Last Week’s Links

People Are Happiest At This Unexpected Time of Life

old-people

New research suggests that people get happier with age. Earlier research has suggested that peoples’ mental health improves as they age, and this study of 1,546 randomly selected adults in San Diego County suggests a correlation with happiness.

Have a Story to Tell? Your Personal Memoirist Is Here

Even in an era when it seems every life is displayed on social media for the world to see, a whole generation is getting older, and its stories, if not written or otherwise recorded, will be lost. Serving that market is becoming a small-business enterprise.

This article describes how personal historians work with clients to write the individual’s life history.

Is This Sustainable Village The Future Of Retirement?

An account of Serenbe, a multigenerational community in Chattahoochee Hills, outside Atlanta,GA. The community clusters homes and commercial buildings together so that a large portion of wooded land can be left undeveloped.

Nygren’s vision for Serenbe was modeled on the English countryside, where high-density villages are surrounded by expansive rural spaces.

Writing a ‘Last Letter’ When You’re Healthy

Dr. VJ Periyakoil, director of the Stanford Palliative Care Education & Training Program, describes the Stanford Letter Project, which encourages older adults to write letters to their loved ones expressing sentiments they might not have been able to say face-to-face. The article contains a link to the Stanford Letter Project, which offers free letter templates.

 

© 2016 by Mary Daniels Brown

What I’ve Been Reading

Last Week’s Links

Happiness increases after consumption of fruit and vegetables, study finds

orangesWe know we should eat lots of fruits and vegetables to keep our bodies healthy, but new research suggests this approach may also help our mental health as well. The study out of the University of Warwick, to be published soon in American Journal of Public Health, found that:

people who changed from almost no fruit and veg to eight portions of fruit and veg a day would experience an increase in life satisfaction equivalent to moving from unemployment to employment. The well-being improvements occurred within 24 months.

Star Trek and the Kiss That Changed TV
Star Trek: The Exhibition
Star Trek: The Exhibition

“Everything I need to know about life I learned from Star Trek” has long been my motto. I’m talking specifically here about the original series featuring William Shatner as Capt. James T. Kirk and Leonard Nimoy as Mr. Spock.

Finding this article truly warmed my heart. Natalie Haynes writes that Nichelle Nichols, who played Lt. Uhura, said that Gene Roddenberry, the series’ creator, believed in a world of tolerance: “He believed in that world, if you got it you got it. If you didn’t get it, you’d see it anyway.”

It’s a neat summary of the allegorical complexity of Star Trek: if you get the subtext, you get it. If you don’t, you just see the surface story. Whenever Roddenberry or his writers had a political point to make, they tended to use allegory as their best way to get that point across. One of the joys of Star Trek is that our crew is constantly exploring, constantly curious. So there is always a planet, a species, a story which can throw its illuminating light upon the less exotic world of the earthbound viewer.

Haynes examines how the same approach continued in the later Star Trek spinoffs, The Next Generation and Deep Space Nine. I haven’t watched all of the episodes of the later shows, but I cannot forget the lessons that the original series taught us about racism, greed, war, despotism, and other dark aspects of human nature.

© 2016 by Mary Daniels Brown

Last Week’s Links

Thriving at Age 70 and Beyond

From Jane E. Brody, long-time health writer for the New York Times:

A recently published book, “70 Candles! Women Thriving in Their 8th Decade,” inspired me to take a closer look at how I’m doing as I approach 75 and how I might make the most of the years to come. It would be a good idea for women in my age cohort to do likewise. With a quarter of American women age 65 expected to live into their 90s, there could be quite a few years to think about.

About the book 70 Candles! Women Thriving in Their 8th Decade, Brody writes:

What are the most important issues facing these women as they age, and how might society help ease their way into the future? Leading topics the women chose to explore included work and retirement, ageism, coping with functional changes, caretaking, living arrangements, social connections, grandparenting and adjusting to loss and death.

Curtis Sittenfeld: Pride and Prejudice Then & Now

Curtis Sittenfeld’s latest book, Eligible, is a modern retelling of Jane Austen’s classic novel Pride and Prejudice.

While social rules have changed dramatically in the 200 years since the publication of Pride and Prejudice, Austen’s themes of love, wealth and class are still relevant. Women today can secure financial independence and enjoy intimate relationships without a marriage certificate. Yet societal pressures to marry and bear children persist. And so does the allure of “a single man in possession of a good fortune.”

Men Have Book Clubs, Too

Book clubs have a reputation as something women do together, but this article focuses on an all-male group in Marin County, CA:

The Man Book Club is going into its ninth year. It has 16 members, a number of whom are lawyers and engineers in their mid–50s. Each month, the host must prepare a meal appropriate to the book under discussion.

There’s also information on other all-male book groups around the country.

What You Really Lose When You Lose Perspective

Our perspective is how we perceive people, situations, ideas, etc. It’s informed by our personal experience, which makes it as unique as anything could be. Perspective shapes our life by affecting our choices. But the minute our minds become steeped in worry, perspective goes out of the window. We forget about our triumphs. We stop being optimistic as fear takes the wheel.

Sarah Newman explains how fear can cause us to lose sight of all the wisdom we’ve accrued over our lives.

Meg Rosoff on Coming of Age

Coming of age is such a common topic for fiction that this type of novel has its own name: Bildungsroman. These novels focus on the psychological growth of the main character from youth into adulthood.

Here novelist Meg Rosoff discusses these coming-of-age novels:

  • A Separate Peace by John Knowles
  • Pride and Prejudice by Jane Austen
  • Henry IV Part I by Shakespeare
  • Tess of the D’Urbervilles by Thomas Hardy
  • All the Pretty Horses by Cormac McCarthy
Older women more likely to be overprescribed inappropriate drugs: Study

A recent research study from the University of British Columbia found that:

Older women are nearly 25 percent more likely than men to be over-prescribed or inappropriately prescribed drugs, with a new study pointing to social dynamics as the explanation for the discrepancy.

When authors’ prejudices ruin their books

This is a common question among avid readers: Should authors’ prejudices affect our reactions to their books?

In this article Imogen Russell Williams asks:

The unsavoury attitudes found in novels from writers such as GK Chesterton and Susan Coolidge have ruined some of the fiction I loved most as a child. But where do you draw the line when you return to tainted classics?

© 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.

Remembering My Father on Veterans’ Day

My father
My father (1924-1960)

My father fought in World War II. He was among those whom Tom Brokaw described as the greatest generation: people who left their jobs and went off to war to save the world from unspeakable brutality, then came back home, returned to work, and went on with their lives. It’s a great story to describe even greater people.

Except that not all returning veterans’ lives followed that narrative. My father’s certainly didn’t. I wish I could tell you his story, but I can’t. I know very little about him, either before or after the war.

What I do know is that after the war he married my mother and fathered me. The marriage soon faltered. I have one memory of a loud argument that included the breaking of dishes, which I heard from outside. He had trouble holding a job. He would often tap his foot or bounce his knee while sitting. His frequent stops at one or another local tavern became the source of more conflict. My mother took me to live with her parents when she filed for divorce.

Shortly after the divorce was finalized, my father killed himself, two months before my 12th birthday. He was 36. After that, it was as if he’d never existed. No one has ever talked about him, at least not to me. I have a few hazy memories, which may or may not be accurate. I’ve spent much of my life trying to piece together at least a broad outline of his life story, but it’s woefully incomplete.

He joined the Navy in 1941 at age 17. He spent at least some of the war on the USS Intrepid in the Pacific. I have a general impression that his family and friends thought he came home from the war a different man from the one who went in, although I can’t document exactly where that impression comes from.

For much of my adult life I avoided talking about my father. I could have asked his mother and siblings about him, but our culture does not encourage such discussions. Like everyone else, I felt the stigma of my father’s suicide and tried to push it out of my mind.

But as I’ve reached my later years, I’ve wished that I had tried to talk to the people who had known him. They’re all gone now.

So I’ve been researching the only aspect of his life that’s available to me now: the subject of veterans and suicide. More recent wars in the Persian Gulf, Iraq, and Afghanistan have forced us to address this issue as we didn’t before. We have come to acknowledge the interconnections between war, PTSD (post-traumatic stress disorder), and suicide. Everything I’ve read has convinced me that my father came home from World War II with unrecognized and debilitating PTSD.

Recently I read a New York Times article written “to answer readers’ questions about the devastating effects of combat and the high suicide rate among veterans.” The article focuses on soldiers who have returned from Afghanistan since 2008, but I can see the parallels with what little I remember about my father.

In this article Dr. Charles Engel, of the RAND Corporation, and two Marines who served with the battalion in Afghanistan, Arthur Karell and Keith Branch, answer questions posed by readers in October on a Facebook discussion.

The first question asked why the military isn’t more effective in identifying soldiers in need of mental health care. Keith Branch replied:

there is an extremely prevalent negative stigma associated with seeking mental health services, especially in the combat arms occupations where weakness is not tolerated.

This is a problem now and was probably an even greater problem at the end of World War II. Those soldiers were, after all, members of what we later came to call the greatest generation. They did their duty and then were expected to go home and resume their lives. That’s just what everyone did.

Branch also said:

From my experience, many Marines do not show signs of mental health problems until they separate from the service. I think being surrounded by the people who served in combat with you provides a sense of security. However, that security is lost when service members separate and return home.

Being surrounded by people who have shared your experiences is enormously comforting. But military life also provides a sense of security in another way. It’s a structured life. Soldiers know exactly what they are required to do and when they are required to do it. Such a regimented routine makes performing everyday duties relatively easy. It’s only after leaving the military that life becomes more difficult. People may flounder without the rigid structure of knowing what’s expected of them.

Another question asked was whether veterans’ pain in rooted in the events of the past or in their outlook for the future. Arthur Karell said:

The events of the past inform the outlook for the future. When the events of the past repeatedly trigger an anguish that doesn’t abate, it may cause a veteran to question what kind of future they have in store.

The important word here is trigger. The flashbacks of PTSD can be triggered by something as unpredictable as the sound of a truck. And once these memories have been triggered, the events are no longer in the past. A person having a flashback relives the disturbing experience all over again, as if it were happening right here, right now. Instead of separating the past and the future, PTSD condemns people to a horrific moment frozen into a debilitating present experience.

When asked to discuss treatments available for symptoms of PTSD, Dr. Charles Engel replied:

the downstream effects of PTSD can be broad and include a range of mental and physical health effects that fall outside the technical definition of the disorder. The most common of these include depression, anxiety, alcohol and drug misuse, chronic pain and sometimes poorly explained but disabling physical symptoms.

I now know that my father’s foot tapping and knee bouncing are common signs of anxiety. And, although I don’t remember him drunk, I do know that he spent many evenings at a bar.

All of these elements are probably interwoven in my father’s life story. I regret that I know so little of that story, but the little I do know I understand much better now than I did in my younger years.

Photo Credit

The photo at the top of this post is of the Intrepid Sea, Air & Space Museum. It was taken by deror avi on 25th September 2006.

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.

Film Review: “Still Mine”

‘Still Mine’ Adds to Movies on Aging

Paula Span reviews this new film:

Not long ago, I could name the really excellent recent movies about aging on one hand. Now I’m running short of fingers, which I hope reflects filmmakers’ dawning recognition of the way this global demographic shift affects all our lives. The latest entry, a Canadian movie called “Still Mine,” opened in New York, Washington, Phoenix and several other cities last month and will arrive in Denver, Atlanta, Seattle, Charlotte and more locations today.

And, just as rain is the standard symbol for Seattle, dementia has become a standard trope for aging:

Interesting, isn’t it, how many of the best films about aging zero in on dementia? On my personal favorites list (adding “Still Mine” to “Amour,” “The Iron Lady,” “Iris,” “The Savages,” “Away from Her” and “About Schmidt”), all but the last incorporate a central character suffering from this disease. Screenwriters, and novelists like Walter Mosley and Alice LaPlante, can’t seem to resist its intrinsic here-but-not-here drama.

“Still Mine” is clear-eyed about this phase, not nearly as brutal as the masterful “Amour,” but more grounded than “The Best Exotic Marigold Hotel” and “Quartet,” both of which featured charming British actors in fluffy screenplays that carefully evaded most realities of advanced age.

This film doesn’t, but it is gentle, more gentle than life can be.

 

A Dark View of Assisted Living

A Dark View of Assisted Living – NYTimes.com

the hourlong “Frontline” documentary “Life and Death in Assisted Living,” airing Tuesday night on PBS stations across the country, doesn’t really break new ground on the subject. But it is important nonetheless.One reason is that families, who make most of the decisions about assisted living, don’t pore over gerontology journals or state regulations as they are looking for a place that is not a nursing home.

So they don’t always realize that these reassuring-looking residences may have no nurse on the premises most of the time, that health care in assisted living frequently consists of a 911 call, that the average length of stay — according to the Assisted Living Federation of America — is less than two years.

Canada’s elderly at high risk of suicide, can’t afford mental health care: experts | The Lethbridge Herald – myLH.ca

Canada’s elderly at high risk of suicide, can’t afford mental health care: experts | The Lethbridge Herald – myLH.ca

TORONTO – Studies show that Canada’s elderly are at a much higher risk of suicide than adolescents, and there is growing concern among mental health experts that psychological care may be out of reach for most seniors.

Dr. Marnin Heisel, a clinical psychologist and professor at the University of Western Ontario, says lack of public awareness of the issue is a key problem that affects not only the elderly, but their families and the public in general.

Although this article reports on the problem in Canada, depression among older adults is by no means confined to that country.

As pointed out here, there is a need for public awareness about the issue of older adults and depression. Family and friends should be aware of what signs to look for and should not hesitate to discuss the issue with older friends and family members.

One interesting point here is the observation that suicide might sometimes pass for death by natural causes in this age group unless coroners, alerted by reports of depression, know to look specifically for signs of suicide on autopsy.

Concerns About Dementia Screening

Concerns About Dementia Screening – NYTimes.com.

This article describes a patient who benefited from early diagnosis of a rare form of Alzheimer’s disease. But for most people, early diagnosis of dementia only provides knowledge of a problem for which there is no effective treatment.

the push for ever-earlier dementia screening raises troubling questions for patients and their families. When the diagnosis is early Alzheimer’s disease, the medical profession has little treatment to offer. This month, researchers at an Alzheimer’s Association conference in Boston urged policy makers to think hard before recommending wider dementia screening, saying studies have found no evidence that early detection improves outcomes.

And the experts said that little, if anything, is known about the potential risks of early detection. The diagnosis may cause stress, anxiety, depression and even suicide in patients, and can have implications for employment, purchasing life and long-term care insurance, and one’s overall quality of life, sense of autonomy and self-image.

While there are no easy answers, the article concludes with an encouragement for older adults and their family members who begin noticing signs of cognitive impairment to get a thorough medical examination:

The physician should take a history, do a thorough exam, and rule out a number of potential causes of mental impairment: depression; thyroid, kidney and liver function; vitamin B12 levels; infections; and dehydration and electrolyte disturbances. . . . The physician should also do a careful review of medications, since many drugs can have adverse effects on cognition. . . . Reassuringly, many people who experience mild cognitive impairment do not progress to dementia, and many even return to normal, some studies suggest. A study of primary care patients seen at Wishard Health Services identified 130 patients with mild cognitive impairment. A year later, most were stable, and nearly one-third had reverted to normal.