Rodger Marion

Where I live we don’t have cable or DSL. Our Internet connection comes via an antenna on the roof that gets a signal from a line-of-sight transmission from the next hill. Our Internet provider is a sort of homebrew  company that was founded by a guy at my church. It’s all a local effort.

When people ask me about the speed of my Internet, I usually say, jokingly, that we get it via the barbed wire fences that run between all the houses.

Well, at one time using the fence wire was how rural people communicated (Trew, 2003; Wheeler, 2014; Zhang, 2014). Stop here and go read one or more of these links. If you just read one, make it Wheeler.

I meant to use the barbed wire telephone story almost a year ago, but somehow it fell between the cracks. What struck me about this story was how people did this themselves. They figured out new technology and made it work where no business or corporate entity would. This sort of creativity, that overlaid the latest technology on mundane everyday things, seems lost today.

I wonder if health care has any niches that would profit from this sort of frontier innovation? I don’t have an already selected answer for this question.  I think though that more problems need to be solved at a grass roots level than by a bunch of specialists in some exotic corporate structure.

Maybe the rural environment is more conducive to practical innovation. Sort of a skonk works* for real.

Join us for a real-time discussion about ideas raised by this essay on Friday from 12:00 p.m. to 12:45 p.m. See Discussion and SL tabs above for details. Link to the virtual meeting room: http://tinyurl.com/cjfx9ag.

* Skonk Works – a small, independent group charged with a highly innovative task and characterized by reduced corporate interference. Term originally came from Al Capp’s newspaper comic strip, Li’l Abner, and was adopted by Lockheed Martin for its development facility. In the latter usage as Skunk Works® it is registered by Lockheed Martin.

References

1. Trew, D. Barbed Wire Telephone Lines Brought Gossip and News to Farm and Ranch. Farm Collector, September 2003.
2. Wheeler, C. Wired for Sound. Texas Co-op Power, May 2014.
3. Zhang, S. Barbed Wire Fences Were An Early DIY Telephone Network. Gizmodo, January, 2014.

Next week will be March and Spring will be blossoming in Texas. This week however it’s still Winter and the water in my birdbath is frozen solid. I am again pondering my lack of motivation for exercise, especially over the Winter months. In the Winter about all I manage is a daily hike up and down the hill to the mailbox and chopping wood for the fireplace.

Spring will bring new resolutions. I was reminded of an earlier column where I found a compromise, or perhaps false hope, in the exercise continuum.

 And so, without further adieu, a recycling of a post from week 41 titled Springtime in Texas.

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I tend cycle my level of exercise with the seasons. Winter in Texas does not qualify as more than a cool Fall day in Northern climes, but the trees do lose their leaves and I do a mild form of hibernation. With Spring comes the growth that stirs me to action. Some of the trees I hoped the drought did not kill, are dead and need taking out. The meadow is being taken over by thistle. Dianne wants a new meditation spot below the house. So, I’m out doing all that physical labor I put off in Winter and feeling more fit and muscular as a result.

I do feel however a change in strength and coordination as I age and it seems an area to be mindful about. Now loss of muscle mass as a function of age is pretty well documented (Doherty, 2001; Newman et al., 2003; Janssen & Ross , 2005; ). This age-related reduction in skeletal muscle even has a name, sarcopenia (Abellan van Kan, 2009: Visser, 2009). It seems to become more prevalent as we move through the 70s and 80s and to be associated with a variety of factors. However, one consensus is consistent, as we age we get weaker.

Now it seems obvious that a good diet and exercise is about the best thing one can do to prevent or at least slow down this situation. (Fielding, 1995). What sort of exercise is optimal is difficult to proscribe and probably varies with the individual. See Onambélé-Pearson, Breen & Stewart (2010) and Zak, Swine & Grodzicki (2009) for studies of the benefits of various exercise intensities and nutritional approaches.

Science aside, I think there is a functional component to eating, working and living. Carefully regulated diet plans and finely delineated exercise regimens have their place in maintaining wellness, but I feel there is a natural flow of heath that can be tapped by listening to the land, working it as needed and feeding the body as a result of those labors. This model has a champion in my wife’s hero, Tasha Tudor. Her approach to a long life is worth considering (Tudor & Brown, 1992).

I may stick with Winter hibernation and long Summer days of work. That’s a form of cross-training, right?

References

1. Abellan van Kan G. Epidemiology and consequences of sarcopenia. J Nutr Health Aging, Oct 2009, 13(8), 708-12.
2. Doherty TJ. The influence of aging and sex on skeletal muscle mass and strength. Curr Opin Clin Nutr Metab Care, Nov 2001, 4(6), 503-8.
3. Fielding RA. The role of progressive resistance training and nutrition in the preservation of lean body mass in the elderly. J Am Coll Nutr, Dec 1995, 14(6), 587-94.
4. Janssen I & Ross R. Linking age-related changes in skeletal muscle mass and composition with metabolism and disease. J Nutr Health Aging, Nov-Dec 2005, 9(6), 408-19.
5. Newman AB et al. Strength and muscle quality in a well-functioning cohort of older adults: the Health, Aging and Body Composition Study. J Am Geriatr Soc, Mar 2003, 51(3), 323-30.
6. Onambélé-Pearson GL, Breen L &Stewart CE. Influence of exercise intensity in older persons with unchanged habitual nutritional intake: skeletal muscle and endocrine adaptations. Age (Dordr), Jun 2010, 32(2), 139-53. Epub 2010 Apr 21.
7. Tudor, T & Brown R. The Private World of Tasha Tudor. Little, Brown & Company, Boston, 1992.
8. Visser M. Towards a definition of sarcopenia–results from epidemiologic studies. J Nutr Health Aging, Oct 2009, 13(8), 713-6.
9. Zak M, Swine C & Grodzicki T. Combined effects of functionally-oriented exercise regimens and nutritional supplementation on both the institutionalised and free-living frail elderly (double-blind, randomised clinical trial). BMC Public Health, Jan 2009, 28, 9, 39.

Image

• http://www.feminineways.com/uploads/2/8/7/2/2872172/1226453_orig.jpg Image copyright Tasha Tudor and Family Inc. and from http://www.feminineways.com/farmgirls.html
• http://www.storytimecrafts.org/wp-content/uploads/2010/11/hibernating-bear-150×150.jpg

Last week I spent a significant portion of four days installing a roll bar in my Miata. Such a simple looking thing… two steel hoops, one behind each seat. I had to take half the car apart to bolt that thing in. It was worth it. Now my aging bean is really protected should the Miata ever roll over and the chassis is somewhat stiffer. The stiffness improves the handling, converting it from a roller-skate to a roller-skate on steroids.  My car adventure reminded me of an earlier blog Tony wrote in 2013. So today we reprise Tony’s examination of driving while elderly.

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Remember when the ultimate sign of freedom was being able to jump in your car and just drive? No one was telling where to go or what time to you had to get there.  Just drive!  The only thing you loved more than your car was probably your mom and her apple pie!

Lately there have been a slew of news articles examining current trends in driving habits – number of people with driver’s licenses, monthly average number of miles being driven, who are buying new cars, etc…  Almost all indicators suggest a decline in driving, especially among young adults and teenagers.  According to economists Don Pickrell and David Pace, driving habits peaked in 2007 and they suggest several reasons for the decline since.

Mostly reasons seem to be economical – high gas prices, recession, and high cost of new cars.  But there are other possible reasons.  Maybe there is less fascination with the cars themselves – driving a ‘computer car’ just doesn’t compare to driving a classic pink Cadillac, an old Chevy Coupe or a ‘Hot Rod Lincoln.’  We have become more sensitive to environmental pollution due to gas emissions and the dependence on foreign oil.

But the groups being most affected seem to be younger.  The older driver seems to be hanging in there with their driving habits, especially older men.  The paradox here is that economically you would think the older driver would be less inclined to drive.  Elderly on fixed incomes may be more negatively affected by high gas prices and the outrageous cost of a new car (average price $31,000).  Yet, older folks seem to be driving as much as ever or even more.

I’m not sure why, but I have some theories.

First, driving equates to independence.  Older drivers seem to be more likely to hold on to that old feeling of freedom and driving.  Giving up their driver’s license is like a death sentence and the first major indicator of losing one’s independence.

Second, older drivers drive more for purpose than pleasure.  I think they drive more often for a specific reason – to get to the store, the doctors, to socialize.  The art of joy riding doesn’t fascinate them as much as it might a younger person who is looking for kicks in a fast car and wanting to be noticed.

Also, older drivers may have advantages in driving habits compared to younger drivers. It’s been said that older drivers are the safest drivers on the road – as long as they are healthy.  Insurance is cheaper for them and maybe an ‘old-timer’ is more likely to hold on to that old car longer, have it paid off and drives only when absolutely necessary.  No need to trade it in for something they can’t afford.

As I get older I find myself holding on tighter to my 2002 Camaro and not being so in love with newer cars.  I can hear the sound of my car’s engine, especially when I start it.  I can feel and ‘hug the road’ with my wide tires.  Deep down I know if I wanted to I can blow the doors off most cars on the highway.  And when I close the door, it sounds like a car, not a tin can.  I still want to know how to do basic maintenance on my own car.  And, if needed, I have a trusted mechanic who is a good friend of mine and understands my car, as well as me. So I am probably on my way to being one of those folks who will probably hold on to that car forever and that feeling of freedom while driving.

How do you feel about driving in today’s world?  Sitting in traffic as your expensive gas is used up.  Is it still fun?  Can you still remember the first time you got in your own car after getting your driver’s license and you could go anywhere you wanted?  I do!

Our Guest Blogger this week is Tony DiNuzzo, PhD, Director, East Texas Geriatric Education Center-Consortium.

Join us for a real-time discussion about ideas raised by this essay on Friday from 12:00 p.m. to 12:45 p.m. See Discussion and SL tabs above for details. Link to the virtual meeting room: http://tinyurl.com/cjfx9ag.

Reference

Lowy, J. Americans Driving Less as Car Culture Wanes. ABC News, Aug. 29, 2013. http://abcnews.go.com/Politics/wireStory/stats-show-americans-driving-anymore-20102969

Original Posting from Week 111 – Goodbye Yellowbrick Road – http://wp.me/pH3Dx-dy

This week’s Time magazine has a cover story about the new entrepreneurial economy typified by such businesses as Uber (the ride sharing business) and Home Away (the house sharing business). The author, Joel Stein, wonders about the value of these emerging businesses. Stein asserts that the corporations are taking advantage of workers by allowing them to participate in these businesses as independent contractors and then ignoring benefits, like health insurance, or any other sign of corporate responsibility. He’s probably right and these new practices have a high technology, urban flavor that seems foreign to those of us who live somewhat apart from the urban world.

I’m talking about rural living of course and here independent contractor and sharing are the rule, not the new exception. Living in a small, rural community engenders a lot of non-corporate businesses and just plain old barter for services and goods. The I.R.S. hates rural entrepreneurs because they often don’t pay enough taxes or jump over all the regulatory hurdles.

Regardless, rural life depends on the handyman, the friend next door, and the mom & pop stores in town for daily existence.

This is of course changing somewhat. Large firms based in cities have expanded their service areas to include rural towns. I can ask my friend, the handyman, to fix my stove or I can call Sears and get a technician to stop by. Which is better?  As a recent rural inhabitant with a long history of urban living, I tend to want the security of Sears but really the local guy is the better moral choice.

As we all get older and find that age has cut our mobility and strength options, a local person who can fix things and who is also a friend looks better and better. My son, when he first moved from San Francisco to Wimberley, worked with one of our venerable handymen. It usually ended up with my son doing all the work while the handyman chatted with the customer. It turns out that human contact is as important as fixing the toilet. My son wondered how the handyman ever got any work done before he had him as the assistant.

We don’t really “live-off-the-grid” here but a bit of that old Texas grit and independence of sprit is alive and well in rural communities.

Reference

Joel Stein. On-Demand Economy. Time, February 9, 2015, 185, 4, 32-40.

Image Source

https://openideo.com/challenge/vibrant-cities/inspiration/community-bartering

Join us for a live discussion about this post on Friday at noon. Link to the meeting room in the virtual world of Second Life: http://tinyurl.com/cjfx9ag. Also, see Discussion and SL tabs above for details.

I live at the edge of the city limits of Wimberley where my neighbors are out of sight and the nearest store is a couple of miles away. The four chickens who live in the chicken coop down the hill are cranking out so many eggs that my spouse and I are supplying all the neighbors with free eggs. We feel live we live in a rural community with all the benefits of quiet surroundings, wildlife with four legs,  and friendly neighbors sharing a modicum of frontier spirit.

However are we really in a rural area? Austin is 45 minutes to the North East and San Marcos (20 miles East) may be re-classified as a “small urbanized area” and that would disqualify them from funds set aside for rural transportation, like the Capital Area Rural Transportation System (CARTS) buses.

Might we become a “small urbanized area” too?

How to know?

There is an on-line resource center for rural programs for the elderly. It’s called the Rural Assistance Center.  It’s not a new operation nor probably unknown to the majority of our regular readers.

To digress for a moment, this is what the center does. “A product of the U.S. Department of Health and Human Services’ Rural Initiative, the Rural Assistance Center (RAC) was established in December 2002 as a rural health and human services ‘information portal.’ RAC helps rural communities and other rural stakeholders access the full range of available programs, funding, and research that can enable them to provide quality health and human services to rural residents.” (From the RAC About page)

Now back to the fun and relevant feature of the web site. Ever wonder if you actually live in a rural area? Well, if like me you do, then you can check your address at the Am I Rural feature of the RAC. Enter your address and it will check a bunch of Federal databases and tell you under which Federal classifications your one acre falls.

I put in my address and after much whirling of gears and clacking of electrons I learned that I’m rural in every category and a Medically Underserved Area as well.

Join us for a real-time discussion about questions raised by this essay on Friday from 12:00 p.m. to 12:45 p.m. See Discussion and SL tabs above for details. Link to the virtual meeting room: http://tinyurl.com/cjfx9ag.

Today’s image is of American Gothic a classic painting of rural Americana by Grant Wood. This image of the painting is in the Public Domain.

• Image and details about usage: http://commons.wikimedia.org/wiki/File:Grant_Wood_-_American_Gothic_-_Google_Art_Project.jpg
• Discussion about painting: http://en.wikipedia.org/wiki/American_Gothic

Each year WordPress.com, the company that hosts this blog, prepares summary statistics on the blog’s activity. The most basic number is how many people viewed the posts each day/month/year. The table below is a summary of blog views from 2011 through 2014.

Summary of Blog Views by Month and Year

The blog began in July 201. We have written 177 blogs and those blogs have been viewed at total of 11,507 times. I have written the majority of the blogs but a huge number of guest bloggers have been involved too. This year there were 18 guest bloggers. Listed in no particular order, they were: Rebecca Galloway, Amanda Scarbrough, Tony DiNuzzo, Linda Rounds, Meredith Masel, Tom Knight, Adele Herzfeld, Rachel Little, Bronia Michejenko, Karen Brown, Mark Scott, Shontel Minor, Barbara Orantes, Leah Jacobs, Danielle Rohr, Krista Dunn, Paula Crawford and Leslie Hargrove. I am very grateful for each person’s time and intellectual contribution.

Referring to the table above, the most views ever happened in May 2013 and 2013 was the year with the highest overall, total views. But if you look at the monthly totals you can see viewership has grown since 2011 and then held fairly steady until dropping off in the Fall 2014. I’ve had the feeling that the project overall has been winding down somewhat and maybe the blog is reflecting this trend. Overall, the blog has reached quite a few people.

People can add comments to each post. There were not many posted comments in 2014. Most were from me (42), second highest was from a non-UTMB aging professional (12), with a few posts from Tony DiNuzzo and Mary Wainwright. There were more comments, but not vastly more, posted on the Facebook page but Facebook does not provide summaries of that information. Overall, response to the blogs has been more readership than discussion.

Summaries exist for all years except 2011. You can look at various statistics from each year by clicking on the links below:

• 2014 Summary
• 2013 Summary
• 2012 Summary

We also did a panel discussion on aging in March 2014. This was held at the UTMB island campus in Second Life® and the presenters were: Tony DiNuzzo, Rebecca Galloway, Bronia Michejenko and Rodger Marion. The video recording of this discussion, Hometown Science Presentation (3/15/2014) – Aging and Wellness: Ways Science Can Help, is below.

While we still use Facebook, mainly for its ability to insert updates onto the main ETGEC web page, we were disappointed in using Facebook as a social communication medium. People just were not going there to dialog. Using LinkedIn was suggested as people thought it might be more professionally acceptable. Many people like to reserve Facebook for personal communications. So we have been using a LinkedIn group with every blog posted there as a new discussion. Initially 15 people joined the group and four liked the first post. We have posted 26 blogs to LinkedIn. Activity has been quiet since that first posting. So, neither Facebook or LinkedIn have served the ETGEC/C as a communications tool.

The Weekly Discussion on Aging will resume next week but on a new day. It will be held on Fridays 12:00 p.m. to 12:45 p.m. UTMB is hosting Science Fridays at 1 p.m. Perhaps these two activities will dovetail nicely. See Discussion and SL tabs above for details.

Join us on Friday, January 9 at noon in Second Life. In order t0 stay consistent with the policy of using the blog as the basis for discussion, blogs will be published on Wednesdays, beginning on January 14.

Rodger Marion prepared this annual summary.

When does aging begin? There’s an interesting question. We have always assumed for this column that aging has to do with old people. Actually, in a sense aging begins immediately after birth. Every day cells in our body die. I assume they die of “old age.” They are of course replaced with new cells and the process goes on. Habits fixed at 20, can have a causative effect on health at 80. We are always changing and each change is a step towards that moment when the whole organism, that is me and you, dies. Death is the final step in aging and birth the logical first step.

I looked around for others with this viewpoint that aging is a process that begins at birth and found an interesting web site dealing with the notion of  “transgenerational design.” This is the notion of designing products and services that pay simultaneous attention to the needs and desires of different age groups. It has a number of useful categories and the overview of the aging process was especially valuable and the design of a transgenerational house was quite clever (1).

Then, there are those who would define aging as a process of decay. Thus, humans would not begin to age until after they stopped growing and had reached maturity. Also, there is the viewpoint that aging, being a degenerative process, can be stopped or slowed down (2). The anti-aging movement has a very good point and there are many things we can do to improve our odds at having long, healthy and productive lives.

I think though aging as a term can be used in a number of contexts.

So as aging vs. anti-aging we have value judgments based on wellness and function. For example: good diet and exercise can maintain function and thus reduce the effects of aging.

In another sense, we have aging as a simple chronological fact. After every day we are older. Every day we age.

I’m going for something more philosophical. Let’s think of aging as the process a fine wine goes through. We get better as we age.

References

1. Transgenerational Design Matters. http://transgenerational.org/aging
2. Anti-Aging Today. http://www.anti-aging-today.org

Some Housekeeping for the Blog and Discussion

The blog will take a holiday break for the last two Fridays of December, with publication renewing on Friday, January 2, 2015. Happy New Year! Also, the discussion will go on holiday as well.

I’m thinking of moving the Weekly Discussion on Aging over to Friday at noon. The discussion is held on the UTMB Island in Second Life and attendance has been sporadic. We are going to be hosting a gathering to listen to the NPR program, Science Friday, at 1 pm (Texas time) on the SL UTMB island, so maybe the discussion would be more popular as a prelude. If the discussion moves to Fridays, then I’ll probably move the blog posting back to Wednesday.

Stay tuned for the final plan.

I have a friend who lives on a farm in Minnesota. Her father, who is around 90 and still actively farming, has a condition that makes his hands shake quite a lot. He is very patient and careful but eating is a frustrating experience due to his severe tremor.Now he has a new computer controlled spoon that vastly reduces the shaking and makes eating much more enjoyable (1, 2).

This product is the Liftware spoon and it is described on the Liftware web site as “Liftware is a stabilizing handle and a selection of attachments that include a soup spoon, everyday spoon, and fork. Liftware is specially designed to improve the lives of those with Essential Tremor, Parkinson’s Disease, or other motion disorders” (3, 4). This is a very cool product and appears to be the first such product on the market (5).

A few years ago, my friend’s father and I played golf on a day that was over 90 degrees and even with his tremors he was hitting some pretty good shots that day. A computer controlled putter however might cut a few strokes off his game. Heck, it would probably improve mine.

References

1. A Spoon That Shakes To Counteract Hand Tremors. All Things Considered, NPR program, May 13, 2014. Audio recording found at: http://www.npr.org/blogs/health/2014/05/13/310399325/a-spoon-that-shakes-to-counteract-hand-tremors
2. Anupam Pathak, John A. Redmond, Michael Allen, Kelvin L. Chou. A noninvasive handheld assistive device to accommodate essential tremor: A pilot study. Movement Disorders, 2013; DOI: 10.1002/mds.25796
3. LiftLabs (owned by Google) web site found at: http://www.google.com/liftware
4. Lifeware demonstration and promotional videos. Found at: https://vimeo.com/74643550 and https://vimeo.com/user15993486
5. International Essential Tremor Foundation. Describes a number of devices to help those with tremors to do ADL activities easier. Found on the Assistive Devices page: http://www.essentialtremor.org/treatments/assistive-devices

Join us for a real-time discussion about questions raised by this essay on Tuesday from 12:00 p.m. to 12:45 p.m. See Discussion and SL tabs above for details. Link to the virtual meeting room: http://tinyurl.com/cjfx9ag.

You may have heard of food desert and wondered just what does that mean?  The term food desert was coined by the U.S. Department of Agriculture and refers to urban neighborhoods and rural towns without ready access to fresh, healthy and affordable food.  Instead of supermarkets and grocery stores, these communities may have no food access or are served only by fast food restaurants and convenience stores that offer few healthy, affordable food options.  In terms of distance, if you live in an urban community and have to travel at least one mile to get to a grocery store you are in a food desert.  For rural towns, where the population is more sparely distributed, it means needing to travel at least 10 miles for groceries.  If you have a car and can drive, that doesn’t sound like a great distance.  However, if you require a bus, taxi or special transportation to get to the grocery store, 10 miles can be a huge barrier.  In terms of health, the lack of access contributes to a poor diet and can lead to higher levels of obesity and other diet-related diseases, such as diabetes and heart disease. 

The elderly are at increased risk of malnutrition due to many reasons including poor dentition, decrease in taste buds and appetite, difficulty cooking and preparing health food.  Health conditions common among the elderly, such as dementia, arthritis, and diabetes combined with financial constraints and fixed income, all contribute to increased risk of malnutrition.  But what about the impact of poor access to good, healthy food on health?  Just how widespread is the issue of food deserts and what is being done about it?

According to the USDA Economic Research Service and its High Priority Performance Goals approximately 23.5 million people live in food deserts. More than half of those people (13.5 million) are low-income.  It is extremely difficult to come up with a fair and accurate estimate of the number of elderly, 65+ years of age, who live in food deserts.  Estimates among elderly living in food deserts have ranged anywhere from 10% in urban communities to 25% in rural areas.   According to Eric de Place (2009), residents with lack of access to grocery stores end up over-spending, or buying food with limited nutritional value, or both. Fresh fruits and vegetables—so important for a healthy diet—are in short supply, if they exist at all.   Finding local or organically grown food is even more remote.  So food deserts can result in poor health, tight budgets for those who can least afford it, or long cumbersome bus trips to other neighborhoods. He acknowledges that the problem is most severe for the elderly, single parents, and the disabled.  It’s not just an urban land use issue: it’s a problem with profound social justice implications.

Many agree that solutions to food deserts are few and mostly inadequate.  Legislation has been proposed, such as developing a revolving fund to offer loans to small grocers that can operate in food deserts.  But somehow throwing money at the problem never seems to work well, especially in politics.  Others suggest community involvement, such as volunteering at your local food bank, offer a ride to your elderly neighbor who is having difficulty accessing grocery stores.  Large food conglomerates, such as Wal-Mart, have a double-edged sword.  While many blame large food chains for putting smaller, local grocery stores out of business due to feasibility of competing with offering lower prices.  Yet many bus lines have large stores, including Wal-Mart, on their stop routes.  Another ‘solution’ may be to for private taxi companies to offer a lower, standard rate for elderly traveling to the grocery store.  De Place warns that assuming vulnerable low-income populations can just buy laptops, get high-speed Wi-Fi, order healthy groceries on-line and have them delivered, is obviously not a solution. Even if the tools of the Internet Age were widely available and affordable—and they’re not yet — they wouldn’t be of much use to the elderly, immigrants with limited English, or folks who don’t have a credit card or bank account.   Some grocery stores offer delivery service.  But then affordability for the service becomes a barrier.  Local community farmers markets are becoming more popular.  But if you’ve ever been to one, the majority of visitors are young and full of resources, such as money, energy and bright eyes.

Is it possible that more health providers, especially social workers and community health workers, can become more involved in identifying at risk elderly, who may be having issues accessing good, healthy food?

So, as I consume my huge Thanksgiving dinner and try not to feel guilty, I can hope that maybe increased awareness, empathy and community involvement can work in tandem to possibly increase access to food among older populations in our communities.  Anyone have any other ideas?

References

1. Eric de Place (@Eric_deP), March 5, 2009. Deliver Us from Food Deserts. Economy & Jobs, Food & Sustainable Living, Land Use & Transportation
2. Associated Press, 2012. Residents do Without in America’s Food Deserts. http://www.nbcnews.com/id/5353901/ns/health-fitness/t/residents-do-without-americas-food-deserts/
3. Morton, L.W. and Blanchard, T.C. Staved for Access: Life in Rural America’s Food Deserts.  Rural Realities, Vol. 1 (4), 2007.

Our Guest Blogger this week is Tony DiNuzzo, Ph.D., Director, East Texas Geriatric Education Center/Consortium, UTMB.

Join us for a real-time discussion about questions raised by this essay on Tuesday from 12:00 p.m. to 12:45 p.m. See Discussion and SL tabs above for details. Link to the virtual meeting room: http://tinyurl.com/cjfx9ag.

We all age (some better than others). But what happens to those who age in prison? We usually think of prisoners as young but there is an increasing number of 65 and older prisoners in the system. Aging men and women are the most rapidly growing group in US prisons. The number of sentenced state and federal prisoners age 65 or older grew at 94 times the rate of the overall prison population between 2007 and 2010. The number of sentenced prisoners age 55 or older grew at six times the rate of the overall prison population between 1995 and 2010 (1)

The question is what to do with older prisoners? How can we humanely address their needs? The Texas prison system has about 300 beds statewide for sick and mentally ill inmates, as well as two prison hospital facilities, in Texas City and Huntsville, but these facilities were not specifically designed to care for the needs of the elderly.  Older prisoners who are frail, have mobility, hearing, and vision impairments, and are suffering chronic, disabling, and terminal illnesses or diminishing cognitive capacities may have difficulties functioning in these facilities (1).

States are considering radical alternatives to prison hospital facilities for elderly convicts.  Some consider early release to a family home, while some states use private nursing homes (2). Regardless of the method for the delivery of care, carefully thought must be given to ensure that we are appropriately treating those who are incarcerated and ageing.

This week’s Guest Blogger is Amanda W. Scarbrough, PhD, MHSA. Healthcare Administration Program Coordinator and Assistant Professor, Department of Health Services and Promotion, Sam Houston State University.

References

1. http://www.hrw.org/news/2012/01/26/us-number-aging-prisoners-soaring
2. http://www.governing.com/news/headlines/gov-states-look-to-nursing-homes-to-lower-prison-health-care-costs.html

Image Source: Photograph by Adam Jones, released for public. Accessed at: http://www.readthespirit.com/religious-holidays-festivals/tag/milestones

Join us for a real-time discussion about ideas raised by this essay on Tuesday from 12:00 p.m. to 12:45 p.m. See Discussion and SL tabs above for details. Link to the virtual meeting room: http://tinyurl.com/cjfx9ag.

Past Posts: We have addressed the issues surrounding the aging population in US prisons twice before:

1. Feb 3, 2012 – Al Capone is Old and Sick and in Jail – http://wp.me/pH3Dx-3m
2. May 31, 2013 – Growing Old in Prison – http://wp.me/pH3Dx-cf

 I keep coming back to creativity in old age (1). I see creativity and the products of our creative minds and spirits as a major component of why we are going through this particular life. While there are more components to our lives and not everyone seeks creative expression but those who do have a lot tied up it.

Over the last eighteen months, I have been writing, producing, directing and editing a 96-minute, feature film that will be released in early Spring 2015. I consider that to be my creative endeavor and I’m grateful that I can still do such projects as the age of 70 draws near.

I am reminded of a very real concern that we all have as age and its associated consequences march on. That concern is the loss of the ability to do one’s creative expression. I’ve written before about people who held onto their creativity in spite of impairments and who found ever increasing creative options. For example, Matisse who switched to collage (paper constructions) at the end of his life when confined to a wheelchair. He felt these, gouaches découpés, were the culmination of his creative processes (2).

Music has been on my mind recently. My film is at the stage in post production where the musical score is being written and the composer and I are engaged in the process of mating music with images and dialog. Today, my thoughts followed this music theme to movies about musicians at the ends of their careers and how they deal with the changes.

Two movies come to mind: Quartet and The Last Quartet.

Quartet, both a play and a film (3, 4), deals with four retired musicians, singers actually. They live in a retirement home and every year the residents present a concert to celebrate Verdi’s birthday. These four want to participate but find their singing voices are not up to the task. They do a great deal of soul searching and in the end they do perform at the concert. However, as an adaption to age, they do so by lip-syncing to a previous recording of themselves when they were at their prime.

The Last Quartet is different. “After a classical string quartet’s 25 years of success, Peter, the cellist and oldest member, decides that he must retire when he learns he has Parkinson’s Disease”(5). The film focuses on how Peter deals with his retirement from the group and the various ways in which the other members respond. It reminds us of how our lives become intertwined with those whom we work as well as family.

Time spent with these films is productive. One of the strengths of film is how it opens issues, shows how various people respond and allows us to examine our own thoughts and feelings. More pedantic methods (lecture, formal seminars, etc.) rarely allow such freedom to form our own strategies and understandings.

References

1. See earlier blogs: Art and Death and Creativity and Choices.
2. Henri Matisse: Paper Cut Outs (gouaches découpés). Accessed at http://www.henri-matisse.net/cut_outs.html
3. Quartet (1999, play) by Ronald Harwood is available for performance from Samuel French (http://www.samuelfrench.com/p/9245/quartet)
4. Quartet (2012, film). Written by Ronald Harwood and directed by Dustin Hoffman. http://www.imdb.com/title/tt1441951
5. A Late Quartet (2012). Directed by Yaron Zilberman. http://www.imdb.com/title/tt1226240

Image Source: Portion of the score from Theme from Impasse (2010) by Jason M. Marion .

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I hate product ads that appear to be misleading and that are aimed at older people who might be a more vulnerable audience. Well, actually I hate any ads that seem targeted at groups that you think would know better but probably don’t. Like those ads selling you sacks of coins, where, who knows, there might be a rare and valuable coin inside. Or when you have 10 minutes to order your super, energy-saving, space heater before they are all sold out.

In Thursday’s Austin American Statesman (10-30-14), there was an ad for a health product that claimed “Drug companies fear release of ‘Jacked Up’ pill.” This is a product, that the ad asserts, will stimulate increased testosterone levels in men over 50 and that cites exceptional benefits of increased energy, focus, drive and libido. It also includes the usual disclaimer at the bottom in fine print, “These statements have not been evaluated by the US Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease. Results based on averages.”

So, within the above qualification, I will assume this product is meant for men in normal, good health who are experiencing a reduction in energy, focus, drive or libido, who may have lower testosterone, and who might, on the average, feel better if they take this product.

What this product might be is never stated but I’m going to guess it’s some herbal preparation. If you search for “herbs and testosterone” you will discover many, many options but none quite so abstract as the “jacked Up” product. I decided to go to my usual choice for herbal information: the American Botanical Council. See below for results. There are a lot of studies with a lot of results. Simply the diversity of citations is enough to warn one that there is no simple, “wonder” treatment here.

I also checked out another usual source, the National Center for Complementary and Alternative Medicine, but found nothing specific on “testosterone and herbs.”

Maybe “Jacked Up” is not based on an herb. Maybe it’s caffeine and sugar. I have no idea, but I would steer any client or friend away from such a source and send them instead to the literature and then to a licensed health care provider of their choice.

Reference

Results of a search for “testosterone” on the American Botanical Council web site: http://cms.herbalgram.org/searchresult.html?searchfor=testosterone&option=all&KY_WS_LOW=2636%7C2631%7C2626%7C2627%7C2629%7C2633%7C2638%7C2641%7C2888%7C6543%7C1%7C7107

Image Source: http://sdwriters.files.wordpress.com/2012/03/cocaine.jpg

Join us for a real-time discussion about questions raised by this essay on Tuesday from 12:00 p.m. to 12:45 p.m. We use the self-same virtual world as was mentioned above. See Discussion and SL tabs above for details. Link to the virtual meeting room: http://tinyurl.com/cjfx9ag.

Since next week is elections for various Federal and state offices, I was wondering what the voter turn-out rates were for older citizens and if they had changed over time.  I first hit upon a summary of exit poll results from interviews of randomly selected voters as they exited voting places across the country on Tuesday, November 6, 2012 (1). This sample broke down into four groups: age 1-29 – 19%, age 30-44 – 27%, age 45-64 – 38% and 65 and over – 16%.

That number for the 65+ seemed to disconnect, so I found another source. This time a Pew Research summary of the Census Bureau’s voting report (2). It said, “The turnout rates of adults ages 65 and older rose to 71.9% in 2012 from 70.3% in 2008.” This seemed more in line with my expectations. See attached figure.

Another report from the Census Bureau shows that the 65+ group had the highest voter turn-out rate among all age categories.  This has not always been the case. “The phenomenon of elderly Americans voting at higher rates than all other age groups is a fairly recent development in American elections. Between 1964 and 1992, voting rates for the 65 years and older group were either lower than or not statistically different from at least some other age breakdown” (3).

I then wondered about the exit poll survey that showed that the 65+ group were only 16% of those polled. Are the elderly simply grumpy people who won’t respond to survey takers’ requests upon exiting the polls?  Maybe, but what about early voting and mail-in voting?

An older report (1994) from the Federal election administration provides some insight but because early voting and mail-in voting is managed by the states, the available data was rather limited (4). Texas actually provided fairly good data on a county-by-county basis and showed early voting rates between 47% to 24% in the largest counties. Mail-in ballots were lower, varying from 1.7% to 5.5% (p. 40). A report from the organization, Nonprofit VOTE, shows that early voting has expanded over the last twenty years (5). “National polls showed 33-40% of voters voted early in-person or by mail, up from 31% in 2008 and 23% in 2004” and “Older voters prefer to vote early, while younger voters prefer to vote in-person on Election Day. The same poll revealed that nearly half of voters 65 and over had either cast their votes in advance or were planning to, compared to a quarter of young voters aged 18-29.”

I used early voting this last Wednesday and it seems from the local news that early voting rates are way up this go around (6). Frankly as a techie person, I’m waiting for on-line voting myself.

References

1. How Groups Voted in 2012. Roper Center for Public Opinion Research. Accessed at http://www.ropercenter.uconn.edu/elections/how_groups_voted/voted_12.html
2. Paul Taylor, P. & and Mark Hugo Lopez, M. H. Six take-aways from the Census Bureau’s voting report. Pew Research Center. Accessed at http://www.pewresearch.org/fact-tank/2013/05/08/six-take-aways-from-the-census-bureaus-voting-report
3. File, T. Young-Adult Voting: An Analysis of Presidential Elections, 1964–2012. U.S. Department of Commerce, Economics and Statistics Administration, U.S. Census Bureau, April 2014. http://www.census.gov/prod/2014pubs/p20-573.pdf
4. Rosenfield, M. Early Voting. National Clearinghouse on Election Administration, Federal Election Commission, April 1994. http://www.eac.gov/assets/1/Page/Innovations%20in%20Election%20Administration%209.pdf
5. America Goes to the Polls 2012. Nonprofit VOTE, Accessed at http://www.nonprofitvote.org/documents/2013/03/america-goes-to-the-polls-2012.pdf
6. Roth, Z. After push to mobilize new voters, turnout surges in Texas. MSNBC, 10/22/14.  http://www.msnbc.com/msnbc/after-push-mobilize-new-voters-turnout-surges-texas

It’s curious how the mind jumps from point to point. As an example, let’s look at my mind this morning.

The newspaper today was describing a man’s car collection and one of the cars was a 1942 Oldsmobile B-44 Sedanette. The B-44 was in honor of WWII bomber airplanes. That reminded me of the P-38 Lightning, another WWII airplane. The P-38 reminded me of Antoine de Saint-Exupéry, who was flying an F-5B photoreconnaissance version of that plane in July 1944 when he was shot down and killed (1).

Saint-Exupéry was a pioneer flyer and author of many well-known books, The Little Prince, Wind, Sand and Stars, etc. Recalling his last flight reminded me that he was quite old to have been in a fighter airplane over France in 1944.

He wrote on the last day of his life, “… I fight as earnestly as I can. I must be the oldest fighter pilot in the world. The normal age limit for the type of fighter plane I fly is thirty. And the other day I had mechanical trouble while flying over Annecy at the precise moment I became forty-four years old! … If I’m shot down, I won’t regret anything.” (2, p. 208)

Saint X, as he liked to be called, learned to fly in 1921 when airplanes were little more than sticks, fabric and wire (3). His P-38 Lightning was an all-aluminum, twin engine, turbo-supercharged, fighter that could hit 400 miles per hour. Aviation had advanced several generations between 1921 and 1944 and Saint-Exupéry had shown great flexibility in advancing as technology marched onwards.

This is where Saint X, who never really lived long enough to be an old person, fits into our new old person model. The old are no longer the depository of the past but are staying on top of new developments and current trends. I recall how my parents and their friends (all greatest generation) were so old. My friends (and me too) are in the same chronological ballpark now and we are so young. It boggles the mind.

As this is supposed to be an interactive discussion, I’d like to hear some stories of how the old are staying new. Got anything interesting to share?

References

1. Lockheed P-38 Lightning. From Wikipedia, the free encyclopedia. See section 7.6 discussing Antoine de Saint-Exupéry.
   http://en.wikipedia.org/wiki/Lockheed_P-38_Lightning
2. Saint- Exupéry, A. de. Wartime Writings: 1939-1944.  Harcourt Brace Jovanovich, San Diego, CA., 1986.
3. Liukkonen, P. Antoine de Saint-Exupéry (1900-1944) – in full Antoine-Marie-Roger de Saint-Exupéry. Authors’ Calendar – Books and Writers, 2008.
   http://www.kirjasto.sci.fi/exupery.htm

Image Source: http://commons.wikimedia.org/wiki/File:Lockheed_P-38_Lightning_USAF.JPG

Join us for a real-time discussion about questions raised by this essay on Tuesday from 12:00 p.m. to 12:45 p.m. We use the self-same virtual world as was mentioned above. See Discussion and SL tabs above for details. Link to the virtual meeting room: http://tinyurl.com/cjfx9ag.

I’ve been reading a biography of Orson Wells (1) as I move through the editing process for my own feature film (2). Wells was and still is considered a genius at filmmaking. His career in films was marked by nearly constant struggle with the people financing his films. At the end of his life he was very unhappy about how it all worked out for him.

Yesterday I was at the McNey Art Museum in San Antonio and saw a wonderful landscape by Pierre-Auguste Renoir. At the end of his life Renoir suffered from terrible rheumatoid arthritis and then was confined to a wheelchair due to a stroke (3). Even up to the end he continued to paint outdoors. His assistants carried him and handed his brush to him, as picking them up was difficult due to the rheumatism. He died in 1919 and retained his mastery of painting until the end. The image here is of one of these last paintings done in 1918.

It was the parallels of these two lives that struck me. Both were creative geniuses and widely acknowledged as such by the world. Both men were working at their crafts all their lives. One however was successful and, apparently happy, throughout his life. While the other experienced stress and frustration.

We say that one component of aging well is to stay busy. I content that being busy is not enough. One needs to foster the energy that comes from creative endeavors. I think it’s the creative fire that feeds the soul.

So, why was one man unhappy and the other content? We might look to their past for issues and phobias. Better however I think to look at the decisions made moment-by-moment. No matter how hard we always have a choice and we can always chose again. Nothing extends beyond now. Each man chose and got his choice.

“Wells refused to accept ‘that genus disappears with old age… Fitzgerald [like Hemingway]… was rotted with the same anguish. That attitude is death.” It was that process of creation that kept Wells alive and kicking (1, p. 353).”

I just don’t think he was very happy about it.

References

1. Heylin, C. (2005). Despite the System: Orson Wells Versus the Hollywood Studios. Canongate Books, Ltd., Edinburg, Scotland.
2. Nudged. (2014). The Nudgedmovie.com website. Retrieved 07:32, Oct 03, 2014, from http://nudgedmovie.com.
3. Pierre-Auguste Renoir. (2014). The Biography.com website. Retrieved 07:32, Oct 03, 2014, from http://www.biography.com/people/pierre-auguste-renoir-20693609.

Image Source: WikiArt: Visual Art Encyclopedia. (2014). Madeleine Leaning on Her Elbow with Flowers in Her Hair (1918) by Pierre-Auguste Renoir. Retrieved 07:32, Oct 03, 2014, from http://www.wikiart.org/en/pierre-auguste-renoir/madeleine-leaning-on-her-elbow-with-flowers-in-her-hair-1918.

Join us for a real-time discussion about questions raised by this essay on Tuesday from 12:00 p.m. to 12:45 p.m. We use the self-same virtual world as was mentioned above. See Discussion and SL tabs above for details. Link to the virtual meeting room: http://tinyurl.com/cjfx9ag.