Last Week’s Links

‘I am mine’: This is what Alzheimer’s is like at 41

Early-onset Alzheimer’s disease is particularly devastating. This article tells the story of a loving couple when the husband, Jo, was diagnosed:

Four years ago, Jo was diagnosed with dominantly inherited Alzheimer’s disease, an extremely rare form caused by a genetic mutation slithering through his family tree. Jo watched his mother die of the same illness when he was a teenager. Even in this early-onset form of Alzheimer’s, Jo is a terrible rarity: he was 37 years old when he was diagnosed.

The publication carried an earlier story, soon after the diagnosis, that is linked here.

This article decorously discusses the many issues this family faces, including information about the decision to place Jo in an a home and end-of-life directives in patients with dementia.

Lies, lies and more lies. Out of an old Tacoma house, fact-checking site Snopes uncovers them

In the pre-internet days we called wild-sounding stories urban legends. Nowadays most such stories are spread across the internet, and we call them hoaxes.

All those viral hoaxes, spread by social media, have created a market for fact-checking sites, with Snopes, started in 1994, being the champ.

I’ve been consulting Snopes for ages, but I did not know until I came across this article that it is run out of a 97-year-old house in Tacoma, WA, my new home town. In fact, the Snopes house is in Tacoma’s North End, which is where I also live.

Snopes is particularly busy in the current political climate, in which “the hoax reports just keep rolling in.” So before you blindly repeat that story you heard on Twitter or read on Facebook, ask yourself: “ Just what is your receptivity to something that sure looks like it came from a bull?”

Best Buy is cashing in as Americans grow older

Big electronics store Best Buy is positioning itself to attract an older clientele by becoming the go-to niche market for digital health:

In August, Best Buy announced it would buy GreatCall for $800 million. GreatCall makes Jitterbug cell phones with big buttons and bright screens designed for senior citizens, as well as medical alert devices that can detect falls and summon help.

The demand for digital health products and services will grow in the future as the U.S. population of people over 65, now at around 50 million, doubles over the next 20 years as Baby Boomers retire.

Google Plus Will Be Shut Down After User Information Was Exposed

I was somewhat relieved to read this news. When Google Plus came into being, I tried for a few weeks to use it. But I never really got it: Its interface wasn’t obvious, and I never saw the point of simple links with no context.

So I’m glad to learn that I no longer have to feel inadequate about not knowing how to use Google Plus effectively. Now if I could just figure out Instagram …

Nursing Homes Are Pushing the Dying Into Pricey Rehab

Bloomberg reports:

Nursing home residents are increasingly spending time in rehabilitation treatment during the last days of their lives, subjected to potentially unnecessary therapy that reaps significant financial benefits for cash-strapped facilities, a study shows.

A study out of the University of Rochester, based on data from 647 New York-based nursing home facilities, revealed that “Some residents were found to have been treated with the highest concentration of rehabilitation during their last week of life.”

 

© 2018 by Mary Daniels Brown

Last Week’s Links

What will your life story say about you?

Life is a story that we write and while writing we rediscover our unique selves as well as the opportunity to newly discover the uniqueness and diversity in others.

In this short article Anita P. Jackson, a clinical counselor and emerita professor at Kent State University, explains how we can examine our own life stories to better not only ourselves but society as well.

How the Elderly Lose Their Rights

Guardians can sell the assets and control the lives of senior citizens without their consent—and reap a profit from it.

Here, according to this article from the New Yorker, are the facts:

In the United States, a million and a half adults are under the care of guardians, either family members or professionals, who control some two hundred and seventy-three billion dollars in assets, according to an auditor for the guardianship fraud program in Palm Beach County. Little is known about the outcome of these arrangements, because states do not keep complete figures on guardianship cases—statutes vary widely—and, in most jurisdictions, the court records are sealed. A Government Accountability report from 2010 said, “We could not locate a single Web site, federal agency, state or local entity, or any other organization that compiles comprehensive information on this issue.” A study published this year by the American Bar Association found that “an unknown number of adults languish under guardianship” when they no longer need it, or never did. The authors wrote that “guardianship is generally “permanent, leaving no way out—‘until death do us part.’ ”

In the United States, guardianship is governed by state, not federal, law.

This long and frightening article focuses on cases around Las Vegas, NV, but some of the information is generally applicable.

Are Job Ads Targeting Young Workers Breaking The Law?

When an employer sets out to recruit young people for a certain job, is it discriminating against older job seekers in a way that breaks the law? That question is at the center of several pending lawsuits that could help improve job opportunities for older Americans.

11 Novels with Older Characters You’re Sure to Love

Taylor Noel offers a list of “11 novels with older protagonists that you’re sure to love.”

‘A different way of living’: why writers are celebrating middle-age

But we search in vain if we turn to these books for answers, partly because these writers are more interested in asking questions, and partly because they are too singular, and too defiant, to tell us what to do. Greer ends by announcing that though younger people anxiously inquire, and researchers tie themselves in knots with definitions, “the middle-aged woman is about her own business, which is none of theirs”. Women come racing up from behind, asking how to negotiate the next phase. But we’re not going to learn much because, Greer says, the middle-aged woman is “climbing her own mountain, in search of her own horizon, after years of being absorbed in the struggles of others”. The ground is full of bumps, the air is thin and her bones ache. Nonetheless, the ascent is worth it, however baffling it may seem to others. Greer exhorts her middle-aged readers not to explain or apologise. “The climacteric marks the end of apologising. The chrysalis of conditioning has once and for all to break and the female woman finally to emerge.”

© 2018 by Mary Daniels Brown

U.S. Just Made It a Lot Less Difficult to Sue Nursing Homes – The New York Times

The federal agency that controls more than $1 trillion in Medicare and Medicaid funding has moved to prevent nursing homes from forcing claims of elder abuse, sexual harassment and even wrongful death into the private system of justice known as arbitration.

An agency within the Health and Human Services Department on Wednesday issued a rule that bars any nursing home that receives federal funding from requiring that its residents resolve any disputes in arbitration, instead of court.

The rule, which would affect nursing homes with 1.5 million residents, promises to deliver major new protections.

Source: U.S. Just Made It a Lot Less Difficult to Sue Nursing Homes – The New York Times

Last Week’s Links

Older Entrepreneurs Take On the ‘Concrete Ceiling’

Many older Americans want to start a business but find they lack certain skills, and sometimes also the confidence to try something new. In response, more organizations focused on training entrepreneurs are targeting baby boomers.

A look at programs across the U.S. that help older adults start their own businesses.

‘Elder Orphans’ Have a Harder Time Aging in Place

I had never heard the term elder orphan before I came across this article and had no idea what it might mean.

An elder orphan has no adult children, spouse or companion to rely on for company, assistance or input. About 29 percent (13.3 million) of noninstitutionalized older persons live alone. The majority of those are women (9.2 million, vs. 4.1 million men).

Carol Marak, who describes herself as an elder orphan, writes about why we need more services for people like herself who have no family to help them make crucial life decisions as they age. Marak started the Elder Orphan Facebook Page “designed for individuals over the age of 55 who live without a spouse and adult children to look after us as we grow older.”

Vitamin B12 as Protection for the Aging Brain

Jane Brody, age 75, writes that even though she eats a balanced diet, she’s considering taking a vitamin B12 supplement. As people age, she says, their ability to absorb B12 from dietary sources may diminish:

“Depression, dementia and mental impairment are often associated with” a deficiency of B12 and its companion B vitamin folate, “especially in the elderly,” Dr. Rajaprabhakaran Rajarethinam, a psychiatrist at Wayne State University School of Medicine, has written.

Others besides people over age 50 who may have a B12 deficiency include vegetarians and vegans who eat little or no animal protein, people with stomach or small-intestine disorders like celiac disease or Crohn’s disease, people whose digestive systems have been surgically altered for medical reasons, and chronic uses of proton-pump inhibitors to control acid reflux. A blood test can measure one’s level of B12.

 

© 2016 by Mary Daniels Brown

Last Week’s Links

Middle-age memory decline a matter of changing focus

The inability to remember details, such as the location of objects, begins in early midlife (the 40s) and may be the result of a change in what information the brain focuses on during memory formation and retrieval, rather than a decline in brain function, according to a study by McGill University researchers.

Senior author Natasha Rajah, Director of the Brain Imaging Centre at McGill University’s Douglas Institute and Associate Professor in McGill’s Department of Psychiatry, says that this decline in middle age may be a sign not of declining brain function, but rather of focusing on different aspects of information. “Rajah says that middle-aged and older adults might improve their recall abilities by learning to focus on external rather than internal information.”

Too Old for Sex? Not at This Nursing Home

A nursing home in the Bronx, New York, follows a “sexual expression policy” that allows residents to spend time together:

a number of older Americans … are having intimate relationships well into their 70s and 80s, helped in some cases by Viagra and more tolerant societal attitudes toward sex outside marriage. These aging lovers have challenged traditional notions of growing old and, in some cases, raised logistical and legal issues for their families, caretakers and the institutions they call home.

But the article also notes the other side of such a policy:

But intimacy in nursing homes also raises questions about whether some residents can consent to sex. Henry Rayhons, a former Iowa state legislator, was charged with sexual abuse in 2014 after being accused of having sex with his wife, who had severe Alzheimer’s disease and was in a nursing home. A jury found him not guilty.

Alexander Masters’s book based on discarded journals gives ‘throwing your life away’ a new meaning

leather diaryMany of us in our later years think about writing down something about our lives to leave a legacy for future generations. Here’s an interesting story about a biographer, Alexander Masters, who has published the book A Life Discarded: 148 Diaries Found in a Skip. In 2001 two Cambridge University professors found 148 diaries in a Dumpster (the Canadian term is skip). Not wanting their find to go to waste, they gave the diaries to Masters.

Becky Toyne examines Masters’ project here and concludes:

We don’t have journal writing like this any more. We remain obsessive chroniclers of our lives, only in public pictures rather than private text (and we edit out all the sad bits). By contrast, the diaries of “I” build to a 40-million word chronicle of a life containing very little excitement. The difference? “These books were alive,” says the Cambridge professor upon finding them strewn about a skip – and in Masters’s heartbreaking, heartwarming biography we learn that, however unremarkable or littered with disappointments our existence might turn out to be, so are we.

What Do Contested Conventions Look Like? Ask Hollywood And Sinclair Lewis

I offer this article in preparation for the upcoming political conventions.

And this is as political as I’ll get here, I promise.

 

© 2016 by Mary Daniels Brown

Notes on Aging

Tai Chi and Heart Disease

Tai chi is a favorite type of exercise offered to older adults because it requires only slow, gentle movement and deep breathing. Tai chi helps improve balance, an important benefit to help prevent falls and their related injuries. Some more recent evidence also suggests that tai chi may also promote cardiovascular health by slowing heart rate and lowering blood pressure.

Ask Your Doctor if This Ad Is Right for You

The health care industry spent $14 billion on advertising in 2014, according to Kantar Media, a jump of nearly 20 percent since 2011. That includes over-the-counter medications, but not sponsorships (the Super Bowl had two health care systems as partners). While magazine advertising has dropped off somewhat with the withering of the publishing industry, television advertising has risen 55 percent for hospitals and 30 percent for prescription drugs in that period.

This article, not specifically directed toward older adults, examines advertising trends that attempt to drive people with good health insurance toward expensive prescription drugs and treatment programs. Many of these advertisements occur on television during popular programs such as presidential debates and sports events like the Super Bowl. Many of the pricey drugs advertised are available in much cheaper generic brands.

But as the volume and spending on advertising increases, health economists and doctors are raising concerns about the trend, which they say increases prices and encourages patients to seek out more expensive and, often, inappropriate treatment.

Using the Arts to Promote Healthy Aging

across the country, the arts in their myriad forms are enhancing the lives and health of older people — and not just those with dementia— helping to keep many men and women out of nursing homes and living independently. With grants from organizations like the National Endowment for the Arts and the National Institute on Aging, incredibly dedicated individuals with backgrounds in the arts have established programs that utilize activities as diverse as music, dance, painting, quilting, singing, poetry writing and storytelling to add meaning, joy and a vibrant sense of well-being to the lives of older people.

Read about how programs that keep people creatively engaged in the arts are improving the quality of life for many older adults.

Why living in a 55-plus community may be better for your health

When my husband and I decided to move 2,000 miles away for retirement, we had to decide whether to buy a house or enter a retirement community in our new city. We decided on a retirement community because we didn’t want to have to bother with chores such as mowing the lawn and cleaning out the gutters. Only after we had been here for a while did we realize how much easier it is to meet people and to stay socially active in a retirement community than it would have been in a house.

This article well describes how living in a senior-oriented community can improve quality of life for older adults. There’s also information here on CCRCs, continuing-care retirement communities, which offer “a range of long-term options that, in addition to independent town homes or apartments, can include on-site assisted-living facilities, memory care units for residents who develop dementia, and nursing homes.”

Entering just about any senior community can involve many rules and regulations, so be sure to read over and understand everything before you sign a contract.

The $1,000 Shoes

Joyce Wadler confesses:

I just paid $1,000 for a pair of orthopedic shoes. I was forced to do this because as one gets older, one’s feet often get wider, and designers, concerned as they are with cultivating older shoppers, offer shoes that look like boats… . When I was in my 20s and saw older women in these ugly shoes, I wondered what made them buy them. Now I understand that it was the same thing that made them go out with unsuitable men: availability. You search and search and there’s nothing out there. After a while you say: “I can’t take it. Just let me find something I can make do with. I don’t care if it’s not perfect, just let it get me through the Kornberg destination funeral.”

I haven’t worn anything but flat shoes for probably 15 years now. My problem wasn’t my feet; it was my back. At some point you just have to decide which is more important, vanity or comfort.

And here’s another confession, perhaps related: I haven’t worn a dress or skirt in about the same length of time. Pants are just so much more comfortable, and they cover my worst feature, my large calves. Also, it’s much easier to find flat shoes to go with pants than flat shoes that go with skirts.

And thank heaven for retirement, which has rendered all these considerations moot. I never go anywhere that requires an outfit dressier than nice pants (though I prefer jeans), and I’ll even wear my open-toe sandals, which fit amazingly well, in winter if I can’t get away with comfortable athletic shoes.

I do admit, though, that sometimes even those comfortable athletic shoes cost way more than I think they should. But nowhere near $1,000.

Notes on Aging

Lifting Weights, Twice a Week, May Aid the Brain

Many neurological studies have found that, by late middle age, most of us have begun developing age-related holes or lesions in our brains’ white matter, which is the material that connects and passes messages between different brain regions.

lifting kettle bellThese brain lesions show up on imaging studies before people begin experiencing their symptoms, just as osteoarthritis (joint degeneration) shows up on x-rays before people begin feeling pain. Most studies that advocate the benefits of exercise on maintaining brain health have focused on aerobic exercise, such as brisk walking. But a new study suggests that light resistance exercise, lifting weights, may also improve brain health.

Teresa Liu-Ambrose, professor of physical therapy and director of the Aging, Mobility, and Cognitive Neuroscience Laboratory at the University of British Columbia in Vancouver, looked at the brains of a large group of generally healthy women between the ages of 65 and 75 who already were enrolled in a brain health study that she was leading. The new study focused on 54 of the women whose brain scans showed existing white matter lesions.

For this study, researchers divided the participant pool into three groups:

  1. Those who began a once-weekly program of light upper- and lower-body weight training
  2. Those who underwent the same weight training program twice a week
  3. The control group, who began a twice-weekly program of stretching exercises and balance training

The results found that those in group 2 “displayed significantly less shrinkage and tattering of their white matter” than those in both of the other two groups. These results, published in The Journal of the American Geriatrics Society, suggest that working out just once a week may not be sufficient.

Whatever the reason, exercise, including weight training, clearly “has benefit for the brain,” Dr. Liu-Ambrose said. “However we are just really now gaining an appreciation for how impactful exercise can be.”

Can You Get Smarter?

In this opinion piece in the New York Times, Richard A. Friedman, professor of clinical psychiatry at Weill Cornell Medical College, examines the question of whether brain training can enhance memory and cognitive functioning. Since “one in nine people age 65 and older has Alzheimer’s disease,” concerns about maintaining brain health are common, and brain training has become a multibillion-dollar industry.

Friedman looks at the effects of several areas of intervention on improving brain health: mental exercises, physical exercise, and medication. He discusses both the encouraging news and the caveats arising from the scientific research.

He concludes that there is one thing that consistently seems to help preserve cognitive functioning: other people. Analysis of data from a large study:

showed that people with the highest level of social integration had less than half the decline in their cognitive function of the least socially active subjects. Also, the cognitive protective effects of socializing were greatest among subjects with fewer than 12 years of education.

Friedman concludes:

there is much that you can do to reach your cognitive potential and to keep it. Forget the smart drugs and supplements; put on your shorts and go exercise. If you’re 60 and up, consider brain training. And do it all with your friends.

Costs for Dementia Care Far Exceeding Other Diseases, Study Finds

Three diseases, leading killers of Americans, often involve long periods of decline before death. Two of them — heart disease and cancer — usually require expensive drugs, surgeries and hospitalizations. The third, dementia, has no effective treatments to slow its course.

This eye-opening article looks at the costs associated with long-term care of patients with dementia. What’s most sobering is the that fact that much of the required care is not covered by Medicare:

On average, the out-of-pocket cost for a patient with dementia was $61,522 — more than 80 percent higher than the cost for someone with heart disease or cancer.

While Medicare covers medical care, such as doctor visits, hospitalization, and surgery, it does not cover the personal care required by many people with dementia—help with bathing, dressing, and eating. Most people pay for this care from their own funds. When they have nothing left, Medicaid, a joint federal and state program, takes over.

This article makes clear why caring for an elderly relative with dementia can be such a devastating burden, both physically and financially.

Assessing the Fitness of Wearable Tech

wearable fitness trackerJane E. Brody discusses fitness trackers: “experts say that older adults are among those who could benefit most from such devices.”

The wearable fitness tracker has blossomed, but the gadgets can be expensive, from about $49 to $250, Brody reports. But, according to a study published recently in JAMA (Journal of the American Medical Association), smartphone applications are just as accurate as wearable devices in tracking physical activity.