In this
age of 140-character tweets, my biggest academic adjustment over the past year
has been to adopt the “SF State of Mind,” which seems to emphasize
brevity, or KISS (Keep It Simple Sweetie, as one gentle professor reminded my
class): course assignments were typically 2’ x 3’ posters; research papers ranging
from 5 to 8 pages (like executive summaries); and oral presentations allowed only 2 to 5 minutes on average, and 10 minutes maximum.
For an introvert like myself, who prefers gray matter – complexity versus black/white simplicity, deep discussions versus chit-chat or sound bites, I had to constantly remind myself to be less intense and think like a blogger instead. . . Now in my second (and, I hope, final) year in graduate school, I felt rewarded upon learning that my culminating experience assignment would be 30 pages!
Outside SFSU, I use this blogspot for freely wandering and wondering -- without paying attention to length and time restrictions :-)
For an introvert like myself, who prefers gray matter – complexity versus black/white simplicity, deep discussions versus chit-chat or sound bites, I had to constantly remind myself to be less intense and think like a blogger instead. . . Now in my second (and, I hope, final) year in graduate school, I felt rewarded upon learning that my culminating experience assignment would be 30 pages!
Outside SFSU, I use this blogspot for freely wandering and wondering -- without paying attention to length and time restrictions :-)
Senior & Disability Action: Putting the "D" in SDA! Mind your manners
SDA staff
use popular education in this skit to cover what to do and what not to do in
interactions with persons with disabilities.
Moderator
Donna held up a STOP sign to de-brief after each scenario of Jessica (in
wheelchair) and Tony (standing as her companion) when they encounter Sarah and James at a
meeting.
- Don’t treat a person in a wheelchair as though she's not able to speak for herself
- DO speak directly to the person in a wheelchair, on the same eye level if possible
- Don’t assume low expectations of a person in a wheelchair by making over-the-top comments like “wow, it’s so inspiring how you actually got up and left the house to come here,” as if doing everyday activities is exceptional
- DO remember the person is not a disability
- Don’t be patronizing or pity a person in a wheelchair by offering to “pray so you can be a whole person”
- DO treat all persons with respect and dignity
Aging While Black Forum
Deloris
McGee and Marie Jobling of Community Living Campaign organized their second annual
Aging While Black Forum at I.T.
Bookman Community
Center
Highlight was hearing
from Dorsey Nunn, Executive Director of Legal Services for Prisoners with Children (LSPC), who didn’t find humor in a previous speaker’s “joke" about sending seniors to prisons where they can get their basic needs met including video
monitoring and guards. Some audience members actually laughed at this "joke," which made me uncomfortable to think that the invisibility of persons in institutions like prisons and nursing homes might lead to insensitivity and ignorance about true conditions.
Formerly incarcerated as a 19-year-old, now 61-year-old Nunn said that depicting prison as a luxury vacation is like characterizing slavery as good for jobs – the reality is no freedom in prison and slavery. He invited us to celebrate LSPC’s 35th anniversary next month with Michelle Alexander, author of The New Jim Crow: Mass Incarceration in the Age of Colorblindness, which presents evidence that more Blacks are enslaved behind bars today than were enslaved on plantations in 1850, a decade before the Civil War began and the Emancipation Proclamation was signed.
Formerly incarcerated as a 19-year-old, now 61-year-old Nunn said that depicting prison as a luxury vacation is like characterizing slavery as good for jobs – the reality is no freedom in prison and slavery. He invited us to celebrate LSPC’s 35th anniversary next month with Michelle Alexander, author of The New Jim Crow: Mass Incarceration in the Age of Colorblindness, which presents evidence that more Blacks are enslaved behind bars today than were enslaved on plantations in 1850, a decade before the Civil War began and the Emancipation Proclamation was signed.
Nunn also
talked about the realities of aging in prison, like a 70-year-old struggling to
climb to the top of a bunk bed, defecating on himself, not being able to defend
against younger prisoners who play loud hip-hop, falling inside a cell with no
one to check on him, etc. Read LSPC’s
report, Dignity Denied: The Price of Imprisoning Older Women in California,
by Heidi Strupp and Donna Willmott (note: same Donna as the SDA moderator
above). Consistent with the program’s theme of community building, Nunn also brought
attention to the recent prisoners' hunger strike to protest solitaryconfinement.
On Lok Lifeways Sustainable Long-Term Care: Matter Over Mind?
Mind matters! Raised in the holistic (mind-body connection) practice of Traditional Chinese Medicine (TCM), I find the Cartesian mind-body split puzzling. I also find puzzling the notion of emotions being either “positive” (encouraged) or “negative” (discouraged). According to the Nei Jing (Chinese medical text), the seven emotions—joy, anger, sadness, grief, pensiveness, fear and fright—all appear in healthy individuals, and cannot be separated from the physical. In TCM, moderation and balance are key, so emotions are acknowledged and expressed appropriately; but when an emotion is either excessive or suppressed, then this disharmony results in compromised health.
On Lok Lifeways CEO Bob Edmondson welcomes 300+ conference
attendees
When I
received this year's invitation to the 6th annual On Lok Sustainable
Long-Term Care Conference focused on “the latest developments and innovations
in meeting the mental health needs of older adults,” I was intrigued by the
“Matter Over Mind?” theme, but somewhat disappointed that this emphasis on the
“latest” meant there was no presenter representing the “traditional” Chinese medicine
perspective.
After all, the holistic Chinese perspective influenced On Lok to pioneer the model of coordinated care for older adults with chronic care needs in community settings, rather than institutions, in
AgeSong CEO/Founder Nader Shabahangi's conference moderator role was rather
limited to introducing presenters and fielding questions from the audience. I thought he would be an interesting presenter himself – especially as I was interested in learning more about AgeSong’s new partnership with University Mound Ladies Home.
Pop psychiatrist Daniel Amen on Preventing
Alzheimer's Disease - Former
X-ray technician Dr. Amen said the important question is: how do you know what’s going
on in the brain unless you look? He uses
single-photon emission computed tomography (SPECT), a form of nuclear imaging
test that measures blood flow to the brain.
His belief is that the brain does not deteriorate, but behavior can
accelerate or deteriorate the brain, so we have a choice how fast the brain
ages and can reverse brain damage. But often we
do not care because we can’t see. Dr.
Amen said we need to start by knowing the health of our brain, as revealed by
SPECT scan, and losing belly fat because “the obesity epidemic is the biggest
brain drain.” The rest of his
presentation was common-sense advice to reduce risk factors (avoid anything
that hurts brain, engage in regular brain-healthy habits). Yet, Dr. Amen remains controversial due to
his use of SPECT to diagnose individuals, and the lack of peer-reviewed studies
of his work.
The next two speakers provided an interesting counterpoint with their emphasis on peer-reviewed research. Psychotherapies are about as effective as medications in reducing symptoms of clinical depression or anxiety disorders, but without meds’ side effects.
The next two speakers provided an interesting counterpoint with their emphasis on peer-reviewed research. Psychotherapies are about as effective as medications in reducing symptoms of clinical depression or anxiety disorders, but without meds’ side effects.
UCSF clinical psychologist Patricia Arean, on Behavioral Interventions for Late
Life Depression, Anxiety and Chronic Illness Management, talked
about the evidence-based research to support psychotherapy for older adults: cognitive
behavioral therapy, interpersonal therapy, and problem-solving.
On Lok Lifeways Chief Medical Officer Jay Luxenberg on Drugs and Other Therapies for
Mental Illness in the Frail Elderly: What is the Evidence?
Next up
was a more touchy-feely presenter, Khatera Aslami,
who is President of the Board of Directors at Copeland Center
Engineer Joseph Choi founded TheraBaby, life-sized baby dolls that
serve as companions for seniors living with dementia. His own mother, who had late-stage
Alzheimer’s disease, had dramatically improved her quality of life after bonding
with the first TheraBaby, which also sparked social interaction among other
residents. In July 2012, Choi launched TheraBaby
as a social good project by finding sponsors to adopt TheraBaby into senior
care organizations in the Bay Area and Hawaii
Brain-friendly Mediterranean lunch of salmon on bed of greens:
what's good for the heart is good for the brain
Psychiatrist Roberto Mezzina on An
Open Door/No Restraint System of Care for Recovery and Citizenship in Trieste,
Italy, reported that Trieste
I also missed the last presentation on Harnessing Neuroplasticity of the Older Brain to Enhance Cognition, by UCSF neuroscientist Adam Gazzaley. However, I’d read about Gazzaley’s study suggesting that older adults can improve cognition by playing video games, which are fast-paced and unpredictable, adaptable in difficulty, and challenging to working memory, attention and processing speed. Sure, this might be one of the “latest developments and innovations,” but I prefer to engage my brain from traditional social interactions in the real world rather than games in the virtual world. The former is intrinsically rewarding, while the latter is just a means to an end—much like how I prefer getting my nutrition from traditional whole foods, rather than supplements or fortified foods.
Brain Fitness
Psychologist Charles Vella presented Aging, Dementia and
Brain Health in gerontologist Hope Levy's popular Brain Fitness series
at the Main Library through City College of San Francisco's Older Adults
Program. Here are Dr. Vella’s Ten Commandments for
Brain Fitness:
1. Thou shall exercise daily.
2. Thou shall minimize risk factors
for cerebrovascular disease (hypertension, hyperlipidemia, diabetes,
overweight, smoking)
3. Thou shall eat Mediterranean diet.
4. Thou shall choose thy parents
wisely.
5. Thou shall maintain intellectual
engagement throughout life.
6. Thou shall cultivate and sustain
friendships and good company.
7. Thou shall obtain restful sleep.
8. Thou shall enjoy only one drink of
alcohol.
9. Thou shall manage stress
effectively.
10.Thou shall not text or use cell
phone while driving.
Mindful Eating
Neuropsychologist Nancy Hoffman on Food and Mood: How the
Food You Eat Affects the Way You Feel, at Life Planning Network meeting,
hosted by Lee Abel, at AgeSong's rooftop garden. Hoffman based her talk on nutritionist
Elizabeth Somer’s book, Food and Mood, focusing on food sources of
neurotransmitters like mood-enhancing dopamine
(meat, milk, eggs, fish, beans, tofu), calming serotonin (tryptophan with complex carbs), pain-killing endorphins (high protein, daily
exercise) and acetycholine for
memory/new learning/attention (egg yolk, wheat germ, soy, cauliflower,
chicken). It was very similar to Marin County
psychotherapist Julia Ross’ The Mood Cure, which I
read while studying holistic nutrition.
Moving Meditation
I get my qi flowing during Da Yan Qi Gong class at Botanical Garden inside Golden Gate Park.
EBSA News Release: [11/08/2013]
ReplyDeleteAdministration issues final mental health and substance use disorder parity rule
Final rules break down financial barriers and provide consumer protections
WASHINGTON — The Departments of Labor, Health and Human Services and the Treasury today jointly issued a final rule increasing parity between mental health/substance use disorder benefits and medical/surgical benefits in group and individual health plans.
The final rule issued today implements the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act, and ensures that health plan features like copays, deductibles and visits limits are generally not more restrictive for mental health/substance abuse disorders benefits than they are for medical/surgical benefits. . . .
By issuing this rule, the administration has now completed or made significant progress on all 23 executive actions included in the President and Vice President's plan to reduce gun violence. An updated report summarizing the status of all 23 executive actions is available here: http://www.whitehouse.gov/sites/default/files/docs/november_exec_actions_progress_report_final.pdf.
In January, as part of the President and Vice President's plan to reduce gun violence, the administration committed to finalize this rule as part of a larger effort to increase access to affordable mental health services and reduce the misinformation associated with mental illness. As the President and Vice President have made clear, mental illness should no longer be treated by our society — or covered by insurance companies — differently from other illnesses.
http://www.dol.gov/opa/media/press/ebsa/EBSA20132158.htm
Extending Elder Justice and Human Rights to Incarcerated Older Adults
ReplyDeleteposted 11.14.2013
By Tina Maschi
The aging prison population crisis is gaining international attention as researchers, scholars, journalists, human and civil rights advocates detail the rapidly growing numbers of older adults in prison and the high human and economic costs of warehousing older adults in prison, according to 2012 reports from the ACLU and Human Rights Watch.
In 2010, colleagues and I conducted a study (“Trauma and Coping among Older Adults in Prison: Linking Empirical Evidence to Practice,” forthcoming in The Gerontologist) of 667 adults ages 50 and older in a northeastern state prison system. Study findings revealed the previously overlooked issue in this population of undetected and untreated cumulative traumatic life experiences and their cost to prisoner’s physical and mental well-being. Such experiences occurred prior to entering prison, while in prison and in anticipation of release from prison.
As a group this aging prison population has experienced a lifetime of cumulative disparities and discrimination based on characteristics such as age, race or ethnicity, physical and mental disabilities and substance-abuse histories, as well as social structural factors such as poverty, lack of education and punitive sentencing policies.
Some lifetime and cumulative experiences include: childhood or adult exposure to violence (being a victim or witness to physical or sexual assault); unexpected and expected loss of a loved one; caregiving stress; medical neglect; family separation; being diagnosed with a serious physical or mental illness; discrimination (based on race, gender, sexual orientation); homelessness; combat in war; and, natural and manmade disasters. . . .
Table 1: Coping Resources and Resilience Among Older Adults in Prison
•ROOT: Basic Needs (Survival & Foundation in Love and Family)
•PHYSICAL: Exercise (Yard, Run/Walk, Yoga, Sports), Medication
•COGNITIVE: Find Peace Within, Think Positive, Making Healthy Choices, Puzzles, Read
•EMOTIONAL: Counseling, Support Groups
•SPIRITUAL: Church, God, Pray, Service to Others
•SOCIAL: Family, Friends, Peers in Prison, Program Participation, Yoga
•PARTICIPATORY: (Leadership, Participation, and Empowerment) Teaching, Leading a Book Club, Being a Paralegal, Advocacy, Group and Workshop Facilitation
The older adults in prison who reported coping resilience also were more likely to report higher levels of physical and mental well-being.
http://asaging.org/blog/extending-elder-justice-and-human-rights-incarcerated-older-adults
Can you improve brain health? Scientists weigh in
ReplyDeleteBy STEVE VERNON
December 8, 2014, 8:24 AM
As baby boomers age, dementia and Alzheimer's could create significant financial and social burdens in the years to come. As a result, scientists are researching ways to mitigate or even prevent these dreaded conditions, and corporations are smelling a business opportunity.
In recent years, companies have developed a number of online cognitive training programs -- brain games -- to help improve memory and brain processing speed. They've been promoted as a fun way to help people stay mentally sharp as they get older, building on the widespread popularity of video games. In a sign of what some see as the commercial potential, Investors also hope to develop the world's first prescription video game.
So is playing fun video games really the answer to the threat of Alzheimer's?
Many scientists think not. According to the Stanford Center on Longevity (SCL) and the Berlin Max Planck Institute for Human Development, there's no reliable scientific evidence to support the notion that cognitive training can improve overall brain performance (disclosure:The author is a research scholar at SCL).
Indeed, 70 of the world's leading neuroscientists and cognitive scientists took the unusual step of signing a statement that directly challenges the claims made for brain games:
We object to the claim that brain games offer consumers a scientifically grounded avenue to reduce or reverse cognitive decline when there is no compelling scientific evidence to date that they do. The promise of a magic bullet detracts from the best evidence to date, which is that cognitive health in old age reflects the long-term effects of healthy, engaged lifestyles. In the judgment of the signatories, exaggerated and misleading claims exploit the anxiety of older adults about impending cognitive decline. We encourage continued careful research and validation in this field."
…A recent article in Scientific American, written by a prominent psychologist, digs deeper into the research regarding cognitive training and provides evidence confirming the position taken by SCL and the Planck Institute...
Both the Scientific American article and the statement issued by SCL and the Planck Institute identify methods currently known by science to help maintain brain health:
• Enhance your physical health through diet and exercise. After all, your brain is flesh and blood, so what's good for your body is also good for your brain. In particular, there's evidence that aerobic exercise can result in modest improvements in cognitive functioning.
• Maintain an active social life, with stimulating conversations and activities with a variety of people.
• Continue to learn new skills and stay engaged with life.
Other tips to help with brain health include getting sufficient sleep, not smoking, and not abusing drugs or alcohol. Unfortunately, for now there's no known cure for either Alzheimer's or dementia. The best you can do is adopt a lifestyle that improves your odds of maintaining a healthy mind as long as possible. Also, you'll want a strategy to address the financial consequences of needing long-term care in your later years, since Alzheimer's and dementia are common reasons for needing such care.
Both SCL and the Planck Institute confirm that people can continue to learn new tasks and improve performance well into old age. . .it's probably a waste of your time and money to think of brain games or other such activities as medicine, or as a vaccination against Alzheimer's or dementia. Instead, aging boomers should take a cue from their youth: Do what turns you on. Get better at skills and activities that have meaning for you. Even if you don't get smarter, you'll be enjoying your life.
http://www.cbsnews.com/news/can-you-improve-brain-health-scientists-weigh-in/
Pioneering Doctor Working to Reverse Alzheimer's Offers Ways to Help Avoid the Disease
ReplyDeleteBy Martha Ture
December 26, 2014
Alzheimer's disease (AD) affects more than 5 million Americans…It is the sixth leading cause of death in the United States, after heart disease, cancers, chronic lower respiratory diseases, stroke and accidents.
In a recently published paper, Dale Bredesen at the Buck Institute showed that 9 of 10 patients participating in a program showed reversal of cognitive impairment associated with Alzheimer’s disease. Six of the 10 study participants had had to leave work, or were struggling at their jobs, due to AD; after going through the program, all were able to return to work or to continue working at better performance levels.
This is the first time anyone has shown it may be possible to reverse memory loss associated with Alzheimer’s...
To quote from the abstract:
"…Improvements have been sustained, and at this time the longest patient follow-up is two and one-half years from initial treatment, with sustained and marked improvement. These results suggest that a larger, more extensive trial of this therapeutic program is warranted. The results also suggest that, at least early in the course, cognitive decline may be driven in large part by metabolic processes."
…Dr. Bredesen’s study results should be interpreted with a lot of caution, primarily because of the small size of the study group, and because the participants had a range of diagnoses, resulting in different interventions. But the basis of his work was the idea that there are multiple risk factors leading to AD, and therefore, a multiple factor approach, rather than administration of one drug or another, would show beneficial results…
Dr. Bredesen’s multiple factors include diet, exercise, sleep, stress reduction, and brain training, commonsensical in the broad view. But he has identified 36 separate elements of a therapeutic system for patients, many of which are surprising to more traditional western medicine.
…Bredesen stresses that identifying the factors for early Alzheimer's symptoms must be based on a patient's specific deficits and imbalances. He added that many elements of his program could be used as a prevention strategy, even in people without symptoms of AD…
Here we go with the list, with the caveat that certainly one should consult one’s own physician, concerning doses, contraindications, and concerns specific to your personal brain and body issues.
1. Eliminate or greatly reduce simple carbohydrates and processed foods from your diet, including sugar, grains and other starches, since they can stir up inflammation in the brain.
2. Add probiotics to your diet
3. Take 5,000 IUs of Vitamin D3 daily.
4. Take a good multivitamin daily.
5. Take Vitamin B6 daily.
6. Take Vitamin B12 daily.
7. Take CoQ10 daily.
8. Add fish oil to your diet.
9. Take coconut oil daily.
10. Exercise rigorously, 30 to 45 minutes, 5 days a week
11. Sleep 8 hours a night.
12. Fast for a minimum 3 hours between dinner and going to bed.
13. Fast a minimum 12 hours between dinner and breakfast
14. Take turmeric daily. Consider taking Ashwagandha and Bacopa monniera daily.
15. If you eat meat, make it chicken, non-farmed fish, and occasional grass-fed beef.
16. Floss your teeth at least twice daily.
17. Meditate daily: adequate sleep and exercise improve blood flow to the brain and instigate neuron generation.
18. Hormone replacement therapy is indicated for women who have a hormonal imbalance that may be affecting brain function.
http://www.alternet.org/ways-avoid-alzheimers
The Death Rate Is Rising for Middle-Aged Whites
ReplyDeleteAddiction and mental-health issues largely drive a reversal of decades of longevity gains
By Betsy McKay
Nov. 2, 2015 4:24 p.m. ET
White, middle-aged Americans are dying at a rising rate, a new study shows, a startling reversal that suggests addiction and mental-health issues are setting back decades of gains in longevity.
Suicide, alcohol abuse, drug overdoses and chronic liver diseases largely drove the rise, which occurred between 1999 and 2013, according to the report published Monday in the Proceedings of the National Academy of Sciences. Those causes of death offset declines in other major drivers of mortality in midlife, such as lung cancer, the study said.
…No other rich country has seen a similar reversal, and the trend is at odds with falling death rates for black and Hispanic Americans in that age group over the same period, said the authors, Anne Case and Angus Deaton, who are economics professors at Princeton University. Mr. Deaton won the Nobel Prize in economics this year.
The rise occurred primarily among men and women between 45 and 54 with no more than a high-school education. But deaths from those causes also rose for better-educated middle-aged whites as well as whites in other age groups, according to the study. Death rates are defined in the study as the number of deaths per 100,000 people for each age cohort.
Ms. Case and Mr. Deaton found that mortality rose half a percent annually for whites aged 45 to 54 between 1999 and 2013, after declining 2% a year on average between 1978 and 1998. Had mortality continued to decline at that rate, 488,500 deaths would have been avoided between 1999 and 2013, they said…
The authors warned that by the time white people in this age group are eligible for Medicare they could be in worse health than the current elderly population. That means they could require more expensive care.
…Ms. Case and Mr. Deaton found in health-survey data from the CDC that middle-aged whites have increasingly reported mental-health problems and difficulties dealing with daily life. One in three reported chronic pain between 2011 and 2013.
Those increases in mental-health and musculoskeletal problems may “explain some of the recent otherwise puzzling decrease in labor-force participation in the United States, particularly among women,” the authors said. Participation in the labor force has fallen since 2007, according to the Bureau of Labor Statistics.
Economic stress may play a role in substance abuse by middle-aged white people, according to the study…
The rising death rate is linked in part to the epidemic of prescription drug abuse. Whites have one of the higher rates of nonmedical use of prescription painkillers among ethnic groups, according to the Substance Abuse and Mental Health Services Administration.
The majority of those who died from overdosing on prescription painkillers between 1999 and 2013 were white, according to the CDC. People between 45 and 54 had the highest rate of such deaths of all age groups, at 10.6 per 100,000.
Suicide in 2013 was highest among whites and people ages 45 to 64, according to breakdowns by ethnicity and age. The U.S. suicide rate overall rose from 10.9 per 100,000 in 2005 to 12.6 per 100,000 in 2013, according to CDC data…
http://www.wsj.com/articles/the-death-rate-is-rising-for-middle-aged-whites-1446499495
A Lonely End for South Koreans Who Cannot Afford to Live, or Die
ReplyDeleteBy CHOE SANG-HUN
NOV. 1, 2015
SEOUL, South Korea
... A growing number of South Koreans are dying alone, with no relative willing to claim their remains and perform a ritual Koreans believe is essential to easing the deceased’s passage to the other world.
The surge in so-called lonely deaths — to 1,008 last year from 682 in 2011, according to government statistics — provides a small but poignant glimpse of how South Korea’s long-cherished traditional family structure is changing. Though South Koreans have mostly benefited from a strong economy in recent decades, families have come under strain from economic and demographic upheaval.
“Those falling behind get increasingly lonely because, unlike the poor of the old days, they see their communities destroyed for urban redevelopment,” said the Rev. Kim Keun-ho, a Christian pastor who has been working among Seoul’s dwindling hilltop slum neighborhoods, known as “moon towns.” “The poor and old have nowhere to go.”
Mr. Kim and other observers trace the problem to the Asian financial crisis of the late 1990s, when lifetime employment, once a given in South Korea, evaporated. Many who lost jobs then never recovered, as an already fast-paced society got even more competitive.
Now in their late 40s or older, some of these unfortunates are found sleeping in cardboard boxes in Seoul’s subway stations or underpasses — scenes reminiscent of the desperate years after the Korean War.
Their fall symbolizes the crumbling of a Confucian social contract Koreans have lived by for ages. Parents spent all their earnings for their children’s success, and in return counted on their support in old age. Now, many older Koreans find themselves without retirement savings or children capable of supporting them.
On the question of whether they had relatives or friends to depend on in times of need, South Koreans ranked at the bottom of countries in the Organization for Economic Cooperation and Development, according to its annual “How’s Life?” report, released in October. The social support was the lowest among South Koreans who were 50 or older.
…The activists say that one of the greatest fears of the poor is to die without being given a proper funeral — the ultimate sign of life on the margins.
…“Especially in the case of elderly people living alone or the homeless, survivors in the low-income class don’t claim the family member’s corpse because of the economic burden of a funeral,” said Kim Jae-ho at the Korea Institute for Health and Social Affairs.
…South Korea has one of the fastest aging societies in the world, with those 65 or older now accounting for 13.1 percent of the population, up from 3.8 percent in 1980.
Caught off-guard, the government is scrambling to strengthen the social safety net, but benefits remain paltry.
The 2015 Melbourne Mercer Global Pension Index, released in October, measured the retirement income systems of 25 major economies and ranked South Korea 24th, with only India ranked lower. Last year, only 45 percent of South Koreans between 55 and 79 received pensions; their monthly payout averaged $431, or 82 percent of the minimum cost of living for a single person, according to government data.
About 30 percent of older South Korean families have a monthly income below the absolute poverty level. But they can get welfare only when they can prove that their family is unwilling or unable to support them. Many reject that option because they find it too embarrassing to reach out to relatives they have not contacted for many years.
And one out of every four elderly people in South Korea has depression, according to a study published by the Korea Institute for Health and Social Affairs in September. As a group, their suicide rate is double the national suicide rate.
http://www.nytimes.com/2015/11/02/world/asia/a-lonely-end-for-south-koreans-who-cannot-afford-to-live-or-die.html
Ganesh: It's time to rethink how our health-care system treats seniors
ReplyDeletePublished on: June 13, 2016
…Social Admission. Failure to Thrive. Unable to Cope. These are the all-too-common, highly non-specific, unfortunate and overused phrases that one will see as the admitting diagnosis for many hospitalized elderly patients across North America and Europe every day.
They are medical shorthand for elderly patients brought into hospital because they simply aren’t being supported well enough in the community — either their daily care needs aren’t being met, or they cannot get sufficiently close/careful management of their complex medical conditions to remain independent.
We blame them for failing to cope with their deteriorating situation rather than acknowledge our health and social care system’s failure to adequately respond to their evolving needs. We know, even as we admit them, that the hospital isn’t going to fix their problems. If anything, there is a strong chance that our traditional care models, designed for younger and more nimble patients, will make things worse.
… stay in hospital dragging on and on as they acquire more medical issues that make it less likely that they can ever return home. Because their stays are more complicated than those of their younger and more nimble counterparts, we may give them an additional badge of shame by calling them “bed blockers”.
If they are lucky enough to leave, it won’t be long before our systems condemn them to return to hospital as their communities are not enabled to meet their care needs.
…Now, thanks to advances in medicine, we are living much longer lives, likely with a number of illnesses that have become rendered as chronic diseases. However, while our patients have changed, our health care systems haven’t — the focus needs to shift from just fixing issues to keeping these patients living independently in the community with increasing levels of homecare or nursing care.
Instead, our hospitals, designed to deal with discrete emergent issues, have become incubators for these patients as they await the right “social” environment for their discharge… high time to refocus and redevelop our health care systems to respond to the unique needs of our aging population, who collectively represent 60% of all hospital days in Canada.
…Dr. Samir Sinha, Director of Geriatrics of the Sinai Health System…is leading an evidence-based approach to develop a National Seniors Strategy for Canada…for a paradigm shift in our approach to health care for older adults. There are five principles…
1. Access –shifting the focus away from these often useless hospital admissions to more personal, long-term management of their conditions in the primary, home, and community care settings…respond to the unique needs of the elderly — for those that can’t come to us, we may need to go to them, through a return to traditional home visits or newer telemedicine strategies.
2. Equity —appropriate care will require acknowledging their socio-cultural circumstances.
3. Choice — offering effective and creative choices that are independent of the hospital setting for frail patients like Mr Peterson.
4. Value — best value possible to improve care for our seniors.
5. Quality — empowering primary care providers to better care for patients in the community would actually save costs of acute hospital admissions in the long-term.
…in their development of an Acute Care for Elders (ACE) Strategy that was pioneered at Mount Sinai Hospital — a seamless model of care for older adults, spanning the patient care continuum from emergency to in-patient, ambulatory, and community care settings.
Geriatricians, psychiatrists, other doctors, social workers, therapists, pharmacists and dietitians worked together to provide coordinated care for elderly patients. Their ACE Strategy has generated sustained results…
http://calgaryherald.com/health/seniors/ganesh-its-time-to-rethink-how-our-health-care-systems-treats-seniors