Slow medicine encourages less aggressive and less costly care at the end of life reports the New York Times in For the elderly, being heard about life's end.
Grounded in research at the Dartmouth Medical School, slow medicine encourages physicians to put on the brakes when considering care that may have high risks and limited rewards for the elderly, and it educates patients and families how to push back against emergency room trips and hospitalizations designed for those with treatable illnesses, not the inevitable erosion of advanced age.
Slow medicine, which shares with hospice care the goal of comfort rather than cure, is increasingly available in nursing homes, but for those living at home or in assisted living, a medical scare usually prompts a call to 911, with little opportunity to choose otherwise.
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The chief medical officer at U.C.L.A., Dr. Tom Rosenthal, said that aggressive treatment for the elderly at acute care hospitals can be “inhumane,” and that once a patient and family were drawn into that system, “it’s really hard to pull back from it.”
“The culture has a built-in bias that everything that can be done will be done,” Dr. Rosenthal said, adding that the pace of a hospital also discourages “real heart-to-heart discussions.”
Beginning that conversation earlier, as they do at Kendal, he said, “sounds like fundamentally the right way to practice.”
That means explaining that elderly people are rarely saved from cardiac arrest by CPR, or advising women with broken hips that they may never walk again, with or without surgery, unless they can stand physical therapy.
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Some of those most in tune with slow medicine are the adult children who watch a parent’s daily decline. Suzanne Brian, for one, was grateful that her father, then 88 and debilitated by congestive heart failure, was able to stop medications to end his life.
“It wasn’t ‘Oh, you have to do this or do that,’ “ Ms. Brian said. “It was my father’s choice. He could have changed his mind at any time. They slowly weaned him from the meds and he was comfortable the whole time. All he wanted was honor and dignity, and that’s what he got.”
Jennifer F has written a remarkable post that may cause you to reconsider your world view
All of my scattered thoughts on the subject were brought into relief the other day when I had a conversation with an immediate family member (whom I don't want to identify directly). He seemed depressed and uneasy about something, and when I asked him why he said it was about his retirement account. He's deeply distressed that he won't have enough money to afford anything other than a government-run nursing home in his old age. I reminded him that my husband and I would love for him to move in with us when it gets to the point that he doesn't feel comfortable living on his own. We weren't even talking about a situation where he might need intensive medical care, yet he flatly refused to even consider the notion.
"I would never do that to you," he said. "I would never have you put your life on hold like that."
We've had this conversation many times before, yet this time, the first since my conversion to Christianity, I was hit by just what a profoundly sad worldview this reflects. I've always wanted this family member to live with us when he can no longer live on his own, and he's always refused on the same grounds. That part is nothing new. Yet this time I saw clearly that the situation goes beyond an unfortunate refusal of help: it reflects a worldview in which well-meaning people like my relative believe that the best thing they can do for their loved-ones is to not burden them with their presence, where the very meaning of life has been twisted to suck love out of the world.
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It leads us to believe that if we were ever to lose our self-sufficiency, our presence would not just be an annoyance but would in fact prevent our loved-ones from fulfilling their very purpose in life.
When I compare my life with the self-focused worldview to my life with the other-focused worldview, the difference is striking. Not that I am anywhere near some saint-like level of always seeking to serve others before myself, but simply understanding that that is the goal, that my own life isn't about me, has changed everything. It's counter-intuitive, it requires sacrifice, and it isn't always the most comfortable path. But it is clear that, truly, this is how we were designed to live. After all these years of trying it my way, it's like I'm finally operating my life according to the instruction manual. And it is ultimately a manual for how to live a life of love, written by he who is Love itself.
I love stories about feisty old women fighting off criminals. Here's one that tops them all.
When a man smashed the glass of the door to force his way inside, a 95-year-old woman in a wheelchair fought him off with a screwdriver!
For an hour and a half she fought him until he passed out and she could call 911!
Every time the man would poke his hand through the window she jabbed him until he quit.
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"There was busted glass where they had busted out. She had blood on her. There was glass in her hair."
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“What do you tell your friends in county jail, where did you get those wounds? I don't know that he's going to tell them he got them from a 95-year-old lady confined to a wheel chair."
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Police suspect it will be a long time before anyone trespasses on her property and neighbors like Gerri call her a hero. “She's very sweet. She doesn't want to go to the nursing home and she's doing a pretty good job protecting herself.
Hats off to Gerri Grindle.
The oldest Americans are also the happiest
"The good news is that with age comes happiness," said study author Yang Yang, a University of Chicago sociologist. "Life gets better in one's perception as one ages.
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Yang's findings are based on periodic face-to-face interviews with a nationally representative sample of Americans from 1972 to 2004. About 28,000 people ages 18 to 88 took part.
They are also far more social than we have been lead to believe, one factor in their happiness, along with being content with what they have and who they are.
The unhappiest time is midlife and the boomers are the unhappiest of all.
Yang's study also found that baby boomers were the least happy. They could end up living the unfortunate old-age stereotype if they can't let go of their achievement-driven mind-set, said George, the Duke aging expert.
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So far, baby boomers aren't lowering their aspirations at the same rate earlier generations did. "They still seem to believe that they should have it all," George said. "They're still thinking about having a retirement that's going to let them do everything they haven't done yet."
With all of us boomers getting older, it's good to know that MIT has an AgeLab to develop new ideas to improve the quality of life for older folk and those that care for them.
Technology and nurses will be our best hopes for aging well because there will not be enough geriatricians for us; there's not enough now as I wrote in "Nothing, It's Too Late."
Selected by the Wall St. Journal as one of the 12 People Who Are Changing Your Retirement, Joseph Coughlin describes his work as "trying to get people to 'age cool'."
he is pushing advances in transportation, health care and housing off drawing boards and into older adults' lives.
And he can't do it quickly enough.
"If we don't hurry," he says, "the products being designed now aren't going to be there when the [baby] boomers need them."
In a piece by David Ho, MIT AgeLab Preparing for an Older Tomorrow, Coughlin is quoted
"Our greatest success is now our greatest challenge," Coughlin says. "Where are you going to live? How are you going to get around? What are you going do in those 10, 20, 30, 40 years of extra time?"
So he founded AgeLab
to unravel a paradox: Humanity in the last century achieved the dream of much longer life, but didn't plan for the effects on work, health and daily living.
One of its projects is a partnership with the Business Innovation Factory and the Tockwotton Nursing Home in Rhode Island to creating a real-world laboratory for improving elderly care by developing and testing new solutions, products and models
Some interesting thoughts on the aging of the boomers.
"Boomers have a clear sense that their own aging is next," writes Matt Thornhill, head of the Boomer Project, that focuses on understanding the boomer generation and is part of a larger market research firm.
What a Long, Strange Trip It's Been --And Continues to Be
In survey after survey, boomers tell us they are not yet "done." They have mountains to climb, worlds to conquer, wrongs to right, and grandbabies to kiss. For most boomers, they'll be over the hill when they're under the hill.
The quest, it seems, isn't for the Fountain of Youth, but the Fountain of Vitality. Boomers will spend time, money, and considerable effort to maintain their vitality until their last breath. Viva the Vital! -- Long live the vital! --will be the mantra for the next 40 years. It is the context that explains the path boomers are taking.
John Martin sees in the retirement of boomers, happy days for organizations that depend on volunteers as they watch their ranks swell by as much as 50%
Boomers are Wired to Work and are volunteering in larger numbers and greater percentages than previous generations.
Our national research suggests that people over the age of 50 (which is where the majority of boomers are at present) have reached a point in life where they are less likely to focus on "becoming someone" and instead are focusing more on "being someone." While younger cohorts are driven more by interpersonal or external social values, boomers, especially boomers over 50, are more motivated by internal values such as self-fulfillment, self-respect, and sense of accomplishment.
Boomers Search for the Wisdom in Faith
Members of the generation that came of age tripping on mind-altering substances are more than likely exploring a new path at midlife and beyond: spiritual enlighten ment. In our work at the Boomer Project, we uncovered that baby boomers, now ages 44 to 62, are shifting their life's focus from trying to "become someone" to more about "being someone." This shift starts to happen around age 50, truly "midlife" (at least) for most of us.
Boomers beyond age 50 typically have become more motivated by inner feelings and beliefs, and are not driven so much by what their friends, peers, co-workers, or even family feel or believe. Boomers at midlife are beginning to wonder about their purpose, and what legacy they will leave. And it is the culmination of these feelings that has many midlife boomers becoming more religious and spiritual.
It surprised me to learn that six in seven boomers identify a religious affiliation.
When Thornhill wondered how he found himself back at church at 48, he found Dr. Gene Cohen's concept of the smarter and wiser brain and "developmental intelligence" compelling,
This is the combination of wisdom, judgment, perspective, and vision one develops later in life. It is characterized by three types of thinking and reasoning typically developed after age 50 or so: relativistic thinking (recognizing that knowledge is relative and not absolute); dualistic thinking (the ability to uncover and resolve contradictions in opposing and seemingly incompatible views); and systemic thinking (being able to see the larger picture, to distinguish between the forest and the trees).
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Accepting religion requires faith, which is not a black and white thing at all. Most religions require followers to uncover and resolve contradictions as a matter of course. And one must be able to see the larger picture in order to accept the tenets and beliefs of most religions. All of these tasks are much easier for boomers who have brains that are growing older and wiser every day.
Making art, whether it be singing, writing, painting or crafts seems to be the key in the art of growing older happily, still contributing, still creating.
Studies Suggest There's An Art to Getting Older
In 2006, the preliminary findings from the federally funded Creativity and Aging Study suggest that
making art, or even listening to music or viewing paintings, supports physical, mental and emotional well-being and eases some symptoms of illness, including dementia.
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Sometimes arts participation can be powerful therapy. Susan Perlstein, the founder of the National Center for Creative Aging and New York's nonprofit Elders Share the Arts, recalls a Holocaust survivor who sat watching her peers perform theater for a year before she told them how she escaped death more than 60 years earlier. The group turned her story into a play and made her the star.
"She said to the group . . . she felt for the first time she could feel at home," Perlstein said. "This process of being able to share your stories and transform them into art is actually a deeply healing process. She went from a depressed, sick older person to a lively young person. It was phenomenal to watch this change."
Taken as a whole, the benefits to the well-being of the old who participate in creative arts are quite extraordinary:
• new growth of brain cells stimulated
• better overall physical health
• less depression and loneliness
• medication use down
• a heightened sense of control and social engagement
• increased sense of independence
No wonder he's called Buster. When he was a hundred, he fought off a gang of muggers in South London.
He has 17 kids and still works as a van cleaner, returning to work at age 99 saying he was bored after 2 years of retirement.
Well, he's taken up running in his spare time and completed a half-marathon in five hours, 13 minutes last weekend.
Now he plans to run the London Marathon and celebrate after as the world's oldest marathon runner.
"I've said I'll attempt it," he told Reuters by telephone from his workplace at Pimlico Plumbers. "I haven't said I'll complete it. If I do make it, all the better. I hadn't thought of doing it before but someone asked me and the money goes to charity so why not?"
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"If I finish, I'll do what I always do and have a pint and a fag," he said. "People ask what is my secret but I haven't got one. They say fags and booze are bad for you -- but I'm still here, aren't I?"
Who do you think you are, Buster?.
Buster's a hero of mine.
When we think of older people, we think of them as getting stiffer, more close-minded in their opinions. In short, "as rigid as their arteries" as Nicholas Danigelis, a sociologist at the University of Vermont says.
Yet the opposite is true. People grow more liberal and tolerant as they age; their political attitudes grow more liberal and flexible.
Danigelis in a recent study published in the October 2007 American Sociological Review, looked at the political attitudes of 46, 520 people.
"We found no support for the bogeyman of gerontology, which is that the older you get, the more conservative and rigid you become," he says.
Yes, older Americans are less tolerant of gays, blacks or women in certain positions of authority. But they were less likely to hold onto those prejudices. In some areas – censorship of library books or unpopular public speakers – the group of people in the older age bracket has became more open-minded over the last 30 plus years as younger people went in the other direction, this survey found.
“Both the grumpy young people and the grumpy old people became more tolerant over the years,” said Danigelis, in an interview. “But the grumpy old people did so at a much quicker pace.”
They may be old dogs, but they are open to new opinions, more so than the young pups.
Ah, the benefits of living a long life.
While still a preliminary finding, it seems that the mental acuity of seniors is improving, older people are functioning at a higher level for a longer time.
And the five easy steps to living long and well reports the New York Times are
... abstaining from smoking, weight management, blood pressure control, regular exercise and avoiding diabetes. The study reports that all are significantly correlated with healthy survival after 90.
While it is hardly astonishing that choices like not smoking are associated with longer life, it is significant that these behaviors in the early elderly years — all of them modifiable — so strongly predict survival into extreme old age.
“The take-home message,” said Dr. Laurel B. Yates, a geriatric specialist at Brigham and Women’s Hospital in Boston who was the lead author of the study, “is that an individual does have some control over his destiny in terms of what he can do to improve the probability that not only might he live a long time, but also have good health and good function in those older years.”
"I have a population that, having survived this terrible illness, is now getting illnesses of old age 10 or 20 years sooner than normal," said Dr. Ardis Moe, a physician at UCLA's Center for Clinical AIDS Research and Education. "That's the bad news. The good news is that they're not dead."
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With HIV, growing older, faster
Now more than a quarter of the estimated 1 million Americans living with HIV are, like Gibson and Golay, older than 50, according to the federal Centers for Disease Control and Prevention. By 2015, half will be older than 50. At least two long-range studies of people aging with HIV are underway, by the National Institutes of Health and the Veterans Health Administration.
A 2006 study by the New York-based AIDS Community Research Initiative of America on the interaction of HIV and aging on mental health found depression to be almost 13 times higher in longtime survivors than in the general population. As do the very elderly, whose suicide rate is the highest of any age group, longtime HIV survivors often grow despondent over health disabilities and the deaths of friends.
"Everybody I knew died in the late '80s or early '90s," said Los Angeles resident and longtime survivor Thomas Woolsey, 59. "It sounds like I'm the lucky one, but I don't really think so. What good is a life without any friends?"
Most people lose a lot of their desire to live when they lose all their friends, particularly if they don't have close family.
You've probably seen or read about brain fitness software that are supposed to ward off memory loss and combat the dulling of the mind.
Most haven't done any scientific research to bolster their health claims.
Two scientists have taken a skeptical view.
Sandra Aamod, editor of the journal Nature Neuroscience, and Sam Wang, professor of molecular biology and neuroscience at Princeton University, offered a critical view of the products in a November New York Times opinion piece. A better bet, the authors argued, is physical exercise.
"So instead of spending money on computer games or puzzles to improve your brain's health, invest in a gym membership," the authors wrote. "Or just turn off the computer and go for a brisk walk."
Retraining the brain for the aging workforce
The search for the quick fix and the quick buck continues. If software doesn't work, maybe a surgical procedure or a drug will do the trick.
The old ways are still the best even if we get bored hearing them.
good nutrition
exercise
socializing with friends
positive attitude towards aging
spirituality
mental stimulation
Leading a sedentary lifestyle may make us genetically old before our time.
Sedentary life 'speeds up ageing'.
They particularly focused on telomeres, the repeat sequences of DNA that sit on the ends of chromosomes, protecting them from damage.
As people age, their telomeres become shorter, leaving cells more susceptible to damage and death.
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But men and women who were less physically active in their leisure time had shorter leukocyte telomeres compared to those who were more active.
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The most active people had telomeres of a length comparable to those found in inactive people who were up to 10 years' younger, on average.
The grandmother who fought back during a carjacking.
"I said, 'Look, if you do don't stop this car and get out I am going to stab you in the eye with this ink pen and I'm serious,' 'OK.' So, he turned the corner right there at the Kangaroo and he got out."
Why didn't someone think of this before? Lights on walkers may cut falls
Forget driving in the dark — sometimes it's dangerous just walking in the dark.
As the population ages, medical teams are responding to more calls from people who have fallen in the night. Many are from older adults who toppled over their walkers while reaching for a light switch on the way to the kitchen or bathroom.
Credit Ron Olshwanger, director of the Creve Coeur Fire Protection District, whose own experience with his own mother ultimately led to his inspiration.
The lights (which are a lot like bicycle lights) cost $34 at Medical West, a medical supply firm that can install them on new or existing walkers.
Olshwanger emphasizes that he and the fire department won't make any profit off the headlights. His inspiration is his mother, Bernice Bormaster, who died five years ago. After breaking her hip, she called her son three times in the middle of the night for help getting back to bed.
"It's a perfect example of what can happen. A lot of these people, their minds are fine, their bodies are just a little weak." Olshwanger said. "These people want to live a normal life, and I think this will help."
HT bookofjoe
Last week I wrote Life Imitates Art, this week there is a much finer piece in The Boston Globe about the situation facing Sandra Day O'Connor called A love supreme finds space in dementia.
So this, in the end, is what love is.
Former Supreme Court justice Sandra Day O'Connor's husband, suffering from Alzheimer's disease, has a romance with another woman, and the former justice is thrilled - even visits with the new couple while they hold hands on the porch swing - because it is a relief to see her husband of 55 years so content.
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And despite the stereotypes, researchers who study emotions across the life span say that old love is in many ways more satisfying than young love - even as it is also more complex.
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Researchers trying to understand aging and emotion performed brain scans on people across a range of ages, gauging their reactions to positive and negative scenes. Young people tended to respond to the negative scenes. Those in middle age took in a better balance of the positive. And older people responded only to the positive scenes.
"As people get older, they seem to naturally look at the world through positivity and be willing to accept things that when we're young we would find disturbing and vexing," said Dr. John Gabrieli, a professor of cognitive neuroscience at MIT and one of the researchers.
Or maybe creative people have a greater sense about what's in the air.
Justice O'Connor's husband forms romance with fellow Alzheimer's patient.
Last week I watched Away From Her, a movie starring Julie Christie as Fiona who, suffering from Alzheimer's disease, decides she would be better off in a retirement home than with her husband of fifty years whom she dearly loves, despite some troubled spots that they never discuss.
New patients at the retirement home are not allowed visitors for thirty days so they can adjust more quickly. When the husband finally is allowed to visit his wife he finds Fiona has fallen in love with a fellow patient.
The movie is a brilliant adaption by Sarah Polley of an Alice Munro short story, "The Bear Came Over the Mountain."
Ronni Bennett over at Time Goes By has posted a two-part interview with Dr. William Thomas, a young geriatrician and author of What are Old People For?
"What Are Old People For?: How Elders Will Save the World" (William H. Thomas)
Here is one excerpt.
We human beings live a long time after our reproductive peak. This is no accident. Our species took the necessity of aging and, from that, refined the virtues of elderhood. Elders are an integral, biologically determined element of the human cultural fabric and it is time they understood this role and begin to play their part.
And another on the two most important things he's learned from elders.
1. Wisdom lies in knowing what to overlook. 2. In the end, no one gets out alive and so, for the time we are here, it is all about relationships. Nothing else really matters.
Part One
Part Two
Grandmother celebrates 100th birthday by becoming world's oldest paraglider.
"I was sitting in a chair floating above the mountains. I'm not scared at all.
"I love heights, I love climbing, I love getting up in the air. I hope to do this again when I am 105, but this might be my final goodbye to all my flying escapades," she said.
Civic Ventures, a think tank founded in the late 1990s is "reframing the
debate about aging in America and redefining the second half of life as a source of social and individual renewal"
It's about "helping society achieve the greatest return on experience."
They begun a number of programs including the Experience Corps, a national service program for Americans over 55, the Next Chapter working in local communities to help people in the second half of life connect with peers and find pathways to significant service.
The Purpose Prize provides 5 awards of $100,000 each to people over 60 who are taking on society's biggest challenges.
Here are some of the winners about whom Mark Freedman, founder and President of Civic Ventures said,
"These men and women - some national figures, some local heroes - disprove the notion that innovation is the province of the young and show us the essence of what's possible in an aging society."
Nominations for the 2008 Purpose Prize are open November 15 through March 1.
The foundation also publishes a number of booklets available for download including The Boomers' Guide to Good Work
Just about everyone in Australia knows Olive. She's the blogger who is turning 108.
Three cheers for Olive!
You can watch her sing My Blue Heaven on YouTube and hear her tell stories as well.
Mona Shaw reached her breaking point, then reached for her hammer and so lived out what most of us only fantasize about.
Taking a Whack Against Comcast
The insulting idea that, as Shaw puts it, "they thought just because we're old enough to get Social Security that we lack both brains and backbone."
So, after stewing over it all weekend, on the following Monday, she went downstairs, got Don's claw hammer and said: "C'mon, honey, we're going to Comcast."
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Hammer time: Shaw storms in the company's office. BAM! She whacks the keyboard of the customer service rep. BAM! Down goes the monitor. BAM! She totals the telephone. People scatter, scream, cops show up and what does she do? POW! A parting shot to the phone!
"They cuffed me right then," she says.
Her take on Comcast: "What a bunch of sub-moronic imbeciles."
The best thing to keep normal, aging brains sharp is physical exercise which seems to help the brain as much as the body.
And you want a 'bushy' brain not a 'twiggy' one.
A healthy brain is a bushy one. Branch-like tentacles extend from the ends of the brain's cells, enabling them to communicate with each other. The more you learn, the more those connections form.
Doctors discuss theories on aging brains.
About three weeks ago, the chef at a nursing home in England brought in a video games console, the Nintendo Wii, that belonged to his son so that the staff could play it on the weekend.
But once the residents, ages 80-103, got a gander at the console, they were so enthralled they demanded the staff purchase one immediately. Forget bridge, crosswords, even the telly, all these residents want to do is play Wii.
"They were absolutely hooked.
"They're up of their armchairs and moving about and there's a real team spirit."
The games system has proved to be such a success that executives at Sunrise Senior Living are now planning to buy one for each of their 15 residential homes.
If this goes ahead, inter-care home tournaments would take place with teams of elderly residents travelling to other care homes via mini-buses for matches.
Dr Lorna Layward, research manager at Help the Aged, said: "Anything that gets elderly people up off their feet and trying something new is a very good thing.
Elderly 'addicted' to Nintendo Wii at care home.
76 years old, Doris Anderson was hunting elk with her husband when their truck broke down. They began walking out when they got separated in the woods. Two weeks passed, the hunt had stopped, the memorial service was being planned, when Doris was found by the police, alive and well.
Surviving canyon ordeal
"My mom is much stronger than I ever knew that she was, I thought that she was more fragile than that and she's proved me wrong and I'm glad," she added.
Equally delighted is Mrs Anderson's husband Harold who had carried on looking for help when his wife had become exhausted and decided to try to return to their vehicle.
A disorientated Mr Anderson was later picked up by another hunting group, but they failed to find his wife.
"I thought my wife was dead," Mr Anderson said of the news that his wife was alive. "It's a living miracle, it has to be."
The New York Times has a good piece on the Grass-Roots Effort to Grow Old at Home with a handy sidebar giving contacts for aging in place communities across the country.
“A few neighborhood-based, relatively inexpensive strategies can have an enormous effect,” Mr. McCallion said. “If people don’t feel so overwhelmed, they don’t feel pushed into precipitous decisions that can’t always be reversed.”
For inspiration, the nascent groups looked to Beacon Hill Village in Boston, which pioneered the approach six years ago. Beacon Hill’s 400 members pay yearly dues — $580 for an individual and $780 for a couple, plus à la carte fees — in exchange for the security of knowing that a prescreened carpenter, chef, computer expert or home health aide is one phone call away.
I wrote about this new phenomenon that started on Beacon Hill in Aging at Home last year.
It's cheaper by far, and desired by a great majority of the elderly. The biggest question will it work in the suburbs, outside an urban neighborhood?
At Times Go By, Ronni Bennett nicely organizes links and summaries to David Wolfe on Jung's Seven Tasks of Aging
Here quickly are the seven tasks -
1. Facing the Reality of Aging and Dying
2. Life Review
3. Defining Life Realistically
4. Letting Go of the Ego.
5. Finding a New Rooting in the Self
6. Determining the Meaning of One's Life.
7. Rebirth - Dying with Life
When a electronics company no longer sees future profits in electronics because of competition from Asia
and decides to focus on the elderly who want to live independently, that's big news. But that's just what Phillips Electronics has done.
Electronics Giant Seeks a Cure in Health Care (WSJ, subscription only)
Philips paid $750 million last year to buy Massachusetts-based Lifeline, an acquisition that represented a turning point for the company.
For decades, its medical-systems division made and sold large, professional equipment like X-ray and CAT-scan machines to hospitals. Now, Philips is attempting to meld its health-care experience with its knowledge of consumer marketing. The goal: carve out a new high-growth business selling health-related products and services.
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One of the hot areas Philips identified was "independent living," or elderly people who wanted to live on their own for as long as possible.
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Philips organized focus groups of elderly people and their adult children in Madrid, Frankfurt, San Francisco and Boston. They made some key findings. For instance, a stigma exists among many seniors who are reluctant to acknowledge their frailty or ill health. Another problem: Elderly patients often aren't comfortable with high-tech products, and prefer a measure of human interaction. Sometimes, arthritic fingers prevent them from navigating tiny buttons.
Philips developed a profile of the elderly customer it wanted to target. Internally, they dubbed it the "Senior Solutions Sweet Spot." People in this group, they determined, valued self-reliance, felt that staying connected to friends and family was important and yet wanted to address "functional decline" like weakening vision or trouble walking.
This is coming just in time for aging boomers since we know there won't be enough geriatricians, It's already too late.
When the family tree becomes a beanpole, there's no one left to take care of the old folk.
So, Italy's Aged Turn to Foreigners for Care
Marzano is one of a swelling number of Italians entrusting themselves to an army of foreign workers from eastern Europe, South America, Asia and Africa who are doing what families here are increasingly can't or won't do - take care of their elderly.
Long life and low birthrates have conspired to change family life, which long had been the one institution Italians could count on while history rolled past, with its parade of conquerors and short-lived governments.
Italy's demographics - and Europe's as a whole - give new meaning to the term "Old World."
Twenty-four of the world's 25 oldest countries are in Europe, noted a joint report by the European Commission
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"I would have thought I would have lived with my son; I would never have thought that it would be like this," said Marzano.
The alternative solution in Italy is to send the old folk to be cared for by nuns, many of whom have converted their former schools into rest homes.
I'm so delighted to have access to my blogs again even though I've lost all my draft posts, no doubt my most brilliant. I'm off to my Smith College reunion in an hour or two and looking forward to seeing all my classmates and to learn what's happened in their lives.
Here's a picture of me and friends on Ivy Day, some years ago. I'm the one on the right in the shadow.
"..whenever I had a problem, I went to something wholesome to solve it."
One of the “wholesome” things that helped, he said, was bowling.
That's about as good an explanation of dealing with problems as I have ever heard.
The Older-and-Wiser Hypothesis in the New York Times Sunday magazine.
The popular image of the Wise Man usually does not include a guy in a bowling shirt, but several qualities have emerged again and again in older people like J. who score high on Ardelt’s wisdom scale. They learn from previous negative experiences. They are able to step outside themselves and assess a troubling situation with calm reflection. They recast a crisis as a problem to be addressed, a puzzle to be solved. They take action in situations they can control and accept the inability to do so when matters are outside their control.
so how do academics define wisdom now that they have begun studying it? For one thing, you don't have to be smart or accomplished or even old, though most older people are more even-keeled and emotionally resilient.
Certain qualities associated with wisdom recur in the academic literature: a clear-eyed view of human nature and the human predicament; emotional resiliency and the ability to cope in the face of adversity; an openness to other possibilities; forgiveness; humility; and a knack for learning from lifetime experiences. And yet as psychologists have noted, there is a yin-yang to the idea that makes it difficult to pin down. Wisdom is founded upon knowledge, but part of the physics of wisdom is shaped by uncertainty. Action is important, but so is judicious inaction. Emotion is central to wisdom, yet detachment is essential.
Vivian Clayton whose research has made many breakthroughs in understanding, first analyzed the Hebrew bible
“What emerged from that analysis,” she says, “was that wisdom meant a lot of different things. But it was always associated with knowledge, frequently applied to human social situations, involved judgment and reflection and was almost always embedded in a component of compassion.” The essential importance of balance was embodied in the Hebrew word for wisdom, chochmah, which ancient peoples understood to evoke the combination of both heart and mind in reaching a decision.
Another researcher Birren boiled it down to the "Berlin Paradigm" and defined wisdom as
an expert knowledge system concerning the fundamental pragmatics of life.
Ardelt who's now doing research in Boston analyzing Harvard University graduates says
People who rated high in wisdom, she adds, were “very generous,” both financially and emotionally; among those who rated low in wisdom, “there was this occupation with the self.”
What is very clear is that old people with a more positive attitude towards old age lived seven and a half years longer.
They can regulate their emotions better, registering the negative, focusing on the positive.
It may be that the seeds of wisdom are planted early in life with exposure to adversity or failure, that one called a "stress inoculation" that enhances the person's ability to regulate emotions.
Ronni Bennett delivers unwelcome news and a whole lot of numbers from as well as a good exegesis of Atul Gawade's piece in The New Yorker on The Way We Age Now
There will not be enough doctors trained in geriatrics to deal with us aging boomers. There's not enough now.
Seems as if the number of geriatricians is declining while the number of plastic surgeons is rising. Doctors just don't want to deal with "Old Crocks" which is what we all will be given enough time.
Even if we stop obsessing on how well we look, and start focusing on how well we are, we're out of luck and on our own. When asked whether enough geriatricians could be trained to serve the booming elder population, Chad Boult, professor at John Hopkins said,
"Nothing, it's too late."
Read Ronni's post but don't miss the Gawade piece to get the full flavor of what we individually and as a society are avoiding, the certainty of our decrepitude and the words of a wonderful writer.
Even as our bones and teeth soften, the rest of our body hardens. Blood vessels, joints, the muscle and valves of the heart, and even the lungs pick up substantial deposits of calcium and turn stiff. Under a microscope, the vessels and soft tissues display the same form of calcium that you find in bone. When you reach inside an elderly patient during surgery, the aorta and other major vessels often feel crunchy under your fingers. A recent study has found that loss of bone density may be an even better predictor of death from atherosclerotic disease than cholesterol levels. As we age, it’s as if the calcium flows out of our skeletons and into our tissues.
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Decline remains our fate; death wil come. But, until that last backup system inside each of us fails, decline can occur in two ways. One is early an precipitately, with an old age of enfeeblement and dependence, sustained primarily by nursing homes and hospitals. Th other way is more gradual, preserving, for as long as possible, your ability to control your own life
Is it hopeless? Are we all doomed? Not if Chad Boult can get geriatricians to train primary care doctors to treat the very old. But that's a tall order given that today, 97% of medical students take no course in geriatrics, 97%!
Frankly, I have a lot more hope in Gould's backup plan called "Guided Care" which calls for nurses to be given a highly compressed, three-week course in making geriatric care plans for individual patients and working with patients, families and doctors to implement the plans.
I count myself very lucky that my sister Colleen, a nurse, plans to become a certified nurse practitioner to work with us future "old crocks."
Venus Ramey, Miss America in 1944, is now 82 and needs a walker to get around her Kentucky farm where she sells trees.
When she caught Curtis Parish stealing scrap metal from her yard, she took out her gun and shot out his tires as he was leaving.
"The first time I was robbed on the other side road about 6 or 7 years ago, I caught one man," Ramey said.
But now both police and Ramey say they don't think this man will try to steal from her again.
Police say Ramey had every right to fire the gun since they say she witnessed the men committing a crime on her property.
I wonder how many older people feel safe only because they have a gun to defend themselves and to keep people from preying on them.
You may know him as geriatric 1927 , Peter Oakley, the Englishman who became an unexpected star on YouTube when he began telling his life story in videos.
Now he's "the new old age happening". Now he's going to be a music star as he tells us himself and lets the secret out with a message from the old people to the youth of the world.
We are old. We are here. We have much to contribute. We object to the abuse that sometimes happens to old people.
At the behest of the BBC, he's sings "Talking About My Generation" by the Who and backed up by a geriatric chorus with an average age of 78, called the Zimmers. A CD was produced at Abbey Roads Studio by Mike Hedges with a release date for the CD is May 28th, proceeds going to age-concerned charities. He's hoping it climbs the charts to get the message out.
Ronni, that's your cue.
I watched the slide show and the video here on MySpace.
It's fabulous.
Big thanks to Hootsbuddy
Update. Buster is part of the band! I know Buster. He's the 100-year-old man who fought off a gang of muggers.
[AUTHOR'S NOTE: Last month, I guest blogged at Ronni Bennett's Time Goes By, the indispensable blog for anyone who wants the real skinny on what it's like to get older.
I could say Ronni is a Dame Commander but she's more of a mother hen keeping track of a growing brood of over 50 "elderbloggers", swatting away ageist snark while still laying before us one perfectly composed post every day to enjoy with breakfast.
Her photo time line is a model of how family photos can be meaningfully enhanced with just a few lines of context. As a movie buff, her TGB ElderMovie List is a fine resource when looking for a movie you can watch without embarrassment with your parents and with pleasure just by yourself. So when she asked me to write something about aging, Margaret Rutherford immediately came to mind.]
Growing older has never really bothered me, perhaps because I was lucky in having wonderful role models of older women. Every May there is an alumnae parade at Smith College and the largest, loudest cheers go up for the oldest women in their 80s or 90s who march proudly under the banner of their graduating class. I’d be all right, I thought, if I could be one of them.
But it was seeing Margaret Rutherford for the first time that absolutely convinced me how delightful it could be to be like her. I was gobsmacked and totally enchanted when I first saw her play Miss Marple in the four “murder” films based on the Agatha Christie novels: Murder She Said, Murder at the Gallop, Murder Most Foul, and Murder Ahoy - every one of which deserves prominent placement on the TGB ElderMovie List
She was endearing, stout as an armchair and as comfortable too, a bicycle-riding, tea-making, pie-baking sleuth with an admiring male pal, cheerful in cape and hat, perfectly dressed no matter what the occasion, sensible to human frailties, fearless, smart as a whip and as funny as all get out. Who knew that being an old lady could be so much fun?
A force of nature, she could do things with her mouth, her tongue in cheek, that have never been equaled and will make you forswear even the idea of plastic surgery if it would rob you of the expressiveness of a ravishing, totally lovable old face like hers.
Born in a London suburb in 1892, nine years after her father murdered her grandfather with a chamber pot, Margaret Rutherford was an only child. Her mother died when she was 3 and she was brought up by a pair of guardian aunts.
Maybe the experience of living with a mentally ill father who was readmitted to Broadmoor, a British hospital for the criminally insane, when she was only 12, disposed her to a life in the theater. She wasn’t pretty, but she was funny and I think a late bloomer. She was 33 when she made her stage debut at the Old Vic in 1925 and 53 when she married a fellow actor Stringer Davis.
She really came into her own in her late 60s and 70s when she began to play Miss Marple. She worked with Elizabeth Taylor and Richard Burton, winning an Academy Award best supporting actress in The V.I.P.s. In her 70s, the Queen named her first an officer of the British Empire, later a Dame Commander.
And what a Dame Commander she was as Miss Marple, laying bare evil and overcoming it with goodness, everything made right. And she did it by becoming and being her magnificent self all the time. Take one scene from Murder Ahoy:
MISS MARPLE: Are you implying that I am unhinged?
DETECTIVE INSPECTOR CRADDOCK: No. No, of course not!
MISS MARPLE: Then what are you implying, pray?
DETECTIVE INSPECTOR CRADDOCK: Well, just that you are temporarily not yourself.
MISS MARPLE: Chief Inspector, I am always myself!
In one interview, she said,
"I hope I'm an individual. I suppose an eccentric is a super individual. Perhaps an eccentric is just off centre - ex-centric. But that contradicts a belief of mine that we've got to be centrifugal."
Centrifugal she was, radiating out from a deep core of self, to delight and gift the world.
Since I believe that the point of aging is to become more ourselves, our best selves, and to give our best selves away, I would make Margaret Rutherford a patron saint of aging.
She’s mine anyway.
Because human nature doesn't change, bringing out the classics to train doctors is illuminating.
The Difficult Patient, a Problem Old as History
Sophocles somehow got that tenuous position just right, just as he knew that sick people, isolated and transformed by chronic disease, dread being alone and forgotten more than they dread pain or even death.
What will happen when so many singles - never married, divorced or widowed - get older alone?
I say let's give 3 cheers to the 100-year-old man who fought off a gang of muggers in south London.
This WWII vet called Buster busted the chops of 3 youths who jumped on him from behind as he was leaving a pub and knocked him down. They ran away while Buster, bloody and bruised, walked to the hospital.
I was confused and I was lashing out at them. How the helI I found the strength I don't know. I think it came from my temper. I don't lose it often but when I do it's not a pretty sight.
Buster who was born in 1906 and has 17 children still works as a van cleaner and said
As long as I still wake up in the morning, I will continue to work.
In this digital age comes a new way of tapping into the wisdom of people with a great deal of life experience.
An Online Outlet for the Wisdom of the Aged.
600 seniors answer several thousand letters a month AND publish a weekly advice column in 22 newspapers.
Mayyasi purses her lips and goes to work, mauve fingernails clicking across the keyboard. At 73, she is restlessly retired. This is her volunteer work. People need her, and she is their cyber-grandmother, a virtual plate of fresh sugar cookies, warm and reassuring in lives full of cold rain.
Is a courtesan, not a prostitute, but a courtesan the ideal archetype for a truly modern woman?
Robert Paterson and his sister Diana will be exploring the lifestyle of courtesans in a short series on Trusted Space that looks very interesting.
Here's a taste.
Looks are transient. A beautiful woman becomes a faded beauty, something sad to behold.
A clever, witty and kind woman ages without her age being noticed, and she, has maturity, and good sense and a great deal to offer younger women and she knows well her time has passed and she loves nothing more than to pass on her experience to a
younger intelligent woman she respects.
Age is no obstacle for her. She has no need of plastic surgery because she takes on her new role as grand dame with great relief.
She has had many men and many experiences, and she is happy to live with her memories and move forward with her personal interests. She does not need to diet because she is now fulfilled by things that feed her mind. Her pleasure of the body has been replaced by the utter pleasure of all things interesting to her.
She sleeps alone and comfortably. She leaves the fretting of love and not love to younger women. She has no more of those thoughts to cloud her mind and take away her sleep. She is comfortable with herself.
Education is the signal factor that most effects good health and long life.
The Surprising Secret to a Long Life
The one social factor that researchers agree is consistently linked to longer lives in every country where it has been studied is education. It is more important than race; it obliterates any effects of income.
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Year after year, in study after study, says Richard Hodes, director of the National Institute on Aging, education “keeps coming up.”
And, health economists say, those factors that are popularly believed to be crucial — money and health insurance, for example, pale in comparison.
It may be too late for Christmas, but designer crutches are cool. For that special someone who wants to age with grace and grit.
Adding comfort to an uncomfortable item are LemonAid Crutches.
It's real physical exercise, not crossword puzzles, that keeps your aging brain fit reports the Wall St Journal.
For the first time, scientists have found something that not only halts the brain shrinkage that starts in a person's 40s, especially in regions responsible for memory and higher cognition, but actually reverses it: aerobic exercise. As little as three hours a week of brisk walking -- no Stairmaster required -- apparently increases blood flow to the brain and triggers biochemical changes that increase production of new brain neurons.
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support for the brain benefits of physical exercise has become stronger. A number of earlier studies showed that elderly people who take up aerobic exercise show improved cognitive function after a few months, says Arthur Kramer of the University of Illinois, Urbana
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As little as three hours a week of aerobic exercise increased the brain's volume of gray matter (actual neurons) and white matter (connections between neurons), they report in the November issue of the Journal of Gerontology: Medical Sciences. "After only three months," says Prof. Kramer, "the people who exercised had the brain volumes of people three years younger.
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"This is the first time anyone has shown that exercise increases brain volume in the elderly," says Dr. Kramer. "It suggests that aerobic exercise can stave off neural decline, and even roll back some normal age-related deterioration of brain structure."
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With more gray matter and white matter, "the brain is more interconnected, more plastic and more adaptive to change," Prof. Kramer says.
Dogs may hold the secret to a long life.
DOGS may be the secret to health and happiness because they encouraged their owners to walk them daily whatever their mood or circumstances, British researchers said today.
Researchers at the University of Portsmouth found that dog owners felt obliged to walk their dogs despite bad weather or low moods, keeping them fit and making them feel better once they were out.
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Ms Knight said that many participants in the study were retired people, including those who had been widowed or otherwise lived alone, or were recovering from illness or operations.
She said that they discussed occasions when they had felt lonely, isolated or depressed, and reported that their dogs helped them stay physically fitter and helped maintain social contacts.
Besides, what other creature gives so much unconditional love and affection?
Dogs have given us their absolute all. We are the center of their universe. We are the focus of their love and faith and trust. They serve us in return for scraps.
It is without a doubt the best deal
man has ever made.
Roger Caras
Our poet laureate, Donald Hall is 78, says that poetry is well suited to the rigors of old age.
"Poems are made for other persons to read but made out of silence and solitude, and perhaps there is more silence and solitude in the world of the old."
Take 95-year-old Anne Porter featured today in the Wall Street Journal and whose first volume of poetry was published when she was 83.
Asked why she keeps writing poems through her 80s and 90s, Mrs. Porter responds that art may be the only pursuit that old age can't wreck:
"You can't sing anymore, you can't dance anymore, you can't drive anymore -- but you can still write,"
Here she is on "Old in the City."
You stay away from doctors,
They'd send you to the hospital,
Where pieces are cut out of you,
And after that you die.
On finding a ticket that says "Keep This Ticket" in her purse, she wrote.
I keep it carefully
Because I'm old
Which means
I'll soon be leaving
For another country
Where possibly
Some blinding-bright
Enormous angel
Will stop me
At the border
And ask
To see my ticket
On getting older, she says
"People don't use their creativity as they get older," she said. "They think this is supposed to be the end of this and the end of that. But you can't always be so sure that it is the end."
With the help of her readers, Ronnie Bennett at TimeGoesBy has put together a list of "eldermovies" which just might be handy if you're spending a weekend with an elderly parent.
I haven't been posting as much as usual because I've been taking care of my mother who just had major surgery to remove cancer from her colon.
Like many older people, she doesn't have a computer or internet access. Yet as she recovers, she realizes that she'll need a cell phone if she plans to drive again, just in case of an emergency.
Jitterbug is what she's looking at. They have made cell phones easy-to-use for the technologically-challenged. With big buttons, bright screens and no unnecessary features, it looks great for the elderly who want something just for an emergency. Best of all, there's an operator always standing by to help out.
Has anyone had experience with them?
He started law school at 86 and finished at 91, one year ahead of schedule.
And to do it, he had to teach himself how to use a computer and the Internet.
Allan Stewart said, "Time is of the essence. I think if I had let it run too much longer I might not have finished it."
Good show, mate.
Why do some people age well and others get frail?
Two reasons:
1. undetected heart disease
2. having positive images of growing older
Old but Not Frail: A Matter of Heart and Head
You’re only as old as you think you are. Rigorous studies are now showing that seeing, or hearing, gloomy nostrums about what it is like to be old can make people walk more slowly, hear and remember less well, and even affect their cardiovascular systems. Positive images of aging have the opposite effects. The constant message that old people are expected to be slow and weak and forgetful is not a reason for the full-blown frailty syndrome.
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More and more scientists say they have been won over by an accumulating body of evidence.
“I am changing my initially skeptical view,” says Richard Suzman, who is director of the office of behavioral and social research programs at the National Institute on Aging. “There is growing evidence that these subjective experiences might be more important than we thought.”
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Dr. Levy wondered, were there long-term effects of believing the stereotypes of aging? She found a study that could provide answers, the Ohio Longitudinal Study of Aging and Retirement. The two-decade-long study included 1,157 people, nearly every resident of Oxford, Ohio, who was 50 or older and was not suffering from dementia. And it had questions about beliefs about aging.
It turned out that people who had more positive views about aging were healthier over time. They lived an average of 7.6 years longer than those of a similar age who did not hold such views, and even had less hearing loss when their hearing was tested three years after the study began
Our fears of aging become self-fulfilling prophecies
Neferititi was actually a fascinating aging beauty
Cleopatra was not a young hottie, but a mature beauty, a woman of a certain age. She had wrinkles on her neck and bags under her eyes according to a new examination of the famous bust.
Which just underscores the importance of lighting.
He was forced to take a day off when he turned 100.
He had planned to mark his 100th with a pint at his local but colleagues arranged a VIP tour of Chelsea's Stamford Bridge stadium, where he will be presented with a shirt with 'Buster 100' on the back.
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Buster said: "Boredom is a big killer. I went back to work as I like to keep active. If I didn't work I would become the most miserable sod you have ever come across so I don't want to stop working."
New ways to grow older at New Rentals that Aim to Age with Creativity.
Like the Burbank Senior Artists Colony the NYT reporter likens to Golden Girls meets Yaddoo.
They sing, they dance, they paint, they create their own movies and radio shows.
We’re thinking beyond the problems of aging to its potential,” said Dr. Gene D. Cohen, the director of the Center on Aging, Health and Humanities at the George Washington University Medical Center. “What’s emerging is a very talented group of people who are an under-recognized national resource.”
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The colony is the brainchild of Tim Carpenter, the founder of More Than Shelter for Seniors, who grew up near Yaddo, the New York artists’ community. Mr. Carpenter recruited an advisory board sprinkled with actors to hone the concept and drew an initial core of tenants, ages 55 and older, through local arts organizations. No tryouts or portfolios are required, but the artistic ambitions of residents transcend the flutophone or macaroni-glitter-and-glue crowd.
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Like a challenging painting, life at the arts colony has become an exercise in perspective. “You meet yourself,” she said. “You find out who you really are.”
He thought he had found an easy mark in the woman in a wheelchair. He bent over to grab the chain around her neck; she grabbed her pistol and shot him in the elbow.
Margaret Johnson, applauded across the country, is no victim because she took responsibility for protecting herself seriously.