyone who, like me, procrastinates for years due to being totally overwhelmed by the sheer volume of conflicting advice on where to start. It focuses on the five major compound exercises, needs minimal equipment found at any gym (or cheaply secondhand) and is quick (30ish minutes 3x per week).

> I’d recommend StrongLifts 5x5 […]

SL is a convenient (free; with paid upgrade) app that gets the basic going, but it is basically a copy of the Starting Strength program/book.

* https://startingstrength.com/get-started/programs

* https://www.youtube.com/playlist?list=PLNhFKPjedRnQ_qs4ID5gl...

* https://www.youtube.com/@startingstrength/videos

Adjacent to this, I recommend reading (and perhaps even sharing with your parents) “Being Mortal” by Atul Gawande. It is a masterpiece on the reality of aging and what is important in managing the process towards a good life and ultimately death.

As someone dealing with a long term, chronic, progressive and currently incurable condition I can say that for me it really helped to find a better focus and conversation around what is important and how to communicate needs and desires towards good outcomes.

There is no prevention to aging 8-/

matheusmoreira's recommendation sums it up: Nutritious diet and as much exercise as possible.

Dementia is really the worst case scenario. A friend in Germany recently allowed her mother to stop eating, leading to death, in order to avoid further mental decline.

Death is inevitable, the best hope is a healthy happy live until death. So let your parents do whatever they want, don't try to coral them into what seems best to you...

Make sure they keep on top of getting sight & hearing checked, and encourage getting things fixed - my MIL has quite considerable cognitive decline, and with a bunch of ableism and anxiety resisted things like cataract surgery and hearing aids which I suspect could have kept her more engaged with the world for longer - I don't know if it would have made a BIG difference but still worth doing.

Also, support them to move to more supported living arrangements (or living arrangements with step-up care available) before they need it. It would allow better decision-making, and allows more agency to the aging parent.

Hydration.

Many symptoms of inadequate hydration include confusion, memory loss, and balance issues which are often interpreted as early onset dementia. Especially if blood tests don't indicate actual dehydration.

Watch for the flags: minor headache, slight nausea, blood pressure and pulse fluctuations, and constipation to name a few.

And always be skeptical and knowledgeable about the medications prescribed. Learn the side-effects and be ever vigilant about the recommended dosage.

This!

They test for dementia at the hospitals. Unfortunately these tests also say "Dementia! Put them in a home!" if they simply didn't drink enough and let's face it, hospital staff just don't have the resources to ensure everyone drinks enough.

This happened to us and we luckily were aware, gave them enough to drink on our own and everything was completely fine. No dementia whatsoever.

Don't be a nag. If they want to exercise, hydrate, etc they will do so on their own. If they don't, you'll just be annoying.

That said. I did nag my elderly mother about her terrible mattress and couch that were causing back issues. She replaced both and says her back has improved. It's difficult to know how much advice to give. She's always been independent and will resent too much even if it's helpful.

Objectively, "frailty" is the medical term for the inability to move resiliently, which causes a cascade of problems from becoming sedentary.

Subjectively, interventions commonly fail because they have to be precisely tailored to what's possible and desirable from the subject's perspective. As a family member, you quickly lose credibility when insisting on activities that make them uncomfortable.

The aging mind ends up with pockets of confidence surrounded by undifferentiated fear when outside that comfort zone. Risks like breaking a hip and the imminence of death in general will shrink anyone's comfort zones.

We high-achieving people generally only deal with others who are similarly flexible, so we end up with little insight, understanding, or patience for dealing with difficult people - people whose range is scattered or chaotic. We often don't even recognize there is a problem with people who hide behind acceptable patterns and thus present as rigid but strong.

Finally, age often separates couples: first they no longer share activities, and then their perspectives shift, but all that is hidden since they are essentially trapped together. It's particularly difficult for children to interact with each parent separately in a way that respects their emerging differences; the parents typically aim for a united front, and to prevent their children from having to care for them.

Being close to each parent is a lot of work, but that love make even the end of life worthwhile, and it can dispel much of the existential fear that isolates the elderly. If you find healthy habits you can do together, so much the better.

Most important is to let them lead when they can, and to get them used to taking advice when they need to. They need to both be themselves, and to flex into their new selves gracefully.

I will throw in some rare stuff: Contact your local fire department. Have them set up a "caution note" for your parents' address detailing any particular illness that might matter, like oxygen for COPD, restricted movement, and so forth. This will get pushed to the dispatch center. This note will be automatically added to what is essentially a trouble ticket for first responders once there is a call. Additionally, ask to have a "Knox Box" installed. That contains a key the firefighters can get to so they don't have to break down the door in case someone cannot get to the door. Seconds count, and they like to know what they're dealing with before they go through that door.

Get some legal stuff out of the way. This is apparently hard. I can't even find a lawyer to talk to me about the questions I have. I'm willing to pay! So this may take longer than you'd like.

Just taking a short walk each day.

It's a good habit, doesn't feel like exercise, and helps the whole body.

(My brain found the question perplexing: how does one prevent having parents? How prevent them from getting older? Obvious solution seems simple but has terrible repercussions. Most emphatically don't listen to my brain.)

highly recommend the book Outlive [0] by Dr Peter Attia. My dad's taken a lot of the advice to heart and is in much better shape than I am now!

[0] https://peterattiamd.com/outlive/

Second that. Joe Rogan's interview with Dr Peter Attia is also quite good. See: https://www.dailymotion.com/video/x8jrpbm

The podcast is also excellent: https://peterattiamd.com/podcast/

Why: He's a very skeptical, very good scientist, trained as a surgeon, and thinks like an engineer/mathematician, while also having been a life-long athlete (he swam from Catalina to Long Beach more than once).

You would probably benefit from re-asking more specific forms of this question.

Physically: strength training. low impact aerobic (walking lots and lots)

Mentally: Something to engage the think-melon. The bridge club gang seems to stay sharp far better than the average couch potato.

(1) Motion detection lights above every doorway in the house. (2) Anti-slip pads beneath every carpet. (3) Guardrails and grip points in places where you normally wouldn't consider it (e.g. garden).

I knew the people who made GrandCare. Its some non-invasive monitors in the house -- basically the point is if your mom fell down and can't get up -- it should detect it and alert you. I've not used it, but they've been in business for a while now so I assume its alright.

Nutritious diet and as much exercise as possible. Sarcopenia is a major cause of immobility in the elderly. Lack of activity causes muscle loss which causes further lack of activity. The elderly also tend to have diminished appetite which contributes to that.

Strong, well maintained muscles also lead to generally higher stability. Which means reduced risk of falls, fractures and their complications.

Take care of their mental health. Depression and anxiety often manifest as cognitive impairment in the elderly. Deteriorating senses can cause social isolation and depression.

I don't know your situation, but my parents, who lived together, were considering assisted living. They got some advice that the cost of two people in assisted living was most likely more than the cost of a live-in caretaker (non-nursing, basic cooking and laundry) and this was probably the best decision they ever made. If they had gone into assisted living, most likely one or both of them would have ended up in a nursing home. Instead, they lived out their lives at home.

30 comments so far, and nobody has struck on the single most important thing you can do:

Talk to them. Listen to them. You will find everything else follows from there.

Strength training with weights + adequate protein intake, more than ok, if not probably even better frankly, to include whey protein powders maybe a couple times a week.

Commonality of many of the people who live well (i.e remain functional and independent, 90+ years old) is proximity to hills. Make what you will of that, but exercise involving uphill steps is probably important.

Community / friends, ideally with some sort of bond over hobbies or common interests. It’s one thing to sit together and chat but it’s another for them to get creative together.

Omega 3? Probably, but not through supplements. A balanced diet (Mediterranean diet probably easiest to look up) with good amounts of fish.

Only supplements that have ever made sense to me (apart from a very clear/documented deficient in something) are vitamin D and iron.

Get them gardening: https://www.bbc.com/worklife/article/20181210-gardening-coul...

Imagine a world where you spend $12k per month on assisted living. Yeah, it’s a fun ride.

I know a couple guys in that biz. Own assisted living villages. They are quite wealthy. One has an airplane AND a helicopter.

A lower carbohydrate diet is key to improving mental and physical health. More fat, less sugar. Read Big Fat Surprise [0].

Social interaction also seems to be key to healthy longevity, frailty can be a barrier to socialisation, as can be hearing loss.

However, your parents are their own people. You won't be able to force them to do anything they don't want to do, but you still need to love them even if they won't listen.

[0] https://ninateicholz.com/about/the-big-fat-surprise/

Other than the general physical (walking and others but need to be careful: falling and breaking bones is a significant cause of loss of quality of life) and mental (sudoku, Jeopardy, reading news from Internet, learning a new language) I would say the most important thing is to routinely be in contact with them using remote video calls. This serves two purposes: (1) Keeps them connected, mentally alert and feeling valued and (2) it will provide you a quick way to assess their condition and notice and red flags early.

The question for me is, how do I convince them to do anything? I've tried sharing all the stats, buying them a peloton, using scare tactics. Everything. At a certain point you can't convince someone to do anything and unfortunately as one of their children I will have to take care of them like adult toddlers and watch them decline.

Just trying to convince my dad to not fall asleep on his couch watching tv is impossible. They are actually hopeless and I'm already starting to see signs of dementia.

When you get to his age, you'll have seen and experienced enough to realize activities and fitness and diet are all bullshit. You, like your dad, will just want to be comfortable.

Yeah, they aren't bullshit and I will be the one to suffer because I will take care of him since he was a good father.

Not necessarily simple.

1) Keep moving. Exercise and stretch. Even if it takes half an hour to get going, don't just sit in a chair all day or soon you won't be able to do anything but sit in a chair.

2) Go to the doctor regularly. Listen to them.

3) Encourage them to downsize their home and move into something wheelchair accessible or even assisted living before it becomes medically necessary. This can be really hard for some people to admit that it needs to happen, but it's A LOT harder for everyone when it's forced.

1) Keep moving. Exercise and stretch. Even if it takes half an hour to get going, don't just sit in a chair all day or soon you won't be able to do anything but sit in a chair.

Dad got his mom a physical therapist and she comes multiple times a week to help her either move or just do like light arm workouts

That's fantastic. My hope is that I'll remember this stuff for myself as I get older.

Honestly, to get some friends. Wife's dad is divorced and retired. All his friends were work friends and he didn't realize and as soon as he wasn't at work anymore he didn't see them anymore. Now he just sits at home with nothing to do as he made his whole life about work.

So I would very much encourage everyone to get some friends and hobbies before you retire.

What is true specifically with those last three words remains true in general without them.

Was a recent study about having a pet as well helping with staving of cognitive decline as well:

https://www.msn.com/en-us/health/other/pets-appear-to-slow-c...

Simple is difficult. I like some of the suggestions here, re diet, walking, building strength, getting legal stuff into trusts or joint ownership, etc. but let me say this:

I am 75 and some of this is scary. I AM that old parent. I live alone post divorce in the boondocks (Sierra Foothills) and thought that friends would flock to my place. Wrong. It is beautiful and I take fabulous photos without leaving the property, but all my friends are 50 miles away, the Bay is 150 miles away, and family is spread out. Good friends are essential. Loneliness is a killer of older people. I may actually move this year.

Next stop (hint, hint ) I am going to get a new bed and mattress, and lazy boy. Couches and cheap chairs are back killers.

I also suggest having someone clean now and then, and a handy-person nearby for minor things, and also to find professionals when something major needs work. This extends to health. A sharp friend might spot some minor problem that isn’t minor.

I do get out and work out with the chainsaws. Heck, trees fall in the storms. This is not for everyone. Nor is climbing. I live on a ridge and everything’s a climb. Can’t complain about the exercise. Walking is great. I’ll use the elliptical that I used when we lived in flatland when I move. Family got me an Apple watch, which nags me to move, stand and exercise. Exercise doesn’t really count until you punch “Workout”.

Mentally, I have no TV. That’s a big win for sanity. I love classical music and play as much and as well as I can. Music is great for the mind and nerves. Playing is a challenge for the brain and motor circuits. Puzzles are good. I have been an amateur photographer for over 50 years. If I’m not wandering around the property, grabbing sunrises and sunsets, I do get out, and plan to get out more. Driving is a PITA for seniors (not all of them) so a small group photo outing is great and I plan to do so when there are people nearby to recruit. Phones have popularized (good) and also trivialized (bad) photography. But it’s a challenge to stand out from the ordinary selfie world.

A big vote for strength exercises. Muscles protect joints. Period.

A second boost for getting some help now and then. When my daughter visited, she did a lot of cleaning and straightening up that gave me a head start in my attempts to single-handedly create some order out of chaos. Much appreciated. Also, I’d really like to give away some excess items, but she lives in a tiny condo, which is frustrating. If folks mention unused items, offer to take the items away for them.

I’d garden but deer eat everything here outside of a 7 foot fence, and gophers and rabbits get the rest. I used to grow roses and a few veggies. Gardening (when it’s not warfare) is a great hobby. My grandfather came from the old country and had a big garden, so I’ve been doing it almost all my life.

Encourage! Visit. Get friends to visit. If they’re old like me, they probably grew up in the 60’s. Bring brownies. Bring good food or somehow have it sent, that’s out of the ordinary good or a pain to make. One way to help oneself is to help others. If I weren’t so isolated, I’d be repairing things for other seniors. A friend was transitioning off SLR’s and is batshit happy that I showed off and recommended my mirrorless camera. Seeing for real and chatting with others and helping them is a way to get one’s own troubles off the front burner onto the back burner.

Find old photos, or have them find and catalog them. Helps with memory. I scanned all the old photos my parents had collected. I have no problem with memory, except short-term, so I got a bunch of air-tags to go along with the Apple Watch my family bought me for my birthday (nice!) My mind just gets overloaded by reading Hacker News, of course.

And if they’re not computer-savvy, offer some help. On my “other than HN” haunt, I offer help whenever I can. It’s a good feeling. (Karma instead of paycheck, oh well). HTH.

Daily exercise outdoors. Social engagement. Making them feel useful and cared for. I think multigenerational households are great.

There is no preventing death but people can be healthy and feel valued into great old age with family, community support.

Additionally I think futile medical procedures or efforts toward the end of life should be avoided. Quality of life over quantity.

I am an aging parent, although possibly not as old as yours.

Why would I want random advice on health that my son obtained from a tech forum?

Weigh the advice on its own merits, regardless of source. You can always experiment with things like increasing hydration, mobility, lifting weights, and see if they help you. Those are hardly risky endeavors.

Not a health suggestion, but I would get the power of attorney and advanced care directives done while they are sentient. Dealing with a dementia/Alzheimer's parent would be 100x worse on my sister and I without those instruments already in place.

Compound weight training has been shown to increase bone density and decrease cognitive decline in the elderly regardless of gender. Even starting at a later age (60+) still shows many positive benefits in anecdotal and scientific studies.

Limit drinking

daily physical exercise

keep a healthy weight

moderate caffeine intake

high antioxidant, omega 3, nut, leafy green intake (Mediterranean diet)

active social life

Avoid smoking

Avoid drugs

That is for people of all ages.

> moderate caffeine intake

is there any science for this?..

Don't forget financially, there's a lot of elder scams.

drive somewhere nearby and go short hiking. low risk, high reward. so many apps nowdays that list trails and difficulty.

I want to second this. So much of the health of the mind is related to doing new things, making new connections in the brain. If our parents keep doing the same old thing day after day, their brains are going to atrophy.

Find elderly walking clubs. You get age appropriate exercise and the ability to make friends, or at least acquaintances.

Introduce them to drugs.

"It's better to burn out than to rust." - attributed to James Dean

What help have they asked you for?

I'll just add swimming

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