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At
60 years, American Society on Aging (ASA) is
finally an older American under the Older Americans Act (OAA)!
More than 2,500 registrants, including
yours truly, convened in sunny San
Diego
Earlier
this month, I attended a celebration of life to honor my 94-year-old landlord. It was a lovely memorial service which
included remembrances from family and friends that were heartfelt, funny and
lengthy. Now I wondered how to capture
the essence of his 94 years of living in a single line message—though my
clueless neighbors recalled “he didn’t allow pets.” When I learned about his death, I called his
landline telephone number only to reach his recorded message, “This is the
Hallford residence,” and later suggested that his widow keep the recording because
it’s like part of his legacy. Sadly, Mr.
Hallford did not have a HJPPY death but a pLinful one from an
infection caused by botched surgery.
(Note: The 5th annual Dying Matters Awareness Week: You Only Die Once takes place May 12-18, 2014.)
Aviva bonding with her daughter
Chelsea.
Chronic
Disease Self-Management Program (CDSMP)
Over two years ago, I became interested in adapting CDSMP to make it more relevant to different groups ever since our San
Francisco Commission on Aging President Edna James told me this could be done
while maintaining fidelity to Stanford’s evidence-based model, citing work done
by Philadelphia’s Harvest Health: Translation of CDSMP for Older African Americans in a Senior Setting. I work part-time organizing CDSMP workshops under
a San Francisco Department of Aging and Adult Services (DAAS) grant that provides for targeting groups that have been identified as
demonstrating the greatest economic and social need: low-income, non- or limited-English speaking,
minority, frail and Lesbian-Gay-Bisexual-Transgender (LGBT). For my graduate
culminating experience, I am researching and writing about adapting CDSMP to
target low-income groups, based on a behavioral justice model (or providing universal access to resources needed to engage in
health-promoting behaviors) to potentially reduce
health disparities. With this focus, I
decided to attend sessions relating to CDSMP, health promotion, and senior
poverty.
CDSMP
sustainability
National Council on Aging (NCOA)’s Howard Bedlin and Emily Dessen joined
Administration for Community Living (ACL)’s Michele Boutaugh for Evaluation
of Two National Initiatives Implementing and Sustaining Self-Management followed by Moving Toward a Sustainable Infrastructure
for Delivery of Evidence-Based Programs.
Michele discussed ACL’s initiatives focused on scaling (marketing
and partnerships) and sustaining (diversify funding and referrals) self-management and other evidence-based
health promotion programs. San Francisco
Also
in the audience was Oklahoma Department of Human Services Research Manager
Zohre Salehezedeh, who presented Diabetes
Self-Management Program Effectiveness in Preventive Care Practices in the previous afternoon (which I
missed due to my volunteer duty). It was
great to finally meet and thank her in person because I had e-mailed her last
year to obtain a copy of her study, The
Impact of CDSMP on Nursing Home Residents, which was instrumental in
convincing Jewish Home of San Francisco to host our CDSMP-Healthier Living
workshop series for their residents, which included a couple of centenarians!
Michele mentioned that we
could learn more about Medicare reimbursement for Diabetes SMP from consultant Tim McNeill in Network On Multicultural Aging (NOMA)
Program—Diversifying Funding, Partnerships
and Organizational Approaches to
Diabetes Self-Management for Older Adults.
CDSMP adaptations & translations
Diabetes Self-Management
Programs: Best Practice Models of State Implementation for Diverse Populations
was an interesting panel discussion on the challenges of reaching diverse
groups with Stanford’s highly structured Diabetes SMP. Tammi Pollum reported that Detroit Area Agency on Aging dropped
Stanford’s Diabetes SMP due to cost, length and inflexibility, in favor of
Merck's Conversation Map,
another evidence-based program reimburseable under Medicare. Kristen Smith said San Diego's Aging and Independence Services offers CDSMP in English, Spanish, Somali, Tagalog, Vietnamese and Arabic. Robin McConney of Chicago's Rush University Medical Center adapted Stanford Diabetes SMP to target African-American women in Health Legacy Program that features Diabetes SMP health education along with cardiovascular exercise,
support group/counseling and hands-on meal planning/nutrition counseling;
clinical measures are included to monitor progress. Finally, Merlyn Puente's Health Foundation of South Florida partnered with organizations serving
primary target populations to serve 35,000 older adults in 5 years: 50%
Hispanic, 17% Black, 25% White, 4% Haitian and 4% Other; the completion rate
was 76% for English language, and 88% for Spanish language.
I attended a couple of sessions presented by the award-winning Hawaii Healthy Aging Partnership (HHAP),
which has successfully adapted its evidence-based
programs for Asian and Pacific Islanders:
CDSMP and Diabetes SMP.
Senior poverty: do something
Yet public programs designed to blunt the impact of elder
poverty rate haven’t been updated much. Supplemental
Security Income (SSI) supports two million of the poorest seniors (majority are
women), lifting monthly income to maximum $721 (or 74% Federal Poverty Level), but
a senior cannot have more than $2,000 in resources to be eligible, as the
benefit rate and resource limit have been updated only modestly since 1972 when
Nixon envisioned SSI as providing “a step out of poverty and toward a life of
dignity and independence.” (California
provides $156 monthly supplement, but does not allow SSI recipients to receive
CalFresh food stamps.) NSLC is
advocating for SSI Restoration Act of 2014 to increase eligibility by raising amounts (for resource limit, general
income disregard, earned income disregard) and providing for annual adjustments
to reflect inflation.
San Francisco State University (SFSU) presence
SFSU Professor Brian and graduate Loren Meissner join
ACRIA’s Mark Brennan-Ing and SAGE’s Aaron Tax in presentation on The Intersection of Research, Policy and
Advocacy Issues Among Older LGBT and HIV+ Adults. Professor Brian and Loren presented
preliminary research findings in last year’s ASA poster session.
This SFSU presence reminds me that I have to get back to work on
my culminating experience and brevity . . .so few more conference highlights:
Past & future
19 years ago, ASA’s The
Future of Aging session featured Ken Dychtwald, Betty Friedan, Bob Butler
and Fernando Torres-Gil (then the first U.S. Assistant Secretary for Aging).
Port of San Diego's Greatest Generation Walk
James and Jo of Maui
County Office on Aging with palm trees behind
San Francisco-based Community Living rocks! Marie Jobling
of Community Living Campaign and Darrick Lam of Administration for Community Living
Surprise! Jenn Chan, founder of San Francisco-based Senior Shower Project: A Novel Approach to Celebrating and Educating New Family Caregivers
Technology
Outliers: Who's Doing the Cool Stuff and What
Difference Will It Make? featured
The Patterson Foundation-funded Institute for the Ages,
a non-profit based in Sarasota (oldest county in America, with 32% of its
residents age 65+) that offers the market research services of its seniors to
companies developing products and services to the growing senior consumer
market.
Diversity
Joined roundtable discussion on Fear
of the Other: Managing Diverse Clients in a Segregated Culture to
brainstorm strategies for developing greater acceptance of differences
in a safe environment that respects everyone: communicating what’s appropriate
ahead of time, posting reminders (table tents, posters) about acceptable
behavior, correcting without shaming to protect everyone, organizing activities
to move from fearing differences to understanding commonalities, showing films
to start conversations versus lecturing, etc.
One self-described “white, gay man”
expressed his frustration at Diversity Summit, which focused on racial-ethnic
diversity until one of the last presenters mentioned gay marriage. Services and Advocacy for GLBT Elders (SAGE) Executive Director Michael Davis discussed the need for LGBT training for
different care settings because LGBT elders faced official discrimination when being LGBT was considered a mental illness and crime, and "don’t ask, don’t tell, live and
let live," creates obstacles to person-centered long-term care. For example, the mentality not to
appropriately ask if a client is LGBT means missing out on learning about a
piece of one’s identity. (This month San
Francisco’s LGBT Aging Policy Task Force issued a report, LGBT Aging at the Golden Gate, which addresses these concerns with proposed solutions relating to data collection on gender identity/sexual
orientation, cultural competency, access to health/social
services/housing/legal services, etc.; page 13 of report acknowledges
contribution of SFSU Professor Brian de Vries!)
ASA's popular webinar voice. . . er, host Steve Moore organized poster session: now we can match his smile to his voice :-)
March is National Nutrition Month
Brain Food: Bringing an Evidence-Based Nutrition
Program to Assisted Living and Adult Day Health was a joint presentation by Amazing Place Executive
Director Tracy Brown who worked to implement a brain-healthy meals plan at her
senior facility with Nancy Emerson
Lombardo, founder of Brain Health and Wellness Center. Nancy
- increase amount & variety of
anti-oxidants from plant foods (spices, leafy greens, nuts & seeds,
whole grains, berries)
- increase omega-3s (fish, fish
oil, flax seed); decrease omega-6s
(corn oil)
- reduce inflammation (increase omega-3s,
berries, greens, green tea)
- reduce insulin resistance (reduce sugar, eat complex carbs like whole
grains)
- reduce LDL cholesterol &
saturated fats; avoid trans fats
- assure adequate B, D, & E
vitamins
Aging's Not for Sissies: Guiding Seniors to Live Life
to the Fullest presentation by vegetarian
Seventh-day Adventists Rhonda Whitney and Marilyn Renk who discussed
whole-person health CREATION (acronym for Choice, Rest, Environment, Activity, Trust,
Interpersonal relationships, Outlook, Nutrition)
Never too late
After ASA conference
ended, I returned to San Francisco
What senior vegetarians
look like: San Francisco
Former President Bill
Clinton went vegan at age 64, and reportedly his heart is “younger than it was 10 years ago.”
A Diet Might Cut the Risk of Developing Alzheimer’s
ReplyDeleteBy SUMATHI REDDY
April 20, 2015 6:32 p.m. ET
Researchers successfully tested a special diet they designed that appears to reduce the risk for developing Alzheimer’s disease.
The study compared the so-called MIND diet with the popular, heart-healthy Mediterranean diet and the DASH diet, which is intended to help control high blood pressure…
The study, conducted by researchers at Rush University Medical Center in Chicago, found…only the MIND diet seemed to help counter the disease even when people followed only some of the diet’s recommendations. The research was observational, not randomized or controlled, and therefore isn’t evidence the MIND diet caused a reduced risk for Alzheimer’s. Instead, the research shows there is an association between the two.
The study is part of a small body of research investigating how nutrition can improve brain health and stave off the cognitive decline and memory impairment that comes with Alzheimer’s disease and other forms of dementia. Experts say there is growing awareness that lifestyle factors—not just genetics—play a prominent role in the development of Alzheimer’s, and researchers hope to come up with an optimal diet that will lessen the chances of developing the disease…
The MIND diet, which took two years to develop, stands for Mediterranean-DASH Intervention for Neurodegenerative Delay. Researchers modified the Mediterranean and DASH diets based on evidence from animal and human studies looking at nutrition and the brain. DASH stands for Dietary Approaches to Stop Hypertension.
The MIND diet has 15 dietary components
• •Green leafy vegetables
• •Other vegetables
• •Nuts
• •Berries
• •Beans
• •Whole grains
• •Fish
• •Poultry
• •Olive oil
• •Wine
The five unhealthy groups are
• •Red meats
• •Butter and stick margarine
• •Cheese
• •Pastries and sweets
• •Fried or fast food
The MIND diet includes at least three servings of whole grains, a salad and one other vegetable every day—along with a glass of wine. It also involves snacking most days on nuts and eating beans every other day or so, poultry and berries at least twice a week and fish at least once a week. Dieters must limit eating the designated unhealthy foods, especially butter (less than 1 tablespoon a day), cheese, and fried or fast food (less than a serving a week for any of the three), to have a real shot at avoiding the devastating effects of Alzheimer’s, according to a study by Rush University Medical Center researchers.
http://www.wsj.com/articles/a-diet-might-cut-the-risk-of-developing-alzheimers-1429569168
Latinos Live Longest Despite Poverty. Here’s Their Secret
ReplyDeleteJasmine Aguilera posted Dec 08, 2015
… Author Claudia Kolker took a closer look at such cultural practices for her 2011 book, The Immigrant Advantage. Her book examines why immigrants are often healthier than native-born Americans—a question that continues to be explored. Some credit this perplexing phenomenon to the idea that immigrants must be healthy to migrate. Kolker’s research shows its connection to customs like Danza Azteca: close community bonds, traditional foods, and la cuarentena, a Latin American tradition in which a new mother rests for the first 40 days after giving birth, not lifting a finger except to breastfeed and bond with her child. Kolker also has a hunch that a lack of smoking is a factor, and other researchers agree.
But these findings not only show an immigrant advantage; they present a paradox, too.
Recently arrived immigrants, especially Hispanics, experience nearly double the poverty rate of the U.S.-born population. Despite their economic situation and lack of health insurance, Hispanics tend to live longer than both black and white males and females: about three years more than whites and six years more than blacks. However, they still have higher death rates when it comes to diabetes, cirrhosis, and hypertension.
The Latino Paradox
Despite nearly a quarter of their population living in poverty, Latinos have higher average life expectancies than white Americans, who have a much lower poverty rate…
Kolker says immigrants who are not used to consuming so much fast or processed food have an upper hand when they arrive in the United States because their dishes are usually made up of more natural, healthier ingredients. Maintaining that diet once in the United States takes commitment.
…As generations become more Americanized, their health begins to decline.
U.S.-born Hispanics face higher prevalence rates for unhealthy behaviors than foreign-born Hispanics: a 72 percent higher smoking rate and a 30 percent higher obesity rate. They also have a 93 percent higher cancer rate, according to the Centers for Disease Control and Prevention.
Timothy Smith, a psychology professor at Brigham Young University, also has studied this scientific wonder and suggests that social bonds and culture do contribute to health. While more research is needed to know for sure, one thing is certain: American assimilation isn’t exactly healthy. “They’re adopting the local culture, which does have some adverse consequences,” he says.
Cuarentena
…In her book, Kolker describes cuarentena as a tremendous health benefit for both mother and child. The mothers are never alone and are fed healthy food; the babies can nurse whenever they want.
…Aguilar plans to do the same when she has her own children—she wants everything to be as natural as possible. She believes that, in the United States, pregnancy is treated as a disease rather than a spiritual process. Too many doctors, too many medications…
Food
…“Our philosophy is that the more we go back to our traditions, the healthier we’ll be,” says Lorena Andrade, director of La Mujer Obrera…“When we cross the border, we lose our sense of community and our connection to the land, verdad?” …
Family and community
...It’s not uncommon in Latino families for three or four generations of relatives to live under one roof. This close family dynamic and sense of community contributes to the overall health of each member, Kolker says….
“When each member of the family is involved in the health and needs of the other, everyone is healthier.”
http://www.yesmagazine.org/issues/good-health/latinos-live-longest-despite-poverty-heres-their-secret-20151208
UCSF study suggests novel treatment for fending off chronic age-related diseases: Moisturizer
ReplyDeleteBy Alyssa Pereira, SFGATE
Friday, March 15, 2019
A new UCSF pilot study has a simple suggestion for a treatment to fend off serious age-related issues like Alzheimer's, diabetes and heart disease. The best part? You might already own it.
University researchers in tandem with the San Francisco Veterans Administration (VA) Health Care System now have reason to believe that inflammation of the skin may further the development of multiple chronic diseases, and one way to help fix the issue is by applying reparative moisturizer.
The study's authors write that as skin begins to lose moisture and deteriorate around age 50, it begins to experience a breakdown of the "permeability barrier." The barrier is meant to both keep water in the body
and act as a shield from sinister pathogens outside our bodies.
When this barrier weakens with age because of the loss of moisture, it releases cytokines (a sort of protein released by immune system cells) to signal inflammation in age-affected areas of the skin. Typically, such cytokines are meant to help repair the barrier, but older skin takes more effort to fix, researchers write, so the skin repeatedly releases these "inflammatory signals." Eventually, the cytokines can leak into the blood, potentially causing inflammation all over the body.
Previously, researchers didn't suspect that skin could be to blame to furthering such diseases, but more recent studies have pointed to the possibility that skin inflammation may be to blame for heart disease.
"The inflammation must come from an organ big enough that very minor inflammation can affect the whole body. Skin is a good candidate for this because of its size," said study senior author Dr. Mao-Qiang Man. "Once we get old, we have dermatological symptoms like itchiness, dryness and changes in acidity. It could be that the skin has very minor inflammation, and because it's such a large organ, it elevates circulating cytokine levels."
The UCSF study was conducted with 33 adults between the ages of 58 and 95 years old. They were given a type of moisturizer researchers had noted for its ratio of three lipids known to be beneficial to skin health. The participants were directed to apply the moisturizer all over the body twice a day for a month, after which clinicians found their cytokine levels "to be nearly equivalent with people in their 30s, suggesting that rejuvenating the skin can reverse 'inflamm-aging.'" The name and brand of the moisturizer was not given, but the study notes it had a "beneficial ratio of three types of lipids (cholesterol, free fatty acids, and ceramides) that are vital for skin health."
Next, scientists will follow up on their initial findings with a more long-term study to test the effects of applying the moisturizer. If the findings are similar, it may confirm that applying reparative moisturizer may be an effective way of staving off chronic diseases.
https://www.sfgate.com/science/article/UCSF-study-skin-moisturizer-inflamation-disease-13691930.php