What is wellbeing? Wellbeing is defined by the Oxford English Dictionary as “the state of being comfortable, healthy, or happy.” It’s the complex combination of our emotional, mental, physical and also social health. When the needs of each of these are met, it can promote life satisfaction, resilience to difficulties and overall happiness. Our environment can also play a huge factor in our well beingness. Recent studies have shown how pleasant surroundings can help to improve your mood and also affect your immune system. So does your home environment improve your wellbeing and, if so, how can you help to improve it? De-clutter the mess, so that you can de-stress Stress is a proven factor against contributing to your overall wellbeing. It can cause physical health problems such as hypertension and irritable bowel syndrome. Therefore, managing your stress levels is a key factor to consider when developing your home environment. An eyesore such as an untidy, dirty, or overwhelming environment can cause us to feel down, worried, or even helpless. As opposed to a well-organised, clean living space, which gives us a feeling of calm and contentedness. Free up space by having a spring clean and getting rid of things that you no longer need or enjoy Lighten up the place Studies show that natural daylight is associated with improved moods and energy levels. Therefore, it’s really important to make the most of the natural light available. Try to have light curtains or blinds in dark rooms and ensure that you don’t block the window space with bulky furniture. Using mirrors, opposite sources of light can also help to spread natural sunlight into the other corners of the room. To help assist your body clock, try using dimmable lighting prior to going to bed. This has been shown to also improve the quality of sleep itself. Be comfortable in your surroundings We all possess a strong desire to feel safe and secure, especially within our home environment. Physical comforts, such as the right temperature, are key to helping us feel relaxed and comfortable. Optimising home accessories such as bed linen and throws for example, can help us with this. During colder climates, you may want to consider having some small carpets and rugs over any cold floors, which you can then store away throughout the warmer months of the year, so that you can feel the coolness under your feet. Don’t neglect the senses When considering what to do with your space at home, it’s often quite tempting to just consider the visual aspects, such as colour combinations. But while colour is still a key factor in creating a relaxing space to enjoy, your other senses should also be put into consideration. For example, having fresh flowers and scented candles in your home can help to bring brightness and create a sense of wellness. Likewise, consider texture within your space. Large cushions and fluffy blankets can bring about good vibes which help you to feel more relaxed and cosier within your home. Be Natural Studies have shown that even just short contact with nature can significantly reduce stress levels. If you are lucky enough to have a view of nature, then make the most of it; plan your furniture layout so that you can enjoy it. If not, you could use indoor plants, terrariums, and artistic scenes of nature to help to create the effect of bringing the outside in. By creating a space that helps you to feel positive, peaceful and tidy, will help you to reflect those same values within your current mindset. Try it - have a look around you to see what you could change within your home environment, which you’d also like to change within yourself.
Saying goodbye to a loved one is never easy. No matter when it happens it can be a tough time. Being prepared and staying informed is the best way to approach a difficult situation like this. In this guide to planning a funeral, you'll find all the information you need about not only planning for your own funeral but the funeral of a loved one. Here are the areas that will be covered: How to put a plan in place for your own funeral. Typical funeral costs and what you should consider. How to go about choosing a funeral director and what are your options if you don’t want to go with a funeral director. Organising a funeral service and the considerations that need to be made with arranging the ceremony. How to plan a funeral for someone else; from how to register the death to informing the relevant institutions. A helpful guide to arranging the details on the day of the ceremony. What to expect after the funeral, dealing with legal and financial issues. Planning for your own funeral Are you planning your own funeral? You may want to leave clear instructions with your family in order to personalise your legacy. Discuss how you would like the funeral service to proceed and how you would like to handle the disposition of your body. This will make planning your funeral more straightforward while taking the weight off your loved one’s shoulders. Essential Funeral Planning Documents Organising your records and placing them in a safe place will make things a lot easier for whoever is responsible for taking care of your funeral or managing your estate. Before we get into the details of planning your own funeral there are a few documents that would be great to have sorted out ahead of time. Important end of life documents can include: Your Will Birth certificate Forms of ID Real estate documentation information like deeds or proof of ownership Information on financial assets i.e. your bank accounts, Life insurance policy Stocks, bonds or savings accounts Information on liabilities and debt i.e. mortgages, personal loans, credit cards. Gather all your important documents, put them somewhere for safekeeping. Then, inform one or two of your closest friends or family of the location of these items. Some of these items must be physical copies or originals like your birth certificate for instance, but other items can be stored digitally. This could be stored on a USB key or in an online document that can be accessed with a password. You could ask someone tech-savvy for help with this if you’re unsure. Choose whatever you’re most comfortable with. Just remember to let the right people know where and how to access these documents. Review your will One of the most important preparations to be done in advance of our death is the writing of a will. This legal document determines how your estate and assets are divided up after you die. You could leave money and property to relatives, however, you could also leave everything to a charity close to your heart. Determining who gets what eliminates the potential for ambiguity and rifts developing between relatives after your death. Discussing your wishes with your loved ones Discussing your wishes with your loved ones is an important part of planning your own funeral. When we don’t talk about our death with our loved ones, they’re left unprepared during a stressful time. Having a chat about your funeral wishes helps clear up any confusion. But what’s the best approach to such a sensitive subject? How to talk about your funeral Begin by preparing the details in advance, that way you know exactly what you would like to say, and you won’t leave anything important out. Consider what kind of funeral you would like. Maybe you don’t want a funeral at all - the point is, it’s up to you but you should know what you want before starting a conversation around it. There are plenty of options for you to choose from, the most important thing is that your wishes are realistic. Once you have everything clear in your mind, it’s time to start preparing the details. It’s important to make sure you cover all grounds, even if the conversation veers off-topic every so often. The best way to keep everything on track is with a checklist. Here’s an example of a list of funeral details that might be worthwhile discussing: Where would you like to hold the funeral? A church, your home, another venue? Burial vs Cremation - what’s your preference? Would you like a secular or religious funeral? Who will give the eulogy? What personal touches would you like to add i.e. music, video or photos? Would you prefer an open or closed casket? Who would you like the pallbearers to be? What funeral director would you like to go with? Payment, do you have life insurance or a funeral plan or will the family be expected to pay? Do you have a preference when it comes to burial garments, makeup, hair? How would you like the disposition of your body handled i.e. donated to science, ashes spread in a place of your choosing Be prepared for an emotional response Be prepared for emotions, it’s perfectly normal for people to react differently. Even if there are a few tears shed or there is tension, try your best to remain calm and carry on with the conversation until you’re positive you’ve made your wishes clear. If you wish, you can take this opportunity to discuss things like your will, life insurance beneficiaries, your estate. Having protection like over 50 life insurance can put your loved one’s mind at ease as it can be used towards funeral expenses. Make room for any questions your loved ones might have concerning your wishes. Disagreements could arise, be sure to stick to your guns but be open to hearing people’s opinions. Make it clear that you hear and respect what they have to say but it is you who should get the final say on how your assets, your funeral and any other details are handled. You want to end the conversation with a sense that there won’t be any confusion over details when the time comes. Funeral costs An important part of planning for your own funeral is deciding how you’re going to pay for it. More and more people are thinking ahead to try and take the stress and financial strain away from their families. If you’re thinking about paying for a funeral in advance, there are a few options you can consider. How much does a funeral cost? In the UK, the average estimated cost of a funeral is around £4,000. It can be a hard pill to swallow when we think about our loved ones being left out of pocket should the worst happen. However, that doesn’t mean people are preparing for the worst, only 22% of UK adults have life or funeral cover in place to cover the costs of their funeral*. With these shocking statistics in mind, it's more important than ever to have a plan in place for these costs. Making sure your family is protected doesn’t have to be stressful. With a little bit of planning you can feel proud you’ve helped to look after your loved ones. Some examples of how you can pay for your funeral: Money generated from your estate Out of your own pocket Funeral Plans Dipping into savings Over 50s Life insurance Saving for funeral expenses You can put aside a portion of your estate to help your relatives with the costs by yourself, without pension companies or financial providers getting involved. It could be a good idea to open a joint bank account with the person who will organise the funeral so they can withdraw the funds and then close the account upon your death. Different banks and building societies have different policies regarding the management of joint accounts so ensure that your needs will be met before signing any agreements. Funeral payment plans Prepaid funeral plans, which are also sometimes referred to as annuities, guarantee a certain level of service by allowing you to pay today’s prices for the type of funeral you want in the future. Funeral plan providers will offer a few different plans with varying levels of service (such as different types of coffin, the option of following limousines in the procession and so on). Customers purchase a plan and can either pay the full amount upfront or commit to a monthly fee. As important as it is to plan ahead when it comes to funerals, many people just don’t want to think about it. How can having Over 50 Life Insurance help me? Over 50s Life insurance can pay out a lump sum to your loved ones to help cover funeral costs. There will be various plans available, so it’s important to compare them as much as possible to ensure that you’re getting what you want (or as much as possible) from the plan you choose. Remember that you’ll also have to budget for what isn’t included. -Choosing a funeral director How do I choose a funeral director? Choosing a suitable funeral director is the first step as it’s their job to handle arrangements, with your guidance of course. You must meet with the funeral director at their office or in your home and you may need to meet with more than one funeral director to ensure that they are: able to provide you with everything you need offers it at an affordable price Before getting into the personalisation of the ceremony, they will take care of the practicalities like ensuring the handling of the body and the funeral service meets all legal, religious and personal guidelines. They will make sure that relevant paperwork has been transferred with little or no fuss, for instance, the Certificate of Burial or Cremation issued by the registrar once the death has been registered. You may or may not be aware of what kind of service the deceased would have wanted. If you’re unsure you can always ask the funeral director for advice, it is their area of expertise after all. To find a funeral director you know will maintain an exceptional level of professionalism, visit the National Association of Funeral Directors website to find a NAFD member. I don’t want to use a funeral director, what are my options? You can always take matters into your own hands when it comes to planning a funeral. DIY funerals can be a cost-effective alternative. Not only that but it could be a more personal send-off. Be aware that it may involve more planning, so expect to hold the funeral at a later date if the death was unexpected. Be sure to contact your local council if you want to arrange a funeral in your local cemetery or crematorium Disposition of the body These days, people have all sorts of strange requests when it comes to the disposition of their bodies. Gone are the days of the standard burial or cremation being the only way; being cryogenically frozen, turned into a diamond or a tree, being buried at sea and even being shot into space are gaining popularity. In many cases, the disposition of the body is important when determining the type of service you will hold. A burial, for instance, will involve a service in a church or another venue and then a subsequent burial service to follow, while a cremation usually consists of one service, ending with a committal where the coffin is taken into the crematorium. Arranging the ceremony The details of the funeral service will depend largely on the values, personality, interests, and beliefs of the person who is being honoured. Those who are organising the ceremony will know the deceased well enough to organise a meaningful service. It may be religious, non-religious, traditional, non-traditional or it may be simply a family celebrating the life of a loved one from the comfort of their own home. There are several ways to celebrate the life of someone you love, and there’s certainly no right or wrong way to do it. Where is the best place to have a funeral service? Again, this will depend on the type of funeral service. It may take place in a place of worship, a crematorium, a funeral home, a chapel at a cemetery or a family home. Open or closed casket You may consider holding an open-casket funeral assuming the body is intact. In some circumstances, the funeral director may advise against an open casket as sometimes the body may be in a later stage of decomposition or the cause of death has affected the body in such a way that might be upsetting for some. Choosing the perfect coffin, casket or urn When it comes to purchasing an urn or a casket, you may want to go down the route of a traditional high-quality, polished wooden coffin, or maybe you want something a little different like an eco-friendly biodegradable coffin that’s more in-line with the deceased’s values or interests? What about a steel casket? The point is, there are many options to choose from. For instance, some caskets include memento drawers and personalised finishing like custom colours or cushioning. Generally, urns are made of wood, porcelain, brass, glass, copper and other materials. If you’re scattering the ashes as opposed to keeping the urn you might opt for a simpler option. If you plan on keeping your loved one’s ashes, there are lots of ways to personalise the urn by adding artwork, engravings or decorative touches. Planning someone else’s funeral Losing a loved one can leave us feeling lost, and planning a funeral only adds to an already stressful situation. But not to worry, this guide is here to help you figure out what steps to take when someone close to us passes away. From registering a death, to choosing the right funeral director, and finding a way to cover costs; here’s what to do when someone dies. The very first steps The very first thing you must do when someone dies is contact those are closest to the deceased to inform them of the bad news. Next thing is to ask a doctor to issue a medical certificate stating the cause of death. If someone dies at home, you can arrange for a funeral director to collect the body. If your loved one happens to pass away in a hospice or a hospital, then the medical staff can offer advice on what to do next. Often when someone dies in a hospital, their body will be kept in the morgue for days, or sometimes even weeks which will give you more time to arrange the funeral. If someone dies unexpectedly or under suspicious circumstances, you must call 999 as soon as possible. The police and paramedics will request a coroner who can investigate the cause of death. The coroner will most likely arrange for a funeral director to bring the body to the morgue for a post-mortem examination. You are not obliged to use this funeral director for your own arrangements. Once a cause of death has been determined, you will be given forms granting the release of the body for burial or cremation. How do I register a death? To register a death, it’s advised that you visit the nearest registry office to the location where the individual passed away. Registering a death won’t take long if you phone ahead and make an appointment. You will have 5 days to register a death if you’re located in England, Wales or Northern Ireland and 8 days for Scotland. Click here to search for a registrar office near you. Who can register a death? You can register a death if you are a close relative to the deceased, someone who was present when they died, an administrator from the hospital in which they died or whoever is the executor or administrator of their estate. What documents do I need to register a death? You will need to bring the medical certificate stating the cause of death and it may help to speed things along if you have any of the following items at hand: Birth certificate of the deceased Their NHS card or National Insurance Number A marriage or civil partnership certificate Their passport, proof of address (this can be a utility bill) Their driver’s licence Council Tax bill What happens after I register a death? Once a death has been registered, you will receive the following documents: The Certificate of Notification of Registration of Death Copies of the Death Certificate The ‘Green’ Certificate for Cremation of Burial Information on government benefits for the bereaved You will then be ready to start making funeral arrangements. Does it cost anything to register a death? Registering a death is free but you must pay for a death certificate. This costs £11 in England and Wales, £12 in Scotland and £15 in Northern Ireland. We would advise you to get extra certificates in case you need them for claims to pensions, savings etc. as institutions like banks and insurance companies won’t accept a photocopied version. Who must I inform when someone dies? It’s not just family, friends and colleagues of the deceased who need to be informed of their passing. In fact, you may not realise just how many organisations you must inform. After registering someone’s death, you should begin contacting the relevant government bodies and financial organisations immediately. You can notify just about every important government office at once by filling out one simple form or with a quick phone call with the Tell Us Once service. However, this service may not be available in your area. If this is the case, you’ll have to contact all the relevant offices individually. You must also contact any relevant financial organisations such as pension providers, banks or building societies, credit and store card companies, mortgage providers and insurance companies. Utility companies like gas, water, phone and internet companies must be notified along with Royal Mail, the Bereavement Register and Mailing Preference Service who will help you to remove the deceased’s name from commercial mailing lists. You may also need to inform the individual’s landlord if applicable. Close and memorialise online accounts One of the knock-on effects of the rise of technology is the abundance of online accounts we now have – everything from internet banking and shopping to social media. Give the details of each account to a family member so they can delete them or do so yourself if there’s time. In the case of banking and phone providers especially, the process is much quicker if the organisation can speak directly to the account holder (although allowances will be made if that person has passed away). -On the day Planning the journey to the funeral Traditionally, a casket is transported to the funeral service in a black hearse while immediate family follows behind in a car or limousine – this is often arranged by the funeral home. Other mourners will then follow closely behind. All vehicle headlights should be on, and the funeral home may provide other identifying flags or markers to participating vehicles. There are many alternative hearses available these days and it’s not unheard of for people to choose something very different like a horse-drawn carriage, a fire engine or even a tank. The route The route that the funeral procession takes is determined by the family of the deceased, it may pass by their home or places that were meaningful to them. Some decide to skip this part altogether and request that mourners meet at the ceremony. The funeral home may charge more if you request a specific route. Planning a truly meaningful ceremony You may or may not be aware of what kind of service the deceased would have wanted. Planning a funeral can be tough for anyone and making decisions around the ceremony can be even more difficult. If you’re unsure of what to plan you can always ask the funeral director for advice, it is their area of expertise after all. Choosing the right music You must choose entrance and exit music to play as the coffin arrives and leaves the service venue. But what’s the best music to pick for a funeral service? The music at religious ceremonies generally consists of the deceased’s favourite hymns but different types of funerals may include other kinds of music, particularly the favourite songs of the deceased. “My Way” by Frank Sinatra and Monty Python’s “Always Look on the Bright Side of Life” are popular choices. You may also wish to include instrumental pieces to play during the ceremony. -Readings and eulogies Who should read a eulogy? Think carefully about who knows the deceased the best. It’s a good idea to choose someone who doesn’t shy away from public speaking. What should I say in a eulogy? The better someone knows the deceased, the more meaningful their words will be. Bible readings are common at traditional, religious funerals while poems are a popular choice for secular services. Photos, videos and imagery Photographs and videos are a fantastic way to remember the ones we love. It’s easy to forget that funerals are as much about remembering the life of a person than just mourning their passing. Use an appropriate, clear photograph for the order of service and the big display photograph. Many people choose to print other photos from throughout the deceased’s life and use them as decorations at the service and/or the wake. Additionally, PowerPoint presentations and video compilations are increasingly being used as a comprehensive means of honouring the deceased during the service. Pallbearers Pallbearers are usually male and are often members of the deceased’s family – their spouse, children, fathers, brother and so on – or their closest friends. Typically, there are six handles on a coffin and therefore six pallbearers. Pallbearers must have the emotional and physical strength to handle their roles. Honorary pallbearers are often chosen to walk beside the coffin as it is carried if they cannot physically do it themselves. Flowers It’s becoming increasingly common for families to request that well-wishers donate to a chosen charity in lieu of flowers while some buy floral tributes that are placed against the casket both in the hearse and during the funeral service. Traditionally, white lilies are a common choice, but many prefer to use the deceased’s favourite flower (if they had a preference). Decorations & mementos Decorations for the funeral service are often personalised in honour of the deceased and they should be easy to set up and take away when the time comes. Decorations might include flowers, photographs, ornaments that were sentimental to the deceased, their favourite football team’s jersey, a hat that they wore every day or something else that they were heavily associated with. These items are often placed on top of the coffin during the ceremony. -After the funeral Choosing and placing a memorial When we lose someone we love, we often want to pay tribute to them in a meaningful way. Many people do this by arranging an engraved headstone or by arranging a memorial of some kind. This may be something placed on their grave, a plaque mounted on the ground or in a crematorium, or maybe even a park bench. There’s been a recent trend in people planting memorial trees in honour of their loved ones. Just remember, you may have to contact the council or relevant local authority if you wish to place a bench or plant a tree in memory of the deceased. Dealing with legal and financial matters Once the funeral is over and everything has settled down a bit, you will have to start thinking about legal and financial matters. This may be outstanding debts, dealing with someone’s estate, sorting the will (or lack of will), inheritance tax and so on. Where can I get bereavement support in the UK? Grief can be exceptionally hard to handle and there’s no reason why you should have to face it alone. The National Bereavement Service offers people free practical, social and emotional help when dealing with the loss of a loved one. They can also help with a lot of the practical work which could be unfamiliar to you.
Inherited conditions To count as an inherited condition, MS would have to be passed on in a predictable way, which it isn’t. Inherited conditions are caused by faulty genes which are passed on from one generation to another. Typically, a child has either a one in two or a one in four chance of inheriting the condition from their parents. Examples of conditions inherited in a predictable way are Haemophilia and Muscular Dyastrophy. In inherited conditions, identical twins will either both have the condition or both be free of it because they carry identical genes. This doesn’t happen in MS. If one identical twin has MS, the other twin only has about a one in four chance of having MS, again showing that MS is not a truly inherited condition. Also, most people with MS have no history of MS in the family so it seems to have appeared from nowhere. The role of genes in MS Genes do play a part in MS. Some genes make it more likely that someone gets MS but having those genes is definitely not enough on its own. Other factors are needed to trigger MS in someone who carries genes that make them more susceptible to getting MS. Recent research has found over 100 genes that contribute to susceptibility to MS. Each gene represents a tiny part of the risk so the more of these different genes that someone carries, the more their risk is increased. Consequently, there isn’t a simple genetic test to say whether someone is susceptible or not. Other factors that play a part So, what factors can trigger MS in someone who has got the genes that make them more susceptible? A whole range of factors have been investigated and the evidence for which factors might be triggers is patchy. The strongest contenders are: lack of sunshine which is linked to lack of vitamin D exposure to the very common Epstein Barr virus which causes glandular fever in some people smoking Adding it all together The bottom line is that MS is not inherited but there is an increased risk in families who already have a member with MS because they carry some of the same genes. However, other factors are needed to trigger the condition and, overall, MS is still considered as a relatively rare condition compared with, for example, diabetes or breast cancer. The risk of MS in a family member depends on how closely related they are. The more closely related, the more likely that both will have MS. In a recent study of over 42,000 people in Sweden who had a parent with MS, only 515 (1.2%) had also been diagnosed with the condition. This translates into roughly a one in eighty chance of a parent and their child both having MS. This compares with a roughly one in 400 chance in completely unrelated people. Is MS hereditary or not? Returning to the original question at the top of this blog: MS is not inherited in the true sense of the word and this is what many neurologists tell people with MS. However, there is an increased risk in families so it is not surprising to sometimes hear of two members of the same family both having MS.
The Effects of Sleep Deprivation on Your Body If you’ve ever spent a night tossing and turning, you already know how you’ll feel the next day — tired, agitated, and out of sync. But missing out on the 7-9 hours of recommended sleep does more than make you feel groggy and grumpy. The long-term effects of sleep deprivation are real. It drains your mental abilities and puts your physical health at real risk. Science has also linked poor sleep with a number of health issues, from gaining weight to a weakened immune system. Causes of sleep deprivation In a nutshell, sleep deprivation is caused by a consistent lack of sleep or even a reduced quality of sleep. Regularly getting less than 7 hours of sleep can eventually lead to health consequences that affect your entire body. This could also be caused by an underlying sleep disorder. Your body needs it’s sleep the same as it needs air and food to function correctly. Whilst you’re sleeping, your body heals itself and restores its natural chemical balance. Your brain also forges new thought connections and helps memory retention. Without enough sleep, your brain and body systems won’t function as it should. It can also have a dramatic effect on your quality of life. A study also found that sleeping too little at night can increase the risk of early death. The most noticeable signs of sleep deprivation are: Excessive sleepiness Irritability Fatigue Frequent yawning Stimulants, such as caffeine, aren’t enough to override your body’s natural profound need for rest and sleep. In fact, these can actually make sleep deprivation worse by making it harder to fall asleep at night. This could then lead to a cycle of night-time insomnia, followed by daytime caffeine consumption to combat the tiredness caused by the lost hours of sleep. Behind the scenes, chronic sleep deprivation can interfere with your body’s internal systems and cause more than just the initial signs and symptoms as those listed above. Central nervous system Your central nervous system is the main highway of information for your body. Sleep is necessary to keep it functioning correctly, but chronic insomnia can disrupt how your body normally sends and processes information. During sleep, pathways are formed between nerve cells (neurons) in your brain that help you to remember the new information that you’ve learned. Sleep deprivation, however, leaves your brain exhausted and unable to perform its duties as well as would under normal circumstances. You may also find it increasingly difficult to concentrate or to learn new things. The signals that your body send may also be delayed, decreasing your coordination and increasing your risk of accidents. Sleep deprivation can also negatively affect your mental abilities and your emotional state. So, you may feel more impatient or prone to mood swings. It can also compromise the decision-making process and your creativity. If sleep deprivation is allowed to continue long enough, then you could start suffering from hallucinations — seeing or hearing things that aren’t really there. Lack of sleep can also trigger mania in those who have bipolar mood disorder. Other psychological risks also include: Depression Anxiety Paranoia Impulsive behaviour Suicidal thoughts You could also end up experiencing microsleep during the day. During these episodes, you’ll fall asleep for a few to several seconds without even realising it. It is out of your control and it can be extremely dangerous, especially if you’re driving. It can also make you more prone to injury if you operate any heavy machinery at work and have a microsleep episode. Immune system Whilst you’re sleeping, your immune system produces protective, infection-fighting substances such as antibodies and cytokines. It then uses these substances to combat foreign invaders, such as bacteria and viruses. Certain cytokines can also help you to sleep, giving your immune system more efficiency to help to defend your body against illness. Sleep deprivation prevents your immune system from building up its defence. So if you don’t get enough sleep then your body may not be able to fend off invaders, and it may also take you longer to recover from illness. Long-term sleep deprivation also increases your risk for chronic conditions, such as heart disease and diabetic mellitus. Respiratory system The relationship between sleep and the respiratory system goes both ways. A night-time breathing disorder called such as OSA (obstructive sleep apnoea), can interrupt your sleep and lower the quality of sleep itself. As you wake up throughout the night, this can cause sleep deprivation, which leaves you more vulnerable to respiratory infections such as the flu and the common cold. Sleep deprivation can also make any existing respiratory diseases such as chronic lung illness worse. Digestive system Along with not exercising enough and eating excessively, sleep deprivation is another risk factor for becoming overweight and obese. Sleep affects two hormonal levels, leptin and ghrelin, which control feelings of hunger and fullness. Leptin tells your brain that you’ve had enough to eat. Without enough sleep, your brain reduces leptin and raises ghrelin, which is an appetite stimulant. The flux of these hormones could explain night-time snacking or why someone may overeat later in the night. A lack of sleep can also make you feel too tired to do any exercise. Over time, reduced physical activity can make you gain weight, because you’re not burning enough calories and not building muscle mass. Sleep deprivation also causes your body to release less insulin after you eat. Insulin helps to reduce your blood sugar (glucose) level. Sleep deprivation can also lower the body’s tolerance for glucose and is associated with insulin resistance. These disruptions can lead to diabetes mellitus and obesity. Cardiovascular system Sleep affects the processes that help keep your heart and blood vessels healthy, including those that affect your blood pressure, blood sugar and inflammation levels. It also plays a vital role in your body’s natural ability to heal and repair the blood vessels and the heart. People who don’t sleep enough are more likely to get cardiovascular disease. One report linked insomnia to an increased risk of having a stroke or heart attack. Endocrine system Hormone production is dependent on your sleep. For testosterone production, you need at least 3 hours of uninterrupted sleep. Waking up throughout the night could affect this hormone production process. This interruption can also affect your growth hormone production, especially in children and adolescents. These hormones help the body to build muscle mass and repair cells and tissues, in addition to other growth functions. The pituitary gland releases the growth hormone throughout each day, but adequate sleep and exercise can also help the release of this hormone. Treatment for sleep deprivation Getting the right amount of sleep, typically 7 to 9 hours each night, is the most basic form of treatment for sleep deprivation. However, this can often be easier said than done, especially if you’ve been deprived of precious sleep for several weeks or longer. After this point, you may need additional help from your doctor or a sleep specialist who, if needed, can diagnose and treat a possible sleep disorder. Sleep disorders can make it difficult to get some quality sleep at night. They may also increase your risk for the above effects of sleep deprivation on the body. Here’s some of the most common types of sleep disorders: Insomnia Obstructice Sleep Apnoea Restless Leg Syndrome Narcolepsy Circadian Rhythm Disorders To diagnose these conditions, your doctor may ask you to undertake in a sleep study. This is traditionally conducted at a formal sleep centre, but there are also options to measure your sleep quality at home. If you are diagnosed with a sleep disorder, then you may be given medication or a device to help to keep your airway open at night (in the case of obstructive sleep apnoea), to help combat the disorder so that you can get a better night’s sleep on a more regular basis. Prevention The best way to prevent sleep deprivation is to make sure you get adequate sleep and follow the recommended guidelines for your age group, which is 7 to 9 hours sleep for most adults aged 18-64. Other ways in which you can get back on track with a healthy sleep schedule are: Limiting the amount of daytime naps (or avoid them altogether would be best) Go to bed at about the same time every night and get up at the same time on a morning Try not to have any caffeine past 12pm or at least a few hours before bedtime Stick to your bedtime schedule routine during weekends and holidays Spend an hour before bed relaxing; by reading, meditating, or taking a bath Avoid having any heavy meals within a few hours before bedtime Try not use your mobile, tablet or electronic devices prior to bedtime Exercising regularly, but not in the hours close to bedtime Reduce your alcohol intake If you continue to have problems sleeping at night and are fighting daytime fatigue, then try talking to your doctor. They can test for any underlying health conditions that may be getting in the way of your sleep schedule.
In the UK, there are almost 2 million people living with sight loss. Of these, around 360,000 are registered as blind or partially sighted. Being told you have a visual impairment that can't be treated can be difficult to come to terms with. Some people go through a process similar to bereavement, where they experience a range of emotions including shock, anger, and denial, before eventually coming to accept their condition. Specialist referral If you're blind or partially sighted, you may be referred to a specialist low-vision clinic, which is often located within a hospital. Staff at the clinic can help you understand your condition and come to terms with your diagnosis. They can also advise you about practical things, such as lighting and vision aids, and let you know about further sources of help and support. Ask your local hospital if they have an Eye Clinic Liaison Officer (ECLO), whose role involves providing support to people with vision loss in eye clinics. Support groups If you're blind or partially sighted, you may find it helpful to contact a support group for people with vision loss. Royal National Institute of Blind People (RNIB) The Royal National Institute of Blind People (RNIB) is the UK's leading charity for people with vision loss, and it has useful information about coming to terms with sight loss. The RNIB's helpline is open Monday to Friday from 8am to 8pm and Saturday from 9am to 1pm. The number is 0303 123 9999, with calls costing no more than a standard rate call to an 01 or 02 number. You can also email helpline staff (email@example.com). The RNIB's website is specially designed for people with sight loss and provides a wide range of useful information and resources, including an online community and online shop. Other national charities Other national charities that specialise in vision loss and you may find useful include: The Macular Society – helpline: 0300 3030 111 International Glaucoma Association – helpline: 01233 64 8170 Retina UK – helpline: 0300 111 4000 or email: firstname.lastname@example.org Diabetes UK – 0345 123 2399 or email: email@example.com Blind Veterans UK – 020 7723 5021 Royal Society for Blind Children SeeAbility Local organisations There are also many local voluntary organisations around the country that help and support people with vision problems. You can find local support organisations on the Visionary website, which allows you to search by postcode. Registering as blind or partially sighted If your vision has deteriorated to a certain level, you may choose to register as visually impaired. Depending on the severity of your vision loss you'll either be registered as sight impaired (previously "partially sighted") or severely sight impaired (previously "blind"). Your eye specialist (ophthalmologist) will measure your visual acuity (ability to see detail at a distance) and your field of vision (how much you can see from the side of your eye when looking straight ahead). These measurements will help your ophthalmologist determine whether you’re eligible to be certified as sight impaired or severely sight impaired. If you are, they will complete an official certificate with the results of your eye examination. In England and Wales this certificate is called the Certificate of Vision Impairment (CVI), in Scotland it's called BP1, and in Northern Ireland it's called A655. Your ophthalmologist will send a copy of the certificate to you, a copy to your GP and a copy to your local social services department. Upon receiving the certificate, your local social services team will contact you to ask whether you want to be added to its register of visually impaired people. After you're registered, social services will contact you again to arrange for an assessment to be carried out. The aim is to assess your needs and find out what help you require to remain independent, such as help with cleaning and cooking, or help with mobility and transport. Registering as visually impaired isn't compulsory, but it can entitle you to a range of benefits, including: Disability Living Allowance (DLA) or Personal Independence Payment (PIP) – a tax-free benefit to help with any costs relating to your disability or illness a reduction in the TV licence fee a tax allowance reduced fees on public transport parking concessions The RNIB website has more information about registering your sight loss. GOV.UK has more information about registering vision impairment. Changes to your home Most visually impaired people can continue to live at home. However, you'll probably need to make some changes to your home, particularly if you live on your own. Below is a list of some important pieces of equipment you may find useful. Big-button telephone – both landline and mobile models are available from the RNIB online shop. Computer – the internet can provide a real sense of connection to friends and family as well as other people with a visual impairment. It's also a practical way of finding out information and obtaining goods and services. Big-button keyboards, screen display software and text readers are available from the RNIB. Community alarm – this small, wearable device has an alarm button which, if pressed, sends an alarm signal to a response centre, which will alert a nominated friend or carer. Your local authority should be able to provide you with further information. Bright lighting – bright light bulbs and adjustable lights are essential for your home, particularly in the kitchen and the stairs (areas where you're most likely to have an accident). Fluorescent bulbs are recommended because they produce the most light and tend to be cheaper in the long term than conventional bulbs. Bathroom adaptions – As part of our mobility bathrooms, in addition to our white and chrome grab rails, we also offer blue grab rails - to aid the visually impaired and to help create a safer environment. The way your house is painted can also make it easier to find your way around. Using a two-tone contrast approach, such as black and white, can make it easier to tell the difference between nearby objects, such as a door and its handle or the stairs and its handrail. Reading and writing There are several options available if you're having problems reading standard text in books, newspapers and magazines. One of the simplest options is to use a magnifying device that can make print appear bigger to help you read. These can be obtained from a number of places including hospital low vision services, optometrists, local voluntary organisations, and the RNIB. The RNIB also has a collection of large print publications you can borrow, as do most libraries. You could also use an e-reader to help you read. E-readers are handheld devices that allow you to download books and subscribe to newspapers and magazines on the internet. You can choose a setting that allows you to display text at a larger size. If you're unable to read at all you could sign up to the: National Talking Newspapers and Magazines scheme, which can provide audio versions of more than 230 titles online or on a CD RNIB Talking Books Service, where you're sent audio books to listen to on your computer or on a device known as a DAISY player You can also install screen-reading software on your computer that will read out emails, documents and text on the internet. A charity called Communication for Blind and Disabled People has released a free screen reader for the PC called Thunder. Similar software is available for Apple devices, although you may have to pay a small fee. There are also voice recognition programmes where you speak into a microphone and the software translates what you say into writing. These programmes can also be used to issue commands, such as closing down the internet and moving from one website to another. Braille Some people with severe sight loss, particularly those who've had the problem from a young age, choose to learn Braille. Braille is a writing system where raised dots are used as a substitute for written letters. As well as Braille versions of books and magazines, you can buy Braille display units, which can be attached to computers that allow you to read the text displayed on a computer screen. Braille computer keyboards are also available. The RNIB website has more information about reading and Braille. Getting around There are several different methods you can use to get around independently if you have a problem with your vision. Long cane You may find a long cane useful when travelling. These canes are usually foldable and can help you get around by detecting objects in your path. The cane will also make drivers and other pedestrians aware that you have sight loss. To get the most from a long cane, it's a good idea to attend a training course that will teach you how to use it. The RNIB or Guide Dogs can provide you with further details about training. Guide dogs The charity Guide Dogs has been providing guide dogs for people with vision loss for many years. Guide dogs can help you get around, and provide both a sense of independence and companionship. If you apply for a guide dog, Guide Dogs provide all the essential equipment free of charge and can also offer financial assistance if needed for things like food or vet costs. You don't need to have lost all your sight to benefit from a guide dog and you don't have to be officially registered as blind or partially-sighted to apply for one. The Guide Dogs website has more information about applying for a guide dog. Guide Dogs also offer a number of other services for people with a visual impairment (even if you don't have a guide dog), such as Children and Young People's Services and mobility training. The charity also provides the My Guide service, which aims to reduce the isolation that many people with sight loss experience, helping to rebuild their confidence and regain their independence. Global positioning system (GPS) A global positioning system (GPS) is a navigational aid that uses signals from satellites to tell you where you are and help plan your journeys. GPS devices are available as stand-alone units that can be programmed using a Braille keyboard, which tell you your current location and give you directions to where you want to go. If you have a smartphone, there are a number of GPS apps you can download. The RNIB website has more information about technology and products for people with sight loss, including GPS. Driving If you're diagnosed with a condition that affects your vision, you have a legal obligation to inform the Driver and Vehicle Licensing Agency (DVLA). Failure to do so is a crime and can result in a fine of up to £1,000. Visit GOV.UK for more information about driving with a disability or a health condition. If you're registered as having a sight impairment, the DVLA will assume your driving licence is no longer valid and you'll no longer be able to drive. Exceptions are occasionally made for people with mild vision impairment. If you think this applies to you, then your doctor will need to fill in a DVLA medical information questionnaire (PDF, 265kb). You're only legally allowed to drive if you can read a number plate from a distance of 20 metres (65 feet), and an eye test shows your visual acuity is at least 6/12. You're allowed to wear glasses or contact lenses when reading the plate or letter chart. There are also standards relating to your visual field and driving. If you have a condition that may reduce your visual field, the DVLA may ask you to complete a visual field test to demonstrate you're safe to drive. Employment If you're currently employed and have recently been diagnosed with a visual impairment, you should contact the Access to Work scheme. Access to Work is a scheme run by Jobcentre Plus that provides advice and support about what equipment and adjustments may be required to enable you to do your job. They also offer a grant to contribute towards the costs of any equipment or training you may need, such as voice recognition software, a Braille keyboard and display unit and a printer that can convert text into Braille (Braille embossers). Depending on the size of the company you work for, the grant can pay for 80-100% of costs, up to £10,000. If you're currently looking for work, there are two main organisations that can provide extra advice and support: The RNIB, which has a useful section on its website about looking for work Jobcentre Plus You don't have to disclose that you have a visual impairment when applying for a job, but it's usually recommended that you do. If you feel you've been turned down for a job because of your disability, and you were capable of doing the job, you can make a complaint under the Equality Act 2010. Some people with a visual impairment decide to become self-employed, often because it allows them the flexibility to work at home for hours they choose. The RNIB website has more information and advice about work and employment. Regular sight tests If you have vision loss, it's still important to have regular sight tests so your optometrist (eye specialist) can check for further changes in your eyes and give you advice about how to make the best use of your vision. Find an optician near you and read more about NHS eye care services.
Overview Your will lets you decide what happens to your money, property and possessions after your death. If you make a will you can also make sure you don’t pay more Inheritance Tax than you need to. You can write your will yourself, but you should get advice if your will isn’t straightforward. You need to get your will formally witnessed and signed to make it legally valid. If you want to update your will, you need to make an official alteration (called a ‘codicil’) or make a new will. If you die without a will, the law says who gets what. Write your will Your will should set out: who you want to benefit from your will who should look after any children under 18 who is going to sort out your estate and carry out your wishes after your death (your executor) what happens if the people you want to benefit die before you When you need legal advice You can get advice from a professional if your will is not straightforward, for example: you share a property with someone who is not your husband, wife or civil partner you want to leave money or property to a dependant who cannot care for themselves you have several family members who may make a claim on your will, such as a second spouse or children from another marriage your permanent home is outside the UK you have property overseas you have a business Keep your will safe You can keep your will at your home or store it with: your solicitor your bank a company that offers the storage of wills - you can search online the London Probate Service Read full guidance on storing your will with the Probate Service (leaflet PA7) You should tell your executor (the person you’ve chosen to carry out your will), close friend or relative where your will is. Make sure your will is legal For your will to be legally valid, you must: be 18 or over make it voluntarily be of sound mind make it in writing sign it in the presence of 2 witnesses who are both over 18 have it signed by your 2 witnesses, in your presence If you make any changes to your will you must follow the same signing and witnessing process. You cannot leave your witnesses (or their married partners) anything in your will. Update your will You should review your will every 5 years and after any major change in your life, for example: getting separated or divorced getting married (this cancels any will you made before) having a child moving house if the executor named in the will dies Making changes to your will You cannot amend your will after it’s been signed and witnessed. The only way you can change a will is by making an official alteration called a codicil. You must sign a codicil and get it witnessed in the same way as witnessing a will. There’s no limit on how many codicils you can add to a will. Making a new will For major changes you should make a new will. Your new will should explain that it revokes (officially cancels) all previous wills and codicils. You should destroy your old will by burning it or tearing it up.
The problem This customer had problems getting in and out of the bath. The lady lived on her own and was worried about having an accident whilst getting in or out of the bath. There was also a storage cupboard which was taking up quite a big part of the bathroom, that needed to be removed. The toilet and the basin needed updating and the customer also wanted more space for storage in this part of the bathroom. The Solution We suggested the walk-in shower bath combo, so that the lady could have the best of both worlds; a long relaxing bath or a quick shower. We also fitted the rainfall shower head, which gives the bathroom that "luxurious hotel feeling". We then fitted a new toilet and basin combination unit, which gave the lady additional storage space and the new toilet also uses less water than the previous one - a much greener option that is also easier on the pocket.
OVERVIEW High blood pressure, or hypertension, rarely has noticeable symptoms. But if untreated, it increases your risk of serious problems such as heart attacks and strokes. Around a third of adults in the UK have high blood pressure, although many will not realise it. The only way to find out if your blood pressure is high is to have your blood pressure checked. What is high blood pressure? Blood pressure is recorded with 2 numbers. The systolic pressure (higher number) is the force at which your heart pumps blood around your body. The diastolic pressure (lower number) is the resistance to the blood flow in the blood vessels. They're both measured in millimetres of mercury (mmHg). As a general guide: high blood pressure is considered to be 140/90mmHg or higher (or 150/90mmHg or higher if you're over the age of 80) ideal blood pressure is usually considered to be between 90/60mmHg and 120/80mmHg Blood pressure readings between 120/80mmHg and 140/90mmHg could mean you're at risk of developing high blood pressure if you do not take steps to keep your blood pressure under control. Everyone's blood pressure will be slightly different. What's considered low or high for you may be normal for someone else. Risks of high blood pressure If your blood pressure is too high, it puts extra strain on your blood vessels, heart and other organs, such as the brain, kidneys and eyes. Persistent high blood pressure can increase your risk of a number of serious and potentially life-threatening health conditions, such as: heart disease heart attacks strokes heart failure peripheral arterial disease aortic aneurysms kidney disease vascular dementia If you have high blood pressure, reducing it even a small amount can help lower your risk of these health conditions. Check your blood pressure The only way of knowing whether you have high blood pressure is to have a blood pressure test. All adults over 40 are advised to have their blood pressure checked at least every 5 years. Getting this done is easy and could save your life. You can get your blood pressure tested at a number of places, including: at your GP surgery at some pharmacies as part of your NHS Health Check in some workplaces You can also check your blood pressure yourself with a home blood pressure monitor. Find out more about getting a blood pressure test Causes of high blood pressure It's not always clear what causes high blood pressure, but certain things can increase your risk. You're at an increased risk of high blood pressure if you: are over the age of 65 are overweight are of African or Caribbean descent have a relative with high blood pressure eat too much salt and do not eat enough fruit and vegetables do not do enough exercise drink too much alcohol or coffee (or other caffeine-based drinks) smoke do not get much sleep or have disturbed sleep Making healthy lifestyle changes can help reduce your chances of getting high blood pressure and help lower your blood pressure if it's already high. Treatment for high blood pressure Doctors can help you keep your blood pressure to a safe level using: lifestyle changes medicines What works best is different for each person. Talk to your doctor to help you decide about treatment. This patient decision aid (PDF, 132kb) can also help you to understand your treatment options. Lifestyle changes to reduce blood pressure These lifestyle changes can help prevent and lower high blood pressure: reduce the amount of salt you eat and have a generally healthy diet cut back on alcohol lose weight if you're overweight exercise regularly cut down on caffeine stop smoking Some people with high blood pressure may also need to take 1 or more medicines to stop their blood pressure getting too high. Medicines for high blood pressure If you're diagnosed with high blood pressure, your doctor may recommend taking 1 or more medicines to keep it under control. These come as tablets and usually need to be taken once a day. Common blood pressure medicines include: ACE inhibitors – such as enalapril, lisinopril, perindopril and ramipril angiotensin-2 receptor blockers (ARBs) – such as candesartan, irbesartan, losartan, valsartan and olmesartan calcium channel blockers – such as amlodipine, felodipine and nifedipine or diltiazem and verapamil diuretics – such as indapamide and bendroflumethiazide beta blockers – such as atenolol and bisoprolol alpha blockers – such as doxazosin other diuretics – such as amiloride and spironolactone The medicine recommended for you will depend on things like how high your blood pressure is, your age and your ethnicity. CAUSES In most cases, it's not clear exactly what causes high blood pressure (hypertension). But there are several things that can increase your risk. Who's at risk of high blood pressure Factors that can raise your risk of developing high blood pressure include: age – the risk of developing high blood pressure increases as you get older a family history of high blood pressure being of African or Caribbean origin a high amount of salt in your food lack of exercise being overweight regularly drinking large amounts of alcohol smoking long-term sleep deprivation Making healthy lifestyle changes can help keep your blood pressure at a normal level. Find out more about how to prevent high blood pressure Known causes of high blood pressure In about 1 in 20 cases, high blood pressure happens as the result of an underlying health condition or taking a certain medicine. Health conditions that can cause high blood pressure include: kidney disease diabetes long-term kidney infections obstructive sleep apnoea – where the walls of the throat relax and narrow during sleep, interrupting normal breathing glomerulonephritis – damage to the tiny filters inside the kidneys narrowing of the arteries supplying the kidneys hormone problems – such as an underactive thyroid, an overactive thyroid, Cushing's syndrome, acromegaly, increased levels of the hormone aldosterone (hyperaldosteronism), and phaeochromocytoma lupus – a condition in which the immune system attacks parts of the body, such as the skin, joints and organs scleroderma – a condition that causes thickened skin, and sometimes problems with organs and blood vessels Medicines that can increase your blood pressure include: the contraceptive pill steroids non-steroidal anti-inflammatory drugs (NSAIDs) – such as ibuprofen and naproxen some pharmacy cough and cold remedies some herbal remedies – particularly those containing liquorice some recreational drugs – such as cocaine and amphetamines some selective serotonin-noradrenaline reuptake inhibitor (SSNRI) antidepressants – such as venlafaxine In these cases, your blood pressure may return to normal once you stop taking the medicine or drug. DIAGNOSIS High blood pressure (hypertension) does not usually have any symptoms, so the only way to find out if you have it is to get your blood pressure checked. Healthy adults aged over 40 should have their blood pressure checked at least once every 5 years. If you're at an increased risk of high blood pressure, you should have your blood pressure checked more often, ideally once a year. Having this done is easy and could save your life. Where to get a blood pressure test You can ask for a blood pressure check. You do not have to wait to be offered one. Blood pressure testing is available: at your GP surgery – by a GP, practice nurse, healthcare assistant or self-service machine at some pharmacies at an NHS Health Check appointment offered to adults aged 40 to 74 in England in some workplaces at a health event You can also test your blood pressure at home using a home testing kit. Having a blood pressure test A stethoscope, arm cuff, pump and dial was normally used to measure your blood pressure, but automatic devices with sensors and digital displays are commonly used nowadays. It's best to sit down with your back supported and legs uncrossed for at least 5 minutes before the test. You'll usually need to roll up your sleeves or remove any long-sleeved clothing so the cuff can be placed around your upper arm. Try to relax and avoid talking while the test is carried out. During the test: you hold out one of your arms so it's at the same level as your heart, and the cuff is placed around it – your arm should be supported in this position with a cushion or the arm of a chair, for example the cuff is pumped up to restrict the blood flow in your arm – this squeezing may feel a bit uncomfortable, but only lasts a few seconds the pressure in the cuff is slowly released and detectors sense vibrations in your arteries – a doctor will use a stethoscope to detect these if your blood pressure is measured manually the pressure in the cuff is recorded at 2 points as the blood flow starts to return to your arm – these measurements are used to give your blood pressure reading You can usually find out your result straight away, either from the healthcare professional carrying out the test or on the digital display. If your blood pressure is high, you may be advised to record your blood pressure at home to confirm whether you have high blood pressure. Ambulatory (24-hour) blood pressure monitoring Having a raised blood pressure reading in 1 test does not necessarily mean you have high blood pressure. Blood pressure can fluctuate throughout the day. Feeling anxious or stressed when you visit your GP can also raise your blood pressure. If you have a high reading, you may be asked to take some readings with a home blood pressure monitor, or wear a 24-hour monitor that checks your blood pressure throughout the day. This will confirm whether you have consistently high blood pressure. It's known as 24-hour or ambulatory blood pressure monitoring. Home blood pressure testing Blood pressure tests can also be carried out at home using your own blood pressure monitor. Like 24-hour or ambulatory monitoring, this can give a better reflection of your blood pressure. It can also allow you to monitor your condition more easily in the long term. You can buy a variety of low-cost monitors so you can test your blood pressure at home or while you're out and about. Measure your blood pressure twice a day, ideally in the morning and the evening, while you're sitting down. Each time take 2 readings, 1 minute apart. Continue to measure your blood pressure twice a day for 7 days. Your doctor or nurse will use this information to work out your average blood pressure. It's important to make sure you use equipment that's been properly tested. The British Hypertension Society (BHS) has information about validated blood pressure monitors that are available to buy. Understanding your blood pressure reading Blood pressure is measured in millimetres of mercury (mmHg) and is given as 2 figures: systolic pressure – the pressure when your heart pushes blood out diastolic pressure – the pressure when your heart rests between beats For example, if your blood pressure is "140 over 90", or 140/90mmHg, it means you have a systolic pressure of 140mmHg and a diastolic pressure of 90mmHg. As a general guide: high blood pressure is considered to be 140/90mmHg or higher (or an average of 135/85mmHg at home) – or 150/90mmHg or higher (or an average of 145/85mmHg at home) if you're over the age of 80 ideal blood pressure is usually considered to be between 90/60mmHg and 120/80mmHg, while the target for over-80s is below 150/90mmHg (or 145/85mmHg at home) Blood pressure readings between 120/80mmHg and 140/90mmHg could mean you're at risk of developing high blood pressure if you do not take steps to keep your blood pressure under control. TREATMENT Simple lifestyle changes can help reduce high blood pressure, although some people may need to take medicine as well. Your GP can advise you about changes you can make to your lifestyle and discuss whether they think you'd benefit from medicine. This patient decision aid (PDF, 132kb) can also help you to understand your treatment options. When treatment is recommended Everyone with high blood pressure is advised to make healthy lifestyle changes. Whether medicine is also recommended depends on your blood pressure reading and your risk of developing problems such as heart attacks or strokes. Your doctor will carry out some blood and urine tests, and ask questions about your health to determine your risk of other problems: if your blood pressure is consistently above 140/90mmHg (or 135/85mmHg at home), but your risk of other problems is low – you'll be advised to make some changes to your lifestyle if your blood pressure is consistently above 140/90mmHg (or 135/85mmHg at home) and your risk of other problems is high – you'll be offered medicine to lower your blood pressure, in addition to lifestyle changes if your blood pressure is consistently above 160/100mmHg – you'll be offered medicine to lower your blood pressure, in addition to lifestyle changes Lifestyle changes There are some changes you could make to your lifestyle to reduce high blood pressure. Some of these will lower your blood pressure in a matter of weeks, while others may take longer. Try to: cut your salt intake to less than 6g (0.2oz) a day, which is about a teaspoonful – find out how you can reduce the amount of salt in your diet eat a low-fat, balanced diet – including plenty of fresh fruit and vegetables; get tips on eating more healthily be active – read some tips about getting more exercise cut down on alcohol – get tips on cutting down, including downloading a drinks diary and keeping track of your drinking lose weight – find out what your ideal weight is using the BMI healthy weight calculator and read advice about losing weight if you're overweight drink less caffeine – found in coffee, tea and cola stop smoking – get help quitting You can take these steps today, regardless of whether or not you're taking blood pressure medicines. In fact, by making these changes early on you may be able to avoid needing medicines. Get more advice about lifestyle changes to prevent and reduce high blood pressure Medicines for high blood pressure Several types of medicine can be used to help control high blood pressure. Many people need to take a combination of different medicines. if you're under 55 years of age – you'll usually be offered an ACE inhibitor or an angiotensin-2 receptor blocker (ARB) if you're aged 55 or older, or you're any age and of African or Caribbean origin – you'll usually be offered a calcium channel blocker You may need to take blood pressure medicine for the rest of your life. But your doctor might be able to reduce or stop your treatment if your blood pressure stays under control for several years. It's really important to take your medicine as directed. If you miss doses, it will not work as well. The medicine will not necessarily make you feel any different, but this does not mean it's not working. Medicines used to treat high blood pressure can have side effects, but most people do not get any. If you do get side effects, do not stop taking your medicine. Talk to your doctor, who may advise changing your medicine. ACE inhibitors Angiotensin-converting enzyme (ACE) inhibitors reduce blood pressure by relaxing your blood vessels. Common examples are enalapril, lisinopril, perindopril and ramipril. The most common side effect is a persistent dry cough. Other possible side effects include headaches, dizziness and a rash. Angiotensin-2 receptor blockers (ARBs) ARBs work in a similar way to ACE inhibitors. They're often recommended if ACE inhibitors cause troublesome side effects. Common examples are candesartan, irbesartan, losartan, valsartan and olmesartan. Possible side effects include dizziness, headaches, and cold or flu-like symptoms. Coronavirus advice If you have coronavirus (COVID-19), or think you might have it, keep taking your blood pressure medicines as usual. There is no clear evidence that taking angiotensin-converting enzyme (ACE) inhibitors or angiotensin-2 receptor blockers (ARBs) will cause complications. Calcium channel blockers Calcium channel blockers reduce blood pressure by widening your blood vessels. Common examples are amlodipine, felodipine and nifedipine. Other medicines, such as diltiazem and verapamil, are also available. Possible side effects include headaches, swollen ankles and constipation. Drinking grapefruit juice while taking some calcium channel blockers can increase your risk of side effects. Diuretics Sometimes known as water pills, diuretics work by flushing excess water and salt from the body through your pee. They're often used if calcium channel blockers cause troublesome side effects. Common examples are indapamide and bendroflumethiazide. Possible side effects include dizziness when standing up, increased thirst, needing to go to the toilet frequently, and a rash. You might also get low potassium and low sodium after long-term use. Beta blockers Beta blockers can reduce blood pressure by making your heart beat more slowly and with less force. They used to be a popular treatment for high blood pressure, but now tend to be used only when other treatments have not worked. This is because beta blockers are considered less effective than other blood pressure medicines. Common examples are atenolol and bisoprolol. Possible side effects include dizziness, headaches, tiredness, and cold hands and feet. High blood pressure in older people The target blood pressure reading for the over-80s is below 150/90 mmHg when it's measured in the clinic or surgery, and below 145/85 mmHg for home readings. While there are definite benefits from taking medicines to reduce blood pressure if you're under the age of 80, it's less clear it's useful if you're over 80. It's now thought that if you reach 80 while you're taking medicine for high blood pressure, it's fine to continue treatment provided it's still helping you and is not causing side effects. If you're diagnosed with high blood pressure and you're aged over 80, your doctor will also consider your other health risk factors when deciding whether to give you treatment for the high blood pressure. PREVENTION High blood pressure can often be prevented or reduced by eating healthily, maintaining a healthy weight, taking regular exercise, drinking alcohol in moderation and not smoking. Healthy diet Cut down on the amount of salt in your food and eat plenty of fruit and vegetables. The Eatwell Guide highlights the different types of food that make up our diet, and shows the proportions we should eat them in to have a well-balanced and healthy diet. Salt raises your blood pressure. The more salt you eat, the higher your blood pressure. Aim to eat less than 6g (0.2oz) of salt a day, which is about a teaspoonful. Find out how to cut down on salt Eating a low-fat diet that includes lots of fibre, such as wholegrain rice, bread and pasta, and plenty of fruit and vegetables also helps lower blood pressure. Aim to eat 5 portions of fruit and vegetables every day. Find out how to get your 5 A Day Limit your alcohol intake Regularly drinking too much alcohol can raise your blood pressure over time. Staying within the recommended levels is the best way to reduce your risk of developing high blood pressure: men and women are advised not to regularly drink more than 14 units a week spread your drinking over 3 days or more if you drink as much as 14 units a week Find out how many units are in your favourite drink and get tips on cutting down. Alcohol is also high in calories, which will make you gain weight and can further increase your blood pressure. Find out how many calories are in popular drinks Lose weight Being overweight forces your heart to work harder to pump blood around your body, which can raise your blood pressure. Find out if you need to lose weight with the BMI healthy weight calculator If you do need to lose some weight, it's worth remembering that just losing a few pounds will make a big difference to your blood pressure and overall health. Get tips on losing weight safely Get active Being active and taking regular exercise lowers blood pressure by keeping your heart and blood vessels in good condition. Regular exercise can also help you lose weight, which will also help lower your blood pressure. Adults should do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity, such as cycling or fast walking, every week. Physical activity can include anything from sport to walking and gardening. Get more ideas on how to get active Cut down on caffeine Drinking more than 4 cups of coffee a day may increase your blood pressure. If you're a big fan of coffee, tea or other caffeine-rich drinks, such as cola and some energy drinks, consider cutting down. It's fine to drink tea and coffee as part of a balanced diet, but it's important that these drinks are not your main or only source of fluid. Stop smoking Smoking does not directly cause high blood pressure, but it puts you at much higher risk of a heart attack and stroke. Smoking, like high blood pressure, will cause your arteries to narrow. If you smoke and have high blood pressure, your arteries will narrow much more quickly, and your risk of heart or lung disease in the future is dramatically increased. Get help to stop smoking
It's not just illnesses you need to protect yourself from in winter. Winter weather can bring many risks to you and your family. There's the usual winter coughs, colds and flu, but then there are also risks to your health associated with flooding and storms. Why is winter weather a risk to our health? Cold temperatures have an impact on our health, but there are other risks in winter including physical injuries from slips, trips and falls. As we get older it becomes harder for our bodies to detect how cold we are, and it takes longer to warm up which can be bad for our health. For older people in particular, the longer the exposure to the cold, the more risk of heart attacks, strokes, pneumonia, depression, worsening arthritis and increased accidents at home (associated with loss of strength and dexterity in the hands). Dealing with common winter illnesses If you are normally healthy, many of the coughs, colds and minor illnesses that seem to happen more frequently during winter can be safely managed yourself. There's plenty of advice about dealing with common winter illnesses from NHS on their Stay well this winter website and you can also talk to your local pharmacist. We also have a page about the Norovirus. Flu Flu affects people in different ways. If you are healthy you will usually shake it off within a week. Flu vaccination is offered free of charge on the NHS to people who are at most at risk from the effects of flu. This is to protect them from catching flu and developing serious complications. Find out who is eligible for a free flu jab. Contact your GP or pharmacist if you think you, or someone you care for, should be eligible for a free flu jab. There's further information about flu and the flu vaccine on the flu pages of the NHS Choices website. Keeping yourself warm at home in winter Keep your hands and face warm - if they get cold they can trigger a rise in blood pressure which puts you at increased risk of a heart attack Remember that several thin layers of clothing will keep you warmer than one thick layer, as the layers trap warm air Wear warm clothes in bed. When very cold, wear thermal underwear, bed socks and even a hat - a lot of heat is lost through your head Read more tips about keeping your house warm and find out about the ideal room temperatures for your home. Keep warm to keep well It's important to stay active as this generates heat and helps to keep you warm. Try to keep moving when you're indoors, and don't sit still for more than an hour. If walking is difficult, you can do chair-based exercises. Even simply moving your arms and legs and wiggling your toes will get your circulation going. Eating well in winter It's important to make sure you (or someone you care for our visit) eats enough in winter and hot meals and drinks will help to keep you warm. Follow Age UK's tips to keep you eating well this winter: Try to eat at least one hot meal each day and have hot drinks during the day Include a good range of foods in your diet and aim for five portions of fruit and vegetables each day, so that you're getting plenty of nutrients and vitamins. Remember that frozen vegetables are just as good as fresh If you're worried about a poor appetite, speak to your GP Have a hot drink before bed and keep one in a flask by your bedside For more information or for your free copy of the Winter Wrapped Up guide, visit www.ageuk.org.uk/spreadthewarmth or call Age UK Advice on 0800 169 6565. Cold weather alerts for healthcare professionals The Met Office issues Cold Weather Alerts on our website and these are sent directly to social and healthcare services in England, and to Age UK. These alerts ensure that staff are fully prepared for any cold weather periods, and those who are more vulnerable to cold weather conditions are aware and prepared. Public Health England produces a Cold Weather Plan for England which helps to raise awareness of the harm to health from cold, and provides guidance on how to prepare for and respond to cold weather.