Monday, November 30, 2015

Aging as a Lifelong Process at GSA

“Zeke Emanuel, keynote at GSA, seriously?”
–Thomas Perls’ email message to GSA Executive Director James Appleby
 
Seriously, oncologist/bioethicist Ezekiel (Zeke) Emanuel, who wrote last year’s The Atlantic article, “Why I Hope to Die at 75and then presented a related webinar, “Why I Expect to be Alive at 75” about his personal views on rejecting life-prolonging treatment (“The American Immortal” in favor of focusing on a high-quality, meaningful life), was the keynote speaker at the President’s Opening Plenary Session in this year’s Gerontological Society of America (GSA) Annual Scientific Meeting
 
Zeke told us that he was not happy to be in Orlando.  Our meeting site was Walt Disney World Swan and Dolphin Hotel in Lake Buena Vista, a city controlled by Walt Disney Company with a permanent residential population of ten people.  With so many stimulating sessions to attend, I was okay being stuck onsite though dining options were limited.  As usual, I avoided lodging at the official meeting hotel, which cost $202 per night, in favor of low-budget Roomba room in nearby Kissimmee for $39.99 per night, with fourth night free plus breakfast and watch! I commuted to meeting site via $2 Lynx bus #56 to free Disney Transportation Center, where I took monorail/ferry to Magic Mountain for hotel shuttle bus direct to Swan and Dolphin.  
Spry 58-year-old Zeke did not talk about why he hoped to die at age 75, but chose to talk about the impact of Affordable Care Act (ACA) and future of health care, particularly VIP care for chronically and mentally ill (10% of Americans use up two-thirds of health care spending) via tertiary prevention (coordinating care to keep them healthy and out of hospitals), moving care out of hospitals (Presbyterian Healthcare Services’ Hospital @ Home in Albuquerque, CMS’ Independence at Home Demonstration), long-term care (LTC) financing, and end-of-life care (not death panels).  
Former ballet dancer Zeke was in constant motion on stage.  At left of stage, Zeke discussed ACA’s successes: decrease in uninsured Americans, improved quality (fewer preventable hospital based errors and conditions), slowdown in cost growth in health spending, and job growth.  Yet, he said there is huge waste in health care system, driven by unnecessary and inefficiently delivered services – so moving care out of hospital is key. 
Returning to the podium on stage, Zeke discussed failure of CLASS (Community Living Assistance Services and Supports) Act, a voluntary LTC insurance funded by payroll deductions that was enacted as part of ACA in 2010 but repealed in 2013 because it could not be certified as revenue-neutral.  Zeke noted the challenge to enroll younger, healthy persons without a mandate, whether for health insurance or LTC, so he didn’t think Congress would pass mandate for LTC. (On the day of Zeke's talk, The Wall Street Journal reported that public exchange plans have a hard time attracting healthy consumers, and the nation’s largest health insurer might pull out of the exchanges after 2016.) 

For end-of-life care, Zeke said palliative care should be default regardless of advance health care directive.  After his presentation, he autographed copies of his book, Reinventing American Health Care: How the Affordable Care Act will Improve our Terribly Complex, Blatantly Unjust, Outrageously Expensive, Grossly Inefficient, Error Prone System (2014).
New Interdisciplinary Track

Founded in 1945, GSA is the nation’s oldest and largest interdisciplinary organization devoted to research, education and practice in the field of aging.  When I joined GSA three years ago, I declared my affiliation with Social Research, Policy & Practice (SRPP).  Yet, as a well-rounded, liberal arts graduate, I also enjoy the other three sections, Biological Sciences (BS), Behavioral & Social Sciences (BSS), and Health Sciences (HS). 
This year’s GSA program introduced a new Interdisciplinary (ID) track, and a related online, open-access journal.  Now based on my attendance at sessions identified with this newest track, I might change my affiliation to ID…

In The Limits of Life: When Have I Lived Long Enough? (ID) Harry (Rick) Moody moderated a lively discussion with panelists responding to Zeke’s “Hope to Die at 75.” 
·         Thomas Perls, founding director of New England Centenarian Study and author of online "Living to 100 Life Expectancy Calculator" (just 25 years beyond Zeke’s Hope), said he was concerned Zeke’s view might have unintended consequences (let “nature take its course” and not invest in health care for older adults).  He reminded us that variation in how people age depends on events throughout their life course, so “instead of avoiding aging, build an aging-friendly world:  we must move from a disease-based cure model to a life-course prevention model and facilitative model.”    
·      Eileen Crimmins, AARP Professor of Gerontology at USC, was referenced in Zeke’s article: “over the past 50 years, health care hasn’t slowed the aging process so much as it has slowed the dying process.”  She noted that the length of incapacity is about the same if one dies at 65, 75 or 85.  Zeke implied that well-being and meaning in life decline with age; however, there are no differences in life satisfaction between the old (70-79) and oldest-old (80-104)—what reduces life satisfaction is having disability, having disease, and being lonely.  She concluded that “the greatest challenge of this century is to deal with the consequences of our success in extending life expectancy: reducing time with diseases and disability and providing meaningful lives should be our aim in order to increase the relative length of healthy life and well-being among the old.”
·         Wendy Lustbader, gerontological social worker and author of Life Gets Better: The Unexpected Pleasures of Growing Older (2011), noted that most of us do not fear aging and dying as much as illness and frailty.  She recalled Maggie Kuhn’s remark, “interdependence is the truth of our lives” and added three propositions for living a long life: 1) important opportunities for growth when we become vulnerable at a time of life when we count on kindness (refer to Wendy’s 1993 book, Counting on Kindness: The Dilemmas of Dependency) and care of others; 2)  approach illness, disability and death as time of deep transformation; and 3) opportunities to make sense of past, make peace and settle affairs in a desire to become complete.  She read excerpts from her book, What’s Worth Knowing (2004).
GSA Executive Director James Appleby highlighted the past year’s initiative of 8 Leaders of Aging Organizations, including GSA, to combat ageism and improve public understanding of older adults by partnering with FrameWorks Institute to Reframe Aging. This project has 3 phases: 1) research to map gaps between public opinions/prejudice and facts from experts, 2) describe media discourse, and 3) develop and test language and metaphors to talk about aging that is more appropriately aligned with reality.
 
Reframing Aging: Why Is It So Hard to Get Traction On Policies Important to Older Adults? (ID) Project Manager Laura Robbins introduced FrameWorks CEO Nat Kendall-Taylor, who recommended that aging as individual responsibility needs to be reframed with context (social determinants) and focus on systemic solutions.  During this session, American Society on Aging President Bob Stein made available print copies of Fall 2015 issue of Generations on Ageism in America: Reframing the Issues and Impacts.
Emerging Theory on Aging as Lifelong Process (ID):  Authors of the 2016 edition of Handbook of Theories of Aging.  

“…the search for solutions without regard to theory can lead to several problems, including unchecked assumptions, a lack of evaluative criteria, and the inability to build upon previous efforts. Students and new professionals in gerontology are often motivated to identify the problems of aging and help devise appropriate ways of dealing with them. This assumes that aging is inherently problematic… Without theory, how can gerontologists decide which problems are caused by aging itself, which are age-related phenomena, and which are not due to age at all?” 
-- Are Theories of Aging Important? Models and Explanations in Gerontology at the Turn of the Century by Vern L. Bengtson, Cara J. Rice, Malcolm L. Johnson 
Aging Policies 
GSA President Rita Effros, UCLA Professor of Pathology, presented 2015 Kent Award to social security advocate Eric Kingson of Syracuse University School of Social Work.  Kathy Sykes passed out bookmarks, Send a Gerontologist to Congress - Kingson for New York’s 24th Congressional District

Presidential Symposium: Future Policy Directions to Promote Aging as a Lifelong Process (ID) featured following:
  • Robyn Stone, Executive Director of Leading Age, discussed the importance of affordable senior housing linked to health and support services for low-income seniors to age in place and community, noting that the elderly are the fastest growing group of homeless. 
  • Adriana Perez of University of Pennsylvania’s Nursing discussed environmental policies to promote health aging across diverse populations: walkability and community engagement in health, recreation, housing and economic development, transportation, and Age-Friendly Business District with senior discounts in walk route.
Discussant Toni Miles brought all perspectives together in spectrum of older adults. 
Technology Solutions in an Aging Society: Federal Policy Opportunities moderated by David Lindeman, Director of Center for Technology and Aging at UC Berkeley.  Dr. Christine Cassel, author of Medicare Matters: What Geriatric Medicine Can Teach American Health Care (2005) and Co-Chair of President’s Council of Advisors on Science and Technology (PCAST), joined via telephone conference call to discuss last month’s report, Aging America & Hearing Loss: Imperative of Improved Hearing Technologies.  This report noted that untreated, age-related hearing loss is a significant national problem: a quarter of adults between 60 and 69 years, more than half of adults between 70 and 79 years, and almost 80 percent of those older than 80 years have difficulty hearing.  To address barriers to adoption of hearing technologies by older adults with mild to moderate hearing loss, PCAST recommended improving access by encouraging competition/innovation to lower cost (average $2,300 per hearing aid, not covered by Medicare):
  • Federal Trade Commission (FTC) should allow hearing-aid prescription process that is consumer-driven with opportunity to shop around (similar to eyeglasses)
  • Food and Drug Administration (FDA) should create new category for basic hearing aids and testing for sale over-the-counter; and
  • FDA should withdraw draft guidance on Personal Sound Amplification Products (PSAP) and allow for truthful claims about capabilities in noisy environments.
Margaret Campbell, senior scientist at National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), viewed technology as a bridge for people aging with and into disability, with an emphasis on usability and accessibility in health care technologies; she suggested opportunities in reframing issue of hearing loss as normative process of aging to reduce stigma, and research (last month’s NIH funding of Collaborative Aging in Place Research using Technology and Canada’s Aging Gracefully across Environments using Technology to Support Wellness, Engagement and Long Life, AGE-WELL


International Perspectives
Rashmi Gupta founded Aging in Asia Interest Group, which has grown and spun-off more specialized Chinese Gerontology Studies Interest Group.

Positive Effects of Traditional Chinese Culture on Aging (ID): China’s 5,000 year old history developed a tradition of healthy aging, especially through tai chi chuan (mind-body exercise), Chinese calligraphy, tea drinking (pu’er, green) and Taoism (living in harmony with nature).

Presidential Symposium: International Perspectives on Aging Well/Successful Aging (ID)

  • Dr. John (Jack) W. Rowe, Chair of MacArthur Foundation’s Research Network on an Aging Society, presented Successful Aging 2.0 for 21st Century.  Rowe and Kahn’s Successful Aging model (1987) has been alternatively welcomed and criticized. Jack Rowe made no apologies because Successful Aging reframed aging from disengagement and loss to active participation and growth.  Successful Aging 2.0 is adapted to the societal level to facilitate Successful Aging at the individual level with goals to be productive (paid labor, volunteer engagement), cohesive (intergenerational family safety net), equitable (minimize gaps in opportunities) and resilient.
  • Dr. Bilkish Cassim, Geriatrics Professor at University of KwaZulu-Natal, presented an African Perspective on Successful Aging, noting studies showing one’s subjective assessment of successful aging as higher than objective assessment based on Rowe and Kahn’s criteria.  After discussing the challenges of aging in Africa (life expectancy at birth only 57.8 years, older adults comprise 4.8% of total population or 46.4 million age 60+; universal access to health care in only handful of African countries, overwhelming poverty), she concluded with the South African philosophy of ubuntu (“I am because of who we all are”) that considers caring and social networks.
  • Dr. John Beard, Director of Ageing and Life Course at the WHO, presented Healthy Ageing, defined as the process of developing and maintaining functional ability that enables well-being in older age.  The World report on ageing and health calls for a life course approach to healthy ageing that considers interaction with environments that provide resources or barriers on healthy behaviors.
Behavioral & Social Sciences
Making the Case for Reducing Ageist Attitudes (BSS) After presentations by Hannah Swift (self-fulfilling prophecy conforms to stereotypes), Becca Levy (positive implicit-age stereotype intervention can improve physical function), Sibila Marques (navigating “threatening” environment can activate negative stereotypes), and Hannah Giasson (attributing everyday discrimination experiences to self-perceived ageism), discussant James Goodwin of Age UK called ageism the “last bastion of prejudice” and suggested interventions like age-friendly paradigm and getting older adults to believe in themselves (“love later life”).  
Age Discrimination Examined Through a Life-Course Perspective: Insights From Interdisciplinary Research (BSS) featured presentations by Elisabeth Burgess (researched media reporting of elder abuse, finding that language reinforced and perpetuated ageism with victim described in references to cognitive and physical vulnerability, and prior employment/vocation, but no mention of future orientation and resilience), Tracey Gendron (analyzed tweets for ageist language, finding students used them with intent of conveying positive messages from interactions with older adults), Ernest Gonzales (developed Workplace Age Discrimination Scale) and discussant Jennifer Sasser, who asked, "when does age matter?"  
After these back-to-back sessions, I met Bobbie Sackman, Director of Public Policy at LiveOn NY, the lead advocacy organization of over 100 NY-based member organizations that provide over 600 community-based programs serving 3 million older New Yorkers.  According to LiveOn NY, age matters because growing older presents unique challenges like living on fixed income, seeking age-appropriate healthcare, the shame of ageism that makes older adults invisible, which can cause them to retreat into social isolation. LiveOn NY's mission is to ensure that no New Yorker is alone in facing these challenges. Its website has excellent materials on advocacy, including a thoughtful blog post, “What are HUD 202 Parking Lots and Why Are They Critical to Affordable Senior Housing in NYC?, which proposes to eliminate unnecessary parking requirements, where car ownership is low in transit-served areas, in order to build more affordable housing.  (In San Francisco Bay Area’s year-round growing seasons, edible gardens in place of unneeded parking to provide access to nature and fresh food would be so awesome!)

Aging in Film
Film’s Role in Preserving Personhood Throughout the Life Course (SRPP): Rick Scheidt of Kansas State University considered ageism as a life course illness, with children acquiring ageist notions at age 4.  Though films can have a role in the creation and activation of ageism that can erode personhood, he also saw a “curative role” for documentary film (refer to last year’s Aggregate Survey on True/False Filmmakers on measuring the social impact of documentary films) to counter ageist messages (refer to Leni Marshall’s “Thinking Differently About Aging: Changing Attitudes Through the Humanities,” published in The Gerontologist last year, about using video screening and follow-up discussions as an intervention to reduce ageist ideation).  Examples of these documentaries that match message content to attitude functions for change outcomes: 
 
Helen Kivnick, Social Work Professor at University of Minnesota, discussed Vital Involvement model —a person’s meaningful relationship to environment, or engagement in meaningful activity like arts participation by people with Alzheimer’s and their care partners in Giving Voice Chorus)--to understand personhood throughout the life course.  James Vanden Bosch, Founder/Executive Director of Terra Nova Films and film reviewer for The Gerontologist, discussed aging through the lens of the young and the devaluation of persons living with dementia and old age.  We viewed documentary film clips of Whispering Hope: Unmasking the Mystery of Alzheimer’sGiving Voice ChorusThe Forgetting: A Portrait of Alzheimers, Mum and Me, and Choice & Challenge: Caring for Aggressive Older Adults Across Levels of Care.

Nebraska: Exploring Age Through the Lens of Film Studies, Age Studies and Gerontology (BSS), a Humanities and the Arts Film Symposium chaired by narrative gerontologist Kate de Medeiros.
  • Neal King, Virginia Tech Sociology Professor, saw Nebraska (2013 drama) as a road trip movie, old man hooking up with a younger man, in the tradition of About Schmidt (2002, also by Alexander Payne); marginalized old man with no social support who finds salvation via intergenerational connection; marginalized old woman not on screen or ignored. 
  • Rick Scheidt, an environmental gerontologist who studies aging in rural place, found Nebraska “harmful, condescending and cruel” to small towns that have emptied out and where elderly are trying to hang on to what they have, possibly the last generation to live in a small town—the end of an American way of life.  He also had trouble understanding protagonist Woody, a drunk with incipient Alzheimer’s disease and lack of introspection; his psychologically stuck son David; and gritty black-and-white film reflecting death of small towns in Midwest
  • Helen Kivnick was kinder in her response to watching Nebraska, preferring not to judge, but to understand the complexity from the perspective of life cycle and vital involvement.  She noted that it’s hard to understand Woody, who is a man of few words, slow cognitive process; is he displaying positivity effect, or naïve belief that he won sweepstakes, that gives him purpose for living? She likened Woody character to Dr. Borg of Wild Strawberries (1957 film by Ingmar Bergman) as they undergo life review to enable them to accomplish their psychosocial work and renew age-appropriate themes (intimacy v. isolation, generativity v. self-absorption, integrity v. despair) to resolution.
  Lectures by Awardees
2014 Maxwell A. Pollack Award for Productive Aging recipient Andrew Scharlach of UC Berkeley School of Welfare presented a lecture, Aging in Context: Individual and Environmental Pathways, discussing the giants who influenced his career—Louis Lowy (social work), Albert Bandura (social learning), Paul Baltes (life-span developmental psychology), Vern Bengtson (family systems), Rudolf Moos (social ecology) and M. Powell Lawton (environmental gerontology); perspectives on individual healthy aging (only 10.9% of people age 65+ in U.S. meet “successful aging” definition); 6 C’s of integrated development (continuity, compensation, control, connection, contribution, challenge); and age-friendly environment (older adults want to remain in homes/neighborhoods; see friends/social networks; get to shopping/healthcare; be safe, healthy and involved in community).

Marie Bernard, Deputy Director of National Institute on Aging at the National Institutes on Health and last year’s Kent Award recipient, delivered her lecture on A Gerontologist’s View of Wonderland: The Impact of Scientific Imagination, covering "what's most fascinating": extending life/healthspan (caloric restriction, resveratol, rapamycin, heterochronic parabiosis), preventing/treating Alzheimer's, behavior meaningfully modified (Advanced Cognitive Training for Independent and Vital Elderly, or ACTIVE), clinical findings (prevent mobility disability via Lifestyle Interventions and Independence For Elders, or LIFE) and intersection of man and nature (Precision Medicine Initiative, Brain Research through Advancing Innovative Neurotechnologies Initiative or BRAIN).

Laura Carstensen, Director of Stanford Center on Longevity and last year’s Kleemeier Award recipient, delivered her lecture on Taking Time Seriously in Life-Span Development.  She reviewed her socioemotional selective theory: as time horizons shrink, as when we age, people become increasingly selective, investing greater resources in emotionally meaningful goals and activities—“With age, people strive to live in the moment, know what’s important, invest in sure things, deepen relationships, and savor life”—often this results in a positivity effect, or preference for positive over negative information in attention and memory. 

 
Contrary to the stereotype of aging’s decline, economist Andrew Oswald’s U-curve shows psychological well-being or life satisfaction is high when young, then starts to decline in the early 30s, reaching a nadir in mid-life before rising again to levels even higher than young adulthood. 

(University of Bradford’s Dr. Helena Chui arrived at different findings, based on her research of older Australians living in the Adelaide area:  “It’s the first study to tell us depressive symptoms continue to increase throughout old age. We are in a period of unprecedented success in terms of people living longer than ever and in greater numbers and we should be celebrating this but it seems that we are finding it hard to cope…It seems that we need to look carefully at the provision of adequate services to match these needs, particularly in the area of mental health support and pain management. Social policies and aging-friendly support structures, such as the provision of public transport and access to health care services are needed to target the ‘oldest-old’ adults as a whole.”)


The Personal as Professional


The Personal as Professional (SRPP) session featured Anne Wyatt, Helen Kivnick and Wendy Lustbader sharing how they have aged into the people they serve in their professional gerontological work.  Wendy shared how she “became old when young” at age 26 when she received a scholarship to work in a nursing home and geriatric hospital.  This work with older adults had the effect of aging her internally as they taught her philosophical lessons about “how to live, how to die, what’s important in life and not.”  As a result, she gained an old soul — in the 70s when she was in her 30s, then the 80s when in her 40s, and “now close to 100 years old!”  People would remark, “there’s something odd about you…because you know things you ought to know,” or the “deepest things elders taught.”
The Insiders as Outsiders: Professionals Caring for an Aging Parent by Dr. Robert Kaiser and his sister Susan shared their experience of how they leveraged their professional expertise, geriatrician and geriatric social worker respectively, as caregivers with personal knowledge of their widowed mother’s circumstances in a fragmented health care system that often treated them as outsiders.  At every setting of care—emergency room, hospital intensive care unit, rehabilitation unit—there were the same problems of medication errors, poor communication, understaffing, delays in diagnosis/treatment/transfers, ignorance about special needs of older adults.  Their concluding observations included need for better training of health care professionals about how to approach clinical problems of older patients, need to incorporate caregivers as active members of care team, and need for caregivers to serve as vigilant patient advocates at every setting.

Becoming a Gerontologist: Lessons from WIGL (Women In Gerontology Legacy) Project (BSS) panel featured student interviewers Akiv Dawson (Georgia Southern) and Colleen Bennett (University of Maryland), and social gerontology faculty researchers Adrienne Cohen (Georgia Southern) and Pamela Pitman Brown (Winston-Salem State).  Between November 2014 and July 2015, 26 students interviewed 46 older women gerontologists about their life course trajectories, including when they embraced “gerontologist” as their professional identity.  Some respondents who trained in another field did not identify as gerontologists, which they thought was reserved for professionals formally trained with MA or PhD in gerontology.  WIGL Research Team will present a workshop, Collaborative Research with Professors and Graduate Students: Stories from WIGL Project, at AGHE annual meeting in March 2016.
Fielding Graduate University Professor Connie Corley convened Hartford Change AGEnts' Stories for Change Action Committee meeting.


Aging in Community

Living in Community, Aging in Place (HS)
Lydia Manning, Gerontology Professor at Concordia University, presented We Are Building This City on Rock and Roll: Exploring How Music-Enthusiast Baby Boomers Create a Retirement Community.  She is researching how software developer Jerry Myroup and like-minded, easy-going folks age 55+ are designing their own retirement community, called RockTilYouDrop (RTYD), based on music—particularly Little Feat band (“Old Folks Boogie”)—as a common denominator since boomers were “very fortunate to grow up when some of the best music was being created” in the 1960s and 1970s.  Some features of this planned RTYD retirement community:
  • small senior co-housing that is affordable for starving artists
  • “garages” built throughout the community for musicians to practice and for jam sessions
  • eco-friendly building design to conserve energy
  • amenities to include walking paths, bike trails, fitness centers, greenhouses, gardens, multi-purpose clubhouse and buildings dedicated to music and art
  • “travel” units where owners/renters have option of swapping residences with folks in other RTYD communities, all within one hour drive to international airport
  • near hospitals/medical facilities, cultural establishments, college campuses
  • marijuana tolerant—just like in ol’ hippie communes
 
Kathy Black, University of South Florida Social Work Professor and Age-Friendly Sarasota researcher, presented on Aging in Place With Dignity and Independence 
Cynthia Jacelon, University of Massachusetts at Amherst Nursing Professor on The Gardener: A Life Well Lived in Rural Vermont, her case study of Bea Ward from ages 87 to 101.

Networking Receptions
As usual, GSA meeting was packed with events that ran from 6 am until midnight (USC Leonard Davis and Ethel Percy Andrus Gerontology Reception)!
President’s Welcome Reception – taco bar 
Doris Schwartz Gerontological Nursing Research Award Reception came before Presentation and Lecture 
Minority Issues in Gerontology Award Reception hosted by Senior Service America, Inc. (SSAI) 
SSAI Director Tony Sarmiento chatted with Bobbie Yee and David Chiriboga (GSA power couple) and Rashmi Gupta. 
Maxwell A. Pollack Reception 
Technology & Aging Networking Reception 
Association for Gerontology Education in Social Work (AGESW) Reception 
Emerging Scholar and Professional Organization (ESPO) Awards Reception 
USC School of Social Work Reception recognized Vern Bengtson, recipient of 2015 Richard Kalish Innovative Publication Award for his 17th book, Families and Faith: Generations and the Transmission of Religion (2013).  Carroll Estes of UCSF received Bengtson book for being the person in the room with the most grandchildren (2)! 
At USC reception, Bobbie and David mingle with Peggye Dilworth-Anderson and Rebecca Redmond (both involved in WIGL Project).


SFSU presence
Gerontology Professor Brian De Vries was discussant at symposium on Health Disparities in Diverse Older Adult Populations: Policy and Program Implications (SRPP). 
Gerontology Professor Darlene Yee-Melichar was 2015 Program Committee Co-Chair 
Social Work Professor Rashmi Gupta presented poster, End-of-life-care Treatment for Older Adults in Allahabad, India: Physicians’ Perspectives, which she dedicated to her father, Dr. R.C. Gupta, who supported her research. 
J.F. Oberlin University (Tokyo) Psychogerontology Professor Hisao Osado and SFSU gerontology graduate Sumi Brennan presented poster, Impact of Life Enrichment Services on Quality of Life: A Cross-Cultural Study.


Poster sessions
Ryan Shanley, graduate student at Miami University’s Scripps Gerontology Center, presented Catch Me Before I Fall: Predicting Risk of Falls in Older Adults, finding age, functional dependence, self-assessed risk of falling and fear of falling were significantly associated with Timed Up and Go task that indicates risk of falling. 
Rodlescia Sneed, postdoctoral scholar at University of Pittsburgh, presented Grandparent Caregiving, Race and Cognitive Function: A Prospective Study, finding that grandparent caregivers who provided at least 500 hours of care in the two years prior to baseline demonstrated better cognitive function in 4-year follow-up than non-caregiving grandparents – though this was observed among White caregivers, but not among African-American caregivers.
  
Sheryl Elliott, researcher at Portland State University, presented Culturally Diverse Congregate Meal Sites: Are They Meeting the Needs of Older Adults with Significant Social and Economic Limitations? Recommendations included suggestions about ways to recognize and honor language and culture, increase access by providing affordable means to travel to and from sites, facilitate participation, utilize person-centered approach, and empower clients to seek supports, thereby reducing isolation and enhancing well-being.

At Exhibit Hall Opening, Rick Moody strummed his guitar and sang Jimmy Buffett’s Margaritaville. 
Save these dates for next year's GSA meeting: November 16-20, 2016!


My lifelong process
Since I missed last year’s GSA meeting because I chose to use my limited time-off from work to attend the biennial HPGS conference instead, it was really great to be back soaking up all the latest gerontological research, re-connecting with kindred spirits and just savoring every moment of this year's 5-day GSA meeting …until next year’s meeting, I can re-visit this blog post J.  
The day after the GSA meeting ended, I started a new job working with older adults in senior housing and one of the managers advised me, “remember, seniors are just like children.”  Ouch! This remark reminded me how much gerontologists are needed to educate uninformed people about the realities of aging, including the unique developmental needs of older adults.

Like Laura Carstensen said about people past middle age enjoy life more as our time horizons grow shorter and we see our priorities most clearly,… “we savor life, we are more appreciative, more open to reconciliation, we invest in more emotionally important parts of life, and life gets better … but that same shift in perspective leads us to have less tolerance than ever for injustice.” As it is painful to witness older adults being unjustly patronized by people who hold ageist attitudes, I find myself more understanding when older adults prefer to be in age-segregated settings where there is presumably power in numbers.  Yet I am more appreciative of my upbringing in a three-generation household where my grandparents, models of healthy aging, definitely rocked and ruled … in an ideal world, RockTilYouDrop!

12 comments:

  1. Your Attitude About Aging May Impact How You Age
    Mandy Oaklander
    Dec. 7, 2015
    In a new study, people who believed negative stereotypes about old age had higher risk of Alzheimer's
    How do you feel about old people? Your answer appears to be connected with how well your brain holds up against Alzheimer’s disease, according to a series of two new studies published in the journal Psychology and Aging.
    The researchers, from the Yale School of Public Health, say it’s the first time this type of risk factor has been linked in a study to the development of brain changes linked to Alzheimer’s disease.
    In the first study, researchers looked at data from 158 healthy people without dementia enrolled in the Baltimore Longitudinal Study of Aging (BLSA). In order to find out how people in the study felt about age stereotypes, researchers used a scale with statements like “older people are absent-minded” or “older people have trouble learning new things.” People in the study gave these answers when they were in their 40s.
    About 25 years later, when people in that same group were about 68 years old, they began about a decade of annual MRI brain scans to determine the volume of their hippocampus. Loss of volume in that brain region is associated with Alzheimer’s disease.
    People who held more negative thoughts about aging earlier in life had greater loss of hippocampus volume when they aged. In other words, the researchers say, people who held negative age stereotypes had the same amount of decline in three years as the more positive group had in nine years.
    In the second study, researchers examined two more markers of Alzheimer’s disease: the buildup in the brain of amyloid plaques—clusters of proteins that accumulate between brain cells—and neurofibrillary tangles, twisted strands of protein that build up in brain cells. To do so, they used brain autopsies of people who also had had their attitudes about aging measured.
    The results were consistent: People who held more negative age stereotypes had significantly higher scores of plaques and tangles than people with more positive feelings about growing old.
    The researchers didn’t look at a mechanism by which negative stereotypes might exert an influence on the brain, but they suspect that stress is the driver. Animal research shows that exposure to chronic stress can lead to the same biomarkers examined in the new study, says Becca Levy, lead author of the study and associate professor of epidemiology and psychology at the Yale School of Public Health.
    Past laboratory research on humans shows that when people are primed with negative age stereotypes and exposed to stressors, they have a greater cardiovascular response, which is linked to heart events. And research from 2012 conducted by Levy and others found that people who had more negative age stereotypes before they had reached old age had significantly worse memory performance later in life.
    It may be unsettling to think that negative cultural stereotypes about age could be having such a profound effect on how our brains age. “We know from other studies that as young as age four, children taken in stereotypes of their culture,” says Levy. But the results can be interpreted a different way, too. “Positive age stereotypes seem protective of not experiencing these biomarkers,” she says—so if we can find a way to promote positive age stereotypes on a societal level, our brains may be better off once we reach old age.
    http://time.com/4138476/aging-alzheimers-disease/

    ReplyDelete
  2. Confab highlights LGBT aging research
    12/03/2015
    by Matthew S. Bajko
    As more and more LGBT seniors are living out of the closet, the issues they are confronting during their golden years are receiving increased attention from researchers who study aging.
    Thus, at this year's annual conference held by the Gerontological Society of America, a record number of presentations and posters were presented that dealt with LGBT aging.
    Topics ranged from social isolation and mental distress faced by LGBT seniors to weight issues among lesbian and bisexual senior women and how gay men and their families access end-of-life services. While not always specific to LGBT seniors living with HIV, many panels also discussed various aspects of aging with HIV or AIDS…
    Just as the number of older adults in America continues to climb, so too does the population of LGBT seniors. Yet because many health surveys do not include questions about sexual orientation or gender identity, the true size of America's LGBT senior population remains unknown.
    The U.S. Administration on Aging has estimated the number of LGBT seniors age 60 and older to be anywhere between 1.75 million to 4 million. California is estimated to have 215,000 LGB people age 55 and older. (There is no statewide data for the transgender senior population.)
    As the Bay Area Reporter has previously noted, there are nearly 20,000 LGBT residents 60 years of age or older living in San Francisco. Nationwide, the population of LGBT seniors is projected to double by 2030.
    It is believed that the first LGBT-specific symposium at a GSA convention was held in 2002, a year prior to the formation of the LGBT-focused Rainbow Research Group. At this year's confab there were three LGBT-specific symposiums and five others that included LGBT-centered research presentations. In addition, there were 19 LGBT-specific posters on research studies presented during the conference.
    The increasing inclusion of LGBT aging research points to the "immeasurable change" Brian de Vries, a gay man who is a professor of gerontology at San Francisco State University, has witnessed over the decades as a member of GSA.
    He recalled how during a meeting 10 years ago, when the GSA conference was held in San Francisco, someone asked him what LGBT meant.
    "I think there has been a radical shift. It's in the lexicon now," said de Vries, who helped co-found the Rainbow Research Group. "We have gender-neutral bathrooms now. When I saw that I was really proud."
    This year's meeting, held in late November at the Walt Disney World Swan and Dolphin Resort, marked the first time the GSA confab designated bathrooms as being non-gender specific…
    Another first at this year's gathering was an LGBT poster session …
    At the LGBT-specific symposium de Vries coordinated, the focus was on research he has helped conduct of gay older men in Canada and a smaller survey of Palm Springs residents. The cohort of men in the study is very similar to gay older men in San Francisco, he said, and in both countries end-of-life care is becoming of increased concern.
    In focus groups, when asked if they were prepared for the end of their life, most of the men said they had made out wills. But few had thought about who would take care of them just prior to death as their health failed, said de Vries.
    "People had a hard time getting into that question," he said.
    For heterosexual seniors, the answer most likely would be their children or other relatives. Yet for gay men, who didn't have kids and may have cut ties to their biological family, they far too often do not talk about end-of-life care with their friends.
    His research, said de Vries, aims to help gay men develop opportunities where they can talk to one another about their declining health. In most families, he noted, children will sit their parents down and have that discussion.
    "Gay men don't have that. This is the limits of the chosen family," said de Vries.
    http://www.ebar.com/news/article.php?sec=news&article=71109

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  3. Fighting Ageism in the Twitter Era (Getting Old Isn't All That Bad)
    Arizona Republic/New America Media, Commentary, Linda Valdez, Posted: Dec 04, 2015
    ORLANDO, Fla.--The baby boomers, AKA the nation’s silver tsunami, had better pay as much attention to changing attitudes about aging as they did to shaking up all those previous social norms.
    In American culture, old things get replaced with something nice and new: Like the latest smart phone.
    Apply the concept to people, and it’s called ageism.
    It’s as current as Twitter.
    Tweeted Ageist Stereotypes
    A team of researchers at Oregon State University took a look at tweets about people with Alzheimer’s disease and found ridicule, stigma and stereotypes.
    One unpleasant tweet: “Waiting until your grandparents become senile so you can trick them into giving you their money.”
    Ageism came up frequently at November’s 68th Annual Scientific Meeting of the Gerontological Society of America, in Orlando, Fla. The conference brought together science, medical, social science and behavior experts, as well as policy wonks and other researchers…
    Experts from all over the world discussed research into the challenges of the old, the frail and those with dementia.
    They talked about minorities and the poor, who, after a lifetime of being disadvantaged in our society, will face particular difficulties as they age, including the need to rely on at-risk safety net and entitlement programs.
    Those in the middle class also face poor nutrition in “food deserts” and isolation in their cul-de-sac suburban neighborhoods. Even some retirement communities, built as havens from the hustle and bustle, are less than ideal places to “age in place.”
    Yet, the vast majority of Americans say that’s what they want: to stay in their homes.
    Boomers Internalize Stereotypes
    This is where baby boomers may face their own internalized ageist stereotypes.
    Stephen Golant, author of Aging in the Right Place, (Health Professions Press, 2015) said Americans are “repeatedly lectured” about how to “age successfully.” They are told the importance of remaining young in mind and body: To exercise. To eat right. To maintain their homes.
    This can be pernicious, he said. It suggests those who are not healthy have only themselves to blame. People guilt-trip themselves even more when the demands of homeownership make them feel like life is spinning out of control.
    The perceived stigma of giving up one’s home for a “home” can make life an “emotional battlefield,” Golant said.
    Meanwhile, society does its best to accent the negative.
    Asked to characterize the aging, some people recorded during on-the-street interviews dredged up cliches about spry retirees on vacation, but most talked about decline, disease, dependency.
    “Society isn’t betting on them,” said one man.
    The FrameWorks Institute did the interviews as part of its work with eight national aging organizations.
    The groups are the Gerontological Society, AARP, American Federation for Aging Research, National Council on Aging, National Hispanic Council on Aging, American Society on Aging, American Geriatrics Society and Grantmakers in Aging.
    New Metaphors for Aging
    The goal is to find new metaphors for aging, said FrameWorks CEO Nathaniel Kendall-Taylor.
    He said the way information is framed has an impact on how people use the information, which should come as no surprise to those who reframed cultural norms about race, gender, sex, the environment and entertainment.
    The baby boomers have a lot at stake, and that includes me. I’m no fan of euphemisms, but I’m all for promoting a fine-wine view of life. It should get better with age. We should feel better about aging.
    If some creative wordsmithing and mass marketing helps our society recognize that aging doesn’t diminish value or humanity, it would be a real contribution to our collective understanding of who we boomers are.
    http://newamericamedia.org/2015/12/fighting-ageism-in-the-twitter-era-getting-old-isnt-all-that-bad.php

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  4. Ageism, Attitude and Health
    By Lisa Esposito
    Dec. 26, 2015
    Accomplished, enlightened, learned, sage and wise? Or confused, decrepit, incompetent and declining? The language used to describe aging, the way people talk to and about seniors, matters. Ageism can hurt your health, research shows. Shedding negative stereotypes and embracing positive attitudes now can help make life better as you get older.
    Loaded Language
    And what can I get you for dessert, young lady?
    Subtle ageism comes through in the language people use, says Tracey Gendron, an assistant professor in the department of gerontology at Virginia Commonwealth University. It's a way to treat elders as "others."
    An ageist attitude can come wrapped as a personal compliment. "When we praise someone for looking or being 'youthful,' or having a young spirit or body, that in and of itself is problematic," Gendron says. "Because it's making 'young' the default of what is preferred, what is positive, and 'old' the default of what is negative."
    Gendron challenges well-meaning people when tempted to describe an older adult as "79 years young," to consider what they really mean – that the individual is energetic, healthy, lively, vital or engaged.
    Evidence of Harm
    Becca Levy, an associate professor of both epidemiology and psychology at the Yale School of Public Health, and colleagues are compiling evidence on the physical fallout of ageism. In study after study, they connect negative stereotypes of old age to worse health outcomes.
    On the flip side, subliminal exposure to positive age stereotypes can improve how older people function, according to research presented by Levy at the annual scientific meeting of the Gerontological Society of America in November.
    Her most recent published study is disturbing: Brain changes that are hallmarks of Alzheimer's disease were much more prevalent in older adults who decades earlier had expressed the most negative ideas of what it means to be old.
    The study, which appeared online Dec. 7 in Psychology and Aging, looked at 158 people in a long-term study who responded to a scale of attitudes toward old people. Later, they underwent yearly MRI brain scans, and for some who died, brain autopsies.
    Participants who held more negative age stereotypes had lost more volume in the hippocampus section of their brains. They also had more build-up of amyloid plaques and "tangles" around their brain cells. These signs are biomarkers of Alzheimer's disease. Holding positive age stereotypes appeared to have a protective effect on the brain, the study found…
    Be Kind to Your Future Self
    When it comes down to it, ageism just doesn't make sense. "Watch that language of saying 'they' and 'those,' and make it about 'us' and 'we,'" Gendron advises. "We're all aging, every day. It is about 'us.'"
    At any age, people can strive to change unhelpful attitudes. "The ideal would be to get rid of them; if we could have a society without ageism and without negative age stereotypes," Levy says. But until that happens, she says, question negative stereotypes as you encounter them in media, marketing and everyday life, and look for older role models to bolster a positive attitude and promote good health.
    "We've made [aging] into this scary, horrible thing," Gendron says. "We've made it into something that you dread, not something that you look forward to." Yet, she adds, "Data show people are happiest when they're in their 70s and 80s. Because we don't care what other people think."
    Fisher wants you to know she's about to turn 70. "'For God's sake, say your age – it's OK," she says. "You should be proud that you're 83. It's a 'you made it' kind of thing. Don't hide it."
    http://health.usnews.com/health-news/health-wellness/articles/2015-12-26/ageism-attitude-and-health

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  5. Aging’s Big PR Problem
    Published by Jeanette Leardi, ChangingAging Contributor on December 16, 2015
    …the concept of aging has had major PR problems of its own for a very long time. It’s gotten a horrible reputation as a process of inevitable and irrevocable decline. Widespread ignorance about the physiology of aging has led to culturally accepted negative stereotypes that not only are false but engender fear. And with increased talk about “silver tsunamis” and endangered entitlements such as Social Security and Medicare, it’s accurate to say that the PR problem is now slouching toward the level of PR crisis.
    There is nothing wrong with people getting older. The process is a natural part of life. Just as we don’t consider childhood, adolescence, and adulthood as lifespan aberrations that must be halted or corrected, neither should we feel the same way about elderhood. Each life stage has its problems and challenges, but it also has its benefits and rewards. That’s why it’s important to identify the huge PR predicament we face concerning aging. It is up to all of us to name the real social problem (ageism), tell the truth about it (it’s human-made and preventable), and work hard to solve it as soon as possible.
    All of us have a stake in handling this problem, but none more so than the professionals who work in aging services –– businesses, educational institutions, government departments, and nonprofit organizations whose mission is to serve the needs and aspirations of older adults.
    Ironically, many people in this field manage to contribute more to worsening the PR problem than to solving it. They do so unintentionally by continuing to define elders as a basically needy (in decline) population and emphasizing individual responsibility as the sole requirement for aging successfully. By not giving equal time and energy in the course of their work to raising awareness of older adults’ capacity to be economically and socially productive and of the social factors that limit this capacity, these professionals undercut their efforts to improve the lives of the people they serve.
    When it comes to aging’s PR problem, we need to adopt our own gold standard of crisis-management response. We should 1) immediately challenge ageist views and work to remove them from public discourse, 2) replace those views with tamper-resistant perspectives of aging that are based on science rather than on fear, 3) offer meaningful opportunities for elders to engage with their community in more comprehensive ways, and 4) educate all generations about the challenges and benefits of the aging process at every stage of life…
    http://changingaging.org/blog/agings-big-pr-problem/

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  6. The Six Assets of Aging
    By Jeanette Leardi, ChangingAging Contributor
    …The deterioration-decline meme originates in a narrow perception of the lifespan that is blind to the priceless assets we accrue as we add years to our lives. And this blindness stimulates the deep-seated societal fear known as ageism, which further limits that perception. Breaking this cycle of prejudice isn’t easy, but it’s possible, once we understand exactly what we gain because of, rather than despite, aging. Here are those great assets.
    1. Broader experience, sharper skills, and greater wisdom....longer we live, the more things we learn and experience. We add skills to our repertoire and get better at the ones we continue to apply. We also develop greater wisdom about the world as we are exposed to more people, places, things, and ideas –– provided that we recognize and integrate the lessons they teach us.
    2. Greater individuation. The longer we live, the more choices we make and directions we take, which in turn lead to other ones…we become more dissimilar than alike as members of a generation…add to the diversity of humankind and to what we can share with younger generations.
    3. Closer proximity to mortality. …our consciousness of mortality grows, …the advantage of savoring moments as the precious gifts they are.
    4. Different motives and life purpose. …The last stage (past age 65) is characterized by a person’s need and desire to reflect back on the life he or she has lived and to make sense of it. It’s a process equivalent to what is known as “spiritual eldering.”
    5. A different brain. …age-related changes that occur in the human brain…healthy human brain keeps growing new cells and new connections between existing cells throughout life. In addition, the bridge of tissue known as the corpus callosum, which connects the left and right hemispheres, doesn’t fully mature until a person reaches about 50 years old, and this helps explain why older adults are able to solve problems from a greater number of perspectives…crystallized intelligence grows with age and allows for better application of past experiences to help discriminate relevant from irrelevant information when problem-solving…
    6. Strength in numbers. …With our five other assets displaying themselves in a myriad of ways, we older adults can demonstrate clearly that what many people believe is a “silver tsunami” beginning to threaten society is actually a “silver reservoir” full of promise, purpose, and yes, assets, waiting to be tapped and shared with future generations.
    The next time you encounter someone pushing the deterioration-decline meme, feel free to explain any or all of these six great assets. Better yet, don’t wait until the occasion arises. Proudly embody them every day in your words and actions.
    In time, the people who rely on that meme will get very tired of using it.
    http://changingaging.org/blog/the-six-assets-of-aging/

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  7. Could Thinking Positively About Aging Be The Secret Of Health?
    May 28, 20167:27 AM ET
    INA JAFFE
    The dictionary defines ageism as the "tendency to regard older persons as debilitated, unworthy of attention, or unsuitable for employment." But research indicates that ageism may not just be ill-informed or hurtful. It may also be a matter of life and death.
    Not that it's literally killing people. Researcher Becca Levy, a professor of epidemiology and psychology at the Yale School of Public Health, says it depends on how much a given individual takes those negative ideas to heart.
    In one study, Levy looked at people's attitudes about aging when they were in late middle age and then followed them over time. Some of these people thought of older people as weak or dependent. Others thought of them as experienced or wise. What she found was that the people who had a positive view of aging lived about 7 and half years longer than the people who saw aging in a negative light.
    Now that doesn't mean that if you think positive thoughts about aging, it's OK to sit on the couch in front of the TV and eat a pound of bacon.
    But according to Levy's other studies, this mind/body connection counts for a lot. For example, one showed that middle-aged people who had no cognitive impairment but did have negative views of aging were more likely to later develop the brain changes associated with Alzheimer's disease. And the more negative their views, the worse those brain changes were. On the other hand, another study found that people with positive views of older adults were much more likely to recover from major health setbacks.
    A living, breathing example of how an older person can thrive if they're not weighed down by negative stereotypes is 95-year-old Jim Shute of Medford, Ore. (He's the father of SHOTS editor Nancy Shute, who's written about him here.)
    His typical day? Up at 6:30 or 7, go out to get The Wall Street Journal or the local paper, read the papers over breakfast, check his rose beds and the irrigation system in the garden, trim the bushes. He also likes to fish, plays bridge once a week, hikes nearly every day, refinishes furniture and hunts for morel mushrooms in season.
    Maybe it's not necessary to do all of those things, but having something that gives one's life a sense of purpose can pay amazing health dividends, according to researcher Patricia Boyle, a neuropsychologist and behavioral scientist at Rush Alzheimer's Disease Center in Chicago.
    Purpose, says Boyle, doesn't have to be something complicated and lofty, just something that's goal oriented and gives you a sense of accomplishment.
    "People who have the sense that their life is meaningful are much less likely to suffer early mortality, they're less like to develop disability, that is, trouble taking care of themselves," says Boyle.
    What's more, "they're less likely to suffer strokes. They're also substantially less likely to develop Alzheimer's disease, and they have much less cognitive decline."
    Boyle says having a purpose in life is a robust predictor of how well someone will live and thrive as they age.
    It's not something a doctor can prescribe as easily as a change in diet. But whether it's doctor's orders or society at large, attitudes do change. And Levy's and Boyles' research suggests that if people don't assume that they'll be useless when they're older, the payoff could be huge.
    http://www.npr.org/sections/health-shots/2016/05/28/479751942/could-thinking-positively-about-aging-be-the-secret-of-health

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  8. Jul 13, 2016 @ 04:00 PM
    Aging, Not Obamacare To Fuel Next Decade's Medical Spending
    Bruce Japsen, Contributor
    Health spending will rise nearly 6% for the next 10 years, but it won’t be due to expanded medical coverage under the Affordable Care Act.
    Rather, the 5.8% growth in health spending from 2015 to 2025 “is expected to be influenced by changes in economic growth, faster growth in medical prices and population aging,” according to the latest projections from the Centers for Medicare & Medicaid Services office of the actuary. Details are published in the journal Health Affairs released Wednesday afternoon.
    Projected health spending growth is ahead of growth of the gross domestic product by 1.3%, but medical costs are still rising much slower than they were before in the two-decade run-up to the so-called Great Recession.
    “Following the initial effects of the Affordable Care Act on healthcare spending and insurance coverage, increases in economic growth, faster growth in medical prices, and population aging are expected to be the primary drivers of national health spending and coverage trends over the next decade,” Sean Keehan, an economist in CMS’ office of the actuary, said in a statement accompanying the report.
    Health spending is slower than the growth of 7% or more before 2008. Spending growth has been tempered by increased cost-sharing, like higher co-payments and deductibles, that can get consumers to think twice about a more expensive procedure or brand drug if a generic exists. Health spending is also slower due in part to various changes in Medicare payment.
    The Obama administration is in the process of shifting Medicare payment away from costly fee-for-service medicine that can lead to unnecessary and wasteful spending on care. By 2018, half of Medicare dollars will be shifted to value-based models that tie doctor and hospital payments to performance and health outcomes and various value-based measures pushed by insurers.
    The nation’s giant insurers, including Aetna, Anthem, UnitedHealth Group and Blue Cross and Blue Shield plans are moving even faster than the government toward value-based payments.
    Medicare spending will be a key driver on total health costs in future years, CMS actuaries say. By 2025, 47% of health spending will be sponsored by federal, state or local governments, the report said.
    “ Medicare spending is projected to grow an average of 7.6% in 2020–25 —faster than the spending of other major payers,” Keehan, other CMS economists and actuaries wrote in the Health Affairs article. “This reflects the baby boomers’ continuing to age into the program. It also reflects existing Medicare beneficiaries increasing their use of hospital and physician services to rates that do not reach as high as the program’s long-term averages but that are above the program’s recent historical experience.”
    http://www.forbes.com/sites/brucejapsen/2016/07/13/aging-not-obamacare-to-fuel-next-decades-medical-spending/

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  9. Hearing loss can creep up on you steathily, with disturbing repercussions
    By Marlene Cimons
    August 14
    …An estimated 25 percent of Americans between ages 60 and 69 have some degree of hearing loss, according to the President’s Council of Advisors on Science and Technology. That percentage grows to more than 50 percent for those age 70 to 79, and to almost 80 percent of individuals older than 80. That’s about 30 million people, a number likely to increase as our population ages.
    Behind these statistics are disturbing repercussions such as social isolation and the inability to work, travel or be physically active.
    “It’s not just about the inability to communicate,” says James Battey Jr., director of the National Institute on Deafness and Other Communication Disorders. “It has a broader impact on individuals’ lives. It makes them uneasy participating in activities where hearing is important, such as any kind of social interaction — going to parties or going out to dinner in a restaurant where background noise might make it difficult to engage in a conversation. It also can be dangerous — for example, not being able to hear a warning siren.”
    Studies have shown that hearing loss is associated with depression and the early onset of dementia and that it can increase by threefold the risk of falling, “because you need your ears as well as your eyes and feet to maintain a sense of balance,” says Charlotte Yeh, chief medical officer for AARP Services…
    In June, the National Academies of Science, Engineering and Medicine released a report describing hearing loss as “a significant public health concern,” and recommended removing barriers that make it difficult for people to receive care.
    These barriers include the price of hearing aids, which can be very expensive and are not covered by Medicare or by many private health plans. The report also called on the Food and Drug Administration to remove the requirement that adults have a medical evaluation before buying a hearing aid, and to establish a new category of over-the-counter wearable hearing devices — separate from hearing aids — that could help people with mild to moderate impairment.
    Individuals generally pay a single charge for hearing aids and all associated fitting services, according to Lin, who served as a member of the National Academies panel.
    “The average cost of two hearing aids is about $4,700, which is absurd . . . [because] hearing aids, when purchased in bulk, cost about $400 for a pair,’’ Lin says.
    “There’s been an overwhelming tendency until just recently to view hearing loss as being an inevitable and hence relatively inconsequential part of aging,’’ Lin says. “This impression, as well as the lack of effective therapies for age-related hearing loss at that time, served as the rationale for excluding coverage from Medicare. . . . Both of these assumptions have now radically changed.’’
    …The Hearing Loss Association of America also has a website with guidance on how to obtain financial assistance for hearing aids. The assistance is mostly available for children and low-income adults.
    Fewer than a third of Americans older than 70 who could benefit from hearing aids have ever used them, according to Battey. In addition to the expense and the requirements for obtaining the devices, “it is also a stigma…
    https://www.washingtonpost.com/national/health-science/hearing-loss-can-creep-up-on-you-steathily-with-disturbing-repercussions/2016/08/12/9e415fe8-5cca-11e6-8e45-477372e89d78_story.html

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  10. FDA Decision Could Make Hearing Aids Available Over the Counter
    Adults no longer need a medical exam before purchase
    by Katherine Bouton, December 8, 2016
    Buying hearing aids could soon become as easy as buying reading glasses.
    In a surprise announcement this week, the Food and Drug Administration (FDA) announced that, effective immediately, it would no longer require adults to get a medical evaluation before buying most hearing aids.
    The FDA is also considering creating a category of over-the-counter hearing aids to encourage more “new, innovative, lower-cost products to millions of consumers,” the agency said in a prepared statement.
    The announcement was made at an open meeting of the National Academies of Sciences, Engineering and Medicine. Previous recommendations from this group, as well as from a White House advisory panel on science and technology, and some consumer and audiologist groups, had urged easing this restriction to make hearing aids more affordable and accessible.
    The decision does not apply to those ages 18 and under, who still must have a medical evaluation before purchasing hearing aids. It also does not apply to bone-conduction hearing aids or to prescription-use hearing aids that are inserted deep in the ear canal.
    Hearing loss affects some 30 million Americans, affecting not only their work and social interactions but also their overall health and quality of life. The isolation and loneliness that can result from serious hearing loss have been linked to a higher risk of cognitive decline and dementia.
    Despite the high prevalence and public health impact of hearing loss, only about one-fifth of people who could benefit from wearing a hearing aid actually use one, the FDA noted. The high price of the devices — about $4,600 a set — has been a major barrier. Medicare and many private insurance plans don’t cover the cost of hearing aids, so most consumers are stuck paying for them out of pocket.
    In addition, six companies manufacture nearly all the hearing aids sold, and only one is based in the U.S., a White House blog post about the FDA decision said.
    The impact of the FDA’s move could open the hearing aid market to new companies and more competition.
    “Today’s actions are an example of the FDA considering flexible approaches to regulation that encourage innovation in areas of rapid scientific progress,” said FDA Commissioner Robert Califf, M.D.
    http://www.aarp.org/health/conditions-treatments/info-2016/over-the-counter-hearing-aids-fda-decision-kb.html

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  11. As we age, many of us are faced with the prospect of revising our living arrangements. If you feel overwhelmed by home upkeep, cut off from transport and social amenities, or simply want more companionship with others your age, an independent living facility or retirement home may be a good option.
    Independent Living Units In Adelaide

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  12. Why You Can Look Forward to Being Happier in Old Age
    By JEFFREY KLUGER
    September 6, 2018
    …In some ways, our youth and middle years are really a sort of training period for the unanticipated pleasure of being an older adult, psychologist Alan D. Castel of the University of California, Los Angeles, argues in his new book, Better With Age: The Psychology of Successful Aging. In one 2006 study -Castel cites, a group of 30-year-olds and 70-year-olds were asked which of the two age cohorts was likely to be happier. Both of them chose the 30-year-olds. But when those groups were asked about their own subjective happiness, the 70-year-olds came out on top.
    Psychologists, anthropologists and other investigators have long been intrigued by similar findings—that old age is often a time defined not by sorrow, dread and regret but rather by peace, gratitude and fulfillment. Investigators looking into the happy senescence phenomenon attribute it to a lot of things: seniors become masters of “terror management theory” or “constructive distraction” or “voluntary affirmation of the obligatory.” In other words, they figure: I’m gonna die? What else is new? Meantime, I’ve got my grandkids here.
    Just as surprising as the happy oldster is the miserable middle-ager, Jonathan Rauch reports in his book The Happiness Curve, published in May. Life satisfaction appears to follow a U-shaped course, with its twin peaks in childhood, when the world is one great theme park, and in old age, when we’ve been on all the rides a thousand times and are perfectly content just to watch. It’s in the middle—our 40s and 50s, when our power, potential and productivity are the greatest and we should be feeling our happiest—that life satisfaction bottoms out.
    The U is true across nations, cultures and income levels, research shows…Your evaluative happiness (how your life would appear if measured in terms of wealth, achievements and a stable family) can be very different from your affective happiness (how you actually feel). A life that looks happy is not necessarily experienced as happy.
    In the later decades, this changes in a lot of ways. For one thing, that business of realizing that you may never achieve a long-desired goal can actually be a positive experience. After banging your head against the wall for 40 years to make partner or become department chair, the day you accept you’re free to quit trying comes as a relief.
    There is, similarly, what Rauch describes as an older person’s ability to normalize crises…
    Then, too, there is the business of wisdom. Evolutionarily, any species that hopes to stay alive has to manage its resources carefully...
    In another study cited in Better With Age, a group of successful CEOs of Fortune 500 companies—all 50 to 70 years old—scored lower on lab-based tests of reasoning and processing speed than younger people, yet all the CEOs nonetheless were running huge, stable and exceedingly profitable companies. Clearly, something more than the ability to crunch a lot of data was contributing to their success.
    Earlier in life, wisdom can seem out of reach. But for those who have attained it, Castel writes, “often wisdom allows people to see the obvious, or to use common sense without second-guessing themselves or the outcomes.”
    Yes, death is nonnegotiable—something that can only be delayed, never avoided. It’s a mercy, then, that when we do reach the end, so many of us arrive there smarter, calmer and even smiling.
    http://time.com/5363067/aging-happiness-old-age-psychology/

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