Update on Aging


grandparentsHere’s another topic about which I know little: being a grandparent. Neither of my two sons has ever married or become a father. As a consequence, I have no experience with re-visiting the raising of children as an indulgent spectator, which is the role I assume most grandparents fulfill. Many of my retired friends seem to have focused their lives on grandchildren. I guess that’s a good thing.

Actually my notion of grandparenting is a stereotype. Grandparents take on many active and important roles in helping their children to raise their children. Often even becoming the only parent a child has.

I wondered if the role of grandparent has changed over the years. I could not really find any information on the role of grandparents changing over time. I’d hazard a guess that we are more indulgent and spend more on grandchildren than in earlier times, but change data was a bit thin. The role of back-up parent seems to have always been the role. The age of grandparents is a variable over time.

These days, the average age of becoming a grandparent is about 47 (1) and the average age of grandparents in general is 64 (2). Also, there are about 70 million grandparents in the US (3). Back a few hundred years there were not so many grandparents, they tended to be younger and even still in their own childbearing/rearing processes (4).  However, the trend in childbearing is changing and current generations are having children later in life and this means the role of grandparent may not become available so early in the future (5).

So, maybe there is hope for me still.

References

  1. Graham, B. ‘Grandma gets a Reboot. AARP Bulletin, September 2014, 55, 7, 10-12.
  2. AARP. The Grandparent Study 2002 Report. AARP, May 2002.
    http://assets.aarp.org/rgcenter/general/gp_2002.pdf
  3. Grandparent Statistics. Statistic Brain.
    http://www.statisticbrain.com/grandparent-statistics
  4. Grandparents. Encyclopedia of Children and Childhood in History and Society.
    http://www.faqs.org/childhood/Fa-Gr/Grandparents.html
  5. Tergesen, A. The Long (Long) Wait to Be a Grandparent. Wall Street Journal, March 30, 2014.
    http://online.wsj.com/news/articles/SB10001424052702303775504579395501172676002

Some miscellaneous Links:

  1. Francese, P. The MetLife Report on American Grandparents. MetLife Mature Market Institute®, July 2011.
    https://www.metlife.com/assets/cao/mmi/publications/studies/2011/mmi-american-grandparents.pdf
  2. Fun facts about grandparenting.
    http://www.grandparents.com/food-and-leisure/did-you-know/surprising-facts-about-grandparents
  3. Source for everything about America, statistics-wise anyhow.
    U.S Census Bureau, American Community Survey.
    http://www.census.gov/acs/www

Image Source:  http://www.publicdomainpictures.net

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.

We are moving into the cooler days of autumn and I’m losing my excuses for not exercising more. As I age I’m finding that while my weight is still the same at 150 that my muscles are getting smaller. I need to do better and for me that’s an exercise in willpower over sloth.

Rodger's avatar tries the Tree pose at the Avatar Fitness Club

Rodger’s avatar tries the Tree pose at the Avatar Fitness Club

As we get even older sloth acquires a helper: loss of function. Aging brings physical changes and with those changes comes the need for new approaches to exercise. Now while you see the occasional 90 year old marathon runner, most 90 year olds are doing well to get to the mailbox and even then endurance and balance often require holding on to the mailbox for a moment before hiking back to the house.

For those who still are mobile, gyms or senior centers often offer classes in yoga, tai chi, chair-based exercise, aerobic dance, etc. All of these are good and provide a dose of human contact and companionship, as well as, the exercise part. Here in Wimberley there is an inexpensive yoga class at the community center that fills the hall every week.

When daily travel to the gym or senior center becomes difficult there are some home-based options. Hiring a coach to come to  your house is nice but not necessarily affordable for everyone. I’m aware of three additional options.

First, get an exercise video or find a TV program that offers guidance and, most importantly, moral support for something you like to do for exercise. One video I know about is Tai Chi for Seniors. This was developed by Mark Johnson (http://taichiforseniorsvideo.com) and it’s a well designed program.

The second option is to find a web site that offers basically the same as a video or TV show but web sites have an additional advantage. Web sites usually provide for the users/students to comment to the coach and discuss techniques and progress with each other via text chat. This adds back in the personal, human contact element and can be very supportive. An example of this is Yoga with Adriene. This is a series of yoga videos that are well conceived and that offer the opportunity for socializing as well. It is hosted by Adriene Mishler, who is based in Austin (http://yogawithadriene.com).

My third option is fairly strong on the support side and not much on the exercise. This alternative is to participate in a virtual exercise program in a 3D virtual world. An example of this is the Avatar Fitness Club run by the Cooperative Extension Service. They offer a number of exercise programs that you do as a virtual avatar. Some limited research as shown that virtual exercise can have both mental and physical results. Find the club in the Second Life® virtual world at http://maps.secondlife.com/secondlife/Morrill3/188/95/30

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.

Over the last three years the Weekly Update on Aging has been published 163 times. Over that time period there have been 10,487 views of these thoughtful columns written by those involved with the ETGEC.Rural lighting

How often a single essay (or blog) has been viewed varies from 1 to 849. Below are listed the top three blogs. Each of these has been viewed over 100 times.

Hello in There – Thoughts on Loneliness and Aloneness by Tony DiNuzzo – 106 views

The Kindness of Strangers by Rodger Marion – 313 views

What is Elderspeak? by Bronia Michejenko – the most viewed of all the 163 posts with 849 views.

Following closely are two of my favorites, Yet Another Surprise About Aging (88 views) and Of Cougars and Founding Fathers (71 views).

Y’all may wish to revisit some of these top posts. Further you can use the Search function (on the left there) to jump to any of the posts. I encourage you to explore some of the really incredible richness of the posts from the past.

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Today’s image: One of my favorite photos from a past post that discussed rural electrification.

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.

As one’s health challenges become more chronic, if not critical, and as one’s ability to be active and distracted declines, there is an abundance of time to consider, ponder, reflect…

My friend, John Daws (green shirt),in the recent remake of True Grit.

My friend, John Daws (green shirt),
in the recent remake of True Grit.

I have heard it said that getting old is tough. This is the time when all those health and mobility issues, that are so easily avoided when young, come to the forefront of one’s awareness. At these times resilience of spirit is required and the old John Wayne adage becomes true, “When the going gets tough, the tough get going.” (It seems to need a “Pilgrim” in there someplace).

During this stage of life there appears to be two options: get busy and involved with something or reflect on the cosmic circumstances of one’s soul and the influences of the infinite on longevity. There is really not much in-between except perhaps television or crossword puzzles.

I have always tended to stay active and busy with my life and work and then deal with things as they come along. That has been a way to avoid stress and sleepless nights worrying about the future. However, I wonder if some more “up front” or assertive path is needed has one moves toward the final decades of life.

I have found that awareness, and that even more subtle state of mindfulness, are elusive qualities. Also, one tends to become serious when exploring these ethereal realms and that can simply be a cover up for sadness and depression. It is essential to toss in some lightheartedness and laugher when considering the infinite. If you have ever seen the Dali Lama in action you know his spirit is playful and light.

Old age is a balance and it’s not for the fainthearted.

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As an aside: Other people are important components of both being busy and involved, and reflecting on the cosmic. And because of this I’m not going to dwell on the value of human interaction, support and love today. We’ll come back to that but too many variables get confusing.

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.

This week I sent a 50th wedding anniversary card to my cousin and my wife reminded me that we are coming up to that milestone ourselves in 2017. That got me thinking about how we respond when a long-term relationship like these ends due to the death of a spouse.

Some not-too-recent research shows that men are at greater risk of dying after the loss of a spouse than women (1-4). Also, on a happier note this higher risk diminishes over time.

In my current motion picture project, the main character is an older man who experienced the death of his wife. This loss has affected him, not in any tragic way, but in significant ones. For one he has avoided new romantic attachments. Throughout the film, his dead wife visits him and encourages his re-engagement with life. Below is an excerpt from the unfinished film that illustrates one man’s way of coping with loss.

After watching this clip, consider how you will respond should you become the surviving spouse.

References

  1. Helsing, KJ & Szklo, M. Mortality after bereavement. Am J Epidemiol. 1981 Jul;114(1):41-52.
    http://www.ncbi.nlm.nih.gov/pubmed/7246529
  2. Jacobs, S & Ostfeld, A. An epidemiological review of the mortality of bereavement. Psychosom Med. 1977 Sep-Oct;39(5):344-57.
    http://www.ncbi.nlm.nih.gov/pubmed/333498
  3. Martikainen, P & Valkonen, T. Mortality after the death of a spouse: rates and causes of death in a large Finnish cohort. Am J Public Health. 1996 August; 86(8 Pt 1): 1087–1093.
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1380614/
  4. Martikainen, P & Valkonen, T. Mortality after death of spouse in relation to duration of bereavement in Finland. J Epidemiol Community Health. 1996 Jun;50(3):264-8.
    http://www.ncbi.nlm.nih.gov/pubmed/8935456

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cloudsAs I progress in life I have occasion to visit new and different health care providers. Every one of them gives me a six to eight page form requesting information. It’s the same information every time. It may be formatted differently but it’s still the same information: name, DOB, address, insurance, past history, ROS, permissions, etc.

The electronic medical record was planned to eliminate this endless repetition by putting every one’s information in a “machine readable form” that could then be read by the computer systems at any health care facility.  My colleague, Bruce Niebuhr, and I spent many years following the evolution the electronic patient record or electronic medical record.  Recent years have seen significant advances in the field.

Many hospitals and group medical practices now use some form of electronic record keeping (1). Sharing of information between hospitals and affiliated group practices has increased also. Thus, one can be referred to a provider and that person can access your information on-line. This however does not happen very often. From Thompson, “For example, the [WRJF] study found that 42 percent of hospitals now meet federal standards for collecting electronic health data, but only 5 percent also meet federal standards for exchanging that data with other providers to allow widespread physician access to a patient’s records” (2).

Even with good inter-provider cooperation, I still find myself in the position where one office swears they sent over the data but when I get there that information is nowhere to be found. Again, I offer my own copy for inspection so we can proceed.  This is the interplay of human fallibility with computer systems and it highlights the basic ethical question regarding information. Who owns it and who is responsible for insuring it is available where and when it’s needed.

I think the case is clear that there are many “owners” in this endeavor. The patient owns themselves and whatever he/she can personally report about themselves is theirs. The providers own what they create: test results, assessments, notes on treatments, internal accounting and so forth. Everyone has privacy rights. Patients have the right to control who sees test results owned by the provider. Providers have the right to keep internal accounting and employee data private.  It’s a complicated process.

What about putting all this information “in the cloud?”  The cloud is that transparent realm of distant servers where everything is kept and you can access it anywhere, anytime. It works for your favorite musical selections and family pictures, but how about medical data (3, 4)? Security issues aside (they can always be solved), I like the idea because with a cloud-based information structure there can be many interfaces. There can be one for providers and one for patients. Everyone could review, edit, add and delete information as necessary and stay within their ownership and privacy rights. I’d never have to fill out those redundant “new patient forms” again.

References

  1. Robert Wood Johnson Foundation . Hospitals, Physicians Make Major Strides in Electronic Health Record Adoption, July 8, 2013.
    http://www.rwjf.org/en/about-rwjf/newsroom/newsroom-content/2013/07/hospitals–physicians-make-major-strides-in-electronic-health-re.html
  2. Thompson, D. U.S. Hospitals Triple Use of Electronic Health Records, US News and World Report, July 8, 2013.
    http://health.usnews.com/health-news/news/articles/2013/07/08/us-hospitals-triple-use-of-electronic-health-records-report
  3. Terry, K. Medical Practices Move Health IT To Cloud, InformationWeek, 9-6-2013.
     http://www.informationweek.com/healthcare/electronic-health-records/medical-practices-move-health-it-to-cloud/d/d-id/1111447?
  4. Spottswood, T. Electronic Medical Records in the Cloud: How Safe is It? Northwest Regional Primary Care Association.
    http://www.nwrpca.org/health-center-news/200-electronic-medical-records-in-the-cloud-how-safe-is-it.html

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Blanco County CourthouseSummers can be hot! I remember really hot Summers when I was a teen in Oakland, California. Summers there are often cool but I remember some Summers that were very, very hot.  I’d awaken in the morning and the sun would be bright and the air screamed, “Heat is coming!” My Mother, on those days, would draw all the blinds to keep inside what coolness the night had imparted and in the afternoons we would huddle around our little fan waiting for sundown to bring relief.

I loved to be outside in the heat. I’d ride the bus across Oakland to go to my judo school where I taught children in the afternoons and learned from my masters in the evenings. The judo school was not air conditioned but no one was concerned. We just pushed on. We were like Jack London’s character, David Grief, who “was a true son of the sun, and he flourished in all its ways” (1).

Many people in Texas live through the Summer without air conditioning. How do they manage? In the days before AC, Texas homes were designed to be a little cooler in the Summer by catching breezes and letting the heat escape. Many not-so-old-fashioned houses and apartments are not designed to take advantage of nature and really require AC (2).

The sun can be an unfriendly neighbor. During the California 2006 heat wave, there were 140 confirmed deaths and an additional 515 suspected deaths due to extreme heat (3). Summer’s heat can be dangerous for the very young, the very old and the careless.

Three things I learned recently and that seem relevant: 1) dial 211 for information on community resources, 2) many communities provide “cooling centers” as a place to get a respite from the heat, and 3) the CDC has good educational materials for “safety in the heat.”

Cooling Centers in Texas

https://www.211texas.org/zf/taxonomy/detail/id/650894

References

  1. London, Jack. A Son of the Sun (Adventures of Captain David Grief). Curtis Publishing Company, 1911
  2. Life Before Air Conditioning
    http://mentalfloss.com/article/16842/life-air-conditioning
  3. CDC 24/7 – Saving Money Through Prevention – California’s Success. Centers for Disease Control and Prevention.
    http://www.cdc.gov/nceh/tracking/success/savingmoney_california.htm?s_cid=ostltshyh_cs_029

Resources

Image

The old Blanco County Courthouse has never had air conditioning and makes use of high ceilings and cross breezes to stay cooler.
http://www.historicblanco.org

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Ky Jan home healthIn 1975, I joined a team of educators at the University of Kentucky who were engaged in a very unique form of health science education (See Connelly, Assell & Peck below for further details). We gathered students from across the spectrum of health professions and, along with a faculty member as sponsor, had them live in a rural, Kentucky town during the month of January. Hence the name of the experience: Kentucky January.

The purpose of the three week experience was to allow the students to become more familiar with the health disciplines that were on the team and to study the health care system as it manifested in a rural community. Our premise was that students rarely got to explore all aspects of a community and plot out how they integrated into an efficient or inefficient system.

Our students explored the local hospital from surgery to midnight rounds with the janitor. We visited the coroner, funeral homes, physician and dentist offices, city hall, county health department, local businesses and factories. Since many of our teams were in Appalachian towns, they went down into coal mines and sought out the local moonshiner.

The highlight of every team was travelling with the visiting nurses of the home health agency to remote homesteads in the rugged hills. This is where the students got to meet real people on the fringes of the system and gain an understanding of where the system worked and where people fell through the cracks.

Two weeks ago, I mentioned that my wife, Dianne, was in the hospital with pneumonia. She is home now and recovering but weakened after two weeks in the hospital and the residual effects of pneumonia. Before discharge her physicians suggested a rehabilitation facility for a while as she needed time and assistance for recovery. Dianne had had it with institutions and wanted to get home. So, enter the modern home health agency in a Texas rural area not unlike Appalachia.

This week we have had two visits from a nurse and two visits from the physical therapist. Both have been extremely helpful and of significant benefit.

Home health is a care option that deserves consideration.

Reference

Connelly, T, Assell, P and Peck, P. Interdisciplinary education for health science students in the rural home health agency: Kentucky January. Public Health Reports, 1975, Jul-Aug, 90(4), 325–330.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1437732

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Last Monday marked the centenary of the outbreak of the First Word War. It was a period of bloodletting unsurpassed in history. Nearly 10 million died from combat and probably double that from associated causes. None of the 65 million who served in that war are still alive (1).

It is curious to remember that my mother-in-law and aunt who both died this year at 100 were babies when the war began. My mother was a child of four and in Finland when the war began. My grandmother brought her home to the US before the seas were unsafe due to submarines and blockade.

Wars bring disruption, dislocation, disease and violent death. It would seem a safe assumption to say that war is a health threat and that anyone wishing to live into old age (and hence be a legitimate subject of this column) would do well to work against the causes of war in our times.

I believe war is a mental health problem. While the news is full of apologists for the inevitability of wars due to economic, cultural, social, or political causes, in the final analysis resorting to killing each other is a crazy act and not different from the most demented, psychotic murderer in civilian life. Our inability to stop or cure such violent acts leads to our condoning self-defense and creating a cycle of mutual killing that only now is being seen as a tragedy for both sides.

There was a moment in December 1914, around Christmas time, when the men in the trenches in Flanders put down the guns, crossed into no-man’s-land and engaged in peaceful pursuits. They talked, exchanged food and smokes, played games, buried the dead, and generally behaved in an un-war-like fashion (2). The generals soon put a stop to this foolishness, but for a brief moment there was a pause in the madness.

References

  1. List of last surviving World War I veterans by country. From Wikipedia, the free encyclopedia. http://en.wikipedia.org/wiki/List_of_last_surviving_World_War_I_veterans_by_country
  2. Weintraub, S. Silent Night: The Story of the World War I Christmas Truce. The Free Press, N. Y., 2001. Available from: http://www.barnesandnoble.com/w/silent-night-stanley-weintraub/1111352599?ean=9780452283671

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Rodger Marion, Ph.D. is UTMB Distinguished Teaching Professor and Senior Fellow in the Sealy Center on Aging. Those with time on their hands might want to follow his current film project at http://nudgedmovie.com.

Franklin D. Roosevelt, at his inauguration on Saturday, March 4, 1933 said, “… let me assert my firm belief that the only thing we have to fear is… fear itself… “

In a sense that is so very obvious. The events of life are simply events with no particular meaning of their own. If we are afraid of anything, it is of our own making. That being said, when I’m afraid I’m very uncomfortable and logic rarely comes to my rescue.

I’ve been aware of fear and the anxiety associated with it quite a bit this week. My wife, Dianne, came down with a case of pneumonia and it is seriously impeding her ability to breathe. She has been very anxious, and rightly so, when finding herself unable to take a deep breath or wheezing after just talking with a visitor.

I think we need to be sensitive to when people, who are our patients or our family, are feeling fearful. Logic will not help. Listening does. Prayer does. Appropriate medication will help. Finally, being mindful and caring is the best response.

A colleague and I made a film a few years back that illustrates what can happen when we find ourselves short of breath.

 

I have referred to this film twice is earlier postings: http://wp.me/pH3Dx-3R and http://wp.me/pH3Dx-eY. Obviously it touches on a nerve for me.

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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.

Rodger Marion, Ph.D. is UTMB Distinguished Teaching Professor and Senior Fellow in the Sealy Center on Aging. Those with time on their hands might want to follow his current film project at http://nudgedmovie.com.

halleys cometHalley’s Comet swings by our part of the solar system every 76 years or so. People have observed it since about 240 BCE. Sometimes when it returns the comet is the brightest thing in the sky and people have often associated it with prophecy or saw it as an omen of import.

So, here’s my story. Mark Twain was born when Halley’s comet was in the sky**.  Twain also died when the comet returned in 1910.  My Dad was born in 1910. The comet was due to return in 1986 and somehow I was convinced that my Father was going to die when Halley’s comet was again visible, just like Mark Twain.

I have no idea where this idea came from but I did worry as February 1986 came around. It was for naught. My Dad was in the best of health in 1986 and carried on until he died in 2003.

These days we make much of the power of thought. People have always felt that the religious practice of prayer can bring about change. Popular books examine the influence of thoughts on what happens to us. See for example The Secret by Rhonda Byrne, Wishes Fulfilled by Wayne Dyer or Expect Miracles by Joe Vitale. Attitudes (which is what you are thinking after all) influence your wellbeing. I don’t think anyone would argue that one can worry into illness (probably from stress) and smile into happiness.

Here’s my quandary. Do negative thoughts (not stress causing thoughts, but cosmic, life-changing thoughts) bring about negative consequences even if you don’t really want the negative consequences to happen. I mean, if I worry about getting diabetes, will I create diabetes in myself? I don’t want diabetes but if I think about it, do I make it become so?

I want to think that positive thoughts are taken seriously by the universe but when I’m scaring myself, well I’d like to think the universe knows better and those things won’t just happen because I thought them.

Or is my assumption wrong?  What do y’all think?

I still might get diabetes (or another annoying condition) but not because I thought I might. In another essay, we’ll look at why bad stuff happens, but that’s a different issue.

Two handy quotes to finish:

“As a single footstep will not make a path on the earth, so a single thought will not make a pathway in the mind. To make a deep physical path, we walk again and again. To make a deep mental path, we must think over and over the kind of thoughts we wish to dominate our lives.”
― Henry David Thoreau, author of Walden; or, Life in the Woods, 1854.

“Much more surprising things can happen to anyone who, when a disagreeable or discouraged thought comes into his mind, just has the sense to remember in time and push it out by putting in an agreeable, determinedly courageous one. Two things cannot be in one place.”
― Frances Hodgson Burnett, author of The Secret Garden, 1911.

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* The title is my mis-interpretation of “I think, therefore I am” (from René Descartes, Principles of Philosophy, 1644). My interpretation here is “If I think, shall I be?”

** The comet was brightest during November 1835 and Twain (S. L. Clemens) was born on November 30, 1835. He died on April 21, 1910 when the comet was back in April 1910.

Join us for a real-time discussion about this essay, or another post that’s more relevant to aging, 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.

 

chainsawOver 40 years ago, when we were in the Air Force and had two little boys, we lived in an apartment complex in San Antonio, Texas. My wife, Dianne, and I look upon those Air Force years as a shared period of our lives. Anyhow, that apartment complex had a handyman. He did everything and anything that needed fixing or doing at the apartments. He was a treasure.

I’ll come back to that handyman in a moment, but first here’s what happened to me today. I discovered one of the toilet bowls had a flow valve that was about to fail. So, I ran off to the hardware store, got a new valve and in an hour had it installed and not leaking. I thought about that fairly simple task. If I were older and less mechanically adept, I might not have gotten that fixed so easily or cheaply.

One of the handicaps of getting old is losing the ability to fix stuff. Many skills and abilities go into a simple plumbing repair: being able to drive to go to the hardware store, knowing what to buy, having the right tools, being able to crawl about under the toilet, feeling empowered to take on the task, etc.

This interaction between age and need brings me to my point about handymen.

Here in Wimberley, there are many retired, semi-retired, underemployed, free thinking artists and old hippies. Sometimes I think this population divides itself into two groups: handymen and people who need a handyman. There are handywomen too, but fewer. These folks, like our handyman from years ago, will fix anything for you. They go get parts, come to your home, fix whatever and charge a reasonable fee.

They even provide another benefit. They become part of your social support system. Since they too are a resident in a small town, they not only fix your stuff, they stop to chat with you and are not adverse to a bit of lunch or cup of coffee.  And this is the interesting thing.  We have this network of handypeople. It’s not a church program or something social services thought up. It’s pure enterprise and social interaction all in one.

My son, when he first moved back to Texas from California, was an assistant to a well established handyman. His boss would chat with the customers while my son did all the work. This was a very successful strategy.

Join us for a real-time discussion about this essay, or another post that’s more relevant to aging, 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.

 

SignersOn the Fourth of July one does think about the men who signed the Declaration of Independance back in 1776. When I think of them I imagine those paintings of guys in white wigs standing around in heavy clothes on a hot, sweltering day in Philidalphia. I assume those images are of old people. They all have white hair, so they are old, right? Wrong.

Of the 56 men who signed the Declaration of Independance, seven were 60 or over and five were 30 or less. The average age was 44. A few familiar names (and ages) are: Thomas Jefferson (33), John Hancock (39), John Adams (40), and the oldest, Benjamin Franklin (70).

So revolution is a young man’s game. There were women engaged in the revolution too but they did not get to sign stuff. Just think in 1776, Alexander Hamilton and the Marquis de Lafayette, two guys I really respect, were 21 and 18 respectively.

I’m not sure if there is a lesson about aging here.

Well, at least here’s three cheers for Ben Franklin, who contributed to the development of the United States well into his 80’s.

References and Further Reading

Join us for a real-time discussion about this essay, or another post that’s more relevant to aging, 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.

ConfusedHave you ever had to make a decision for someone you love that will impact the remainder of their life?  If not, chances are good that you will be asked to do so at some point.  To make things more interesting, this task often occurs during an already stressful period.  Wondering what I am talking about?  Let me provide you with an example.

You have an elderly parent who has lived in their childhood home for over 80 years.  They have lived alone for many years and value their independence.  As an only child, your parent has made you their power of attorney for both legal and medical issues.  On your last visit you noticed that they have begun acting out of character and becoming more and more forgetful.  Recently, they fell in their home and had to be hospitalized for almost a month.   The diagnosis is a mild stroke with signs of dementia.  The hospital calls to inform you that they will be releasing your parent in three days but they can no longer live alone.   Of course, your parent is adamant that they can take care of themselves.  They just want to go home.

Here is where the decision comes into play.  The first step is to determine your options.  The number of options you have depends on many factors such as family preference, geographic location, insurance and most often, financial resources.   In rural areas, the number of options available is often limited.   There are few assisted living or long term care facilities in rural areas and locating someone to stay with your loved one can sometimes be difficult.  Adding to the stress is the fact that either option can be financially challenging. You worry about making a choice that is not only safe but comfortable for your parent.    Families often find themselves at a loss when looking for information, support and/or advice.

Healthcare providers can sometimes overlook how difficult making these decisions can be for both the patients and their families.  They make the pronouncement that they cannot go home in the same manner or they order a test or prescribe medicine without offering decision making support.  Providing resources, support and encouragement during this stressful period can truly impact the entire experience.  There are many resources available to help people locate and evaluate assisted living options.  The Texas Department of Aging and Disability Services provide some valuable resources and the contact information for local centers.  Eldercare.gov is another valuable resource.   In my personal experience, a reassuring word that I am not alone in making this decision, and as much lead time as possible, goes a long way to making these decisions less stressful.  Providers should always remember that they too will be asked to make these hard decisions at some point in their own lives.

Our Guest Blogger this week is Leslie Hargrove, Executive Director, Texas AHEC East Coastal Region.

Join us for a real-time discussion about the complex issues 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.

info hwyWhen I’m trying to think of a topic for my blog, I start researching by perusing the AARP website at http://www.aarp.org.  Generally, this is not one of my top sites. I am more of a yahoo news, LinkedIn, weather.com and occasional Facebook surfer (OK and Amazon too).

At AARP, I saw topics that I expected: health, work and retirement, caregiving, social security and Medicare.  These topics were generally informational with articles such as: Social Security Calculator: When Should You Claim Your Benefits; Sign Up for Medicare During Your Own Enrollment Period; and How to Retire the Cheapskate Way.

However, what intrigued me was all the other stuff on the website: the unexpected information. There were sections on food (with recipes), travel (including affordable getaways and a virtual travel agent), games (both fun and brain games) and tools for job searching.

This got me to thinking about the vastness of the information available on the web and how as a daughter and daughter-in-law, I could help my family members find the information that they needed making sure that it is the most reliable information. So I did some research and here are the suggestions that I will be passing along to my family on how to check the credibility if the information.

  1. What is the purpose of the page? Why is this information being posted–as information, as a public service, as a news source, as a research tool for academics, as a personal ax to grind, or as a way to gain attention?
  2. Are there obvious reasons for bias? If the page is presented by a tobacco company consortium, you should be suspicious of its reports on the addictiveness of nicotine. Is there any advertising? If the page is sponsored by Acme Track Shoes, you should be suspicious of its claims for Acme track shoes’ performance.
  3. Observe the URL. What is the site’s domain? Think of this as “decoding” the URL, or Internet address.The origination of the site canprovide indications of the site’s mission or purpose. The most common domains are:
    • .org – An advocacy web site, such as a not-for-profit organization.
    • .com – A business or commercial site.
    • .net – A site from a network organization or an Internet service provider.;
    • .edu – A site affiliated with a higher education institution.
    • .gov – A federal government site.
    • .il.us –  A state government site, this may also include public schools and community colleges.
    • .uk (United Kingdom) – A site originating in another country (as indicated by the 2 letter code).
    • ~  – The tilde usually indicates a personal page.
  4. Is the page current? This is both an indicator of the timeliness of the information and whether or not the page is actively maintained.
    • Is the information provided current?
    • When was the page created?
    • Are dates included for the last update or modification of the page?
    • Are the links current and functional?
  5. Be skeptical. Things that sound too good to be true often are. You want current, unbiased information

Our Guest Blogger this week is Amanda W. Scarbrough, PhD, MHSA, Manager, Operational Planning and Projects, Texas AHEC East, Office of the Provost, University of Texas Medical Branch.

Join us for a real-time discussion about the rather grave question 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 so often overlook our geriatric population – almost see right through them.  And unfortunately, usually all we see is an elderly person.  We should  all remember that even the eldest of our population still probably see themselves as a younger version of themselves.  I know I do, and that’s due to the fact that I am now in the geriatric category myself

I want to blog about my Mother, Pauline, who just turned 93 in May.  Think of the things that she has seen and done.  She has lost a husband, two sons, three brothers and her parents.  Can you imagine?  Through it all, she is always about attitude.  She is of the thought you can be happy with people or you can be sad and alone.  No matter her circumstances, she has chosen happy.

cervasa anyoneAfter my Father died, she was 51 years old and had to literally start a new life.  She had been the proverbial housewife and did not participate in any of the finances, decision making, insurance, bills, etc.  She had not worked outside of the home since a brief stent at 18 as a beautician.  She hesitantly re-joined the workforce and was completely out of her comfort zone.  But lo and behold, she thrived and was very successful in sales for many years.  She loved her job and had a wonderful social life.  During that time, I think she actually went out on the town more than I did and that was saying quite a lot at the time.

To this day, everywhere we go, someone remembers her from working at Leon’s and they all tell her she looks exactly the same.  Through it all she remains one of the most positive and adaptable people I have ever come across and I believe that is the secret to her longevity.  She is a very quiet and reserved person, yet she manages to always do things that are out of her comfort zone.  I thought this picture is a good example.  We were having lunch at a local Mexican food restaurant and I saw the cardboard Corona mariachi players and asked her if we could go pose in it.  Naturally, she said “no way” but after a little persuasion, she was game to do it.  She would really want to fuss at me if she knew I was using this picture.  I just thought it was a good example of her great spunk and spirit. We should all strive to be like Pauline.  I am truly blessed.

This article from WebMD (See link below), I think also makes my point.  Thanks for reading.

Our Guest Blogger this week is Paula Crawford, CHW. She is the Program Coordinator at the Texas AHEC East – Victoria Region, Division of Allied Health, Victoria College.

Link for Further Reading

Live Long and Prosper, The Secrets of Aging Well, Aging Well, WebMD, http://www.webmd.com/healthy-aging/features/secrets-of-aging-well.

Join us for a real-time discussion about the rather grave question 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.

earSomeone very close to us has lived in a worsening state of dementia for more than 10 years. She is still able to live independently, a blessing in itself, but the question in everyone’s mind is, “how long until constant care will be needed?” Recently, we addressed a major issue. The result has halted, and at times, seemed to have reversed the state of her dementia. It’s been such a miracle that I want to share it with you.

Until recently, our loved one refused to wear her hearing aids. We could write a book from all the reasons given for not wearing them… “I don’t need them, I can hear just fine, they buzz when I use the phone, they’re uncomfortable.” The list goes on.

We pointed out many times, most often repeating our advice because she couldn’t hear it the first or second time, that hearing aids would not only help her hearing, but her memory problems as well.

It all changed during a visit to her neurologist for a routine checkup. During the examination, Dr. Ravindran found himself constantly repeating questions. He finally stopped, put his clipboard down, looked our loved one right in the eye and said, “Why aren’t you wearing your hearing aids today? I think you would want to hear what the doctor has to say?” Our loved one rattled off her laundry list of reasons, and Dr. Ravindran nodded each time. Then he said the words that made a difference, “Your hearing is absolutely critical to the function of your brain. If you are not going to wear your hearing aids, you might as well not take your medications for dementia. ”

The way he said it seemed to have an effect. Our loved one looked at her hands a long time then said, very quietly, “Okay, I will. I’ll start wearing them.” Dr. Ravindran pointed out he was not giving a medical opinion. He invited us to look at numerous studies that show the relationship between hearing loss and deterioration of the brain.

Just as Dr. Ravindran promised, I found numerous articles. The brain shrinks as it ages. It’s a natural part of the aging process. But, most studies show the effects are more pronounced than the simple adage “use it or lose it.” At least one study showed brain shrinkage is accelerated in older adults with hearing loss.

This study pointed out that the auditory cortex does not work in isolation. It is an integral part of brain function, especially those carried out by the middle and inferior temporal gyri, major contributors in memory and sensory integration, mild cognitive impairment, and Alzheimer’s disease. The study concluded that hearing loss must not be passed off as part of the aging process.

While surfing other subjects on hearing loss and dementia, I found another study discussing the negative impact hearing loss has on social engagement. A 2005 report by the Honolulu-Asia Study found that those whose level of social engagement declined from midlife to late life have the highest risk of dementia.

So, we began to address our loved one’s hearing loss. We made her wear her hearing aids every day from morning until bedtime. Soon this practice became a habit and a flow chart began to emerge:

  • Wearing hearing aids = increased use of the brain’s auditory cortex
  • Increased use of the brain = better cognition of people, events, and surroundings
  • Better cognitive skills = better social skills
  • Better social skills = better and deeper relationships
  • Deeper relationships = more memories

Those who know our loved one are in awe of the differences in her personality these past few months. Her face and her speech are livelier. She remembers much more than she used to. She has made new relationships with other residents at her retirement community and best of all, found a new zest for life. Turning back time began with addressing her hearing loss, and a few choice words from a neurologist.

Our Guest Blogger this week is Tom Knight, Center Director, Texas AHEC East – North Central Region.

Join us for a real-time discussion about the topics explored in 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.

“It took my mother having a stress-related heart attack before we quit dismissing my father’s progressing dementia to ‘senior moments’ and got him a proper diagnosis of Alzheimer’s. Had we paid attention to the warning signs of this disease, a lot of prevention could have been in place.” — Brent

Know the 10 Signs of Alzheimer'sThere seems to be a blurred line between “getting old” and early warning signs of dementia or Alzheimer’s.   When does forgetting a word more often become a “problem” or a warning sign of more profound changes?  At the Alzheimer’s Association, we have a list of “10 Warning Signs” that we use as a guide to see if a visit to a physician may be needed (for more information, visit http://alz.org/alzheimers_disease_know_the_10_signs.asp).

  1. Memory loss that disrupts daily life
  2. Challenges in planning or solving problems
  3. Difficulty completing familiar tasks at home, at work or at leisure
  4. Confusion with time or place
  5. Trouble understanding visual images and spatial relationships
  6. New problems with words in speaking or writing
  7. Misplacing things and losing the ability to retrace steps
  8. Decreased or poor judgment
  9. Withdrawal from work or social activities
  10. Changes in mood and personality

When I talk to people about these warning signs, many of them say “Oh! I have all of these… does that mean I have dementia??” Not to worry, yet!  These warning signs are just a hint that it may be time to go visit a doctor and talk about the symptoms you are facing.  A lot of people don’t realize that there are reversible types of dementia, such as thyroid issues, that may cause some of these symptoms.  Going to talk to a doctor can determine the cause of these symptoms and some may actually be reversed.

A lot of these “warning signs” seem like typical age related changes.  However, there is a difference between forgetting where you parked your car and finding it a few seconds later (typical aging) and not remember what car you have (a warning sign of dementia).  Another example is confusion with time or place, again, there is a difference between thinking it is Friday when it is actually Thursday (we’ve all done that!) but remember it is Thursday a few minutes later, versus  thinking it is Summer when it is actually Winter (warning sign).

Where do you think we draw the line between “normal” aging and the beginning signs of dementia?  Even though we have these outlined signs, it may be difficult to tell.  When it doubt, I say talk to your doctor about changes so they can be recorded and monitored in the future.

Reference: www.alz.org/texas

Our Guest Blogger this week is Krista Dunn, MPH, Galveston/Bay Area Outreach Coordinator for Alzheimer’s Association Houston and Southeast Texas Chapter.

Join us for a real-time discussion about the 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.

 

MarionsThere are coincidences, accidents, happenstance and serendipity but I wonder if those curious, unanticipated incidences just happen for no reason at all. Allow me to share a few thoughts.

I just learned that the last sibling of my father recently died. This was my 100 year old Aunt Florence. My wife and I had sent her flowers on her 100th birthday and now I learned that she died almost the next day.

She was from California, lived in Arizona and I live in Texas, so our family communications were sparse. None of her children were living and her passing seems to have been almost anonymous. I  discovered it by trying to phone her and learning her number was disconnected. My only other relative on that side of the family, a second cousin (or maybe first cousin, once removed… ?), did not know anything about Florence. No obituary in the local newspaper. I eventually found the Social Security Death Index record that recorded her death.

The curious incident was this.

My Aunt Florence and her sister, Josephine, had not gotten along for over 30 years and never spoke. My Aunt Josephine apparently had a change of heart and phoned Florence when Florence was in a nursing home in California and at the moment of the call, Florence was headed out the door to return to Arizona. They never spoke and Josephine died soon after.

I phoned Florence to follow up on the flowers we sent to honor her 100th birthday but only talked to a nurse at her home, who said that Florence was going to a respite care facility, that she loved the flowers and would be back home in a few days. So like my Aunt Josephine, I came close but she and I did not get to speak. At least she liked the flowers.

I am coming to grasp that a long life very often outlives everyone else (fairly obvious) and the consequence of that is one is left without the network of relatives who communicate and keep everyone connected about what’s happening. There is more to a long life than we contemplate and aging seems to get more complicated all the time.

I’d like to think there is a reason for everything. The hard part is knowing what that is.

Image: From bottom to top, my Father, Aunt Josephine, Aunt Florence, about 1922.

Join us for a real-time discussion about the 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.

I once asked my dad what it was like to get older.  He said “I can still do many of the things I used to do like working hard, but when I was younger I could take a shower and rest for an hour and then go out for some fun.  Now it takes me about two weeks to recover from the same work.”

I have read previous blogs about when we consider ourselves older or aged.  The question came to mind how we prepare for the aging process.  Often in our lives, we are so busy handling the day to day operations, we rarely sit back and think about what we will do when we grow older.  What type of activities will I plan to do?  What type of house will I live in?  When will I retire?

Quo vadisI find that it is common to plan for things such as retirement from a financial support perspective.  We even prepare for our “final days” such as securing retirement homes, funeral plans, burial plots, and advanced directives.  However, how often do we think about planning moderate exercise routines, joining new social groups, downsizing the square footage of our yards and homes to match our physical abilities?  When and how will we decide we should no longer drive or give up certain foods?

I have several friends who have recently retired and it is interesting to see how different people handle retirement.  Some have a solid plan of traveling, visiting relatives, watching grandchildren.  Often, in these individuals, I have seen positive acceptance of aging.  In others, I have witnessed they did not have a plan after retirement.  They knew only that they were ready to stop working.  In these cases, I have witnessed depression, lack of sleep, marriage trouble and disagreement.  I cannot scientifically state that there is a large disparity between having a plan for our aging process or not, but it seems that having a plan promotes positive outlook for living well into your aged years.  What are your thoughts?

Our Guest Blogger this week is Mark Scott, M.B.A., C.P.M., Director, Texas AHEC East-Piney Woods Region.

Join us for a real-time discussion about the rather grave question 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.

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