Category: assisted living

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.

Retirement Lifestyle

Mean Girls in the Retirement Home

Here’s a sad story indeed. Jennifer Weiner writes about her 97-year-old grandmother’s entry into an independent living facility. The mean girls at the facility wouldn’t let Weiner’s grandmother sit at their table in the dining room. They talked about playing bridge but told Weiner’s grandmother that they didn’t need any new players.

Weiner uses her grandmother’s experience to ponder the question of how typical or atypical this treatment is among residents of independent living centers. She cites a recent study by Karl Pillemer of Cornell University that found aggression among residents in nursing homes to be widespread:

According to the study’s news release, one in five residents was involved in at least one “negative and aggressive encounter” with another resident during a four-week period. Sixteen percent were cursed or yelled at; 6 percent were hit, kicked or bitten; 1 percent were victims of “sexual incidents, such as exposing one’s genitals, touching other residents, or attempting to gain sexual favors;” and 10.5 percent dealt with other residents’ entering their rooms uninvited, or rummaging through their belongings.

Weiner also points out that age discrimination is rampant: “Even in a residence for the elderly, the 80-somethings will still be cold to the 95-year-olds.” This discrimination leaves people like her grandmother, now 99 and without cognitive impairment, with no one to talk to. Such is the pain of having outlived almost all of one’s contemporaries.

An Unexpected Bingo Call: You Can’t Play

Here’s another story that even goes beyond the experiences of Jennifer Weiner’s grandmother. Paula Span describes what happened to Ann Clinton, who is 80 and has Parkinson’s disease, at Redstone Village in Huntsville, AL. Redstone is a type of facility known as a continuing care retirement community (CCRC). Such communities offer a full range of care, from independent living through assisted living and then skilled nursing care. Many CCRCs promote their range of care as a benefit for potential residents.

Ann Clinton and her husband began their retirement life in an independent living apartment at Redstone. Her husband moved through the assisted living and skilled nursing continuum and died last fall. Throughout her husband’s decline Ann Clinton found companionship and support at the weekly bingo game held in the independent living area of the building. But when she entered the Redstone nursing wing after back surgery, she was told she could no longer participate in the Monday night bingo game, even though she could easily ride her motorized scooter to the game.

And thus began the bingo wars at Redstone. My heart sank as I read how the conflict has escalated. Both Redstone administration and some independent-living residents want to keep Mrs. Clinton out.

Read how lawyers from AARP and the National Senior Citizens Law Center are attempting to fight such discrimination as a violation of both the federal Fair Housing Act and and the Americans With Disabilities Act.

Retirees Find Meaning Serving the Needs of Their Communities

Not all the news about retirement life is bad, though. This New York Times article describes how retired folks are volunteering to do “difficult and meaningful work” to give back to their communities:

According to the Corporation for National and Community Service, a government agency that runs the AmeriCorps and Senior Corps programs, some 24 percent of older adults volunteered in 2013, providing nearly 190 million hours of service. Despite the disruption of a recession six years ago, that rate has held fairly steady over the past decade.

Read here about three people who

personify what Mitch Anthony, a consultant, speaker and author of “The New Retirementality,” calls the “legacy or mission phase” of life. At this point, people may be less concerned with paying bills and more interested in paying back.

Over 50 and Back in College, Preparing for a New Career

And there’s more good news in another New York Times article:

For many, a retirement of babysitting grandchildren, golfing and relaxing on the beach is passé. Older people today approach work as a pillar of a retirement lifestyle, planning ahead and adding skills even before leaving their current jobs.

Colleges and universities are trying to figure out how to tap into this growing population of potential students. According to the United States Census Bureau, by 2030 the number of Americans age 65 and older will reach 72 million, up from 40.2 million in 2010.

A Merrill Lynch study conducted in partnership with Age Wave, a research firm that focuses on aging, found that nearly three of every five working retirees said retirement was an opportunity to shift to a different line of work.

For some of those seeking to change careers, retirement offers an opportunity to pursue a calling that wasn’t economically feasible earlier. Still others, forced into earlier-than-expected retirement by health concerns or layoffs, need to keep working for financial reasons.

Read here how many colleges and universities, including community colleges, are working to develop both degree and non-degree programs for older adult students. Especially encouraging is the news that state universities in California, Texas, and Pennsylvania offer tuition-free enrollment for older adultls.

Too Many Open Browser Tabs

Whenever I find an interesting article, I leave it open on my browser because I just know it will form the basis of a spectacular blog post. I’ve always done this, but in the past I would finally just close everything and start over again because the web is, after all, an infinite source of riches. But since I challenged myself to write a blog post a day in 2015, I’ve been less eager to close all those tabs down. What if I face a day when I can’t think of anything to write about?

My browser has now become so bloated that I have to do something to make my system work faster. Instead of just closing all those tabs, I’m resorting to a collection of the very best ones here. Because I have lots of wide-ranging interests, this is quite an eclectic collection. But every one of these articles is worth attention. I guarantee it.

The Moral Bucket List

New York Times op-ed columnist David Brooks writes here about some special people:

ABOUT once a month I run across a person who radiates an inner light. These people can be in any walk of life. They seem deeply good. They listen well. They make you feel funny and valued. You often catch them looking after other people and as they do so their laugh is musical and their manner is infused with gratitude. They are not thinking about what wonderful work they are doing. They are not thinking about themselves at all.

Brooks distinguishes between two types of virtues, the résumé virtues and the eulogy virtues:

The résumé virtues are the skills you bring to the marketplace. The eulogy virtues are the ones that are talked about at your funeral — whether you were kind, brave, honest or faithful. Were you capable of deep love?

He goes on to say that a while back he set out “to discover how those deeply good people got that way.” In the rest of the article he describes what he found out.

It’s a good article, and I encourage you to read it. But I’ve left this browser tab open for a while now because this article reminded me of a former friend of mine. She could, at times, act caring and loving, but I always detected the tiniest disconnection between her inner workings and her outer behavior. For example, one day after she had spent a long time describing how each of her three children had recently hurt her feelings, she paused for a second while looking at me, then asked, “How’s your daughter?” During that second I could see the gears working inside her head: “I’ve talked about my kids, so I should now ask about hers.” I knew she wasn’t truly interested, so I said, “She’s fine” and left it at that. She visibly exhaled with relief.

This women always blamed other people for any problem in her own life. Everything was always the other person’s fault. She even developed a convoluted philosophy of life—it involved a person’s True Center of Pure Being (her caps)—that allowed her to avoid having to take responsibility for her own actions. When one of her children made her feel down on herself, she would explode and scream at me, trying to make me feel just as bad about myself as she felt about herself. When I told her, several times, how hurtful her behavior was to me, she said that I should understand that she was under a lot of pressure. “I’m not what I do,” she said.

This woman is the opposite of the people David Brooks describes. One can’t simply invoke one’s True Center of Pure Being. She is what she does. We all define ourselves by what we do and say. And this is why she’s a former friend, not a current one.

Sex, Dementia and a Husband on Trial at Age 78

This article brings up one of those issues that’s so complex and deeply personal that I have trouble figuring out what I think about it. In Iowa, Henry Rayhons, age 78, has been arrested for having sex with his 78-year-old wife, who had severe dementia, in a nursing home. The couple was married in 2007 after each had been widowed.

The top-level issue is whether Mrs. Rayhons was capable of giving consent for sex. But the lower-level issue is the question of who gets to decide whether Mrs. Rayhons was capable of giving consent: her husband, nursing home administrators, her doctor, her children?

This case suggests that someone must take the initiative in setting guidelines:

Sex is one of the most ambiguous areas in the scientific understanding of Alzheimer’s. While there are established methods of measuring memory, reasoning and the ability to dress, bathe and balance checkbooks, no widely used method exists for assessing the ability to consent to intimate relations.

Furthermore, dementia symptoms fluctuate. What may be appropriate on one day may not be appropriate on another day. Even more confusing, what may be appropriate in the morning may not be appropriate in the afternoon of the same day.

I’m glad I’m not sitting on the jury for this case.

Parsing Ronald Reagan’s Words for Early Signs of Alzheimer’s

Lawrence K. Altman, M.D., reports:

Now a clever new analysis has found that during his two terms in office, subtle changes in Mr. Reagan’s speaking patterns linked to the onset of dementia were apparent years before doctors diagnosed his Alzheimer’s disease in 1994.

The findings of the study by Arizona State University researchers were published in The Journal of Alzheimer’s Disease. Altman points out that these findings “do not prove that Mr. Reagan exhibited signs of dementia that would have adversely affected his judgment and ability to make decisions in office.”

But the findings do suggest that alteration in speech may one day be used to predict the development of Alzheimer’s and other neurological conditions long before clinical symptoms appear. Earlier detection could lead to earlier treatment, which in turn could help reduce or at least slow damage to the brain.

This research used the same computer algorithm that other researchers have used to analyze changes in writing by novelists, which I have written about here:

Canadian researchers have reported that analyses of syntax in novels by Iris Murdoch and Agatha Christie indicated early signs of dementia (Ms. Murdoch died of Alzheimer’s; Ms. Christie is suspected to have had it.) The same analysis applied to the healthy P. D. James, who died at 94 last year, did not find signs of dementia.

Scientists not involved in this study caution that much more research is necessary before analyses such as this can confidently be used in examining for Alzheimer’s disease.

Frontline: Life and Death in Assisted Living

Frontline: Life and Death in Assisted Living

http://www.pbs.org/wgbh/pages/frontline/life-and-death-in-assisted-living/

What can one expect in an assisted living facility? It can be hard to evaluate their seemingly bucolic surroundings based solely on their websites and promotional literature. The team at Frontline teamed up with Pro Publica to craft this well-done documentary on the assisted living industry in the United States. Visitors can watch the entire 53 minute documentary online or explore the site’s wealth of extra features. Users shouldn’t miss the interviews with two of the nation’s largest assisted living companies or the very compelling live chat transcript with the filmmakers, titled Is Assisted Living Safe for Your Parents? Journalists, in particular, will appreciate the section How “Life and Death in Assisted Living” Was Reported.

From The Scout Report, Copyright Internet Scout 1994-2013. https://www.scout.wisc.edu/