There's a change for the reason why someone might go to the gym from, "I wanna look good in my clothes," to, "I just wanna remain independent." And so that activity and that going to the gym, doing maybe a little bit of weight training and keeping their endurance up, really impacts their ability to stay independent. If they are aware of that early on, then hopefully that'll translate into less loss of function. It definitely is a very serious conversation that I have with any patient of mine who talks about retirement, and so just to remind them that if you worked 12, 15 hours, 16 hours a day, our bodies are really not designed to go from 60 to zero.

And so, you need to give some serious thought to what you're gonna do with your time, because if you don't do that, then your medical issues have a way of surfacing and really taking over. So one of the things I ask my retirees to do is to take advantage of Silver Sneakers, which I believe is available to those who are 65 and older, and go to the gym. And it turns out that those seniors who are serious about their health are usually there between about 7:30 in the morning and about 9:00. And all of them are not in great shape, but the, the point is that they are deliberately trying to maximize their, their activity and health.

There are a number of things that communities can do to increase activity levels with seniors. They can put together programs that are for seniors, so they may have a senior walk. They may have a senior hour.

They may have some adaptive-type activities, for instance, something like chair yoga, and certainly making seniors welcome, the ones who have higher levels of functioning, making them welcome in some of the other programs that are available. The electronics can make access easier for seniors. However, a lot of seniors are not interested. some of them don't have computers. some of them don't have grandkids to help them do it, so there, there can definitely be some barriers. But if they can embrace the change of technology, then there definitely can be some very interesting adjuncts to their health, everything from getting just health information, being able to Google and ask a question about health, to accessing some of the exercise programs that they find online, or other kind of information about nutrition and, and various topics.

Telehealth can be an excellent way of accessing care. We really, really embraced telehealth during the pandemic because there were offices that were closed, but telehealth allowed us to maintain some contact with patient. And I'll just be transparent in saying that the skills of observation become very important, and there really is a lot that you can tell by actually being able to look at someone online, hear them speak, hear them cough, see what their energy levels look like. There's really a lot of information that can be gathered, and so it wasn't as deficient care as, as I feared.

And so that can be, that can be very, very helpful, especially if and when transportation might be an issue or You know, there can be a number of barriers.

There are some guidelines that need to be followed in order to stay within the, the guidelines of proper telemedicine, but those things are, you know, taken into consideration. Telemedicine can be a very, very helpful, very, very helpful tool. The impact of mental health on physical health can be devastating if their mental health has deteriorated to the point of not being able to communicate, not being able to remember, not being able to handle their activities of daily life, as we call them, cooking and cleaning and showering and, you know, those kind of things. The, the loss of the, the mental capacity can, can be devastating.

Now, particularly for someone who has some physical, ailments that require a certain type of care, if mentally they're not fully engaged, you know, they, they can really have some significant losses in function. Recruiting family members to help out is important, but we also have access to home health, and that can be anything from someone to come in and help with bathing or cooking or, you know, whatever the needs may be. So there are provisions in place, and of course, depending on what type of insurance the patient has and what kind of community they lived in, there, there may be more or less services available.

Resources for caregivers can be support groups, and then there is something called respite, where the patient may go to a facility for a short period of time while the caregiver has vacation or time off. The services, home health and those kind of things, can also be a big help to the caregivers as well, so that their burden is not as heavy with respect to the, the day-to-day activity.