As the
only SFSU gerontology student at last year’s Gerontological Society of America
(GSA) annual meeting ,
I became (by default) GSA Campus Ambassador,
which involved promoting GSA membership and activities, re-activating our gerontology
honor society (Beta Xi chapter of Sigma Phi Omega), obtaining Careers in Aging
Week (CIAW) award, etc. Eager to retire from
Ambassador duties, I was pleased when seven classmates joined me at last
month’s GSA annual meeting in New Orleans (birthplace of Benjamin Button,
who looked like an old man at birth, so he was abandoned on the porch of a
nursing home and then he kept growing younger)!
President’s
Welcome Reception & Exhibit Hall Opening – enjoyed Mardi Gras and
muffuletta
What a
difference a year makes (getting wiser with age and experience): last year, I
was ambivalent about starting over again with a new career and now I feel more
confident about this change. Instead of being all over the place like last
year, I am now more focused on health promotion, home- and community-based
services to support aging in place, and elder rights protection.
Optimal v.
Successful Aging
Adapting
to change has a lot to do with Optimal Aging, the theme of this year’s GSA
annual meeting. According to The Optimal Aging Manual author Dr. Kevin O’Neil,
the definition of optimal aging is necessarily subjective as it takes
into account psychosocial factors
like resiliency, adaptability, good self-esteem, positive attitude,
self-efficacy, as well as spirituality.
Unlike
Rowe & Kahn’s 1997 definition of successful aging (based on avoidance
of disease and disability, the maintenance of high physical and cognitive
function, and sustained engagement), optimal aging recognizes that people can age well in spite of disabilities or chronic
conditions. As Dr. Kenneth
Brummel-Smith wrote in his 2007 Annals of Long Term Care articles on Optimal Aging, “almost all older people are interested in a life that is
meaningful, fulfilling, and relatively independent,” and “much of optimal aging is under the individual’s control;
however, ideally, society provides support and assistance in helping its
members achieve optimal aging."
In The Gerontologist’s December 2013 article,
“Perceptions of Successful Aging Among Diverse Elders With Late-Life Disability," a diverse group of On Lok seniors in San Francisco perceived Successful Aging
as accepting limitations in ADLs/IADLs;
adapting to optimize functions that
are important to them (e.g., “if I cannot walk, I’ll use a walker. If I can’t use the walker, . . . I will use
the wheelchair”); trusting in God;
and shifting priorities (focus on
positive)—rather than rejecting their new reality by clinging to the notion of
successful aging as being forever young or middle-age, which is arguably
ageist.
Ageism
Ageism
“Standing in the way
of optimal aging, however, is that familiar foe: ageism.”
-- U.S. Department
of Health & Human Services blog post, Ageism: How Negative Stereotypes of Aging Impede an Inclusive Society
The term
ageism (discrimination based on age) was coined in 1968 by Robert Butler
Chronological Age Doesn’t Tell the
Whole Story: Current Directions in Perceptions of Aging Research (BSS) looked at older adults’ subjective
perceptions of aging and consequences for their functioning. In Subjective Aging and Cognitive Functioning: A 10-Year Prospective Study, Yannick
Stephan (photo above) found that more stressors and poor health make people feel “older,”
which is a risk factor for cognitive deficits.
“Younger” subjective aging is associated with lower mortality risk,
better life satisfaction, better self-rated health, and better physical
functioning. In When Feeling Different Pays Off:
How Older Adults can Counteract Negative Age Stereotypes, David Weiss discussed older adults’ self-protective responses of distancing,
differentiation, and shifting to alternative age identities (e.g.,
generation).
Social
Psychological Perspectives on the Implications of Ageism for Health and Health
Care Professions (BSS) symposium by Age UK researchers included Hannah Swift’s Being Old and Ill Across Different
Countries: Social Status, Age Identification and Older People's Subjective
Health: in European countries where older people are perceived as having lower social status, strongly identifying with
the old age group is related to higher levels of subjective ill health; in
countries where the status of older people is perceived as higher, there was no
relationship between age identification and self-rated health. (UK law includes age as "protected characteristic" in its Equality Act of 2010, though this ban on age discrimination in the provision of goods and services does not extend to financial services.)
In An
Applied Test of the Contact Hypothesis: Exploring the Effects of Contact with
the Elderly on Care Workers’ Attitudes, Libby Cuthbert found that while
positive contact between age groups reduces prejudice (i.e., less explicit ageism,
less dehumanization, and more empathy), outcomes of negative contact (more
dehumanization) were more enduring than positive.
Meeting Together
Keynote speaker Bruce Clark, a
marketing specialist focused on baby boomers and mature consumers, set the agenda
for GSA attendees of the world’s need for our “expert voices” to counter “sound-bite”
mentality. In this blog post, I’ll attempt
to provide bite-size expert voices.
2012 Kleemeier Award recipient Eileen Crimmins of USC presented lecture, Lifespan and Healthspan: Past, Present and Promise. She concluded that increasing lifespan and healthspan should not
depend only on scientific discoveries, but opportunities to substantially
increase life expectancy with behavioral changes, improvements in early life
circumstances, and reductions in health disparities.
Chronic Disease
Self-Management Program (CDSMP)
Dr.
Brummel-Smith identified the evidence-based CDSMP as a societal approach to
optimal aging.
Living Well with Chronic Illness: Comparing
Research and Policy Developments in Australia ,
Canada , U.S. and China Australia
Last
year’s GSA President Nancy Whitelaw of the National Council on Aging (NCOA) collaborated with CDSMP developer Kate Lorig and Texas A&M researchers
Marcia Ory and Matthew Lee Smith, in the national evaluation of CDSMP in the U.S.
Self-Management of Disability and
Optimal Aging: Current Trends in Research, Policy & Practice (SRPP)
symposium included Outcomes of CDSMP for Persons with
Disabilities presentation by Phillip McCallion,
who found CDSMP participation improved outcomes for persons with disabilities
that significantly impair daily functioning.
His next study will examine persons with intellectual/developmental disabilities
participating in CDSMP adaptation, as there exist versions of CDSMP tailored to
particular groups.
Aging in place
Aging in Multiple Environmental Settings: What Factors Contribute to Optimal Aging? (BSS)
Theoretical and Empirical
Developments in Understanding Aging in Place & Relocation (SRPP) covered continuum of care from homeless to housing to assisted living to
skilled nursing facility. People make
choices based on a cost-benefit analysis of where they are to alternatives that
consider value of stability/status quo; the most vulnerable are those “stuck in
place.”
Inspiration
At last
year’s GSA meeting, I really didn’t know anyone other than SFSU professors but
found it easy to connect with other attendees.
This year’s meeting was like a reunion as I got re-acquainted with my
favorite gerontologists!
SFSU representation
SFSU Gerontology
Professor Darlene Yee (missing from this year’s GSA meeting because she was
attending CANHR’s 30th anniversary celebration)
will co-chair GSA annual meeting in 2015, which marks the 50th
anniversary of the Older Americans Act!
Exhibit hall &
poster session
At
poster session, National Association for Professional Gerontologists (NAPG) Executive Director Donna Schafer stood in for SFSU Gerontology Professor Anabel Pelham to discuss Assessing Gerontology
Competencies: A Pilot Study – which involved graduate gerontology students (including yours truly) responding
to essay questions in this research to measure competencies, as part of a
larger plan to credential gerontologists.
Geroscience:
Societal Implications of Delaying Aging
This
meeting was a follow-up to last month’s Trans-NIH Geroscience summit that explored the physiological effects of aging as
a common risk factor for chronic diseases affecting the aging population. Do aging biology (nature) or lifestyle (nurture)
factors cause chronic disease? Cancer,
diabetes and obesity are found in younger populations, so it’s not like aging
is a disease to attack. The Fall 2013
issue of Public Policy & Aging Report (now included as GSA member benefit!)
is devoted to The Longevity Dividend: Geroscience Meets Geropolitics.
Aubrey de Grey delivered his expert opinion:
“I think we have a 50% chance of adding 30 years to seniors’ healthy
lifespans within 25 years by damage repair, subject to funding.”
Laissez Les Bon
Temps Roulez (Let the Good Times Roll)
The GSA meeting venue was split between
Marriott (near French Quarter) and Sheraton (Central Business District) on
opposite sides of Canal Street San
Diego
Sampled Creole sauces in French
Quarter store
Rain on parade
As a
thrifty graduate student, I took a red-eye flight out of SFO with stopover in ORD
(Chicago) before arriving in MSY (New
Orleans
Po-Boy ending
After
last session ended on Sunday, I took the trolley over to Oak Street Po-Boy Festival!
Living, and Dying, at Home
ReplyDeleteALANA SEMUELS
MAY 1, 2015
…one of the biggest fears many seniors and their families face about aging alone. What if something should happen? What if no one is there to help?
….By 2050, one-fifth of the total U.S. population—about 88 million people—will be 65 and older. Many of them won’t have saved enough money for an assisted living or retirement community. Some low-income seniors may be able to get Medicaid to pay for nursing home costs, but states and local government budgets will have a hard time handling the crunch, and besides, many of the places that take Medicaid are under-staffed and run-down. Many aging people will not find them to their liking.
These are all reasons why an increasing number of people are saying that seniors should stay at home as they age. This change could save the nation billions of dollars—one study found that the median monthly payment for non-institutional long-term care was $928 compared to $5,423 for nursing homes. But shifting seniors to aging at home is going to require a much bigger commitment on the part of everyday Americans—like the Domino’s woman—to pitch in and help their aging neighbors thrive. It’s going to require neighbors to check in on one another all the time; it's going to require college students to provide care to the aged and infirm; it's going to require that everyone thinks more about the elderly people around them, and volunteer to take them grocery shopping or shuttle them to a doctor's appointment. (Yes, including you.)
“Are there strategies that could be used in order for people to stay in their communities for as long as they can and not break the bank? The answer is yes,” said Lawrence Force, the director of the Center on Aging and Policy at Mount Saint Mary College and a proponent of this strategy, told me. “The only thing you have to change is the attitudinal perspective of what kind of supports are out there naturally already.”
...Villages are simple. They create a network of seniors who live at home, and vet service providers that members might need, …
…Of course, people have to have a lot of money to live in Beacon Hill, and for some seniors, the $675 fee would be a deal-breaker. But some villages don’t charge a fee at all. Ninety miles east of Beacon Hill, a man named Dick Elkin and his wife Esther started Nauset Neighbors, a Village for people living on the tip of Cape Cod. They charge members only $75 a year, and they waive the fee for anyone who can’t pay. To keep costs low, the Elkins decided to seek out an abundant local resource: volunteers…
“You ask anybody and they would much rather stay in their home for as long as possible—it's their comfort zone,” he said. “They’d rather stay home and do nothing than be with other people in assisted living.”
…An effort called the Caring Collaborative, launched in 2009, seeks to “organize the goodwill” that exists in informal communities in places such as New York City and San Francisco to help women as they age. The National Shared Housing Resource Center brings together seniors who have housing with housemates looking for a place to live. And Naturally Occurring Retirement Communities (NORCs) in places such as New York City allow seniors to stay in their apartments and have services brought to them.
…Helping seniors age at home can save Medicaid anywhere from $22,588 to $49,078 annually, according to the Center for Housing Policy. That’s even though, in some cases, seniors who aged at home received housing subsidies or government vouchers.
http://www.theatlantic.com/business/archive/2015/05/living-and-dying-at-home/391871/
The Secret To Chronic Happiness As You Age
ReplyDeleteBy Bruce Horovitz
September 5, 2017
By all rights, Fletcher Hall should not be happy.
At 76, the retired trade association manager has endured three heart attacks and eight heart bypass operations. He’s had four stents and a balloon inserted in his heart. He has diabetes, glaucoma, osteoarthritis in both knees and diabetic neuropathy in both legs. He can’t drive. He can’t travel much. He can’t see very well. And his heart condition severely limits his ability to exercise. On a good day, he can walk about 10 yards before needing to rest.
Yet the Brooklandville, Md., resident insists he’s a genuinely happy guy — in part, because he appreciates what he can do…
Hall focuses on the things that bring him joy: writing and listening to music and audiobooks. By juggling those pastimes throughout the day — every day — he ultimately feels a sense of contentment. “Every one of those things requires that I use my mind — which is a good thing.”
Geriatric experts agree that Hall has pretty much figured out the right formula. “You have to be willing to accept your new reality — and move forward,” said Dr. Susan Lehmann, director of the geriatric psychiatry day program at Johns Hopkins University School of Medicine. “Aim to have the best life you can at where you are right now.”
Living with chronic disease often complicates life. The majority of adults 65 and over have multiple chronic conditions that contribute to frailty and disability, according to a 2013-14 report from the Centers for Disease Control and Prevention. The percentage of chronic conditions among people 65 and over has increased over time, too. The percentage of people reporting hypertension, asthma, cancer and diabetes was higher in 2013-14 than in 1997-98, reports the CDC.
…Chronic pain, in fact, more frequently leads to depression than does anxiety, said Dr. Kathleen Franco, associate dean at the Cleveland Clinic Lerner College of Medicine. That depression then leads to additional pain and suffering, she said. “So you have an emotional and physical component.”
That’s why Hall clings dearly to his greatest passion: writing…He stays engaged in daily news by writing...He loves sitting on his balcony in the sunshine and listening to books …enjoys streaming both classical and country music…
Hall finds some excuse to get out of his house every day…Mindfulness, which often involves deep, slow breathing that’s aimed at lowering your heart rate and calming you down, can be highly effective on older, ailing people
…helping others …tend not to get stuck in your own aches and pains
The real key to happiness at every age and stage — particularly old age — is not material things, but gratitude for life’s simple blessings, like laughter among friends or watching a sunset with a loved one, said Lehmann, the Johns Hopkins doctor. “It’s the small things in life that end up mattering most of all.”
12 Tips For Older Adults To Stay Happy
1. Accept your reality and move forward from there.
2. Don’t compare how you feel now to when you were younger.
3. Focus on maximizing what you can do, not what you can’t.
4. Prioritize the things that are truly important to you.
5. Don’t be afraid to ask for help.
6. Plan your day around maximizing your energy.
7. Stay connected with friends and family.
8. Be proactive and advocate for your own health care.
9. Continue to exercise — even while seated.
10. Be grateful for the small things.
11. Have a purpose in your life.
12. Find a way — even a small way — to help others.
https://khn.org/news/the-secret-to-chronic-happiness-as-you-age/
Want to Be Happy? Think Like an Old Person
ReplyDeleteWritten by JOHN LELAND
DEC. 29, 2017
Jonas Mekas turned 95 this year and won a lifetime achievement award in Frankfurt, Germany. Ping Wong, 92, learned new rules for playing mah-jongg. Helen Moses, who turned 93, mostly gave up talk of marrying Howie Zeimer, her steady companion of the last eight years. Ruth Willig, 94, broke a bone in her foot and feared it was the beginning of the end.
John Sorensen’s ashes wait to be scattered on Fire Island. Fred Jones would have turned 90 in March.
Nearly three years ago, I started following the lives of six New Yorkers over the age of 85, one of the fastest-growing age groups in America. The series of articles began the way most stories about older people do, with the fears and hardships of aging: a fall in the kitchen, an aching leg that did not get better, days segueing into nights without human contact. They had lived through — and some were still challenged by — money problems, medical problems, the narrowing of life’s movements.
But as the series went along, a different story emerged. When the elders described their lives, they focused not on their declining abilities but on things that they could still do and that they found rewarding. As Ms. Wong said, “I try not to think about bad things. It’s not good for old people to complain.”
Here was another perspective on getting old. It was also a lesson for those who are not there yet.
Older people report higher levels of contentment or well-being than teenagers and young adults. The six elders put faces on this statistic. If they were not always gleeful, they were resilient and not paralyzed by the challenges that came their way. All had known loss and survived. None went to a job he did not like, coveted stuff she could not afford, brooded over a slight on the subway or lost sleep over events in the distant future. They set realistic goals. Only one said he was afraid to die.
Gerontologists call this the paradox of old age: that as people’s minds and bodies decline, instead of feeling worse about their lives, they feel better. In memory tests, they recall positive images better than negative; under functional magnetic resonance imaging, their brains respond more mildly to stressful images than the brains of younger people…
For three years, visiting them has been a lesson in living, and a rejoinder to the myth that youth is life’s glory, after which everything is downhill. Their muscles weakened, their sight grew dim, their friends and peers gradually disappeared. But each showed a matter-of-fact resilience that would shame most 25-year-olds.
…Their message was so counterintuitive that it took a long time to sink in. But finally it did: If you want to be happy, learn to think like an old person.
Their examples were so life-changing that I wrote a book about it. But this is their story, not mine.
Fred Jones died of a heart attack in April 2016, just past his 89th birthday. John Sorensen died two months later, refusing food in a nursing home he had never wanted to see. He spent his last days listening to his favorite operas and thanking anyone who came near.
For the others, 2017 was a year of continuities and great changes…
John Leland’s book based on his “85 and Up” series — “Happiness Is a Choice You Make: Lessons From a Year Among the Oldest Old” — will be published on Jan. 23.
https://www.nytimes.com/2017/12/29/nyregion/want-to-be-happy-think-like-an-old-person.html
Finding Meaning and Happiness in Old Age
ReplyDeleteBy JANE E. BRODY
MARCH 19, 2018
What’s the best way to develop a healthy perspective on old age? Spend more time with elderly people and discover what brings meaning and pleasure to their twilight years despite the losses, both physical and social, they may have suffered.
…The first book I read was “The End of Old Age” by Dr. Marc E. Agronin, a geriatric psychiatrist at the Miami Jewish Home whose decades of caring for the aged have taught him that it is possible to maintain purpose and meaning in life even in the face of significant disease and disability, impaired mental and physical functioning and limited participation in activities.
The second book, “Happiness Is a Choice You Make,” was written by John Leland, a reporter for The New York Times who spent a year interviewing and learning from six of the city’s “oldest old” residents — people 85 and above — from diverse cultures, backgrounds and life experiences.
As Mr. Leland told me, “These people totally changed my life. They’ve given up distractions that make us do stupid things and instead focus on what’s important to them. To a person, they don’t worry about things that might happen. They worry when it happens, and even then they don’t worry. They just deal with it. At whatever age we are, we can choose to adapt to whatever happens. We have influence over whether we let things knock us out.”
After reading the books, I have a new way of looking at myself: as a “good-enough” aging adult who continues to pursue and enjoy a variety of activities commensurate with the limitations imposed by inevitable changes in body and mind that accrue with advancing years.
…renowned pianist Arthur Rubinstein “who dealt with age-induced declines in his skills by selecting a more limited repertoire, optimizing his performance through extra practice, and compensating by altering his tempo during certain sections to highlight the dynamics of a piece.”
…Dr. Gene D. Cohen, a founding father of geriatric psychiatry who “saw not only what aging is, but what aging could be; not what we accomplish in spite of aging, but because of aging.”In Dr. Cohen’s model of creative aging, people have the potential to see possibility instead of problems; aging itself can be a catalyst for rich new experiences, offering a way to renew passions and reinvent oneself.
…I already know that if and when my physical abilities become further curtailed, I can still enjoy meaningful conversations with these boys, who are all-too-quickly becoming young men…I can help them put their life experiences in perspective and support a decision to leave their comfort zone and take risks that offer growth potential.
…even when physical decline and losses restrict one’s options, there remains the capacity to appreciate and approach each day with a sense of purpose. “It’s all about how you frame what you have,”…
…“positive aging” developed by Robert D. Hill, a psychologist in Salt Lake City, that is “affected by disease and disability, but not contingent upon avoiding it.” Rather, it is “a state of mind that is positive, optimistic, courageous, and able to adapt and cope in flexible ways with life’s changes.”
…At any age, it can open people up to new possibilities and add richness to life. According to Dr. Cohen, creativity can benefit aging by strengthening morale, improving physical health, enriching relationships and establishing a legacy.
Dr. Agronin cites two notable examples: Henri Matisse — “the man who rose from the dead” after cancer surgery in 1941 — who created cutouts when he could no longer paint, and Martha Graham, who reinvented herself as a choreographer when she could no longer dance.
When we become unable to pursue the roles and passions of our younger years, Dr. Agronin says, we can tap into our past for strength and inspiration. We can try something new that is either an extension of what we did before or that takes us in a new direction.
https://www.nytimes.com/2018/03/19/well/finding-meaning-and-happiness-in-old-age.html