Dr. Bill Thomas

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February 15, 2009

ChangingAging.org Redesign -- Please Bookmark!

Attention Readers! We are launching a new design for the blog that will be hosted directly at the URL www.changingaging.org. Please navigate to www.changingaging.org and reset your bookmarks and sign up for our new RSS Feed. In the coming days we will set up an automatic redirect to the new hosting site. See you there!

Web Master

Posted by Kavan Peterson on February 15, 2009 8:00 PM |Permalink |Comments (0)

February 9, 2009

Monkhouse Monday

The "Grande Dame“ of Swiss Acting died in her 90th Year

Anne-Marie Blanc, the grand old lady among Swiss actors died last week, her last stage performance was only four years ago. In an interview she stated that in her 66 years of working (and being a national icon) she never perceived herself as young or old: "I am an actress, trying to get better at what I’m doing all the time“.

Posted by Dr. Bill Thomas on February 9, 2009 8:09 AM |Permalink |Comments (0)

February 6, 2009

Power Up Friday

Reporting from Mission Beach, San Diego:

Dateline February 4th, Walnut Creek CA: Residents of Rossmoor retirement village have voted to hire sharpshooters to kill a couple of dozen acorn woodpeckers, because they are disturbed by the hammering noises.

They apparently tried to shoo the birds in other ways, including playing recordings of birds being killed by predators (and this is LESS disturbing???).

The California Audubon Society has been looking for more humane solutions, such as building granaries and softwood posts with holes, but the neighborhood association has voted them down and hired the sharpshooter. The society says they can no longer work with them, and are "incredibly disappointed".

Just a reminder that the wisdom that comes with age is not a foregone conclusion. If this approach were applied to all environmental noise, we'd be killing snowplow drivers, construction workers and people with loud radios too!

Posted by Dr. Bill Thomas on February 6, 2009 10:51 AM |Permalink |Comments (0)

January 9, 2009

Power Up Friday

As promised, this week's book recommendation is "Glorious Adventure", by renowned nursing home reformer Carter Catlett Williams, (c. 2008, Pioneer Network, Rochester, NY, wwwDOTpioneernetworkDOTnet). Here are some of the opening lines:

"My father, Landon Carter Catlett, Jr., a second lieutenant in the U.S. Army Air Service, was killed in a plane crash in Hawaii in 1925 at age 27 when I, his only child, was barely 23 months old....

"I have no memory of my father. For me he was only the man in the pictures on my mother's bureau, a distant icon, not a flesh and blood person...I was aware that my mother had a box of his letters, and once, in my early forties, I looked at a few of them. They made me sad, so I put them back in the box and gave no thought of returning to them again....

"But then came old age, and with it unguarded moments of reflection on earlier parts of my life and, at intervals, surprising moments of awareness."

At age 63, after her mother's funeral, Carter returned to the box and found over 200 letters and postcards her father had written to his family, many concerning the joy of his infant daughter. Carter read, re-read and distilled his rediscovered life into this moving account.

We not only get a close look at an engaging and memorable personality of the early 20th century, but we get a glimpse of the times and a compelling story of life between the wars. The book is also filled with Carter's personal reflections, painted with the palette of over 80 years of wisdom and experience. A wonderful read!

There is also a moving Afterword, written by Wendy Lustbader, that laments the death of letter writing in our society. How much will be lost to future generations when one's expressions of joy are distilled to "LOL" on a text message?

Posted by Dr. Bill Thomas on January 9, 2009 10:08 AM |Permalink |Comments (0)

January 2, 2009

Power Up Friday #2

Recent research is stressing the importance of vitamin B12 to brain health. For a long time, we have considered a blood level of less than 200-250 to be borderline, and less than 150 to be deficient.

Recent studies, however, have shown that even with B12 levels in the “low normal” range, there is excess brain atrophy. Vitamin B12 plays an important role in the maintenance of fatty acids that promote healthy neurons and their supportive myelin sheaths.

A UK study, (http://www.vitasearchcom/CP/experts/AVoldiatzoglouAT10-12-08.pdf), of 107 healthy older volunteers, free of cognitive impairment, had their brains scanned repeatedly over a five-year period, as well as yearly physical exams and memory tests. They found excess brain shrinkage, (which has been correlated with cognitive loss), in those who had B12 levels in the lower end of the “normal” range.

While this doesn’t prove cause and effect, it suggests that our acceptable levels of B12 may need to be revised. The authors suggest that we use 300 as our lower limit of normal, and also follow other blood tests, (MMA and homocysteine levels), that are more sensitive to early B12 deficiency states.

B12 is plentiful in meat, fish, dairy products and fortified cereals. Older people with decreased absorption may need supplements, as may some vegans. Certain medications, such as seizure drugs and anti-acid pills, can interfere with B12 absorption as well.

Posted by Dr. Bill Thomas on January 2, 2009 10:09 AM |Permalink |Comments (2)

Power Up Friday

I’m catching up on my end-of-year reading, and have a couple of books to recommend. This week, it’s Malcolm Gladwell’s latest tome, “Outliers: The Story of Success”. This book examines those individuals who do better, (or worse), than most and the factors involved. Surprisingly, he finds that success is only partly a function of determination and innate talent. Other factors play a major role, such as timing, serendipitous connections and culture.

The book explores a variety of topics, such as why all the best young Canadian hockey stars are born early in the year, how Korea turned its dismal airline safety record around by de-emphasizing culture, and why rice paddies have helped Asian students, with no greater IQ or innate ability, to outshine us at math. Interesting and thought-provoking stuff.

Apropos to this blog, Gladwell tells the fascinating story of Italian immigrants from Foggia who settled the small Pennsylvania mining town of Roseto. In the 1950s, with heart disease running rampant, it was discovered that these immigrants weren’t dying as early as everyone else in the nation. A local physician found few residents under 65 with heart disease, which was unheard of at the time. (There was also little crime, no suicide, no ulcer disease; most of them simply were “dying of old age”.)

The famous “Mediterranean diet” didn’t seem to be a factor – most of them had adopted a diet high in saturated fats and were obese. They also smoked, drank and worked in the nearby slate quarries. Immigrants from other cultures who settled the neighboring towns had the usual diseases, as did their Foggian countrymen who settled elsewhere in America. Therefore, genes and the local water supply were not the answer.

What the investigation found was that the key to their robust health lay in the community they had formed. They had multiple generations in one household and their village had a very close, collaborative social structure which had been transplanted in order to help them deal with the pressures of living in a foreign society. This community kept them alive.

Such a discovery flies in the face of the traditional “heart healthy” advice, which puts the onus on an individual’s choices-- diet, exercise, etc. Apparently the larger organism of the community must be healthy as well -- that may be even more important than the individual choices we make!

Next week, I’ll tell you about Carter Williams’ fascinating journey through time.

Posted by Dr. Bill Thomas on January 2, 2009 10:05 AM |Permalink |Comments (1)

December 17, 2008

Blanchard WinsDays

Snow Angels – The Neighborly Thing to Do.

A White Christmas loses its romantic appeal when the base layer begins accumulation in mid-December. Just a couple inches of snow can be a mountain of difficulty for the person with mobility challenges. Adding to the challenge of getting out of the driveway, most cities have requirements that snow be removed from sidewalks within a 24 hour period.

So what is the aging in community solution to helping snowbound frail neighbors? A neighbors helping neighbors snow removal program. Snow removal for older adults or others facing health challenges can be a block by block grassroots effort or a more formalized citywide program such as the Boulder, Colorado Icebusters or Hamilton, Ontario Snow Angels which pairs up community volunteers with seniors and persons with disabilities for a winter season.

In Denver, Colorado the Aging in Community Network is pairing up with the Colorado Neighborhood Resource Center and other community partners to design a community based snow removal program for frail elders and persons with disabilities with the outcome being a “how to” manual for other communities to replicate the project, from liability waivers to volunteer recruitment strategies.

How do frail elders in your community cope with snow removal?
Cheers – Janice Blanchard

Posted by Dr. Bill Thomas on December 17, 2008 7:13 AM |Permalink |Comments (0)

December 16, 2008

Ben's Adventure

My name is Ben Cornthwaite. I am a Licensed Nursing Home Administrator at a CCRC in Northern Virginia where I am responsible for the day-to-day operations of a 180-person nursing home and a 104-person Assisted Living facility. Throughout my four years here, I have learned and observed many things that we do extraordinarily well as well as things that require significant change. I continue to seek feedback from residents, families and staff in many areas in an effort to continue to make our home a better place to live and work. My latest attempt to better understand the key issues involved moving into the building that I manage for 7 consecutive days (and nights)!

My life as a resident began with a new name, Happy Sunshine. I simulated an experience similar to the profile of many everyday residents which included the following:
· Surgically repaired fractured hip (requiring the use of a wheelchair)
· Bladder incontinence (requiring the use of an adult brief)
· Visual impairment—courtesy of my Creator
· Total assistance from staff to perform all Activities of Daily Living
· 7 medications (M&M’s J)

My experience included eating all meals in the dining room, taking showers in the neighborhood bathing spas, participating in resident activities, participating in physical and occupational therapy, signing the new resident contract, dependence on staff members to respond to my call light, medical monitoring of my vital signs and weight, and consultation from the doctor, dietician, nurse, therapists, social worker and activities staff. Clearly the staff knows me, so my experience was most likely different than the average experience. However, I now can say that I have a new perspective on what it means to be a resident of my community. Additionally, I found new meaning in just what it takes for the staff to produce the exceptional outcomes that we expect of them each and every day.

Overall, my experience was very revealing—by in large very positive. I encountered many wonderful people doing many wonderful things. Additionally, I found some experiences to be frustrating and difficult. Although there are many actionable items of changes that I will make as a direct result of my greater understanding, there is one profound issue that I encountered that has brought new importance to my day-to-day management. The most revealing experience for me was not my own disability, rather, the disability that we create in our own design. Specifically, the disability that residents in wheelchairs face is profound and utterly unacceptable in creating and maintaining home. The following are plans to address this very important issue:

Our community’s Executive Team has agreed to spend one day in a wheelchair on campus to encounter accessibility obstacles throughout a normal day. It is my hope that this experience will provide all the information necessary for the interdisciplinary team to agree to urgently and strategically implement changes on our campus.
I will pitch to our Executive Director that our campus shuttle schedule should be delayed 10 additional minutes to allow for adequate time to pick up residents in wheelchairs. Currently, our shuttles do not pick up residents utilizing wheelchairs—despite being equipped with wheelchair lifts.

Resident bathroom doors will be equipped with dual-swing hinges to allow the door to swing freely in both directions—this will allow residents in wheelchairs the independence required to utilize the bathroom without staff assistance
Resident bathrooms in long-term care have been evaluated by an architect to shorten one of the walls which will allow for a wider doorway—this will grant residents greater ability to get in and out of the bathroom independently. In fact, we are evaluating removing the door all together and providing a curtain for privacy since these are all private rooms.

Standard room furniture will be evaluated and positioned in a more wheelchair-friendly design allowing residents full access to the useable square-footage in their room. We will also encourage residents to bring in their own furniture that may be more suitable to their needs. Our company’s designer has worked with me on creating this design.

Every wheelchair that is issued will come equipped with a pressure-relieving cushion as standard—wheelchair seats without cushions are cruel and unusual punishment!
I have challenged my Administrator peers at 10 other campuses to also commit to living at least one week in their own facility, thus igniting operational change
I have challenged key corporate leaders within the organization to also gain a first-hand experience at one of our campuses, thus igniting company changes
I have challenged my Administrator and professional peers across the country to commit to living at least one week in their own facility, thus igniting culture change

I have come to realize that the heart of the problems that I faced was mostly due to ageist and declinist thought. To me, it is rather simple to address the cosmetic features that promote significant obstacles to our residents in wheelchairs; however, it is now apparent to me that the real issue at hand is changing a profession’s mindset. We need to consider resident growth and ability in our design and operation—not the inverse of decline and disability. I will do my job different each day as a result of my learned experience—I carry my resident ID band with me each day as a reminder for what I must not forget. Specifically, I will do my part to empower my team and others around me to also confront ageism and declinist thought each and every day.

Throughout my experience, I saw, felt, and heard great satisfaction in the care that is being delivered, despite the frustrations that I also experienced. As the Administrator, I can only imagine that this lesson will allow me to continue to be a better leader for the place we call home. I believe that everyone deserves a little Sunshine.

More here...

Posted by Dr. Bill Thomas on December 16, 2008 3:06 PM |Permalink |Comments (1)

December 15, 2008

Japan: Robot Nation

Japan, the world's second largest economy, is facing a demographic crisis that will shrink the population dramatically. The Japanese aren't having babies, and the country won't accept immigrants to help bolster the population. But Japan may have a unique solution --- Robots!

Video after the jump. You have to see it to believe it. I have two words for the Japanese: Good luck.

-- Kavan Peterson

Posted by Kavan Peterson on December 15, 2008 4:22 PM |Permalink |Comments (0)

December 12, 2008

Meld, Merge, Mosaic

The Aging 600 students wrecked house at the Erickson School over the weekend.

Here are some photos of their attempt to map the concepts that make up the course.

Useful creative thinking is founded on making speculative leaps between novel concepts.

Here are some shots of the whiteboard where the class was making connections.

More fun here...

Truly Bizzaro...

Posted by Dr. Bill Thomas on December 12, 2008 3:09 PM |Permalink |Comments (1)

Bizarro

Based on the comic strip character of the same name, Bizarro was the antithesis of “Superman,” famous super hero of the 1950’s. Created by Otto Binder and artist George Papp, the concept of “Bizarro” means using opposite and twisted logic to explore new ideas, gain new perspectives of commonly held beliefs and assumptions. Taking any concept, turning it upside down, backwards and inside out, the mind begins to create new ideas that run counter to the original thought. One begins to view something in a different way.

“Bizarro thinking” is a tool introduced and used in AGING 600 to help students reframe their conformist, traditional thinking and widely held beliefs surrounding aging.

A recent example of looking at aging from a Bizarro perspective can be seen in this Kaiser Permanente commercial:

Posted by Dr. Bill Thomas on December 12, 2008 12:09 PM |Permalink |Comments (2)

Watson and Spock

HEADLINE: A Blended Approach to Caregiving: based on a developmental approach towards elders and those who work with elders

In our Aging 600 course we explored the views of famous childrearing doctors, John B. Watson and Benjamin M. Spock and paralleled how we treat our elders today. We discovered through our discussions that finding a balance in these approaches was both necessary and essential to ensuring that elders can continue to prosper and thrive in their environment while feeling secure in taking risks.

Watson Views
• Rigid scheduling (eat, bathe, go to bed; formulas;)
• Not touchy feely
• Emotion between child and parent is unhealthy: let them cry – not expressive; not touchy feely
• Behaviorist
• Predict and control actions
• Reduce thinking; just action
• Conditioned responses (fear, rage, love – Albert)
• Behaviorism is the study of what people do
• Stimulus is a response and that is what causes relationship
• Conditioning is learning to react to the environment
• Anti-kiss, anti-touch
• Parents are incompetent

Spock
• Pro-touch
• Pro-affection
• Children prosper by mind-body connection
• Pay less attention to experts; trust your instincts
• Rebelled against his harsh, rigid parents
• Father of permissiveness

Best of both worlds:
• With regard to organizations, which behaviors in which situations are beneficial
• How can you find the best seat on the bus for each type
• Good Behavior would foster consistent values for the organization and the customer and all other stakeholders
• Watson model is efficient – needed to run an organization
• Behaviors should nurture growth without excess risk
• Watson systematic approach allows us to create a roadmap and framework for putting in place our instinctual values
• Trusting our instincts allow us to enhance quality of life through relationship building via touch, talk, smell, ya da ya da ya

Posted by Dr. Bill Thomas on December 12, 2008 12:08 PM |Permalink |Comments (1)

Parens Patriae and Surplus Safety

Once upon a time.in a deep, dark suburb, there was a home for
Elders
called the Earhart Green House. Living among the Elders was a
woman named
Amelia, who was 100 years old, had lived at Earhart for many
years, and
had been a riveter in an airplane factory during WWI. Amelia had
long
dreamed of taking to the air. Then one day, while cruising the
web, she
came upon a YouTube video clip of a younger woman who had sky
dived for
charity. Amelia know is her heart that this was her destiny
before earning
her ultimate wings. Being under the care of the state, she
e-mailed her
Guardian, Ms. Helen No, asking her about the possibility of
skydiving.
Here is how the conversation went:

" You can't be serious - do I need to refer to Dr. Rashid for
neuron psych
referral? I am concerned about your safety, plus how would we
pay this?"
Amelia responds saying, " I feel that I can make this decision
and would
like your support. Also, I have asked John, our Activity
Director, about
this. John told me that his sister, Jess Jecan, who owns a sky
diving
school in the area, and she said she has been looking for an
opportunity
to demonstrate how safe the sport is by offering a free class in
diving to
an Elder. Plus, we could use it as a fundraiser to close the gap
in our
budget due to the recent market collapse."

So, it came to pass that Amelia took to the air with Jess, where
they flew
the friendly skies and had a safe landing. Helen, for her part,
came to
see that Amelia and Elder like her, want to grow and experience
life and
that even with the known limitation imposed by the state (Parens
Patrea),
that creative solutions are possible.

See Amelia's inspiration.

Posted by Dr. Bill Thomas on December 12, 2008 12:06 PM |Permalink |Comments (2)

The Art and Artifacts of Change

Our world is shifting from one that idolizes adulthood towards one that understands and embraces elderhood. We don’t have a choice because our society is aging more rapidly than ever before. Surely we could take the comfortable road to superficial change. Artifacts are only as good the values and norms they represent (like a mission statement collecting dust or wallpaper that doesn’t change behavior or the pets that come to visit once a week). These represent concrete, visual artifacts that are not guided by values and norms. But we have other ideas for change…

Example: The Ericksonville Community Intentional Library decided it wanted to be more user-friendly for their community elders.

Values (Language)
All staff, volunteers and community members participated in a discussion about what they wanted their library to be. The result was new mission and values statements that reflected their well intentions.

Norms (Behaviors)
The library staff created policies and procedure for the employees, a customer service credo and code of conduct for users.

Artifacts (Symbols)
To put their words and behaviors into action, they renovated – added ramps, improved lighting, lowered the shelves and widened the aisles. They also purchased touch screen computers, large print books and books on tape. They also created a community room for book clubs, discussions and such with universally friendly furniture .

Posted by Dr. Bill Thomas on December 12, 2008 12:04 PM |Permalink |Comments (0)

SNOW STORM SPECIAL

I was scheduled to be teaching a Masters' class at UMBC's Erickson School this afternoon.

Mother Nature, however, had different ideas. I am snowed in in Ithaca and I will be conducting the class via

iChat and the ChangingAging Blog.

We are going to be integrating the topics that have been covered in Aging 600.

I think it will be fun. Get ready for a whole slew of posts on a wide range of topics and take some time to read the comments.

For readers who have been considering joining the Erickson School's Masters Program, this event just might be the thing to persuade you that we really are educating the next generation of leaders in the wide open field of aging services.

The fireworks starts at 3:00 pm eastern time.

Dr. Bill Thomas

Posted by Dr. Bill Thomas on December 12, 2008 11:14 AM |Permalink |Comments (0)

December 11, 2008

Scam Alert

I googled "Lift SP" and found that plenty of people are aware that this is a scam.

In addition to the cream being worthless, the company uses customer orders to place multiple credit card charges...

The Rip Off Report has plenty of complaints about them.

This company is a big scam. They are stealing from credit card and bank accounts. They also do not ship product. I am a senior and don't have much money after paying my rent. I have already lost my home and car in a flood and recuperating from hip surgery so this is really devastating to me. I hope filing this report will help prosecute and put this company out of business.
Anonymous
North Mankato, Minnesota
U.S.A.

Posted by Dr. Bill Thomas on December 11, 2008 1:41 PM |Permalink |Comments (1)

December 9, 2008

Monkhouse Tuesday: Oma – one more time

A few blogs ago I wrote about my mother, Oma, the MIP (most important person. Oma is a “title” my mother wears with great pride). I got quite a few comments from people who have had the same experiences and I also received some personal e-mails. Thank you readers, for posting your comments on a matter so close to our hearts.

Reading previous posts by Bill Thomas I noticed that the current US President Elect called his grandmother “Toots”, my husband (from Canada) used to call his grandmother “Nanu” (a two year old grandchild’s version of Grandma). Readers are invited to contribute their real life version of “Grandma” (and of course Grandpa) to our little vocabulary, as a starting point of countering elderspeak.

-- Christa Monkhouse

Posted by Kavan Peterson on December 9, 2008 10:19 AM |Permalink |Comments (0)

Monkhouse Tuesday: Oma – one more time

-- Christa Monkhouse

Posted by Kavan Peterson on December 9, 2008 10:19 AM |Permalink |Comments (0)

December 5, 2008

Power Up Friday

Thanks to my tai chi instructor, Lisa O'Shea, (lisachiATqigongrochesterDOTcom), for passing this one on:

Insomnia is an increasing problem in our society among people of all ages. Because of age-related changes in sleep, many older people complain of insomnia. And many of them, unfortunately, are prescribed sleeping pills that may do more harm than good.

There are many non-drug approaches to insomnia. First and foremost is to educate people about the normal changes in sleep patterns and needs that occur with age. Second is to educate people in the various aspects of good "sleep hygiene". Is there anything that works better than that?

Apparently, tai chi does. UCLA's David Geffen School of Medicine published a study,
which looked at the effects of tai chi on sleep in older adults.

Over 100 community-dwelling adults with moderate sleep complaints, ranging from age 59 to 86, were randomized into two groups. One group was given extensive instruction on good sleep hygiene and the other was enrolled in a tai chi program - 40 minutes of tai chi instruction or health education, three times a week, for 16 weeks. Standardized sleep assessments were done at the beginning, and 9 weeks after the programs ended.

Guess who did better? The tai chi group had a 63% rate of significant responders, compared with 32% in the education group. There was improvement in several sleep subsets and no increase in use of sleeping pills. The results are comparable to other behavioral therapies.

It is theorized that both the meditative, breath-focused nature of the activity and the aerobic component contribute to the benefit. Chinese medicine would suggest additional mechanisms, regarding balance of yin/yang, organ vitality and chi flow. Either way, it works!

Posted by Dr. Bill Thomas on December 5, 2008 5:49 AM |Permalink |Comments (0)

December 2, 2008

The Rubber Hand Illusion

I am deeply opposed to the "declinist" vision of aging because it damages both our society's vision of elders and the way older people view themselves. Dr. Judah Ronch recently forwarded to me a fascinating published study that shows how the use of declinist language to describe age and aging fosters direct, measurable and highly negative changes among young people who use such terms.

Why should mere words matter so much?

The tendency of the human brain to carry out self-fulfilling prophecies is much more powerful than is commonly supposed.

The "Rubber Hand Illusion" illustrates the power of suggestion at work with ordinary people...

Beware of expectations for they can easily become realities.

Posted by Dr. Bill Thomas on December 2, 2008 5:07 AM |Permalink |Comments (1)

December 1, 2008

Monkhouse Monday

Eat your way out of Alzheimers

In yesterday’s Sunday paper there was a report from the annual conference of the Society for Neuroscience (sfn.org). New discoveries say that amyloid-beta-proteins "float“ freely and block“ neural synapses, the good news is that the well-known "plaques“ are actually good, because they "soak“ up some of these proteins.

The even better news is that in absence of a vaccination or medication one can drink red wine, eat oily fish and lots of curries, exercise, rest and avoid stress to escape Alzheimers.
While reading this an old saying came to my mind, a recommendation for a long and healthy life:
Feel hungry once a day (..and then eat oily fish with curry and drink red wine)
Be out of breath once a day (..from some exercise you like to do)
Laugh once a day (...when relaxing with friends)
That’s it for today, I am off to talk to our wine-merchant and the guy from the Indian curry shop. I am off on foot, of course.

Christa Monkhouse

Posted by Dr. Bill Thomas on December 1, 2008 7:37 AM |Permalink |Comments (0)

November 28, 2008

Blanchard WinsDays

Making New Thanksgiving Traditions

As one of seven children, Thanksgiving brings back wonderful memories of childhood, crowded around the table with siblings, family and friends enjoying an overflowing table of goodies. I love the Holidays, but being 2000 miles away from the nearest relative makes it somewhat a less than boisterous meal with my comparatively small family of two children and my husband. Usually, we pair up with other families that are in similar situations to create our own extended family of sorts. That was the plan for this year, but unfortunately the host at the last minute had to cancel leaving us scrambling for other plans.

This past week, I have been doing interviews with members at our Unitarian Universalist Congregation. I am shocked by how many have been members for 30 or more years, once very involved in volunteer and social activities, that no longer participate as much and feel as a consequence they are now growing “invisible.” When asked, several shyly told me that they had no Thanksgiving plans – children had moved away, friends have passed on and there isn’t really a meaningful place or people to spend the day with…. Or is there?

This year, we will spend the early afternoon delivering lunches to homebound elders and others, and the early evening we will enjoy Thanksgiving Dinner in community with about 40 other members of our Church family, several some of my new elder friends. We plan to bring board games and stay late, creating a new tradition that feeds the belly and the soul. How do you celebrate Thanksgiving?

Happy Thanksgiving! Janice Blanchard

Posted by Dr. Bill Thomas on November 28, 2008 8:17 AM |Permalink |Comments (0)

Power Up Friday

Congrats to Fran Markover, Ithaca College Class of 1971, for her first place poem in the college's first arts and literary contest.
Here it is:

The Grandmas
In Gabon, when the grandmothers speak, the president listens...
- Bernadette Rebienot, grandmother of 23

In the Black Hills, on the back page of the Nation
The International Council of 13 indigenous Grandmothers
gathers from each direction of grief --
rainforest, African desert, the Arctic, Great Plains
Their shawls are battle-scarred with red, black and blue
Scarves warm arthritic knees
The grandmas don't speak of soup, of quilts
They are not tourists in Hot Springs
They hold hands, lift them in homage to the pines
The women are quiet spokes, their time

a circle, the fire, burn and ash of past gatherings
like the one at the great hall of Mica, its
UN-votes, treaties undone, urban tricksters
The women inflame the air with sage
Grandma Aggie prays for the home-comings of the condor
Debra White-Plume imagines more children for her tribe
Sisters Rita and Beatrice Long Visitor Holy Dance
invoke an end to Star Wars, 3rd grade gangs, bedroom rape
Chant of babies from un-united states of Fallujah, Kabul,
Phoenix, Katmandu. The grandmothers share

words their elders didn't -- suicide, diabetes, radioactive
Seek Windows and webs that suspend age, that
mid-wife old ladies into shamans, laps into lap-tops
One grandma teaching another about how mushrooms absorb
petroleum spills, how dollars green into trees, roots
de-tox crystal meth. The women hold hands pearled
with sweat. Remember in their bones, in soft-
wear of skin, how seeds and herbs heal wrinkles
of GrandMother's belly. How once they held the final word
'war' 'peace' in each fist

Posted by Dr. Bill Thomas on November 28, 2008 8:07 AM |Permalink |Comments (0)

November 19, 2008

Time Lapse Aging

Watch the aging process...

Posted by Dr. Bill Thomas on November 19, 2008 6:25 AM |Permalink |Comments (0)

November 17, 2008

Monkhouse Mondays: Europe's Last Witch Hunt

Anna Goeldi, Switzerland – The last witch executed in Europe – rehabilitated

Two-hundred and twenty-five years after the execution of Anna Goeldi, a maid in the then upper classes of a small town in central Switzerland, she was officially rehabilitated by the local government in June 2008. This move is significant and has attracted attention from the whole world. Anna Goeldis case is special, she was not „old and wise“ (one of the definitions for witches in the middle ages) but beautiful and attractive, clever and headstrong, she had affairs with local politicians, the doctor, the mayor, adultery was a crime and they would have lost their jobs, so they tried to get rid of her, she was tortured and beheaded.

This happened in a protestant area (witch-hunting was the craft of the Catholics, the Vatican has not apologised until today), years after the Europe-wide witchhunt was over. After much campaigning and political turmoil, Anna Goeldi was rehabilitated in 2008 (!) as a victim of judicial murder.

Watch a short video here (before the rehabilitiation):

and a newspaper story here.

I leave it to the (female) readers to judge what this story has to do with present times and our own, contemporary lives.

-- Christa Monkhouse

Posted by Kavan Peterson on November 17, 2008 8:32 AM |Permalink |Comments (0)

November 14, 2008

Power-Up Friday: A Staggering Question of Health Care Ethics

In the latest issue of Health Affairs, medical technology is highlighted and many questions are raised. A study from Stanford reports that even though the use and cost of MRI and CT scans have increased dramatically since 1995, there is little evidence to suggest that there has been an impact on overall health care or mortality outcomes.

The explosion of medical imaging technology since my medical school days is absolutely staggering. Nevertheless, our infatuation with the latest and greatest machines sometimes keeps us from critically examining just how useful they are in the larger scheme of things. With increasingly tough economic questions being asked, these types of studies will put our health care practices under greater scrutiny in the days to come.

Nowhere is this more important than in the care of older adults. Changing medical conditions and life expectancy put even further constraints on the usefulness of diagnostic testing, as comfort and quality of life concerns begin to overshadow the ability to cure disease. A recent task force on colon cancer screening, for example, has recommended it not be done routinely in people over 75, and similar guidelines for prostate cancer suggest that people with a life expectancy of fewer than ten years not be screened.

The point is that we need to look at each individual in terms of their own situation, their prognosis and life goals, before blindly walking through the available diagnosis and treatment options. This requires practitioners to know their patients well and to initiate values-based discussions with each person before deciding how to proceed. These conversations alone may serve to cut the cost of health care dramatically.

Here's a great quote from A. L. Caplan (speaking about nursing homes), which is even more true 18 years after it was written:

"...ethics concerns not only questions of life and death but how one ought to live with and interact with others on a daily basis. The ethics of the ordinary is just as much a part of health care ethics as the ethics of the extraordinary. For the resident, the small decisions of daily life set the boundaries of his or her moral universe."

-- Al Power

Posted by Kavan Peterson on November 14, 2008 7:03 AM |Permalink |Comments (1)

November 10, 2008

Monkhouse Monday; LIfe - a Stepladder?

Life – a Stepladder?

This is a translated text written by Alice Liber (83) Switzerland, founder of the „New Panther Club“ in Zürich and a strong supporter of the Eden-Alternative®. This is her reflection on ageing:

„As I was trying to sort through my papers I found a picture of my grandmother with her stepladder. Three steps up, a small platform on top, three steps down. Birth on one side, death on the other side, the stepladder was a symbol for life how it was perceived until the beginning of the last century, one had two lives, childhood/youth, grown up. Because, after school, one worked until one died.

In Switzerland in 1948 old age pension was introduced and since then we have had three ages. The European Union now talks about the fourth and fifth age and we are back on the stepladder, seven steps.
But in Switzerland gerontologists still talk about three ages. 50+ and you are old and need care. Some researchers even talk about 45+ where you start to need advice and care. I have no understanding for this.

Many people I know are 60, 70, 80 and over, full of life, even their faces are smooth, they look like 40 or 50. I read that in the US this age is much kinder called „extended middle age“, a decidedly friendlier notion. In Switzerland, you remain 50+. Never before so many studies about aging have been conducted, the stepladder turns into a ladder, up up up until you are 50+, after that, you fall down, open ended falling.

And here is where the notion of care comes in. People ask you strange questions: What is your former occupation? How do you spend your spare time? Why do you still want to learn things? At your age it does not lead to anything, where do you experience unnecessary limitations and challenges in your life?

Such questions are confusing and demeaning for an old person. My former occupation? Why former? It is still part of me, my experience never goes away. I am never bored, so why do I have to fill my "spare“ time? And my curiosity to learn, to learn everyday, will never leave me, a year ago I just got acquainted with the internet.

Sometimes I wonder if other normal people who work with us and for us see us the same way?

Alice Liber (83) alice.liberATgmx.ch
(Translation from German Christa Monkhouse)

Posted by Dr. Bill Thomas on November 10, 2008 5:30 AM |Permalink |Comments (0)

October 28, 2008

Baby Boomers Beware

Attention Baby Boomers! Your children are growing up, and they want their future back:

The movement begins here.

Hat-tip to Andrew Sullivan.

Posted by Kavan Peterson on October 28, 2008 9:57 PM |Permalink |Comments (5)

October 26, 2008

Power up Friday from Sedona

This week I'm attending a medical conference in Sedona, Arizona,
and hiking the beautiful Red Rock country. But I'll take a
moment to comment on the film they showed during the flight out
west. "Diminished Capacity" stars Matthew Broderick as a Chicago
journalist suffering from a post-concussion syndrome, who takes
time off to visit his mother, and winds up in an adventure with
his Uncle Rollie, (Alan Alda), who has Alzheimer's disease.

It sounded like a nice premise to contrast the cognitive issues
both men are facing. However, this is little more than backdrop
for what becomes a comic caper to sell a valuable baseball card
(to keep Uncle Rollie out of the dreaded "Assisted Living"!),
and a romance with the lovely Virginia Madsen.

I didn't expect much more from Hollywood, but one thing bugged
me. Alan Alda's acting was good enough, but they insisted on
portraying him as very eccentric, and left him very unkempt,
with a scraggly beard and hair that never got washed or combed.
Is this our view of Alzheimer's disease? Sounds like we have a
little work to do!

Next time, a review of John Barth's new treatise on what it
means to age in a gated American community...

Al Power

Posted by Dr. Bill Thomas on October 26, 2008 5:00 PM |Permalink |Comments (1)

October 24, 2008

Power up Sedona

Al Power is doing medical education in Sedona, more to come.

Posted by Dr. Bill Thomas on October 24, 2008 9:00 AM |Permalink |Comments (0)

October 20, 2008

Monkhouse Mondays: Cloud 9 (Wolke 9)

“I was tired of the airbrushed, unreal sex scenes in movies, I wanted to tell the timeless story of love, attraction and lovemaking, which takes hold of our body, mind and spirit," said the director of the new German movie Cloud 9, Andreas Dresen, which won the Jury “Coup de Coeur” price at the Cannes film festival this year. And so he does. His protagonists however are Inge (67) and Karl (76). Inge, a seamstress, has been married to Werner for over 30 years, they love and respect each other, look after the grandchildren and their sex life is still happening. Inge meets Karl, when he comes as a customer to have his trousers shortened, she senses that he likes her and also finds him attractive. She decides to deliver the finished trousers to his house, and there she stays, they make love. Both are surprised that this is happening to them at their age.

The director: “We don’t know much about old age, we think old people go for cruises and bus rides and besides that are a burden to our pension-system. We do not realise that there is life, courage to do new things, passion, feelings and attraction which know no age, this is what I wanted to show, real bodies, real people, not some sepia-coloured scenes with trickling piano music."

Inge after much tormented deliberation, tells her husband and finally decides to leave him for Karl.

There is nothing voyeuristic in this film, which moves forward slowly, like a stage-play, no soundtrack, sparse dialogue, the camera focussed on faces to capture every expression of emotion and every little gesture indicating tremendous tenderness. When they lay in bed, talk or laugh, Karl is stroking Inge’s hand with this thumb. Inge and Karl realise that life is precious at any age, but especially at theirs, and their lovemaking is an expression of this.

Watch the trailer here.

-- Christa Monkhouse

Posted by Kavan Peterson on October 20, 2008 9:59 AM |Permalink |Comments (6)

September 24, 2008

Blanchard Wins Days: Aging In Community

[Editors Note -- This is a guest post from new Changing Aging blogger Janice Blanchard. Janice is a gerontologist and nationally recognized writer, speaker and thought leader on aging issues and we're honored to have her join the Changing Aging family. Her posts will run Wednesdays, or Blanchard Wins Days.]

Most older Americans would prefer to “age in place” – to live in their current homes with supportive services if necessary as an alternative to institutional long-term care. Indeed, people go to extraordinary measures to accomplish this goal. While many consider aging in place suitable, others find it a hollow victory, particularly when it occurs in a home that poses physical, financial or emotional challenges and makes meaningful connection with family, friends, neighbors and the community difficult or impossible. For this and other reasons, an increasing number of people now envision a third way—“aging in community.”

In short, “aging in community” presents a proactive, grassroots model that intentionally creates supportive neighborhoods to enhance well-being and quality of life at home and as an integral part of the community for people of all ages and abilities, particularly elders. Aging in community promotes a deliberate consciousness to be “a darn good neighbor.” Relationships between community members are informal, voluntary and reciprocal, and therefore, sustainable over time. Aging in community promotes social capital - a sense of social trust and interdependence enhanced over time through positive interactions and collaboration in shared interests and pursuits. Elders’ wisdom and experience are recognized and honored and opportunities are promoted to share this with others in the community.

A great example of an aging in community neighborhood, is Generations of Hope in Rantoul, Illinois. The visionary founder, Brenda Krause Eheart, recently won the 2008 Heinz Award for her success in building a “community-based model for adoptive families and senior citizens.” Yesterday, the New York Times featured

an article and slide show of this innovative program.

In the Wins Days to come, I look forward to sharing more about other emerging models of aging in community.

-- Janice Blanchard, MSPH

Based in a shuttered Air Force base in Rantoul, Ill., Generations of Hope matches elderly people to serve as surrogate grandparents for children in foster care. For Irene Bohn, 84, a retired schoolteacher, the role of beloved grandmother to Angelo Laws, 9, and his three siblings, has been the happiest and most important of her life.(Photo: Sally Ryan for The New York Times)

Posted by Kavan Peterson on September 24, 2008 10:41 AM |Permalink |Comments (3)

September 22, 2008

Monkhouse Mondays: 2025 and the care gap

Ingrid, a journalist from the Netherlands, interviewed me about the Eden-Alternative in Europe a few weeks ago. The name of the magazine she writes for is "2025“. The name was chosen because 2025 is the peak of ageing in the Netherlands. At the same time, it came to my mind that a large proportion of the current (also large) cohort of experienced nurses and other carers will be retired. A deep care-gap is foreseeable. Nobody seems alarmed. No true human resource policy or management initiatives are in sight. More so, nursing and caring worldwide undergoes serious devaluation*: "Widespread cost constraints and sociopolitical attitudes that devalue care, lead to erosion of working conditions, with resultant potentially catastrophic nurse shortages“. Is Europe sleepwalking into disaster?

As an ever optimistic person, this does not often happen to me, but somehow, for a day, I was left speechless.

*Original article: The Devaluation of Nursing: a position statement, by Helen Allan, Verena Tschudin and Khim Horton, University of Surrey, UK, published in Nursing Ethics 15 (4) 2008 p 549 - 556

-- Christa Monkhouse

Posted by Kavan Peterson on September 22, 2008 2:47 AM |Permalink |Comments (1)

September 18, 2008

Changing Aging in the Gem State

Where I'm staying:

Great discussion of long term care policy in the Governor's Council Chamber at the New Hampshire statehouse:

Posted by Dr. Bill Thomas on September 18, 2008 8:47 AM |Permalink |Comments (0)

August 31, 2008

Changing Aging Updates

[Editor's Note]

Hi Folks -- Another summer is winding down and although peaches will be in season well into September, today feels like a fall day. It was cool and drizzly this morning and campus is once again full of student life.

I want to say welcome to UMBC students from Dr. Thomas' exciting new undergraduate course "You Say You Want a Revolution: How Boomers are Revolutionizing Aging." Bill and his colleague Judah Ronch will be revolutionizing undergraduate education with this groundbreaking course. They're throwing the pointy-headed lecturer model out the window and experimenting with a live video-mashup TV-style interactive classroom. More on that below.

But first, Bill gets back from Italy tomorrow and hopefully will have some great picts and stories to share from his travels. I also want to briefly share a couple new features ChangingAging.org readers can look forward to this fall.

You may have noticed the new box on top of the right hand column that reads "What Am I Doing?" That's called a Twitter feed. What, you may ask, the heck is a Twitter? Simply put, it's a way for friends to share "what they're doing" online anywhere, anytime, through a quick cell phone text message. Here's a quick explainer:

Bill spends a lot of time on the road meeting cool people and visiting cool places and with Twitter we'll be able to hear more about it.

Back to the video mashup course. Starting next week, Bill's students will be visiting the blog as part of their classwork. We'll be launching a new section of ChangingAging.org to feature their course and I invite all readers to follow along. We may even webcast some of the courses live to give everyone a sneak peak.

Until then have a great Labor Day and if you're in Maryland find some peaches, they're amazing this year!

-- Kavan Peterson

Posted by Kavan Peterson on August 31, 2008 9:49 AM |Permalink |Comments (0)

August 29, 2008

Power-Up Friday: End of Summer Reading

I'm reading the new travel narrative, "Ghost Train to the Eastern Star", by Paul
Theroux. Here's a provocative quote from the book, which I will submit for this
week's post:

"As a young man I regarded the earth as a fixed and trustworthy thing that would
see me into my old age; but older, I began to understand transformation as a
natural law, something emotional in an undependable world that was visibly
spoiled. It is only with age that you acquire the gift to evaluate decay, the
epiphany of Wordsworth, the wisdom of 'wabi-sabi': nothing is perfect, nothing is
complete, nothing lasts."

-- Al Power

Posted by Kavan Peterson on August 29, 2008 4:44 AM |Permalink |Comments (0)

August 23, 2008

Advance Directives

Check out this recent post by Jane Gross, who blogs on aging issues for the New York Times:

The article includes a letter written to a nursing home by restraint reduction pioneer Neville Strumpf, regarding her mother's care. The letter is put forth as an excellent example of how family members can provide constructive feedback regarding their loved one's care. But there are more lessons to be learned here.

Unfortunately, all did not go well for Ms. Strumpf's mother. The letter highlights a few areas that seem to be all too common. In large part, it boils down to poor communication.

A precipitous move to a different room was very disruptive to Ms. Strumpf's mother and her family. Subsequently, she was hospitalized for a low sodium level, a condition which was deemed readily correctable, but ultimately was not. (What often looks like a simple chemical imbalance can actually be a sign of impending organ shutdown.)

Most important was the fact that Ms. Strumpf's mother was apparently hospitalized in violation of a prior expressed directive, and she ultimately died in hospital, when a comfort-oriented approach at the nursing home would have been better for all.

This reveals a two important flaws in our system of care. One is the idea that it is okay to ignore a directive if a problem looks like it can be easily treated. A person who requests "no hospitalization" is aware that this could lead to death and has accepted this eventuality. We must respect this choice, and not reverse it without the consent of the person or her proxy.

Another flaw is the refusal of our insurers to pay for more intensive levels of acute or palliative care within the nursing home. Such care is usually more cost-effective than that given in the hospital. But there is no reimbursement for "subacute care" in the nursing home, so the home is faced with the choice of either giving the extra treatment at cost with no reimbursement, or shifting the cost to the hospital, where such treatment may be less desirable but is always paid for. It is a system that encourages expensive treatment by strangers and discourages a more sensible approach within familiar surroundings.

I share Professor Strumpf's frustration. We see this all too often.

Posted by Kavan Peterson on August 23, 2008 9:10 AM |Permalink |Comments (0)

August 21, 2008

Summer Fun -- On the Move

Here's a great example of changing aging, from right here at St. John's Home in Rochester. This was "On the Move" week, supported by a generous gift from Bob and Mary Hastings. Our Generations Child Care has several special events with the elders at St. John's all week long. Here are some highlights:

Monday: NASCAR Day

The kids put on "pit crew" shirts and decorated the wheelchairs, followed by a series of races. It also made the local news broadcast Nascar%20Day%208.08%20018.jpg

Tuesday: Up Up and Away Day

A hot air balloon demonstration, first in the adjacent park:
Up%20Up%20and%20Away%2008%20093.jpg
Then inflated on its side in the Auditorium so kids and elders could go inside the seven story envelope:
Up%20Up%20and%20Away%2008%20296.jpg

Thursday: Water War. This was a hoot and everyone got soaked:

For those who think that life ends when you go through the doors of a nursing home, think again. Many of us are challenging that idea!

Posted by Kavan Peterson on August 21, 2008 10:00 AM |Permalink |Comments (1)

August 20, 2008

On a lighter (summer) note, ageing images

Upload any picture to this ingenious and truly fun Japanese website http://labs.wanokoto.jp/olds. Choose English in the top right hand corner. Push "convert“ and after a few seconds you get the feel of a newspaper clipping, cut out some generations ago. Push "save“ -- fun guaranteed.

--Christa Monkhouse

Dr.%20BillThomas%20in%201948.jpg
[Bill Thomas in 1948]

Posted by Kavan Peterson on August 20, 2008 9:39 AM |Permalink |Comments (0)

August 18, 2008

Monkhouse Mondays: Every wrinkle counts

[Editor's Note: While Dr. Thomas is out of country for the rest of the month, Changing Aging bloggers Christa Monkhouse and Al Power will be filling in.]

"They are not perfect, not young and not frightfully thin. The models involved are over 80 and residents of the Senior-Foundaton Eilenriedestift in Hannover, Germany, so the headlines.

"The models“ consented to being portrayed by three young art-students. This project, "Young looks at Old“ was initiated by Dorothee Wiederhold, a friend, visionary and accomplished leader in ageing-services and director of care. The artists stay in the residence and have so far painted over 70 portraits. The residents stood in line, they loved the idea.

Watch the short TV-clip (2:11) in German, it is mainly self explanatory, but there are some translated quotes from the students below:

"An old face has much more to tell than a young face“
"Every wrinkle tells a story, shows lived life“
"Every wrinkle counts, this is the message, we take away from here“

And finally, an answer to Al Power to his very good Friday-post question: "What are some of the unexpected ways that the aging of our population might change societal conventions and standards over time?“

I think that older faces will be perceived within a new aesthetic, not one of decline, but as one of it’s own beauty, a new artistic iconography of lifespan development, such as Ronni Bennett’s portraits on the Time Goes By website.

-- Christa Monkhouse

Posted by Kavan Peterson on August 18, 2008 1:31 AM |Permalink |Comments (0)

August 15, 2008

Power-Up Friday: Reader Challenge

In an effort to solicit more comments from readers, I'd like to offer a little challenge: What are some of the unexpected ways that the aging of our population might change societal conventions and standards over time? Positive and negative ideas both count.

For example: Will we have different views about the economic value of sports stars and entertainers? Will charitable donations and volunteerism increase or decrease? Will roadways or traffic patterns be constructed differently? What will TV look like? In what ways will the frontiers of technology change?

I have no idea. I'm just asking. Send us your thoughts - let's have a conversation.

I will close with the Quote of the Week, courtesy of Mimi Bommelje: "The reasonable man adapts himself to the world; the unreasonable one persists in trying to adapt the world to himself. Therefore, all progress depends on the unreasonable man." -- George Bernard Shaw (1856-1950)

-- Al Power

Posted by Kavan Peterson on August 15, 2008 8:08 AM |Permalink |Comments (2)

August 7, 2008

The Art of Aging

Great post on aging over at "The Art of Aging."

Being old is only numbers. Being alive to new challenges, new pleasures and new friends is who you can become right now. Make something wonderful happen for you today … for your sake and for all of those who need your help, your experience, your creativity, the valuable, unique person you were yesterday and still are today.

The whole thing is worth reading...

Find it Here

Posted by Dr. Bill Thomas on August 7, 2008 1:05 PM |Permalink |Comments (0)

August 4, 2008

Power-Up Monday: More Dementia News

[Editor's Note: Al Power is filling-in for Christa "Monkhouse Mondays" while she's on vacation.]

I'll follow up Wednesday's "Pre-Dementia" post with three more items that have popped up in the past two days:

(1) On July 28th, our local newspaper described a new study from the University of Kansas, to be published this fall in the American Journal of Alzheimer's Diesase and Other Dementias. In this study, it was found that people with dementia take great offense to being talked down to with demeaning names or infantile language. Many people reacted with increased agitation and physical aggression. Even people with fairly advanced dementia can tell when they are being demeaned or patronized.

This lends support to those of us who feel that interpersonal interactions are an important factor in the genesis of behavioral symptomatology. I only have one complaint: The article states that this method of address is so common that "researchers have coined a word to describe it - 'elderspeak'".

Now wait just a minute here! That isn't elder-talk - it's baby-talk! Let's not besmirch a title of honor and respect by associating it with infantilizing language.

(2) The UK has a new drug that claims to "halt the decline of dementia", something no other drug has succeeded in doing. The media has descended like vultures on the report of this trial drug named Rember (get it?). The study claims that there was no significant decline in cognitive function after 19 months on the drug, compared with an 81% relative decrease in those not taking it.

The drug appears to work by attacking the "tau protein" that forms the damaged nerve tangles of Alzheimer's. This is an industry-sponsored study, and hasn't been put to intense scrutiny or replication yet. However, it was enough to impress Clive Ballard, a prominent researcher in the UK. Others cite the evidence that the drug decreases blood supply to some brain areas as an indication to proceed with caution into further trials.

So we'll keep our fingers crossed and see what happens here...

(3) Finally, back on the topic of social capital, the BBC also reports that single people have three times the risk of dementia that married people have. This was reported by the Karolinska institute, after a study of 1449 Finns. It is theorized that the "intense social and intellectual stimulation" of marriage has a protective effect. Those who were widowed at a young age and never remarried had six times the risk.

This certainly adds to recent evidence about the beneficial effects of social interaction on cognition and other health indicators, (though a few of my formerly married friends might take issue with the hypothesis!).

I would comment that the article does not tell if cognitive testing was done on these people, or just an interview and health history. The latter would not rule out the effects of an ongoing relationship in helping to "cover" for mild deficits. There is also evidence that untreated depression can be neurotoxic - this might also be an issue in cases of divorce and bereavement. Finally, there may be lifestyle differences associated with stable marriages (diet, exercise, etc) which contribute.

Keep an eye on this blog for the latest developments!

-- Al Power

Posted by Kavan Peterson on August 4, 2008 11:20 AM |Permalink |Comments (2)

August 3, 2008

Caring.com: The Interview

I did an interview with Caring.com and now it is up...

Wide ranging and the Camille did a great job of capturing the essence of our conversation.

A sample...

Can you describe Eden at Home?

Yeah! The whole idea is to take all that stuff we've learned in long-term care and make it available to family caregivers at home because, as I was saying before, even if you've got an M.D. from Harvard, you're not prepared. So it takes Eden philosophy and Eden messages and puts them into the hands of people who are caring for somebody they love at home.

What's an example of something from the Eden philosophy that caregivers can integrate into their lives?

We teach people how to go beyond care giving. There's this idea, which is very common in our culture, that care giving is a "pair" relationship: a caregiver and the person getting cared for. It's a one-on-one relationship and other people help, if they can. And that's actually not the way care has been given in most of human history, when care needs were distributed across a clan or tribe or family network.

So we try to help people build "care partner networks," so that the elder is a part of that care partner network, along with maybe a daughter, and maybe a friend from church. We help teach people that one of the most important things you can do as a care partner is to help grow the network, so that you have more people lending a hand, and that is healthier for the elder and the care partner.

Where can people read about the Eden at Home concepts?

At the Eden Alternative website, and there are also trainings people can go to. We're working on making them available in more parts of the country.

Posted by Dr. Bill Thomas on August 3, 2008 1:36 PM |Permalink |Comments (0)

July 21, 2008

"Old Person" is the Ultimate Other

[Editor's Note: below is a post by the editor]

I like this -- a blog post about old bodies from the Poetry Foundation's blog Harriet:

It’s scary to think about what your body is going to look like in forty years
At the swimming pool, I am an honorary old person—I get to swim with the senior citizens, who play volleyball in the shallow end and use the deep end for water exercise.
--snip--
Though at first I felt estranged from (let’s face it: scared of) my swimming partners, I’ve come to treasure being part of the group and making friends across a wide swath of life. The lifeguards sometimes play big band music, which annoys me because most of these people came of age with the early Beatles and Stones.

What I like best is the chance to see bodies. The girls on the synchronized swimming team are in the locker room when we leave, and though they are beautiful their bodies are not as compelling as old bodies, on which you can read the story of childbirth and illness and simply age, which lends interesting variegations and falling-(or-not-)ness to the flesh.

It seems to me that "old person" is the ultimate Other. Old person=not me.

Which, I imagine, is why it's so damn hard to embrace getting old.
(h/t to El Lewis)

--Kavan

Posted by Kavan Peterson on July 21, 2008 2:31 PM |Permalink |Comments (0)

July 15, 2008

World's Oldest Blogger: Dead at 108

Remembering "The Life of Riley"

Wash Day A Century Ago...

You 21st century people live a different life than the one I lived as a youngster in the early 1900s. Take Washing Day, for instance. These days you just toss your dirty clothes into a washing machine, press a few switches, and it's done.

I remember scratching around to find a few pieces of wood to fire the copper for Mum. Sometimes I'd find a broken wooden fruit box that I'd split with a tommyhawk. Sometimes I'd gather some twigs and dead branches, and use them for firewood.

When the water in the copper began to boil, Mum would add a cupful of soap chips, and throw in a cube of Reckitt's Blue wrapped in a muslin bag to whiten the clothes. Then she put in all the dirty clothes, first rubbing out the stains with a bar of Sunlight soap. She used a corrugated washing board for that. .

Some time later, when the fire had gone out, Mum would haul the clothes, dripping wet, out of the hot water with a strong wooden copperstick, and that was jolly hard work. The clothes weighed a lot more sopping wet than when they were dry.

Then she would feed the wet washing into a machine called a mangle. It had two large rollers with a narrow gap between them, and a big metal wheel that had to be turned by hand. That was my job - and it was real hard work for a small kid.

We hung the clothes out to dry on a line strung between two trees and held up with a prop made from a forked branch. Sometimes a crow or a magpie would leave a visiting card on a clean sheet, which would have to be washed again.

Mum used to starch the collars and cuffs of Dad's shirts to make them stiff and neat. He was a big man, and she was proud of the way he looked in his Sunday best, with his freshly ironed shirt.

When we remember, we grow stronger...

(H/T Dorothea Johnson)

Posted by Dr. Bill Thomas on July 15, 2008 1:28 PM |Permalink |Comments (1)

July 14, 2008

Monkhouse Mondays: Timeless Beauty

[Editor's Note: Eden Alternative Europe Coordinator Christa Monkhouse guest-posts on a weekly basis from across the Big Pond. Christa helped introduce the Eden Alternative to Europe, first in the UK, then Denmark, Austria, Germany, Switzerland and soon in Sweden, Finland and other European nations. Stay-tuned for regular updates on 'Monkhouse Mondays'.]

In Zürich the European soccer championship has just ended and with it the endless (female) celebrity photos in the newspapers. At a function recently, I was with some of them and noticed that I felt uncomfortable. They are my age (over fifty) and look thirty-something due to botox and surgery. I asked myself some questions: “If I am irritated, how do other people feel about this? What are we doing to the clues our looks reveal about our experience, worldliness and seniority? Do we compete with younger woman for looks? While they need guidance, admiration and support from us older women, do they need more “rivals” which are probably abound in their own generation? "

After this experience I decided to age gracefully. I want to look old, wise and warm. I don’t want to leave any doubt about who I am. I hope that I will be able to offer a warm smile and share wisdom gained from my rich life in gratitude. I want to become a timeless (not ageless) beauty like Mrs. Lydia R. from Switzerland, pictured here at age 94, intently listening to a lecture.

-- Christa Monkhouse

Lydia%20R.jpg

Posted by Kavan Peterson on July 14, 2008 3:30 AM |Permalink |Comments (2)

July 11, 2008

Social "Disgrace" Security Backlash

It has begun

Seniors for Obama

We know Obama has the "youth vote" thing going, and I suspect many Democrats think that seniors (particularly white seniors) are more inclined to support McCain and have written them off. I think that's a mistake - in just the past day, McCain has famously dismissed Social Security as a "disgrace," and in what I think is a monumental blunder, McCain was the ONLY senator missing from yesterday's vote in the Senate to prevent a devastating cut in payments to physicians treating Medicare patients. Even Ted Kennedy took a break from cancer treatment to show up and vote, for the first time since his diagnosis. Where was McCain? Campaigning.
So, the next time your elderly parents, friends, associates, or relatives express doubts about Obama and/or support for McCain, tell them that Obama took a break from the campaign trail to save Medicare but McCain couldn't be bothered. If they rely on Medicare as so many seniors do, they need to know this.

Posted by Dr. Bill Thomas on July 11, 2008 9:30 AM |Permalink |Comments (0)

Power-Up Friday: Rekindling the Spark of Life

As promised, more on social capital and dementia:

Did everyone see the NY Times on 6/24? More and more people are recognizing the dangers of using antipsychotic medications in dementia.

In my last installment, I discussed how increased social capital leads to many improvements in quality of life and health outcomes, and that increased social integration may even slow memory loss.

We also saw the remarkable results that can occur with interactions that validate the person with dementia and facilitate his engagement with the world (see Jane Verity and Hilary Lee's video posted on Monkhouse Mondays 5/6/08). There is an important message here:

I believe that there are two major morbidities in dementia. The first is the well-recognized progressive damage to the brain cells that occurs as a result of the disease process. This is, as far as we know, irreversible, (though recent studies showing new nerve pathways in stroke patients may give us hope for future therapies).

But there is a second morbidity. This is the excess disability that is caused by our clinical approach to people with dementia. This arises from the defeatist view of the disease that causes us to socially isolate people with dementia, strip them of all autonomy, take a "declinist" attitude toward their future capabilities and resort to giving sedating medication. We often rationalize the latter as reducing suffering in what we view as terminal disease.

However, by creating transformed care environments that re-engage people with dementia and using skilled care partners to bring forth the capabilities they still possess - coupled with removal of those medications - we can effectively reverse their disease, bringing them to levels of function and engagement that they have not enjoyed in many months.

Cecil, who is seen speaking, singing and joking in the Spark of Life video, had not spoken for over a year before being involved in this program. His brain anatomy may not have changed, but one would have to conclude that his dementia had effectively been reversed, by removing these excess disabilities.

Make no mistake about it, these are truly life-saving interventions. While we struggle to find a cure for dementia, we must not overlook the very real transformation of people's lives that we can accomplish for millions of people today!

-- Al Power. MD, FACP
Eden Mentor
St. John's Home
Rochester, NY

Posted by Kavan Peterson on July 11, 2008 8:23 AM |Permalink |Comments (0)

July 2, 2008

European "Baby Bust"

[Editor's Note: The following is a guest-post from ChangingAging blogger Al Power]

Before I share my promised post about social capital and dementia, I’d like to point out a fascinating article in Sunday’s New York Times Magazine, and hopefully get some comments from our community “across the pond."

This article concerns the current “Baby Bust” in Europe, where birth rates have dropped to record lows. A birth rate of 2.1 babies per woman is considered the number needed to maintain a country’s population. This is currently our number in the US. In Europe, however, the level has dropped significantly, and is only 1.3 in southern and Eastern Europe.

There is an interesting contrast between these countries and northern Europe, where the rate is relatively higher at 1.8. The southern countries have more women who stay home after childbirth, yet the birth rate is lower. Social scientists suggest the reason is that although these countries have more traditional views about childrearing, they have fewer social supports.

By contrast, the Scandinavian countries have more social welfare in the form of maternity and paternity leave, childcare coverage, etc. It is felt that these social supports actually encourage women to have more children.

There is also an attitudinal change occurring, especially in Germany and Austria, where greater than 1 in 8 young women feel the ideal number of children to have is “none”.

Rates are also dropping significantly in Japan, Korea and Thailand, and to a lesser extent worldwide. It is felt that the higher US level is due to (1) a more conservative, religious-based view on family size, and (2) greater flexibility with work hours and return to work after long absences offsetting the fewer social supports available here.

With the population aging, this fans the flames of concern about the inability of the workforce to support our elders. Many countries are encouraging people not to retire as early as people do in much of Europe. Incentives, financial and otherwise, are also being given to have more kids.

Of course, many people do not see this trend as a bad thing, especially in terms of environmental impact. And those of us who blog on these pages would look at the last quote, “You can’t have a country where everyone lives in a nursing home”, as further evidence of the need to change aging and raise social capital.

-- Al Power

Posted by Kavan Peterson on July 2, 2008 8:09 AM |Permalink |Comments (0)

June 30, 2008

Monkhouse Mondays: Normal or deficient – a matter of perspective!

My husband Lowell (Canadian) told me this story over breakfast (Sunday, summer morning, sitting outside, in sunny Switzerland near Lake Zürich).

During the early 1970’s he was working with a Canadian provincial government and they were attempting to implement the ideas of the Syracuse University Professor Wolf Wolfensberger who had written the book Normalization. They were developing the requisite services so that people with disabilities could live in the community and not in institutions. Once when visiting a Hutterite Colony with his boss, they saw a young man with Down-Syndrome. At that time this young man would have quite likely been living in an institution if not living on the commune. The boss asked the colony’s headman to tell him about “the young man over there”. The headman responded by saying "who, John the cattle herder?" That, in a nutshell, described the solution.

I drew immediate parallels to how we should treat our Elders today. Readers are invited to respond with their ideas and impressions.

-- Christa Monkhouse

Posted by Kavan Peterson on June 30, 2008 9:29 AM |Permalink |Comments (1)

June 27, 2008

Hmong Aging

Another culture, another reality...

In the world of change where time and quality request financial independence, what will be the colour of our last age, the old age? Who will take care of us becoming old and disable? Worker in a post-industrial society, one only exists by the professional place, the capability to bring back home a salary. As for the Hmong traditional society, one only exists by the social recognition through the kinship and the number of descendants, and not the professional achievement. Reaching the old age, what will be one's life without work, strength to earn a living, family support and love? Beyond the institutional protections (the welfare, the Medi-Cal or Medicaid, the retirement), who will be the caring ones that, unfortunately, money cannot pay for?

Hmong people came from far, from a society promoting auto-sufficiency and interdependence to a society in transition where the individualization process develops new forms of solidarity and responsibility among its members: the notion of sufficiency or interdependence concerns more individuals than community growth. Nowadays, what are the duties of a child toward his/her parents? What kinds of expectation do parents have toward their children? In Hmong American communities, what are the needs of elderly people? Are they different in nature if compared to the ones in the traditional sittings in Southeast Asia? Is there any gap in term of understanding of the Elderly needs, the aging process, the notion of aging on behalf of the children toward their parents and vice versa? Is the senior home becoming the alternative choice for children to take care of their parents? Do elderly parents accept to live in these places?

Posted by Dr. Bill Thomas on June 27, 2008 6:55 AM |Permalink |Comments (0)

June 16, 2008

Monkhouse Monday: Ageing Potential

Last week I received a much treasured present from a friend in South Africa, a bottle of red wine (2005 Shiraz DeGrendel Tijgerberg, Capetown) with two golden stickers indicating it is an award winner. Taking it out of its box and reading the enclosed leaflet, one phrase caught my attention: “Ageing potential 10 years”.

Being a discerning wine-enjoyer, not a wine expert, I looked up the phrase "ageing potential“ on the internet and found that it is a (somewhat artistic) prediction of how the wine will taste in a couple of years time based on the grape, the climate and soil conditions (intrinsic components), production, filling and storage conditions (extrinsic components). The assumption is that there are certain wines which improve with age, reaching their peak taste after a few or even many years.

Thinking about human ageing, I wonder if we replaced the declinist and ageist notion of ageing (extrinsic factors) with the ageing potential of wine, describing it as the synthesis of all human traits, talents and experiences (intrinsic value) and a new appreciation of them (extrinsic value), would we be able to describe a person of 55 or 60 not as old, but as a person with an “ageing potential of 25 to 35 years” and young people of twenty as having an aging potential of 65 to 75 years”?

-- Christa Monkhouse

Posted by Kavan Peterson on June 16, 2008 3:25 AM |Permalink |Comments (1)

June 11, 2008

Bridging the Gap Between Generations

Last month I shared an email from a tremendous high school senior in California, Carrie Ryan. I asked Carrie to send me updates about her initiative, Bridging the Gap Between Generations. Carrie is graduating from her high school this month but she's leaving behind an amazing legacy. Carrie tells her story below:

Dr. Thomas,
So, because of the excitement around the starting of my organization, I forgot to tell you both how I was propelled into this idea for Bridging the Gaps!

My grandfather, one of the most important and influential people in my life, was diagnosed with Parkinson's disease. As difficult as it was for me, I found myself drawn to take care of him. Even when he was put in a home, I found every way possible to be near him.

I constantly volunteered at Monte Vista Grove Homes, where he was living at the time, and not only visited with him, but with the other residents as well. I started to realize how happy I was surrounded by them and how happy I was making them. The relationship was mutually beneficial on both sides!

So, I started to work at Monte Vista Grove Homes as Activities Coordinator. Throughout my years of volunteering and working, I developed a large interest and passion for aging. Simultaneously, my English teacher, Ed Raines, who is quite the visionary, came up with a new course Aging in Literature. Although I was extremely excited about the course, many of my classmates did not share my interest, and with the low number of people signed up, the course did not run.

Luckily though, with my passion and interest in aging and my teacher's willingness to run the course with me independently, I added Aging in Literature to my schedule as an independent study. Throughout this past semester of my senior year, I have read "W;t" by Margaret Edson, "King Lear," "The Remains of the Day," "The Sandbox," and "The Death of Ivan Illych."

This course has transformed my life and outlook. With the help of Mr. Raines, who has encouraged me and inspired me to continue with my passion and interest for the elderly, my independent study has spurred me into creating Bridging the Gap Between Generations. It has been with my understanding of issues surrounding aging in the literature I have read that I have been able to find the knowledge and understanding necessary to create my organization.

Now with Bridging the Gaps, working with the eldelry will become a service learning component to the school. Students from technology classes and even the Aging in Literature seminar (which will be running next year! YAY!), will be volunteering over at Monte Vista Grove Homes.

I have found that the experiences I have had working and volunteering over at Monte Vista have transformed my life and I wish that the girls at my school can share the same powerful experiences! And, with these experiences, the girls will be able to better understand and empathize with the elderly, causing a greater connection and bond to form!

I thought I might share this with you, although a very long email, because it is the fuel that drives my project! Hope this helps!

Carrie Ryan

Posted by Dr. Bill Thomas on June 11, 2008 8:05 AM |Permalink |Comments (2)

June 6, 2008

Power-Up Friday: Changing Aging

The 4th Eden Alternative International Conference will be winding down today. It may take me a while to digest all of the wonderful things I’m experiencing. However, one story from the past came to mind today:

It was six or seven years ago and I was at a Pioneer Network Gathering in Rochester. I found myself sitting in a conference room late at night, conversing with Bill Thomas and renowned elder advocate Carter Williams. Bill was regaling us with tales of his recent Eden bus tour across America.

All of a sudden, Bill paused and said, “You know what’s occurred to me? I’ve realized that it’s not enough to change nursing homes. We have to change society’s view of aging.”

My initial response was mild exasperation, and I thought to myself, “Just as we’re starting to make some noise with the Eden Alternative, leave it to Bill to push things to an impossible level!”

Fast forward to 6/5/08. I sat in the general session yesterday morning and listened to the stories and looked at the faces around me.

And I remembered that night. And I thought, “Damned if we aren’t doing just that! We really are changing aging in our society!”

Sometimes you don’t know where you’re going until you can look back and see where you’ve been.

-- Al Power

Posted by Kavan Peterson on June 6, 2008 7:56 AM |Permalink |Comments (0)

June 2, 2008

Monkhouse Mondays: Social Climate Change

[Editor's Note: Dr. Thomas has invited Eden Alternative's Europe Coordinator Christa Monkhouse to guest-post on a weekly basis from across the Big Pond. Christa is personally responsible for introducing the Eden Alternative to Europe, first in the UK, then Denmark, Austria, Germany, Switzerland and soon in Sweden, Finland and other European nations. Stay-tuned for regular updates on 'Monkhouse Mondays'.]

The social climate change (cooling, not warming)......and it’s solution

I spent the last week in Vienna, Austria, springtime – lilac at it’s peak, roses budding – teaching Eden and attending the Iahsa European conference, listening and learning.

I had the privilege to meet with Prof. Ernst Gehmacher (82). He is member of the Austrian chapter of the Club of Rome for global sustainability and the most prominent person in Europe to measure social capital*. He is convinced that investment into building, nurturing and sustaining human relationships is more profitable (in Dollars and Euros) than "pure“ money investment. As a biologist and sociologist he has accumulated a wide database which clearly indicates that social capital is related to happiness, better health and lower health care costs.

The younger generation, who we confine to grow up in social isolation, their companion pieces of technology such as computers and the internet, is impoverished in terms of social capital, their social climate is getting colder, not warmer. Therefore we should start looking at our elders as providers and deservers of social capital, not just as cost and burden to society and bring the generations back together. And in the end, it will "pay off“ in human warmth and economic growth.

I agreed with him to measure the Eden-Alternative impact with his social capital measurement tools. I keep you posted on this.

*(defined as the sum of social relations at the micro-level such as friends and families, at the meso-level such as membership of clubs, parties and other associations and at the macro-level represented by culture, belief-systems, world- and spiritual views).

-- Christa Monkhouse at info@eden-europe.net

Posted by Kavan Peterson on June 2, 2008 7:11 AM |Permalink |Comments (0)

May 30, 2008

Power-Up Friday: Is Grandma Drugged Up?

Check out the news article on CNN.com, "Is Grandma drugged up?". This is important information, especially for older health care consumers.

The article states that 38 million older Americans suffer from drug complications every year, 180,000 of which are life-threatening.

It adds that people over 65 have a "risk for drug errors" that is seven times greater than those under 65. I'm not sure if their wording is correct here. This ratio might actually reflect the risk of drug complications, not errors. Either way, it is an important caution for older people on multiple medications, (see my post from April 25).

New drugs are rarely tested on older people before FDA approval. The study populations are carefully selected to minimize risk. That's not necessarily a bad thing; but after approval, the companies will often take drugs tested in healthy 40 and 50 year-olds, and promote them for people in their 70s and 80s. It is NOT a valid assumption that these pills will have the same efficacy and safety in older people.

I'm not a big fan of CNN-TV, which seems to use a lot of fearmongering and histrionics to peddle its news. However, this article is a good read. It has lists of potentially harmful drugs and drug interactions, instructions for doing a "brown bag review" of your pills, and suggestions for discussing these concerns with your doctor. Check it out!

--Al Power

Posted by Kavan Peterson on May 30, 2008 9:54 AM |Permalink |Comments (0)

May 27, 2008

Power-Up Tuesday: Aging in Place... at What Cost?

[Editor's Note: Guest post from Al Power below.]

An article in the New York Times on May 25th describes the emerging technology that is allowing older adults to live alone in their homes, (“High Tech Devices Keep The Elderly Safe From Afar”). New monitoring devices, communication aids and medication reminders are helping those whose relatives live far away in our increasingly mobile society.

The article quotes Eric Dishman of Intel Corporation, a leader in new technological research. I heard Eric speak last year, and Intel is doing some amazing things.

Nevertheless, while technology has much to offer, there is a larger picture which concerns me. Technology can be an adjunct to good medical treatment, but it can also be used to perpetuate flawed ideas about “aging in place”. Let me explain:

The article describes an 88 year-old woman whose family who lives several states away. She has macular degeneration and can no longer drive. She takes medication for memory loss, seizures and restless legs.

She is also recently bereaved, as her husband died last summer. Her monitoring system tells her family when she gets out of bed, and whether she uses her medication dispenser as instructed. There is an emergency call system as well. Presumably, someone would find out if she fell, became ill or missed her medication doses. Hopefully, this would help prevent complications, though much of the notification would happen after the fact.

But a person who cannot drive, and who has low vision and memory problems, becomes isolated and disengaged in that home which she is trying so hard to keep. What are the effects on her well-being? Her medications for seizures and restless legs could cause further changes in gait and cognition. She is also grieving the loss of her long-time
spouse. Is this living situation actually better for her in the long run?

Let me put it this way: How many elders have become “prisoners of independence”?

The dread of institutionalization drives many people to keep themselves in living situations that are counterproductive to their long-term health and well-being. Many such people dramatically improve when they finally move to an enlightened nursing home or another environment which provides opportunities for a greater human connection.

Technology should be the servant of a larger continuum of care and well-being. And “aging in community” offers greater opportunities for staying engaged with life than aging alone.

-- Al Power

Posted by Kavan Peterson on May 27, 2008 6:52 AM |Permalink |Comments (0)

May 23, 2008

Power-Up Friday: BE all that you can BE

This week, I’m reporting from Rochester’s Oak Hill Country Club and the Senior PGA Championship, where being 50 makes you a “senior”. My brother’s old high school classmate, Jeff Sluman, made the roster this year. My YOUNGER brother…

Elsewhere, the sports world was rocked by the retirement announcements of two of the greatest women in modern sports history – Sweden’s Annika Sorenstam and Belgium’s Justine Henin.

Sorenstam is the dominant woman golfer of the last quarter century. Although plagued with neck problems last year and bumped out of the #1 ranking by Mexican superstar Lorena Ochoa, Sorenstam has already won three times this year. Her 72-win total puts her one behind Jack Nicklaus, a mark she could easily beat before year’s end. She stands ahead of Palmer, Hogan and Woods in victories, and since Annika’s only
37, Kathy Whitworth’s all-time record of 88 was well within reach.

Henin, who has been #1 on the tennis circuit for 18 months, pulled out right before this week’s French Open, which she has won three straight times. She won 10 tournaments last year and is only 25 years old. She alluded to the fact that she had “hit the wall”.

All of us must deal with some decline in our physical abilities as we age. It must be incredibly difficult to maintain the competitive edge required to compete at such an elite level.

Readers of Bill Thomas will know that the move from adulthood to elderhood involves a gradual transition from a life rich in “doing” to one rich in “being”. But long before we start collecting Social Security checks, many of us make adjustments in this dynamic of our lives, in little or big ways. Elders are the best mentors helping us to navigate
these waters.

Somewhere in the recent past, a voice of experience may have told these women that, while it’s great to make a “run for the roses”, it’s important at some point to stop and smell them too.

We could all learn a lesson here. It’s a good time to reflect on our lives, see if the balance is getting off-kilter, and find ways to readjust our priorities. We could take a tip from the US Army, who might have coined the slogan, “Do all that you can do”, but instead opted for “Be all that you can be”.

Good luck, Annika and Justine, in the next phase of your lives!

-- Al Power

Posted by Kavan Peterson on May 23, 2008 10:00 AM |Permalink |Comments (0)

May 19, 2008

What is the Eden Alternative?

Bill gives a great explanation and overview of the Eden Alternative philosophy in an interview broadcast this morning on ReachMD. Listen Here.

It's worth noting ReachMD is an interesting new media news outlet combining satellite radio and online streaming content to better reach the medical community. From the website:

ReachMD, an innovative communications company, provides thought-provoking medical news and information to healthcare practitioners. Established to help increasingly time-constrained medical providers stay abreast of new research, treatment protocols and continuing education requirements, ReachMD delivers innovative and informative radio programming via XM Satellite Radio Channel 157 and online streaming developed by doctors for doctors.

Posted by Kavan Peterson on May 19, 2008 11:34 AM |Permalink |Comments (0)

May 16, 2008

Power-Up Friday: Enough Mickey Mouse Health Care

Reporting from Disney World, where I'm speaking at a conference:

Associated Press reporter Linda Johnson reported Wednesday in the Washington Post that 51 percent of all insured Americans are on at least one prescription drug for a chronic medical condition. The breakdown includes: two-thirds of women 20 and over, one quarter of children and teens, 52 percent of men and three-quarters of people age 65 and over.

In the final group, 28 percent of women and 22 percent of men are on 5 or more prescription drugs!

In spite of spending more money per capita than any other nation, the US continues to lag many other countries in life expectancy and other important health indicators.

Experts interviewed attributed this trend to poorer public health and more aggressive early treatment of conditions like hypertension and high cholesterol. Average body weight in US adults and children is higher than ever.

Yes, BUT...

- How many of these early treatments truly improve quality and quantity of life, and how many are fueled by relentless advertising by the pharmaceutical companies, and ready reimbursement through Medicare D and other plans? People in other industrialized nations don't treat so aggressively, yet they live longer. We need more evidence-based studies that are not sponsored by the people selling the drugs!
- How much of the pile of health care dollars do we spend for prevention, education and public health improvements? Have we decided that it's just easier to prescribe (or take) one more pill?
- Everyone runs away from the idea of universal coverage because of the fear that it will place too much of a financial burden on companies and taxpayers. Has anyone considered what it costs us all to have such poor public health and 50 million uninsured people?

-- Al Power

Posted by Kavan Peterson on May 16, 2008 6:23 AM |Permalink |Comments (0)

May 15, 2008

Kansas Meets Eldertopia

Last week Dr. Thomas was invited to Kansas to speak at the Governor's Conference on Aging Services. Kansas Public Radio reporter Bryan Thompson visited with Bill to discuss his ideas on a new kind of aging, which he calls Eldertopia, where the Golden Years take on a whole new set of possibilities. Listen Here.

Posted by Kavan Peterson on May 15, 2008 9:18 AM |Permalink |Comments (0)

May 14, 2008

Pinnacle of Adaptation

[Editor's Note: Below is a teaser to Dr. Thomas' new health column to be published bimonthly on www.timegoesby.net. Thanks to Ronni Bennett for inviting Bill to become the TGB Geriatrician.]

I am excited about guest blogging here with Ronni Bennett. TGB is a terrific blog and if I can add something of value to this community, I will be happy.

I am a physician and my background is in Family Medicine and Geriatrics.

My approach to medical issues tends to focus more on the big questions of emphasis and interpretation and less on specific remedies. (Although I do get into that from time to time.) In medical school we used to joke that certain professors seemed to have favorite molecules that they studied exhaustively. That's never really been my thing.

What do I mean by big ideas? Well, how about this: I believe that older people are the healthiest people on the planet.

Huh?

Aren't old people sick most of the time? What about all of the billions of dollars we spend on Medicare? What about the statistics that show older people using the most health care resources per capita of any age group?

Those objections are valid, but they miss the deeper reality.

Click here to continue reading the TGB Geriatrician...

Posted by Kavan Peterson on May 14, 2008 9:38 AM |Permalink |Comments (1)

May 12, 2008

Monkhouse Mondays: Care Capitals of Europe?

From the European Culture Capital to the European Care Capital* – What else?

Every year the European Union (EU) selects and celebrates a cultural capital of Europe. They spend considerable amounts of money to polish them up and promote tourism. In fact, several "B-Cities“ have, through this program, become permanently attractive European tourist destinations. One such city is Graz, the capital city of Styria (Arnold Schwarzenegger was raised nearby), and Linz has been chosen for 2009. It's the capital of Upper Austria, on the (blue) Danube close to where I was born and raised. It boasts galleries, musical performances -- such as the impressive "cloud of sounds" -- and the new and well known solar-city, an energy sustainability experiment, with community and neighbourhood-building projects attached to it.

The time is now right to begin selecting the European Care Capital. Cities could apply to show how they have provided an excellent quality of life for their Elders, how they make them welcome, safe and how they promote growth by providing integrated services, imaginative housing, prevention, education for elders and carers, families and integration for people with dementia into society (see my post last Monday). Money would be proudly invested to motivate other communities to strive for the same excellence.

An inspiring example is the "generation-village“ in Burgenland, Austria, near the Hungarian border. The Strem-Village senior center is now being extended into an intergenerational village, bringing back Elders, creating work places mainly for women and thus benefitting the local school, the kindergarden, local businesses and making this rather remote village in wine growing country among rolling hills and open skys an attractive place to raise families. More housing is being built and population is on the increase while neighbouring villages are losing people. Mr. Peter Kalman (peterkalman@aon.at), the CEO of the development, will speak at the Lahsa-Vienna conference in May. He will explain how their approach makes perfect business sense in addition to preserving and enhancing local culture beyond measurement.

So why not copy, copy, copy on a grander scale.

[*Footnote: The European Care Capital is not my idea, but was put forward to me in 2005 by Mr. Rainer Bensch, a politician from Bremen, Germany. He met with me to talk about the Eden Alternative and how it could be the "blanket“ for our society to care for Elders and how European Care Capitals could become it’s gold standard.

--- Christa Monkhouse

Posted by Kavan Peterson on May 12, 2008 1:43 AM |Permalink |Comments (0)

May 9, 2008

Power-Up Friday: International Eden Conference

For anyone who enjoys reading these pages, I hope you will seriously consider joining us at the 4th International Eden Alternative Conference, June 3-6 in Columbus, Ohio. Every two years, leading innovators from around the world gather at a different city to share exciting developments in changing aging in society. Columbus is easy to
get to, and it should be a fabulous time!

Eden Founder Dr. Bill Thomas will be on hand, and will give the opening Keynote address, and Executive Director Nancy Fox and Board member Sara Rowan will convene the conference. There will be dozens of speakers throughout the meeting, including Jane Verity and Hilary Lee (see the "Spark of Life" video on the 5/6 Monkhouse Monday post). There will be a presentation on Green Houses(R), and one about using computer technology to enhance the lives of elders. Bloggers Christa Monkhouse and myself will have presentations as well.

There will be a dinner/dance which will also include a theatrical performance by Howling At The Moon, a company of 8 women over 60 who write and perform sketches about what it means to be older. An International Reception kicks off the event with a convergence of Eden Associates from all corners of the world. The closing Keynote speaker will be Richard Pimentel, a prominent disability rights advocate recently profiled in the documentary film "Music Within".

In between all of this, you can learn about culture change from Europe to Australia, about aromatherapy, intergenerational experiences, changing roles of nurses and others in the elder care workforce, and many, many other topics.

A discounted "early bird" registration deadline has been extended to May 16th. Your fee covers the whole conference, plus breakfasts and lunches, the Tuesday reception, the Wednesday dinner/theater/dance, and a free showing of "Music Within". It's an incredible deal!

To see the whole program and to register, go to www.edenalt.org, and click on the conference link. See you there!
-- Al Power

Posted by Kavan Peterson on May 9, 2008 8:05 AM |Permalink |Comments (0)

May 6, 2008

Dr. Bill Blogs as The TGB Geriatrician

Ronni Bennett at www.timegoesby.net has an exciting announcement that will interest ChangingAging.org readers:

I am pleased and excited that Dr. Thomas has agreed to become The TGB Geriatrician. Because there are already too few geriatricians in the U.S. and the number of elders will increase dramatically over the coming decades, I'm convinced that we ourselves must take more personal responsibility for our health by educating ourselves and working in collaboration with our physicians who may not have a lot of experience with elder medicine. Dr. Thomas is going to help us do that.
Beginning later this month, his column will appear twice monthly at Time Goes By covering such topics as the myths of aging, exercise, medications, supplements, adaptation to changes, how our bodies age, and our minds, and much more. And as long as you keep it to general topics and not your personal health problems, you will have an opportunity to suggest health issues Dr. Thomas might tackle for us.

This is an extraordinary opportunity for us to learn from one of the most knowledgeable, experienced and visionary aging experts in the world - and, a guy who really likes old people.

We'll keep you posted as Bill's column is published, and feel free to email your suggestions for general health topics you'd like Bill to discuss to changingaging@gmail.com.

---
Kavan, Blog Meister

Posted by Kavan Peterson on May 6, 2008 11:34 AM |Permalink |Comments (0)

Monkhouse Monday: Dementia, Diversity and Eldercare

[Editor's Note: (Below is this week's edition of 'Monkhouse Mondays', accidentally postponed to Tuesday -- Sorry Christa!)
Dr. Thomas has invited Eden Alternative's Europe Coordinator Christa Monkhouse to guest-post on a weekly basis from across the Big Pond. Christa is personally responsible for introducing the Eden Alternative to Europe, first in the UK, then Denmark, Austria, Germany, Switzerland and soon in Sweden, Finland and other European nations. Stay-tuned for regular updates on 'Monkhouse Mondays'.]

Persons with Dementia (PwD), do they need "Special Care“ or simply to be part of our "Cultural Diversity?“

Presenting the Eden Philosophy to varied audiences of professionals I am often asked: "Which model of care do you use for people with dementia?“, implying that surely they must be treated "specially“, given the proliferation of "special care units“.

My answer, informed by experience is: "Intentional and informed diversity-management.“

What do I mean by this? Some context: We know that people with dementia are overmedicated (see Al Power’s post on Antipsychotic Restraints), at conferences we hear about solutions for "wandering“, "aggression“, "unrest“ and "violence“. We keep PwD in "secure“ or "special care“ units. Research has shown that overmedication causes more deaths, that wandering is a normal and purposeful reaction to "feeling out of place“ in an institution, so are aggression, restlessness and violence. Secure units and chemical restraints keep people with dementia away from mainstream society. In Swiss law and medical ethical guidelines (www.samw.ch, english version/ethics/guidelines = coercive measures in medicine) a person can only be "secured“ for a short time if she is a danger to herself or others. Anecdotal evidence shows that people with dementia are actually very cautious, perceiving different colour flooring as "gaps“ and stopping in front of them. The question arises if "secure units“ are a severe infringement of human rights?

The answer? Why not educate the general public, schoolchildren in how to deal with PwD? How to serve them with attention and compassion at the supermarket checkout, the bus, the train, the cafe? If a person has "eloped“ from a care home, educated police will know what to do, normal, everyday business, calm, professional, warm. As there will be more and more people with dementia, they have the potential to add to the diversity of our society, visible at parties, restaurants, parks, hairdressers, beauty parlours, banks and hotels. They should not be marginalized, segregated and hidden. No, they can remind us how being, not just doing, is valuable in our lives and that tenderness and compassion can be practiced every day. This would be a true recovery approach to dementia care as outlined in Dr. T. Adams’ insightful and practical new book on Dementia care(p. 283). PwD would so re-cover the ground they have lost through the socially constructed segregation from mainstream society.

An empathic, practical and useful approach to dementia recovery on a personal level is the Spark of Life program developed by J. Verity, Eden Mentor for Scandinavia and Dementia-care pioneer from Australia. Watch the Demo-Video on YouTube and be moved (I was) to tears

--
Christa Monkhouse, www.eden-europe.net

Posted by Kavan Peterson on May 6, 2008 11:10 AM |Permalink |Comments (2)

Eldertopia and What Are Old People For?

Thanks to Ronni for also posting this excellent video of Bill -- HIGHLY HIGHLY recommended:

Dr. William H. Thomas, who was the subject of a two-part TGB Interview last fall and who blogs at Changing Aging, is an extraordinarily good and influential advocate for elders. I consider his book, What Are Old People For?, one of my personal bibles on aging. Anyone who is old, getting old, knows old people or is concerned with issues of aging in terms of our culture, public policy and politics needs to read this book.
But maybe, like me, you already have too many unread books stacked up. If so, at FORA.tv, there is at a lecture Dr. Thomas gave at the Chautauqua Institution last summer that covers some of the high points of the book. It’s long, worth every minute of your time and Dr. Thomas’s enthusiasm for his subject is infectious. If you don’t have time to view it now, do come back later to watch it.

Posted by Kavan Peterson on May 6, 2008 10:53 AM |Permalink |Comments (0)

May 5, 2008

Power-Up Tuesday: Antipsychotic Restraints Part II

[Editor's Note: Continued from Al Power's April 25 post Antipsychotic Restraints]

My good friend (and restraint reduction pioneer) Dr. Bernie Shore once said to me, “You know, Al, we have a lot of people with dementia who are calm and engaged when you sit and interact with them, but they get agitated again after you leave, and you can’t do one-to-one care all day.” We have all had this experience. Here’s my explanation:

“That person is sitting on a ledge, 50 stories up. And you can crawl out on the ledge and put your arm around him, tell him he’s okay, and calm him for a moment. But when you leave, he’s still on the ledge.”

This is why simple algorithms like a weekly hand massage and daily washcloth folding don’t quite do the job. Until the environment feels safe and comfortable, not toxic and foreign, one can never make great inroads into serious medication reduction.

But it’s happening out there, as we speak. Some people have moved below 5 - 10% prevalence of antipsychotics, and a few homes keep the number near zero.
Three steps to transforming the care environment: (1) create meaningful, continuing relationships. These allow everyone to be well-known, and provide care partners with vital clues to the experiences of the elder. (2) create an environment filled with positive, affirming interactions that provide the elder with choice, engagement and meaning, and respect her basic personhood. (3) Move our frame of reference to enter the elder’s world, rather than to drag her into our reality.

This last step bothers many people, who feel that it means “giving up” on the person, or allowing her to slip further. Some of us have found, however, that much of the psychic distress people experience is caused by trying to force them back into a pattern of “normalcy” that they can no longer process. In fact, when you go to the elder’s point of view and relate on their terms, providing a safe, validating approach and reducing their medications, people usually improve their cognition and engagement to a greater extent than we see when we try to force the improvement.

Ironic, isn’t it?

Is it easy? No! Is it critically important? Yes!!

I’m collecting success stories of people working in this realm. Feel free to share them or pass on any questions; here, or to apower@stjohnshome.com.

Posted by Kavan Peterson on May 5, 2008 3:29 PM |Permalink |Comments (0)

April 25, 2008

Power-Up Friday: Antipsychotic Restraints

The latest issue of the Journal of the American Geriatrics Society adds another nail to the coffin of antipsychotic drugs in older adults. In a Dutch study of nearly 23,000 people on these drugs, there was a 60% increase in pneumonia, compared with those not taking the medications.

Add this to the growing list of concerning reports about this class of drugs in recent years - they make Vioxx look good.

In nursing homes around the industrialized world, about 40% of people with dementia are taking antipsychotic drugs for behavioral symptoms of dementia. Looking at all of the published studies of drug effectiveness, even if you take the results at face value, fewer than one in five people show a clinical benefit.

If these were heart medications or antibiotics, we would have abandoned them long ago. We cling to them because of our narrow view of what elders with dementia need.

Antipsychotic use for dementia is dead – we just don’t know it yet! These drugs are the “physical restraints” of the 21st century. Thirty years ago, we couldn’t conceive of a safe way to untie people without causing greater harm, until some intrepid pioneers showed us the way. We were locked in the wrong paradigm.

And so it is with dementia. The problem lies in our approach to care. We create an institutional environment that favors tasks and interventions over relationships. We remove all aspects of autonomy and control. We try to force people with dementia to try and reorient their minds and bodies to the patterns of “normal” adults. Then we medicate the predictable result. (This happens in the community as well as the nursing home.)

Can we un-medicate people with dementia and have them live fuller, healthier lives? Absolutely! People are doing it as we speak, though their voices are still mostly out at “the fringe”. I’ll tell you how next Friday…

-- Al Power

Posted by Kavan Peterson on April 25, 2008 7:11 AM |Permalink |Comments (0)

April 16, 2008

The White Haired Women Have Spoken

That is all...

Posted by Dr. Bill Thomas on April 16, 2008 9:44 AM |Permalink |Comments (0)

April 7, 2008

Change We Can Live In

If you take a look at the left-hand column on my blog you'll notice a list of books that are Changing Aging. The Erickson School this Friday is providing a rare opportunity to hear from the author of the newest and one of the most influential additions to this list -- "Old Age in a new Age: The Promise of Transformative Nursing Homes," by prominent free-lance journalist Beth Baker.

I've had the privilege of talking to Beth numerous times in the course of her compassionate and insightful reporting on the transformation of long term care in America. Do you think nursing homes have to be a place of last resort? I highly encourage you to come and meet Beth Baker and learn how nursing homes are turning into transformative homes, and how this change will benefit us all.

WHEN: 1:30 p.m., Friday, April 11, 2008
WHERE: UMBC, ITE Building, Room 102

To RSVP, or for more information, contact Kathryn Gallagher at 443-543-5645 or kathryng@umbc.edu

Posted by Dr. Bill Thomas on April 7, 2008 9:28 AM |Permalink |Comments (0)

April 4, 2008

Power Up Friday: Attitude Matters, Dude

There is no doubt that the Eden Alternative has been a major force in the movement to transform long-term care in our society. (That's a fact - I'm not just "kissing up" to the Blogmeister here.)

But even Bill Thomas will tell you that the Eden movement has caused a lot of people to pay too much attention to the superficial aspects of the new habitat - the dogs, cats, birds - what we call the "fur and feathers" of Eden. These are tools to help create a human habitat; but simply bringing a cat or a bird into a nursing home without embarking on deeper aspects of interpersonal and organizational transformation will yield poor results, (as many people have found when they have tried to "short-cut' the process).

Now the Green House Project (TM) has spawned a new movement to complete the physical transformation of long-term care through the construction of small homes that house only 8-10 elders. The media and society at large are paying attention. In addition to Green Houses, many other small house models are in development, and a new movement is born.

But every new trend has potential pitfalls for those who rush to adopt the concept without a deep understanding of its origins. So what do we need to watch out for next? What are the "fur and feathers" of these small house models?

Quite simply, it's the house itself. These homes are such a radical departure from any nursing home we've seen, that they cannot help but astound people who view them for the first time. What a great idea! Why haven't we thought of building these before?

There's an excellent reason why. If the building was all there was to it, we'd have built them a long time ago. However, our ATTITUDES about aged care have created the physical features of traditional nursing homes. Our society's view of aging as decline and our paternalistic approach to elder care have informed the institutions we have built over the past half century. You don't erase those biases simply by putting people in a small house.

I believe that small homes like the Green House are the future of aged care. The best ones, however, realize that the physical structure will not solve the plagues of institutionalization unless it embodies more than walls and windows. It must also reflect a new attitude toward aging and the aged, toward well-being and illness, toward risk and reward, toward autonomy, and toward collaborative approaches to care.

In short, we must build Green Houses in our minds, in our interpersonal relationships and in our operational design, before we lay that first cornerstone. Otherwise, it'll just be a 10-bed institution.

-- Al Power

Posted by Dr. Bill Thomas on April 4, 2008 10:19 AM |Permalink |Comments (0)

April 3, 2008

Pumping Iron the Old Fashioned Way

[Guest post from UMBC's Kavan Peterson]

Interesting story from today's New York Times featuring a local (if you live in Baltimore): 60-Plus, Ripped, and Natural Competitors

UNTIL nine years ago, Dr. Neal Grossman didn’t make a habit of parading around his bedroom in his skivvies and admiring his physique in the mirror. Nor did he ever imagine that his oldest son, then a teenager, would take one look at his father midflex and cry out, “Dad, put your clothes back on!”
But now that Dr. Grossman, a 60-year-old Baltimore dentist, is a competitive amateur bodybuilder, an extra ounce of flab makes the difference between a sizable trophy and going home empty-handed. “The minute you start winning, that’s all the validation people need to accept what you do as legitimate and something to be appreciated,” said Dr. Grossman, who is 5-foot-2 and a chiseled 121 pounds.

He is one of a small but growing number of 60- and 70-year-old bodybuilders stripping down to Speedos, slathering on bronzer, and strutting their stuff onstage in natural, or drug-free, competitions. The season for amateur and pro-level events begins this month.

Here's the best of quote of the story:

“Age is a statistic, not a burden and there is no reason a man or woman can’t get into and maintain the best shape of their lives at any age,” said Scott Hults, 64, who has competed in 26 shows since 2005 and last year won an age-group title.

The story goes on to say that the number of men and women in their 60’s and 70’s competing in bodybuilding competitions has doubled in the past five years. It also claims that "Older bodybuilders tend to be disciplined purists," who are not as likely to be seduced into taking steroids or other illegal enhancements. I hope that's true... but the story also acknowledges that increasingly popular controversial medical treatments such as human growth hormone and testosterone replacement therapy are being abused by older body builders:

Still, antidoping experts wonder just how natural “natural” bodybuilding is.
Neither the World Natural Sports Organization nor the International Natural Bodybuilding Federation perform blood tests, which is the only way to test for human growth hormone, said Dr. Gary Wadler, an internist and a member of the World Anti-Doping Agency.

[Photo courtesy of The New York Times]

Posted by Kavan Peterson on April 3, 2008 4:30 PM |Permalink |Comments (0)

April 1, 2008

Aging, Caring For Aged

[Editor's Note: Dr. Thomas is traveling in the U.K. this week visiting and lecturing for the nation's largest long-term-care agency. We hope to post photos and updates from Dr. Thomas' tour soon.]

Roger Catlin, TV critic for the Hartford Courant, provides a moving review of PBS' upcoming special "Caring For Your Parents":

In a way, each of the stories in the PBS special "Caring for Your Parents" is monumental, with five families in the Providence area attempting to care for the elderly.
Some spend hundreds of thousands of dollars a year to provide care so elderly parents can stay at home at long as possible. Others juggle jobs and family to try to provide that care themselves. Some have sent parents to a nursing home or assisted care facility when it was clear there wouldn't be enough assistance at home. Still others are still trying to convince their aging parents that care is actually needed.

Read the full story here.

"Caring for Your Parents" airs Wednesday, April 2 at 9 p.m. on PBS.

Posted by Kavan Peterson on April 1, 2008 9:43 AM |Permalink |Comments (0)

March 27, 2008

The ProAging Network

Last week the Erickson School hosted a ProAging Network event for aging services workers in MD, PA, VA and DC. I shared some thoughts on my philosophy of Developmental Aging. Take a look:

Posted by Dr. Bill Thomas on March 27, 2008 10:21 AM |Permalink |Comments (1)

March 14, 2008

More Age-Bashing McCain

[Guest-post by UMBC's Kavan Peterson]

Following-up on Bill's post "Age Bashing McCain", The New York Times explores how "codger jokes" have become a mainstay of late-night-comedy in contrast to taboos over gender and race jokes:

“Mr. Leno and his counterparts have been merciless with Mr. McCain, peppering their monologues with digs about dementia, pills, prostates and Miracle Ears. In a nightly schtick, David Letterman compares Mr. McCain to ‘the old guy in the barbershop,’ ‘a mall-walker,’ ‘a Wal-Mart greeter’ and more. Conan O’Brien said recently, ‘After John McCain swept yesterday’s primaries, he purposely stole a line Barack Obama’s been using: I’m fired up and ready to go. When Obama heard this, he stole a line McCain’s been using: I’m old and not sure where I am.’”

Hat-tip to Ronni Bennett for dissecting this story.

Posted by Kavan Peterson on March 14, 2008 10:23 AM |Permalink |Comments (1)

March 10, 2008

TGB's "This Week in Elder News"

[A sample of Elder news from Ronni Bennett at TGB: In this regular Saturday feature you will find links to news items from the preceding week related to elders and aging, along with whatever else catches my fancy that I think you might like to know. Suggestions are welcome with, however, no promises of publication.]

Today marks the launch of a new group blog, Wowowow which stands for “The Women on the Web”. The blog features a bunch of New York’s elite, elder women such as gossip maven Liz Smith, actors Candace Bergen and Whoopi Goldberg, TV journalist Leslie Stahl, “Miss Manners” otherwise known as Judith Martin, comedian Lily Tomlin and a few more. I have no idea yet how “wow” this idea is, but you can read more about it here.

Dr. Robert N. Butler who invented the term “ageism” and who is CEO and president of the International Longevity Center-USA, published an issue brief on elders and drug safety [pdf]. Although elders use 40 percent of all prescription drugs, the FDA does not require us to be included in trials on efficacy and safety. This is crucial information you and your physician should know.

On the same topic, manufacturers increased the prices of prescription drugs by an average of 7.4 percent last year - two-and-a-half times the rate of inflation. The price of the sleep drug Ambien jumped 27.7 percent.

Tenure can be hard to come by for college professors; many wait decades. But 68-year old Victoria Rauch Lichterman, assistant professor of humanities at New York City College of Technology who focuses on the negative effects of ageism, was recently granted tenure after just six years of teaching at the school. Score one for elder academics. [Hat tip to Naomi Dagen Bloom of A Little Red Hen]

When Crabby Old Lady posted her objections last Tuesday to Hillary Clinton Feminists, she quoted but did not comment on a NOW leader’s swipe at black women who choose not to vote for Senator Clinton because – well, Crabby is white and doesn’t believe she can properly speak for black women. Now, G Bitch has done it for Crabby in a colorfully worded and no-uncertain-terms rant.

When, through some glitch in the system, Social Security declares you dead, it is nearly impossible to convince the agency your heart still beats. “’I don’t think people realize how difficult it is to be dead when you’re not,’ said [Laura] Todd, who is very much alive…even though the federal government has said otherwise for many years.” It happens more often than you would think. Between January 2004 and September 2005, Social Security had to resurrect 23,366 beneficiaries and plenty more who remain active and above ground are still on the dead list.

Posted by Dr. Bill Thomas on March 10, 2008 1:24 PM |Permalink |Comments (0)

March 4, 2008

Generation Jones

This is news to me.

Posted by Dr. Bill Thomas on March 4, 2008 6:18 AM |Permalink |Comments (0)

February 29, 2008

12 People Who Are Changing Aging - No. 12

[Editors note -- this is the piece of a 12-part feature by The Wall Street Journal profiling "pioneers who are shaping the way Americans will live, work and play in later life."]

Number Twelve -- Reinventing the Nursing Home

The spark for William Thomas's work came in 1991 while treating a patient in an upstate New York nursing home. "She grabbed my arm, pulled me down over the bed, looked in my eyes and said, 'I'm so lonely,' " he recalls.
To revitalize the place, he opened the doors to children, brought in parakeets, cats and dogs, and plowed up the grounds for a garden. The effort grew into the Eden Alternative, a nonprofit that has helped more than 500 nursing homes across the country shift their focus to their residents' emotional well-being and away from institutional scheduling.

Today, Dr. Thomas is widely regarded as a leader in efforts nationwide to bring humanity to the end of life. In 1999, while touring the country to promote the Eden Alternative's work and a novel about aging, "I realized that America's nursing homes are getting older faster than we are," he says.

Accordingly, he developed the idea of replacing traditional nursing homes with "Green Houses," cozier facilities centered on big kitchens with technology-laden bedrooms and nursing aides who also serve as housekeepers and companions. To date, there are 35 Green House projects; the Robert Wood Johnson Foundation is helping fund an expansion of the program.

For his next act, Dr. Thomas, 48, wants to become "the Dr. Spock of aging."

"The boomers are creeping toward elderhood, and I aim to help explain [the] terrain," he says. "The 'new' old age [is] a time of strength and growth and development and engagement."
-- By Kelly Greene, The Wall Street Journal

Click here for more information on the Green House Project. Visit the Eden Alternative Web site here: http://www.edenalt.org/

[Photo courtesy of Jim Harrison]

Posted by Dr. Bill Thomas on February 29, 2008 12:37 PM |Permalink |Comments (0)

February 28, 2008

12 People Who Are Changing Aging - No. 11

[Editors note -- this is a continuation of 12-part feature by The Wall Street Journal profiling "pioneers who are shaping the way Americans will live, work and play in later life."]

I am honored to count John Stewart as a friend and, just to show you how committed he is to learning, growing and changing--- he is also a student in the Aging 600 course that I co-teach with Judah Ronch. By the end of the year, John will be able to add a Masters in Aging Services degree to his impressive list of accomplishments.

Think about how cool it is to have a Masters program that has one of the top leaders in the field of aging as one of its students.

Out of the park baby!

--Dr. Thomas

Number Eleven -- Urban Planner

John P. Stewart is working on a blueprint for making city services receptive to all of the needs of older Americans -- whether in health care, transportation, safety, employment or continuing education. To date, 16 cities have joined in the effort, including Baltimore, New York, Philadelphia, Chicago and Atlanta.
"I was really struck by the fact that we needed to change the way we look at aging services," says Mr. Stewart, who for 32 years worked as a Maryland state health and education administrator, and is now executive director of the Commission on Aging and Retirement Education for the city of Baltimore.

More than 25% of the U.S. work force is over 60 and living healthier lives, Mr. Stewart says. "A lot of people are going to have to work longer."

To focus on the question of what a senior-friendly city should look like, Mr. Stewart helped create a nonprofit think tank, the Baltimore City Center for Urban Aging Services and Policy Development. Issues under study include how to help grandparents who are raising their grandchildren; upgrading community senior centers with fitness equipment and personal trainers; and providing counseling to help cope with poverty and social isolation.

"This 'declinist' theory that people get old and should be put away is insane," says Mr. Stewart, 63. "We can be an asset."
-- By Kelly Greene (photo courtesy of The Wall Street Journal)

Tomorrow -- Reinventing the Nursing Home.

Posted by Dr. Bill Thomas on February 28, 2008 11:34 AM |Permalink |Comments (0)

February 27, 2008

12 People Who Are Changing Aging - No. 10

[Editors note -- this is a continuation of 12-part feature by The Wall Street Journal profiling "pioneers who are shaping the way Americans will live, work and play in later life."]

Number Ten -- Advocate for the Aging

John Rother, AARP's policy director, is ultimately responsible for everything that the largest membership group for older Americans advocates at the state and national levels. He is constantly in motion, making about 80 speeches a year around the world and lobbying lawmakers nationwide.

"I've got the best job in Washington," says Mr. Rother, 60, who joined AARP in 1984 after serving as staff director and chief counsel to the Senate Special Committee on Aging.

Health care is his primary focus today. "It's too expensive, and we aren't getting our money's worth," he says. Fixing it "is going to take everything we know how to do -- prevention, better management of chronic care, improving quality, being smarter purchasers as the government and individuals."

In recent years, Mr. Rother has played a role in helping to pass -- or block -- some of the most significant legislation in Congress: the Medicare prescription-drug benefit (not "everything we had hoped it would be, but...certainly better than nothing"); Social Security privatization; and the national do-not-call registry.
-- By Kelly Greene, The Wall Street Journal

Tomorrow -- Urban Planner.

Posted by Dr. Bill Thomas on February 27, 2008 12:30 PM |Permalink |Comments (0)

February 26, 2008

12 People Who Are Changing Aging - No. 9

[Editors note -- this is a continuation of 12-part feature by The Wall Street Journal profiling "pioneers who are shaping the way Americans will live, work and play in later life."]

Number Nine -- Senior School Master

Returning to school, in some fashion, is high on many people's to-do lists in retirement. Bernard Osher is helping to build the classrooms and programs you might enter.

Mr. Osher helped his family start Golden West Financial Corp. in the 1960s and created a personal foundation in the 1970s. Today, he is pouring nearly $200 million into what has become known as lifelong learning, or college-based education for older adults.

A native of Biddeford, Maine, Mr. Osher had his first significant exposure to the practice in 2000 during a visit to the Fromm Institute for Lifelong Learning at the University of San Francisco. "I came away very impressed," he says, particularly with "the joy of learning" that he witnessed.

Several months later, a trip to the Senior College at the University of Southern Maine in Portland sealed his interest. The Bernard Osher Foundation made a $2.2 million gift to the Maine program in 2001, allowing the university to expand its peer-taught courses and workshops to more than 1,000 students ages 50 and older. Since then, the foundation has donated $73 million to nearly 120 lifelong-learning institutes on university campuses from Maine to Hawaii. Future grants will be used primarily to augment those programs.
-- By Kelly Greene, The Wall Street Journal

Tomorrow -- Advocate for the Aging.

Posted by Dr. Bill Thomas on February 26, 2008 12:28 PM |Permalink |Comments (0)

February 25, 2008

12 People Who Are Changing Aging - No. 8

[Editors note -- this is a continuation of 12-part feature by The Wall Street Journal profiling "pioneers who are shaping the way Americans will live, work and play in later life."]

Number Eight -- Keeping Minds in Shape

Michael Merzenich is working to make "brain exercise" as much a part of your routine in retirement as walking or jogging.

As chief scientific officer at Posit Science Corp., a San Francisco software maker, Dr. Merzenich, age 65, is at the forefront of efforts to improve mental health in later life. His interest in the field dates to the mid-1980s, when he was involved in experiments training animals at the University of California, San Francisco.

"We were watching [the animals'] brains change as they acquired skills and abilities," he remembers. Consequently, he began investigating tools that could promote and measure mental fitness in humans.

His first company, Scientific Learning Corp., started in 1996, created software for children struggling with language problems. Posit Science, which Dr. Merzenich founded in 2003, is focused on older adults. Its first product was designed to improve memory and cognition (thinking and processing speed), mainly through listening exercises; this spring, the company plans to release a new brain-training program focused on vision.

Dr. Merzenich, still a neuroscience professor at UCSF and an inventor with more than 50 patents, is working on exercises that support decision making, fine motor control (playing musical instruments, for example), and gross motor control (to help restore balance).
-- By Kelly Greene, The Wall Street Journal

Posted by Dr. Bill Thomas on February 25, 2008 12:26 PM |Permalink |Comments (0)

February 24, 2008

12 People Who Are Changing Aging -- No. 7

[Editors note -- this is a continuation of 12-part feature by The Wall Street Journal profiling "pioneers who are shaping the way Americans will live, work and play in later life."]

Number Seven -- Spreading Financial Literacy

Sheryl Garrett is on a mission to bring financial planning to the masses.

In the late 1990s, Ms. Garrett, a certified financial planner in Shawnee Mission, Kan., says she came to realize that many middle-class families knew little about managing money and retirement finances -- and couldn't afford to pay for help. Accordingly, instead of tying her fees to commissions or the size of a client's assets (common practices among financial advisers), she decided to charge by the hour.

"It's sort of like going to the dentist," says Ms. Garrett, who is 45. "You don't pay your dentist a retainer -- you pay him for time and expertise."

She soon found herself profiled in financial publications and fielding requests from consumers as far away as Massachusetts and California who wanted to hire her. In response, in July 2000, she launched Garrett Planning Network Inc., which now has almost 300 advisers across the U.S. The certified financial planners pay $7,500 to license the business model. They are required to offer their services exclusively as fiduciaries (meaning they are legally obligated to put their clients' interests first) and on a fee-only basis. Hourly rates are about $175.

Ms. Garrett is also seeking ways to raise financial literacy among the wider public, including possibly through electronic games, a nighttime soap opera or a personal-finance makeover TV show.
-- By Kelly Greene, The Wall Street Journal

Tomorrow -- Keeping Minds in Shape.

Posted by Dr. Bill Thomas on February 24, 2008 12:24 PM |Permalink |Comments (0)

February 22, 2008

Power Up Friday: "I Want To Be Sedated"

A recent issue of “Caring for the Ages” reports that New York State has seen a leveling off of the use of antipsychotic drugs in people with dementia in nursing homes. These drugs, developed for schizophrenia, have also been used to treat behavioral symptoms that can accompany dementia. In 2005, about 32.5% of New York nursing home residents with dementia were on the medications, and in 2006 it dropped slightly to 31.9%. Dr. Christine Teigland of NYAHSA commented that this was hopefully a positive trend, and that a rate of more than 30% “is probably too high”.

No argument here, except that I would replace “probably” with “way, way”. Overall about 40% of people with dementia in nursing homes of the industrialized world are on these drugs. Perhaps we are seeing a moderation of the epidemic use of these drugs, but I remain skeptical. A little background:

As a result of OBRA legislation, by 1996 the use of these drugs dropped to 16% of all people in nursing homes (with or without dementia). Then a new generation of drugs was introduced. These “atypical antipsychotics” were touted as being safer and more effective, and their use began to skyrocket.

By 2000, the number of Medicare recipients on these drugs had nearly doubled, to 28%. From 2000 – 2005, the total number of antipsychotic prescriptions in the country rose from 29 million to nearly 45 million. (The only target population that increased signicantly in that period was the number of people with dementia.)

But the “atypical” drugs have been found to be much less safe and effective than they were originally claimed to be. These new concerns may explain why their use has leveled off in some areas. Will the trend continue?

A recent industry web posting indicates that there are 40 new antipsychotic drugs in the R&D pipeline. The industry seems convinced that these drugs will be a mainstay of treatment for the increasing elder population who will develop dementia. No doubt, this next crop of drugs will also be released with claims of being “safer and more effective”.

Changing the care environment can drastically reduce the use of these sedating and potentially harmful drugs. But that takes a lot of work - it’s much easier to simply give a pill and sedate the behavior. When will we learn that there is no quick fix?

--Al Power

Posted by Kavan Peterson on February 22, 2008 6:15 PM |Permalink |Comments (0)

12 People who Are Changing Aging -- No. 5

[Editors note -- this is a continuation of 12-part feature by The Wall Street Journal profiling "pioneers who are shaping the way Americans will live, work and play in later life."]

Number Five -- A Life of Purpose

If you find yourself, in your 60s and 70s, immersed in a new career and a new passion -- teaching children to read, for instance, or helping an environmental organization -- you may have Charles Feeney to thank.
Mr. Feeney, 76, is the founding chairman of Atlantic Philanthropies, an international foundation that is committed to disbursing its entire $4 billion endowment by 2020. A large chunk will go to help older adults "live healthier, independent lives with dignity, purpose and meaning," says Brian Hofland, director of Atlantic's international aging program.

The foundation, for instance, has helped fund the Purpose Prize, awards of $100,000 given each year to five "social entrepreneurs" age 60 or older who are tackling some of society's biggest challenges. Civic Ventures, the San Francisco nonprofit that created the Purpose Prize, last year received $10 million from Atlantic Philanthropies in part to stimulate development of "encore careers" for people 50 and older.

Mr. Feeney himself is a bit of a recluse. (He declined to be interviewed for this article.) He doesn't own a house or a car, and when flying, he typically travels coach, says Conor O'Clery, an Irish journalist and biographer of Mr. Feeney. It wasn't until 1997, after Mr. Feeney sold the company he founded (DFS Group, a chain of airport stores), that his sizable charitable efforts became public.

"A lot of what Chuck likes doing is building buildings at universities and hospitals," Mr. O'Clery says. "But more and more, he became concerned with health issues, and I think his interest in aging grew out of that."
-- By Kelly Greene, The Wall Street Journal

Tomorrow -- Staying Mobile.

Posted by Dr. Bill Thomas on February 22, 2008 12:00 PM |Permalink |Comments (0)

February 21, 2008

12 People who Are Changing Aging No. 4

[Editors note -- this is a continuation of 12-part feature by The Wall Street Journal profiling "pioneers who are shaping the way Americans will live, work and play in later life."]

Yesterday, Brenda from MAgS made this excellent comment in response Eric Dishman's laudable efforts to help people live independently:

Staying home is great, and seems to be what everyone wants. But where is the healthcare? In a CCRC, healthcare is available whenever it is needed. At home, unless links have been made in advance, getting healthcare can become a real obstacle to staying put, and people should not be fooled that technology can fully take the place of personal care.

Here's what's at the heart of this debate: Our society judges the worthiness of individuals based almost entirely on their ability to function and act like adults. There's good reason why most folks want to live independently -- failing to live independently is tantamount to failing to be an "adult." The consequences ARE SEVERE. Failing to be an adult can result in loss of home, loss of possessions, having your pets euthanized and ultimately, the loss of freedom, privacy and dignity.

I am keenly interested in the idea of aging in community as a successor to America's increasingly outmoded devotion to Aging in Place. Aging in Place lionizes the private family home as the ONLY legitimate place where older people can and should live. I suppose one could argue that back when we all lived in close proximity to a large network of close blood relatives, aging in place was the natural order of things. But guess what?

The world has changed and our understanding of aging needs to change as well. What people in late life need, in addition to privacy, safety and dignity, is to be part of a real flesh and blood community. The need to be able to participate in a range of meaningful relationships, people (of all ages) need to care and to know that others care about them.

Living alone in a typical detached family dwelling (minus the family) cannot serve this need and that is why I think that Aging in Place is failing us as an organizing concept for the last half of life.

These ideas bring us to the next WSJ Changing Aging profile and a familiar face to the Erickson School family -- John Erickson, founder of Erickson Retirement Communities, who helped launch the Erickson School and continues to be a committed partner in our work. John's genius has, I think, revolved around making the decision to "leave home" into a move toward something -- a vibrant community-- rather than a move away from something-- leaky gutters.

Number Four -- Helping People Leave Home.

In contrast to Mr. Dishman, John Erickson sees a future where millions of Americans leave their homes in later life. And he's preparing your accommodations.

Mr. Erickson, 63, is chairman and chief executive of closely held Erickson Retirement Communities, one of the country's largest developers of continuing-care retirement communities. In a CCRC, residents are guaranteed access to different levels of long-term care as they age.

Starting in Maryland in 1983 with a single facility (a renovated seminary), Mr. Erickson began developing retirement "campuses," where residents, among other activities, can produce their own TV shows. Today, the company has 20 CCRCs with 21,000 residents in 11 states. Mr. Erickson hopes to nearly double that number in five years.

Why should we leave our homes in later life? "Accidents, falls, depression, isolation," Mr. Erickson answers. "That's not what was meant for the last half of retirement."

Beyond housing, Mr. Erickson also may have a hand in shaping what older adults watch on television. In the past two years, he has spent an estimated $100 million building Retirement Living TV, a cable network focused on later life. He also donated $5 million in 2004 to start a professional program at the University of Maryland, Baltimore County, that combines management, policy and aging issues.
-- By Kelly Greene, The Wall Street Journal

Tomorrow -- A Life of Purpose.

Posted by Dr. Bill Thomas on February 21, 2008 10:00 AM |Permalink |Comments (1)

February 20, 2008

12 People Who Are Changing Aging No. 3

[Editors note -- this is a continuation of 12-part feature by The Wall Street Journal profiling "pioneers who are shaping the way Americans will live, work and play in later life."]

Number Three: Helping People Stay Home

For no small number of people, aging means losing their independence -- and, eventually, leaving their homes.

Someday, technology being developed by Eric Dishman and his staff at Intel Corp. may help people stay in their homes longer.

Mr. Dishman has focused on ways to assist the elderly since he was a teenager helping care for a grandparent with Alzheimer's disease. Years later, he was working for Microsoft Corp. co-founder Paul Allen on a "nursing home of the future," he says, when someone made an observation that helped alter his approach to the matter completely.

"Someone said, 'I think we asked the wrong question,' " he recalls. " 'It's not how can we make the nursing home better through technology, but how can technology keep people independent?' "

Mr. Dishman, 39, is general manager in charge of product research and innovation for Intel's Digital Health Group. Prototypes emerging from his group's offices and labs have a Jetsons-like feel: a carpet with sensors that may reduce the risk of a fall; a "caller ID on steroids," which shows and tells you who is at the front door and when you last spoke; a system that helps people with memory problems cook for themselves.
-- By Kelly Greene (Photo courtesy The Wall Street Journal)

Tomorrow -- Helping People Leave Home (THIS ONE hits close to home too!)

Posted by Dr. Bill Thomas on February 20, 2008 9:00 AM |Permalink |Comments (1)

February 19, 2008

12 People Who Are Changing Aging No. 2

[Editors note -- this is a continuation of 12-part feature by The Wall Street Journal profiling "pioneers who are shaping the way Americans will live, work and play in later life."]

Number 2 -- Harnessing Technology

In the mid-1990s, before joining MIT, Prof. Joseph Coughlin was working for a federal contractor, studying the aging population's potential impact on transportation.
"It was like unwrapping an onion," he remembers. "We hadn't thought about housing, [or] the future of work. And we certainly hadn't thought about transportation."

That epiphany led to the creation, in 2000, of AgeLab, where Prof. Coughlin and his colleagues are designing -- and pushing companies to embrace -- technology that will enhance older adults' daily lives.

One of his favorite breakthroughs is a "personal adviser" that Procter & Gamble Co. has licensed, based on AgeLab research, to help food shoppers identify products that are healthy for them. The device, to be attached by supermarkets to their grocery carts, is like a minicomputer with a scanner. Shoppers insert smart cards that contain their dietary particulars. Then, as they shop, they swipe products past the scanner to get the device's opinion. Let's say you're prehypertensive and scan a box of crackers; after reading the bar code, Prof. Coughlin says, the adviser may suggest trying a different product with a lot less salt.

Tomorrow -- Helping People Stay Home.

Posted by Dr. Bill Thomas on February 19, 2008 12:00 PM |Permalink |Comments (0)

AARP U@50 Winners!

UPDATE

Originally Posted Sept. 10, 2007:

I like this...

The "U@50" Challenge has been announced by the
Office of Academic Affairs at AARP and is already
generating great national interest.

U@50 asks those in their twenties to ponder the
question: Where do you see yourself by the time you
turn 50? To answer the question, contestants produce
a one to two minute video sharing their vision of the
future. The winner will receive $5,000 with other
cash prizes for the top five videos chosen.

I look forward to watching the entries--- they should be great.

Well, AARP released the winners last week and I have to say I'm a little disappointed. Of the top five, only Number Two really captured my attention --

Awesome.

Number Five was good for a laugh:

Take a look at the winners here: http://www.youtube.com/uat50

Posted by Dr. Bill Thomas on February 19, 2008 7:17 AM |Permalink |Comments (1)

February 18, 2008

12 People who Are Changing Aging

Or your retirement, to be exact. The Wall Street Journal over the weekend looked into their crystal ball and profiled 12 folks, including myself, "whose work, in effect, is shaping the future of retirement."

From the Encore section of the WSJ, editor Glenn Ruffenach explains:

One thing we try to do with each issue of Encore is to get you to think about retirement and later life -- how you might spend your time and money. As it turns out, a lot of people are thinking about your retirement, and our cover story tells you what they have in mind.

Kelly Greene, a staff reporter in The Wall Street Journal's Atlanta bureau, asked experts in aging across the country to identify those individuals whose ideas and work are likely to have the biggest impact on the future of retirement. The 12 people she profiles already are pushing their plans out of offices and labs and into older adults' lives. We think it makes for an instructive and fascinating read.

We at ChangingAging.org agree. We'll feature all 12 of the WSJ's profiles over the next couple of weeks. Today -- The Numbers Guy

William Bengen
It's the most frequent question, and biggest concern, for many people approaching retirement: How big a nest egg will I need, and how do I make it last?

William Bengen is working on that.

Mr. Bengen, a certified financial planner in El Cajon, Calif., has already achieved what amounts to rock-star status in the retirement-planning business. His pioneering research in the 1990s gave rise to the "4% rule": Withdraw no more than about 4% a year from your nest egg, and it's highly likely that your savings will last 30 years. That finding has already helped to establish budgets and spending patterns for numerous retirees.

Today, Mr. Bengen, age 60, continues to refine his research. In 2006, he introduced a method of withdrawing funds from nest eggs that tailors the 4% rule to individual circumstances. (It's online at www.fpanet.org/journal. Click on "Past Issues & Articles," then on "Past Issues," and go to August 2006.) And now, he is researching, he says, "the possibility that dividend-paying stocks, particularly those that increase dividends over time, might provide a better retirement resource than the S&P 500." As Mr. Bengen explains: "The thesis is that those have at least as high a total return as S&P 500 stocks, and they have lower volatility.... If you have stocks that don't go down as much in the bear markets, you're better off."

Mr. Bengen doesn't see himself as shaping baby boomers' financial future. He says he simply wants to help his 60 or so clients.

"I was starting to get some clients who were planning for retirement," he recalls, "and they were asking me, 'How much can I take out, and how should I set up my investments?' And I couldn't find a thing substantiated by any research."
-- By Kelly Greene, The Wall Street Journal

Tomorrow -- Harnessing Technology

(Or read ahead here)

Posted by Dr. Bill Thomas on February 18, 2008 12:00 PM |Permalink |Comments (0)

February 9, 2008

Power Up Redux: "Away From Her"

[Editor's note: This comment was originally posted by Al Power in response to some fantastic comments on his post about the film "Away From Her." Since it's longer than the original post (and hard to read in the comments section as Naomi pointed out :), I thought it's worth putting up by itself.]

Well, now we're getting somewhere!!

Let me try to explain where I'm coming from in a somewhat coherent way:

First, regarding plot believability (in "Away From Her"), I tried to steer away from those concerns - I could also nitpick some of the details, but I was looking at this movie from a whole different place. I don't see it as overly pretty or rose-colored at all. In fact I think it asks harder questions than "The Savages" did. The latter movie hits the more obvious problems with nursing home care, (all very legitimate), and the family issues rang extremely true to me in that movie, as I have said previously.

"Away From Her", however, touched on areas that I have been wrestling with in my current writings. A major difficulty most people have with my ideas stems from the nature of this disease. It's far easier to make a film that finds hope in coping with, say, cancer or paraplegia without being accused of being Polyanna-ish. But there's something inherently difficult in the concept of losing one's cognitive abilities - people find it much harder to see this as anything but the worst of tragedies. I think we'd all rather lose just about anything than our mental faculties, and many would choose death first.

What I'm trying to say is that it is this very tragic view of Alzheimer's disease that has caused our whole medical and elder care system to treat it purely as tragedy, and to view the person with dementia as fundamentally and irretrievably broken beyond repair.

This has played out in the ways we resort to institutionalized, segregated and programmatic approaches, and resort to medications that we would never rush to use on people in any other state. There is no more disempowered, "abandoned" person in our medical care system than the one with dementia.

As a result, most caregivers don't even bother to, as Fiona said, "try to find a little grace" in a bad situation. And that is what to me is much deeper than The Savages.

It's easy to show a crowded, dingy nursing home with crass lighting, but to show a country club atmosphere with people that say all the right things and still make such incredibly poor choices for those who live there is, to me, a far deeper indictment of how our elder care system needs fixing.

It is this same attitude toward dementia that leads many loved ones to take on the person's disease more as their own personal tragedy, which is what Fiona's husband did. It certainly was a tragedy for him as well, but he kept trying to shake her back to a place her mind could no longer occupy, because he could not find that grace and acceptance of her illness that she had somehow come to terms with in her own way. That is something I see quite often. And his attempts to shake her back to "normalcy" mirror our usual medical approach to people with dementia - it's like pushing a paraplegic out of their chair to try and force them to walk.

And when people fail to respond to our efforts, we medicate them for failing. I liked it that Fiona said that she preferred to sit with Aubrey because "He doesn't confuse me". What I also liked was that Grant finally discovered that the best way to connect to his wife was to go to her place, even if it wasn't his own reality.

This is the core of my work with viewing dementia from an experiential, rather than a neurochemical standpoint, and conforming the environment to the person's needs, rather than trying to force them back into "normal" patterns that no longer exist.

While it certainly doesn't cure the disease, some amazing "blossomings" have resulted - and people often do things that many doctors said were beyond their capability. (There are a few people with dementia who have traveled the world as spokespeople for those with the disease. In her book Dancing With Dementia, patient/author Christine Bryden writes that she has been called a "liar" by neurologists, because she shows a picture of her MRI scan at her talks and they refuse to believe that a woman with such a "swiss cheese" brain appearance can stand up and lecture!)

So ultimately, as crazy as it may sound, I choose to see each person with dementia as a person capable of continued growth, development and engagement with life, in spite of the fact that they have a disease that will, as Grant said, "progress".

And that view informs my out-of-the-box notions of how to care for people with the disease. This is the only movie I've ever seen about dementia that has dared to challenge our conventional view that there is little more than tragedy and loss, and to show the complex capacities that many people maintain well into their disease, (that our usual approach to care unfortunately stifles and suppresses).

What I'm saying may sound hopelessly naive in theory, but when 40% of people with dementia in nursing homes in the US and other developed countries are on antipsychotic drugs and only 7% of mine are, I think there is reason for hope.

Thanks for the responses!

-- Al

Posted by Dr. Bill Thomas on February 9, 2008 12:57 PM |Permalink |Comments (1)

February 8, 2008

Power Up Friday: Honoring Our Elders

The latest edition of the Administration on Aging's "Profile of Older Americans" has been released. Here are a few highlights:

We are becoming more elder-rich. Older Americans, (those 65 and over), now account for 1 in 8 Americans. Elders have increased 10% over the past ten years, and currently number over 37 million. There are nearly 74,000 centenarians.

Our elder population will "boom" soon. The number of people aged 45 - 64, (tomorrow's elders), increased by 39% in the same period, as our "Baby Boomers" move toward becoming "Elder Boomers".

Elders continue to raise children. Nearly a half million elders have primary responsibility for grandchildren who live with them.

Many elders have little or no "nest egg". Nearly 10% live below the poverty level. A third of all elders derive 90% of their income from Social Security.

Elders are overall better educated. From 1970 - 2006, the number of elders with a high school diploma rose from 28% to 77.5%. About 20% of our current elders hold bachelor's degrees.

Elders' health expenses are high. Out-of-pocket costs averaged $4331 last year, over 12% of their total expenses. About 20% of that ($887) was for medications.

If you went to college, you are doing okay.... Elders with a degree had an increase in median household income from $80,000 to $87,000 over the past 20 years.

But if you didn't finish high school, you probably are doing poorly. Median household income dropped from nearly $30,000 in 1984 to only $28,403 in 2004.

Racial disparities persist. Median incomes are 30% lower in people of color and poverty rates are disproportionately high, especially among older African-American and Hispanic women who live alone (about 40% living in poverty).

"Social capital" remains critical. From Laura Beck, Program Director of Eden At Home: About 80% of home care services are provided by family care partners. This represents about 257 billion dollars in unpaid labor yearly.

Commentary: Other than grandparenting and workforce figures, the report makes no mention of the many gifts we have received, and continue to receive, from this amazing group of people. Debates about rising costs of elder care should be framed within a much larger discussion: How should our society honor its elders?

-- Al Power

Posted by Dr. Bill Thomas on February 8, 2008 9:15 AM |Permalink |Comments (0)

February 1, 2008

Power Up Friday: “Away From Her"

The subject matter of this film - a woman in her early 60’s who develops Alzheimer’s disease - may put more than a few people off. But to avoid seeing “Away From Her” would be a mistake. It is simply one of the most beautiful films I have ever seen.

Julie Christie certainly deserves an Oscar for her amazing performance, but Gordon Pinsent is also remarkable as her husband, and Olympia Dukakis puts a special magic into everything she does. Here are my thoughts about the film’s subject matter:

The movie transcends others I have seen on this topic by looking past the usual “movie of the week” portrayal of the illness and discovering the richness of life, rather than the tragedy of disease. In doing so, it instructs us in the art of caring for people with dementia.

We see that a beautiful facility with bright natural light, family-style dining, a variety of programming choices and positive, friendly staff can nevertheless be lacking in the qualities that create home for others. We see the critical importance of preserving ones ability to give care as well as to receive it. We also see a richness of experiential observations from Fiona (Christie) that show that a person with dementia is so much more than a sum of what they can and cannot do.

In spite of her illness, Fiona is able to exhibit grace, wisdom, humor and compassion. She also shows that by letting go and entering the world of the person with Alzheimer’s you can often best reveal the person inside. And the film reaffirms my somewhat unpopular belief that people should not be segregated or stratified based on a disease or level of function.

There is certainly sadness, but it never appears in the places you might expect. Instead it dwells in the complexities of life, love and relationships, rather than in simplistic portrayals of the disease.

Most of all, the film shows the power of love. It reminds us that love is easy and rather common when things are going well, but it is an uncommon love indeed that navigates the rougher waters of life. And the greatest irony is that the wisest words throughout the remarkable script always seem to be spoken by the person with dementia:

“Sometimes there’s something delicious in oblivion.”

“I’m going, but I’m not gone.”

And, “People ought to be in love every single day.”

-- Al Power

Posted by Dr. Bill Thomas on February 1, 2008 7:27 AM |Permalink |Comments (5)

January 30, 2008

BIZZARO news headline

AHHH-HA! This is my kind of news. Go Canada!

Aging really is depressing (until 50)
by TRALEE PEARCE
From Wednesday's Globe and Mail
January 30, 2008 at 8:34 AM EST

The biggest risk for a midlife crisis is not divorce, ill health or losing one's job. It's merely the act of aging itself.

According to new research published in the current issue of the journal Social Science & Medicine, whether you're in Canada, Mexico or Malaysia, most of us bottom out in our mid-40s, describing ourselves as unhappy or even depressed.

But here's the good news: We bounce back and describe ourselves as happier in our 50s and 60s.

Crunching data collected from health and social well-being surveys completed since 1972 by two million people in 80 countries, economist Andrew Oswald of the University of Warwick in Britain found that happiness follows a U pattern regardless of geography.

SNIP...

In some cases, Dr. Oswald and his colleagues were able to pinpoint specific ages that represent the nadir of middle-age mental health.

In Britain, 44 is the low point for men and women. In the United States, women reach it at 40, and men hold out until they're 50. Dr. Oswald says the mid-40s is the stage at which Canadians are most unhappy.

Fantastic news. As a male American, I have only one more year of the doldrums before the genius of aging liberates my mind.

Continue reading here.

Posted by Dr. Bill Thomas on January 30, 2008 8:35 PM |Permalink |Comments (0)

Ronni tells it like is

Ronni at www.timegoesby.net takes on AGEISM in the media. Check It Out: Quindlen's Shameful Ageism

Posted by Dr. Bill Thomas on January 30, 2008 11:44 AM |Permalink |Comments (0)

The Genius of Aging Campaign

[Guest post from Kavan at UMBC]

Earlier this month I highlighted Colorado's innovative strategic plan for aging, Silverprint Colorado. The mission behind this initiative is to "establish a culture for positive aging addressing the needs, contributions and opportunities" for all residents age 60 and up.

Today I want to highlight efforts in another state to put issues of aging and elderhood at the forefront of public discourse. Hawai'i's population of elders is growing more rapidly than anywhere else in the United States. In other words, Hawaii leads the nation in longevity. Hawai'i's CBS TV affiliate, KGMB9, has partnered with Dr. Bill Thomas to produce a ground-breaking, year-long campaign focused on addressing all the issues of aging and caregiving in the state. In "The Genius of Aging Campaign, Honoring Hawai'i's Kupuna," KGMB9 will partner with business, non-profit, government, grass roots, and education to cover related stories about aging, provide information and resources on air and the web.

Click here here to watch an introductory video.

Dr. Thomas kicked-off the campaign with this letter to Hawaiians:

Once upon a time, youth was everything. To be young was to be beautiful, strong, adventurous and good. That was the story we were told. Fortunately, we know that America is beginning to search for the wisdom that lies beyond youth. There is a growing awareness that aging and longevity have beauty and purpose of their own. Nowhere in America is this better understood than in the Fiftieth State.
The people of Hawaii have long appreciated and honored their kupuna. The tradition of respecting one’s elders has shaped the legacy, the legends, the culture, the very people of Hawaii. The time has come to publicly honor that history and to use it as a platform for exploring the new old age that is taking root in Hawaii.

This is what KGMB9's new campaign, "The Genius of Aging: Honoring Hawaii's Kupuna" is all about. KGMB9 is going to peer into and seek to understand how genuine respect for kupuna helped create the society in which we now live. Together, we will look at the present and examine the myriad of creative, exciting innovations that are remaking old age today. Finally, we will seek to understand the future. How will our changing understanding of aging --- change us.

The series is called "The Genius of Aging" because, when you think about it, aging is perhaps the greatest of all human inventions. After all, longevity is what makes grand-parenting possible, it blesses us with kupuna. We live in a busy world (and it seems to be getting busier) but all around us are wise elders, ready to share with us the lessons of lives well-lived. All we have to do is stop, listen and learn.

In the end, that is what this campaign is all about. I am grateful to Channel 9 for their enthusiasm and for bringing these stories to the public, and I value the campaign’s sponsors for their generous support. So, welcome to this fantastic journey.

Together, we can all, truly, honor the real geniuses of aging, Hawaii’s kupuna.

Dr. Bill Thomas

Click here to learn more about Hawai'i's kupuna.

Posted by Kavan Peterson on January 30, 2008 9:12 AM |Permalink |Comments (0)

January 29, 2008

Hey Doc, tell us how you REALLY feel...

From the Telegraph, London, British doctors in a survey tell us how they really feel about the National Health Service, Britain's publicly-funded healthcare system:

Don't treat the old and unhealthy, say doctors By Laura Donnelly, Health Correspondent
Doctors are calling for NHS treatment to be withheld from patients who are too old or who lead unhealthy lives.

Smokers, heavy drinkers, the obese and the elderly should be barred from receiving some operations, according to doctors, with most saying the health service cannot afford to provide free care to everyone.

NHS.htm

So much for the Hippocratic oath. But seriously, this kind of tawdry tabloid news coverage distracts from the real debate raging in Britain -- how does a country, with finite resources and a mandate to provide universal coverage, decide how to allocate those resources? There are no easy answers. What do you think of this decision by the British government (also from the above Telegraph story):

The Government announced plans last week to offer fat people cash incentives to diet and exercise as part of a desperate strategy to steer Britain off a course that will otherwise see half the population dangerously overweight by 2050.
Obesity costs the British taxpayer £7 billion a year. Overweight people are more likely to contract diabetes, cancer and heart disease, and to require replacement joints or stomach-stapling operations.

Continue reading here.

[Picture courtesy of NHS agency auxiliary nurse Tim Burness]

Posted by Dr. Bill Thomas on January 29, 2008 9:57 AM |Permalink |Comments (3)

January 28, 2008

Preventing the Epidemic of Falls

[Editor's Note] This public service announcement comes from Changing Aging reader Nate Bushnell, an 83-year-old retired salesman who is on a mission to bring balance -- literally -- to the lives of elders. Dig this Denver Post story on Nate's generosity.

Preventing the Epidemic of Falls
By Nate Bushnell
The Center for Disease Control predicts an epidemic of falls and injuries among our elderly population as it doubles during the next 12 or 15 years. One third of them will be injured in falls. The cost of caring for those recent injuries was 20 billion dollars per year. There is a need for better prevention of falls.

Understanding falls can be simple. The human body is made up of levers called bones and power sources called muscles. These are controlled by a nervous system which has sensors which help to keep us upright or balanced. When age or injury causes damage to the nervous system falls can happen. Gravity takes control of the off-balance person, causing a fall and injury.

Physical support is needed to prevent or stop a fall. For a balance-impaired person this can be supplied by a walking stick, a walker, a wheel chair or crutches.

The walking stick is a versatile, reliable support which can prevent gravity- powered falls. It has been used for thousands of years in societies around the world. A proven solution to a continuous problem. The Bible mentions it in "Thy rod and thy staff they comfort me."

The stick is a tall lever which connects to a power source, the shoulder and arm muscles, which lets the user pull himself up and prevent a fall. This ancient wisdom works. It needs to be discovered by our modern medical people.

A three-legged stool is more stable than a two-legged ladder.

I am an 83 year old user of a walking stick which has saved me from many falls. My colleague, Van Nielson has been a user for 20 years. I have made and given away over 120 walking sticks.
No complaints. It works.

Dependable support can reduce the injuries caused by the epidemic of falls, which is probably already here and growing.

The Walking Stick

The walking stick is a proven strong support for preventing falls and injuries. A good walking stick should be tall, strong, light weight, non-collapsible and well connected to the user's hand.

The stick is a lever which can reach a large area to give the strong muscles of the arm and shoulder a tall handle where the user can pull himself upright.

The versatile stick can be used to help a person pull himself up from a low chair or bedside, either alone or with the help of another person.

The tall stick makes going down stairs much safer and easier than with a cane.

If a fall does occur the strap on the stick maintains it's hold on the user's hand while the shoulder muscles tense and slow the fall so that little or no damage is done on impact. In three falls on a concrete curb I did not even get a bruise. I am a balance-impaired user, age 83. It works.

For most adults I make a stick 48 to 52 inches tall with a strap much like a ski pole at the top and a rubber crutch tip at the bottom. Parts cost is about $3.50. I have made and given away over 120 walking sticks. No complaints. Some instruction is needed.

"Get a cane" is not good medical advice.

INSTRUCTIONS on the use of the walking stick to add stability for balance-impaired people

Physical support prevents falls. Correct use of the strap for the hand is necessary.

With the stick upright, hold the strap out at right angles to the stick and towards you. Pass your hand up through the loop from below, then open your hand and bring it down on the strap and around the stick in one movement. Much of the weight will then pass through the strap and into your arm above your wrist, reducing wrist fatigue when using the stick.

Getting up from a low chair or bedside:

Scoot forward in the chair, put the bottom of the stick between your heels, top of the stick out in front of your face. Grasp the top of the stick in both hands and lean forward forcefully while pulling yourself up with the stick. This takes some practice to learn to do it well.

A caregiver can help make the above maneuver easier by standing in front of the user, facing him and one step back, both hands on the top of the stick. At the same time the user pulls himself upward while the caregiver pulls backward. An easy pull by both gets the user up.

Amputees who have lost one or two legs can use two sticks to add stability to their walking.

Crutch tips come in sizes. I use the 5/8th inch tip. It is available at hardware stores for about 69 cents. At drug stores they demand about 2 dollars each.

When a crutch tip is wet it gets slick and looses some traction. When I go into a store I scrub the crutch tip on the carpet inside the door to dry it. It helps.

Posted by Kavan Peterson on January 28, 2008 7:39 AM |Permalink |Comments (0)

January 16, 2008

Elders – Boon or Burden?

[Guest post by Kavan from UMBC]

In my years tracking state government news as a reporter for Stateline.org, I saw a lot of doom and gloom stories like this gem from the Cincinnati Enquirer:

Study: Aging Ohioans putting strain on economy
COLUMBUS -- Ohio's aging population is going to put a backbreaking strain on the state's economy, property-tax base, health-care and retirement systems starting in 2012, according to a study released last week.

“Backbreaking”? Sounds like Ohio has a pretty serious problem… OLD PEOPLE… here are the numbers:

Today, Ohio experiences a daily net increase of 14 people age 65 or older. By 2012, that number grows to 119 new retirees per day.

The publisher of the report goes on to call Ohio’s aging population a ”disaster for state and local budgets, with no obvious solution.”

Well, that’s one way to look at our elder-rich future. And I won’t argue with the numbers. For the first time ever in a handful of states, healthcare is supplanting education as the largest chunk of the budget. And we know most healthcare spending goes towards caring for people in the final years or months of their lives. Nationally, America's official debt is over $9 trillion, and our primary social safety nets for older adults -- Social Security and Medicare -- face unfunded liabilities upwards of $40.9 trillion. Locally, nationally and globally, we face some pretty significant public policy challenges in terms of adapting to our rapidly expanding population of elders. Duh. Nobody is arguing with that.

But that is no excuse for the hysterical tenor of most news coverage about the "Silver Tsunamai" waiting to wipe out our economic future. I don't care how scary the demographic projections are, there is no excuse for painting the entire over-65-demographic as a bunch of freeloading leeches poised to suck our economy dry.

In fact, some folks are making a case that there is actual VALUE -- social, economic, spiritual, etc. -- to be gained by welcoming elders with open arms.

Take Colorado for instance -- Boomers blogger Brent Green explains here:

Our state is going to beat your state.
What I mean by this is simply a promise that Colorado will be doggedly persistent in transforming the aging of the Boomer generation into a strategic focus and an economic opportunity. Many states are talking about it; few are taking substantive action.
[snip]
After two years of planning and generous contributions of time, resources and energy, Colorado introduced last November its strategic vision called Silverprint Colorado. Our goal is straightforward:

Colorado will establish a culture for positive aging addressing the needs, contributions and opportunities for all its older residents.

Certainly this vision addresses our intentions to provide quality care and assistance to older Coloradoans late in life. But it’s also a revelation about economic opportunities.

As I discussed in my keynote address, Colorado has exceptional prospects to capitalize on aging in the areas of tourism, housing, spirituality, healthcare, biotechnology, the arts, the green movement, and education, to name a few.
[snip]
Colorado has a mile-high vision for aging; we have broad-based support; and we have an entrepreneurial drive that’s endemic of the new west.

If you live elsewhere and I’ve stimulated your competitive instincts to challenge Colorado's preeminence as the nation’s most hospitable state for Boomers and pre-Boomers, then, frankly, we all win.

I say let the competition begin. Click the logo to learn more.

Posted by Kavan Peterson on January 16, 2008 7:09 PM |Permalink |Comments (3)

January 15, 2008

Courts Run Amok

This should be Banned in Boson

Dawn Cromwell dares not leave her building. If she tried, a device girding her ankle would sound an alarm. For over a year, she has had to use store-bought reading glasses because her pleas for a prescription pair have gone for naught. She is given medications, but, she says, no one will tell her what they are. more stories like this
For 20 months now, Cromwell's life has been defined by a 10.5-by-12.5-foot living space at North End Rehabilitation and Nursing Center. In her tiny closet, there are virtually no clothes, and she has no idea what's become of the cherished possessions in the Boylston Street apartment where she lived for years.

At 73, Cromwell is one of hundreds of forgotten docket numbers in Massachusetts probate and family courts, where judges routinely fast-track infirm elders into the care of guardians, often with little evidence to justify such wrenching decisions.

Cromwell, after a broken ankle and a brief rehab in early 2006, had expected to go home. But on the say-so from the nursing home's doctor - a short, nearly illegible diagnosis - a judge decreed that Cromwell was mentally ill and handed all of her decision-making to a guardian. Cromwell lost all power over her own life, with no opportunity to object, no right to have a lawyer represent her, no chance to even be in the courtroom.

Three months later, the same judge, E. Chouteau Merrill, made the guardianship permanent - in a two-minute hearing in which the judge asked not a single question.

"You think living in America is just great, but you never anticipate something like this," Cromwell said. "It's just been a disaster for me. If I was robbed on the street and everything taken, I wouldn't be as upset as I am now."

This is a failure of our culture.

Posted by Dr. Bill Thomas on January 15, 2008 4:07 PM |Permalink |Comments (0)

January 7, 2008

TGB Rock's this Week in Elder News

New must-read feature by Ronni Bennett at TGB:

[EDITORIAL NOTE: Today we inaugurate a new feature at TGB that will appear each Saturday - links to news items from the preceding week relating to elders and aging, along with whatever else catches my fancy that I think you might like to know about. Suggestions are welcome.]

Catch-up here -- This Week in Elder News.

Posted by Kavan Peterson on January 7, 2008 3:55 PM |Permalink |Comments (1)

The Boomer Bash

[Editor's Note] Below is a post from the latest issue of Age Beat Online (ABO), an e-newsletter for the Journalists Exchange on Aging, which is an excellent network supported by the American Society on Aging. This post is longer than usual, but all our Baby Boomer readers will appreciate ABO Editor Paul Kleyman's rant.

NPR AND THE EDDIE HASKELL FACTOR: Remember Eddie Haskell, Wally’s selfish and conniving buddy on “Leave It to Beaver”? Nobody liked that phony. One would think that at least some in today’s national media would equate the boomer generation more with the Beav: bright, open, curious. But the boomer bashing that continues in mainstream media -- some of it purposeful attacks from those wishing to slash entitlement programs for elders, but much of it gratuitous -- seems to frame the boomers as the Eddie Haskell of generations. RODNEY DANGERFIELD got more respect.

Leave%20it%20to%20Beaver.bmp
(Eddie Haskell, The Beaver and Wally)

A case in point is JOHN YDSTIE’S piece on NPR’s “Morning Edition” this Wednesday (Jan. 2) titled “Baby Boomers Begin to Claim Social Security”. Ydstie, a usually fine reporter and fill-in anchor, starts, “America’s baby boomers have always thought they were special.” Later, “The culture of their youth still lingers in the air.” (That’s the “they’ll never grow up” cliché that’s become so prevalent.) Later still, “Baby boomers have always lived in denial of growing old. Age 62 is the new 50, right? Except that now you are eligible for a Social Security check.” And in discussing the small size of Gen X, which will yield a demolished workforce charged with covering Social Security’s ongoing costs, Ydstie opines, “Of course, that’s the baby boomers’ fault. They had fewer children.” Funny, this boomer remembers being told -- especially by Paul Erlich, a member of the older Silent Generation -- that having too many babies was irresponsible and would set off “The Population Bomb.”

What’s odd about Ydstie’s piece is that these smarmy asides were unnecessary. In a 7½ minute piece, a major story for broadcast, he gets most of his overview of Social Security right. Ydstie does fall into the usual trap of citing the shrinking ratio of workers to pay for the retirement of the aging boomers, a figure widely quoted but almost always misused, but he does not go on, as so many have, to declare that Social Security will be bankrupt and is in crisis. These outright fabrications were fed to the public through a largely unskeptical Washington press corps that had been cultivated by conservative think tanks since the early 1980s. Now it’s refreshing to see other sources cited to balance such claims.

Ydstie includes quotes by the venerable liberal economist HENRY AARON of the Brookings Institution and conservative ALAN VIARD of the American Enterprise Institute both agreeing that Social Security does not warrant, as Aaron put it, “a hysterical sense of urgency” and that Medicare is in a much more precarious financial state. (Ydstie didn’t quite get to the larger concern that Medicare and Medicaid are in trouble because of wider healthcare inflation, but his report is an improvement on past reporting.) At least on the issue of the shrinking fertility rate he didn’t cite rightist economists who have said -- I kid you not -- that young women today should show their patriotism by having more babies, unlike their irresponsible, bra-burning mothers of the ‘60s and ‘70s.

So, what’s with the nasty slams, the pseudo-psycho profiling of the selfish boomers? Is it just too cute to pass up a two-buck chuckle and doesn’t really seem to hurt anyone? Problem is that these kinds of group slurs are expressions of -- dare I say it -- prejudice. ABO has cited more vicious examples, notably Christopher Buckley’s novel “Boomsday,” a laugh-filled promotion of the idea that boomers will drain our children’s future -- and should have an assisted-suicide option for those presumed noble enough not to collect Social Security benefits.

I guess one shouldn’t expect too much originality around national newsrooms, but there is an alternative view: that an older population in which both men and women are healthier, well educated and widely experienced can be a boon to society. Ydstie does note that a longer-working population of elders can do much to close the current projections of Social Security’s 75-year shortfall. But reporters might also talk to someone like THEODORE ROSZAK, author of the 2002 book “Longevity Revolution: When Boomers Become Elders” (Berkeley Books). The historian, whose 1968 classic “The Making of a Counter Culture” added that coinage to the language, posits that older societies have always been wiser, kinder and gentler. There are others we could mention (Bob Butler for one) who can argue pretty convincingly that widespread longevity is not such a bad thing. Or reporters could note that most of the economic problems attributed to spendthrift, “me-generation” boomers have to do with poor management of the national economy. A couple of wars, some tax cuts for the rich, a subprime mortgage debacle, failure to control healthcare costs for the rich, and pretty soon you’re talking about a real crisis. Oh-oh.

But what about this seeming urge to psychologize about the alleged profligacy of an entire generation as if it were one character -- named Eddie Haskell. Even TOM BROWKAW has indulged in some of this couch-jockeying in recent interviews about his new book, “Boom: Voices of the Sixties” (New York City: Random House, 2007.) The characterization seems to spread through news copy like a virus.

A few real facts can be said about the boomer generation in the United States:

* At around 78 million, they are the biggest generation in history.
* The GI bill gave them better-educated parents and a large middle class, so they grew up with a higher standard of living than ever before.
* Universal compulsory education, still only a few decades old by 1946, accelerated after World War II for both boys and girls.
* The pill.
* The diversity of the boomers presents an enormous demographic range for analysis.
* Boomers have more living parents than any previous middle-aged population in history.
* And boomers have the benefit of the longevity revolution in science, technology and social organization.

I’m sure ABO readers can think of a few other incontrovertible and consequential facts. In the meantime, though, I can assure Mr. Ydstie that 62 is the new 62. And that’s something worth celebrating: some aches and pains aside—not something to complain about.

By the way, for a well-balanced treatment of Social Security, see “Fears of Social Security’s Collapse Unfounded, Experts Say,” by BOB MOOS in the Dallas Morning News (Dec. 11, 2007).
Reprinted with permission from Age Beat Online, e-news of the Journalists Exchange on Aging, www.asaging.org/agebeat, copyright JEOA 2007

Posted by Kavan Peterson on January 7, 2008 1:24 PM |Permalink |Comments (0)

December 11, 2007

Which Witch

Once again, science lags behind myth and legend.

This story...

"Our focus has always been on tightening and lifting the soft tissues, skin and muscle in an attempt to cosmetically restore patients' youthful appearance. Based on this information, it might actually be better to restore the underlying bony framework of the face to its youthful proportions."
Since growth plates found in most of the body's bones stop growing after puberty, experts assumed the human skull stopped growing then too. However, the bones that comprise the human skull have no growth plates.

Using CT scans of 100 men and women, the researchers discovered that the bones in the human skull continue to grow as people age. The forehead moves forward while the cheek bones move backward. As the bones move, the overlying muscle and skin moves as well and that subtly changes the shape of the face. "The facial bones also appear to tilt forward as we get older," explains Richard, "which causes them to lose support for the overlying soft tissues. That results in more sagging and drooping."

People have long understood and feared these changes and even created a mythic construct to deal with those fears...

Posted by Dr. Bill Thomas on December 11, 2007 6:52 AM |Permalink |Comments (0)

December 10, 2007

Sunshine Down Under

Similar studies show the same results in the U.S. -- the older we are the less likely we are to be depressed, stressed and anxious:

Middle-aged 'more anxious than elderly'
Elderly Australians are less anxious and depressed than those in middle-age, according to a new study which paints a refreshingly bright picture of growing old.

A major survey of 5,000 people over 45 has found that baby boomers have significantly higher rates of psychiatric and anxiety disorders than those in their twilight years.

"This is a new and very positive view of ageing," said psychiatrist and co-investigator Dr Julian Trollor, from the University of New South Wales.

"The general perception out there is that disease and burden is what you've got to look forward to as you age, but we can be much more positive than that."

Read more in the Sydney Morning Herald.

Posted by Dr. Bill Thomas on December 10, 2007 9:48 AM |Permalink |Comments (1)

December 5, 2007

List of Shame

A guest post from UMBC's Kavan Peterson:

In an unprecedented move, The Centers for Medicare & Medicaid Services is shining the public spotlight on America's Worst Nursing Homes by publicly releasing a list of 54 facilities with the most serious health and safety problems in the nation. Thanks to The Consumerist for alerting us to this development:

CMS has released the first-ever official list of America's Worst Nursing Homes— a move that leads us to suspect that the Department of Health & Human Services must be getting pretty fed up if they are resorting to public shaming. The list includes the 54 most egregious health and safety violators of the 128 SFF, or "Specialty Focus Facilities," in the U.S.
A Special Focus Facility is basically a nursing home that is on double-secret probation— subject to twice as many inspections as a non-SFFs, with the threat of funding cuts for non-compliance.

According to the CMS, the average facility isn't perfect (6-7 violations is the national average.) Those designated as SFFs are guilty of either more violations or more serious violations than usual, as well as a history of fixing problems just long enough to pass inspection, then going right back to business as usual. The CMS dubs this "yo-yo compliance," and the SFF program is designed to deal with it by combining more frequent inspections with more stringent enforcement until the nursing home falls back in line.

If the facility in question doesn't shape up, correct the underlying problems that lead to violations and "graduate" from the SFF program (in about 18-24 months) their funding is cut and they will likely close.

Of course, the first thing I looked for on this list was the names of any nursing homes that cared for loved ones in my family or employed members of my family. To my absolute dismay, I found that the only nursing home in Montana to make this infamous list was none other than Evergreen Missoula Health & Rehab. This facility not only cared for my wife's grandfather during the last months of his life, but it is located on the corner of the street I grew up on and where my parents still live today. I can only hope the public humiliation of making this list will work where government regulations and inspections have not.

Besides sharing this list with as many people as possible, CMS recommends families use its Nursing Home Compare tool to review the ratings of any nursing home they are considering.

For those looking for a ray of hope, go to www.edenalt.org

Posted by Kavan Peterson on December 5, 2007 9:55 AM |Permalink |Comments (0)

December 3, 2007

Time Goes By Goes Bye Bye

Man this is sad.

I accept it. I honor it and, in some ways I understand it. But still, it's a sad day for the elder blogosphere.

As of this post, Time Goes By is over.
The decision to do so has been building for the reasons below and other related ones, but response to today’s post – and it’s only 11AM here - tipped me over the edge. Isn’t it odd how often decisions are made on small events.

I can’t tell you which of half a dozen emails telling me that 60 isn’t old or you’re only as old as you feel or age is relative or whatever other excuse did it. It’s all bullshit. Old is old. The Crabby Old Lady in me is finished arguing that, along with all her versions of old-is-as-worthy-as-every-other-age.

Too many people want to slice and dice the language and proclaim their youthfulness in other ways unto the grave and if that is your position, this or any blog is unlikely to change your mind.

But all this age denial (the negative ones never publish publicly; they just rant in emails to me) before noon has made the decision for me. I’m out of energy to move forward with this.

Posted by Dr. Bill Thomas on December 3, 2007 8:28 PM |Permalink |Comments (3)

November 30, 2007

Arkansas Celebrates First Green House

From Jeff Mores of the Benton Daily Record in Arkansas:

BENTONVILLE — There was a day when senior care meant moving into a hospital-style nursing home.
Things have changed. And in Arkansas, Bentonville’s Legacy Village is leading the way.

Click here to learn how.

Posted by Kavan Peterson on November 30, 2007 10:56 AM |Permalink |Comments (0)

November 27, 2007

No Aging For Old Men

A guest-post from the UMBC’s Kavan Peterson:

“That's what some male movie stars would have you believe - though the smart ones use age rather than fight it,” writes Boston Globe film critic Mark Feeney in a sharp review of how aging male movie stars act their age – or not -- in recent films.

Feeney offers a refreshing critique of the responses of Hollywood’s leading men to the inevitability of aging – which range, he says, “from furtive evasion to forthright embrace.” As Feeney rightly argues, Hollywood’s leading men tend to get a free pass when it comes to confronting age. Think Harrison Ford attempting to reprise his role as Indiana Jones at age 65 (that’s not a hypothetical -- we’ll get to see how gracefully Ford plays an aging Indiana Jones in the fourth installment of the franchise in 2008).

Here’s Feeney’s take on aging Hollywood hunks from a few recent films:

Tommy Lee Jones
'Age will flatten a man," Tommy Lee Jones says in "No Country for Old Men." Yes, it will. It can also deepen, strengthen, and enrich him, too. One look at Jones in "No Country" - or in "In the Valley of Elah" - and you see demonstrated the power of age to bring up as well as bear down.

Jones is 61 now, and in those movies the weight of every minute of his time on earth seems recorded on that face. A moonscape of seams, crags, and creases, Jones's visage doesn't look so much lived in as lived on - a spiritual terrain, an Old Testament geology. Even more than that bark of a voice or big-as-Texas presence, that face is what lends Jones his enormous onscreen authority.

George Clooney

You'd think gravitas would be no less a problem for someone as good looking as Clooney. But it isn't. Maybe it's as simple as not reaching for the Grecian Formula. Clooney's letting himself go gray was always a smart career move. He still looked great, but now had the aspect of a regular guy. It made him seem more honest - more serious, too. In "Syriana," he added a thickened waist and unbecoming beard (which made him a dead ringer for New York Times columnist Paul Krugman) and got himself an Oscar.

Clooney looks a lot better in "Michael Clayton," but he does nothing to disguise the effects of the wringer his lawyer-fixer character goes through: a giant lawsuit on the verge of collapse, a friend losing his mind, a very large debt needing urgent settlement. There are bags under the eyes, a puffy face, a general sense that soon enough the mirror will be as much enemy as friend. The movie ends with a very long close-up of Clooney sitting in the back of a taxi, and there's no mistaking that it isn't just the cab's meter that's running.

Robert Redford

Redford is more or less playing his age in "Lions for Lambs." He's a college professor who served in Vietnam, so he has to be at least 60, and probably older. Yet it's as if he's a superannuated Sundance Kid with tenure. The hair is as thick and golden as ever, the handsomeness little touched by the years.

Partly, that's the benefit of great facial structure (it's always the bones that go last). More than that, though, it's a suspiciously unlined dullness around the eyes that makes him look (there's no polite way to put this) weird. Is it Botox? Lighting? Makeup? Nipping and tucking? The strange thing is, in person, Redford's eyes look normal enough. Whatever the reason, their unblemished deadness in "Lions" helps make his performance all the more wooden - and Redford has never exactly been the most expressive of actors.

Tom Cruise

Underscoring the unfortunateness of Redford's unnervingly age-resistant appearance is the presence in "Lions for Lambs" of Tom Cruise. It's a good thing they don't have any scenes together or gerontology might never recover. Playing a very ambitious Republican senator, Cruise is the best thing in the movie - certainly the liveliest. Yet he seems so unbearably young. At 45, he suffers from a terminal boyishness that makes him seem like a can of Red Bull yearning to be a bottle of Bordeaux. The risky business of aging can cut both ways.

Dustin Hoffman

Wonder, if only titular, informs Hoffman's performance as the most aged character seen on screen this or any other season, in "Mr. Magorium's Wonder Emporium." The toy store owner is all of 243. Oddly enough, this isn't Hoffman's first crack at triple figures. Jack Crabb, the Indian-raised Western pioneer he plays in "Little Big Man," lives to be 121. Hoffman was 33 then, yet through the magic of latex he looked old, seriously, deathly, prune-shriveled old. The curious thing about Hoffman as Magorium, a character twice Crabb's age, is that he looks so, well, good. Does the AARP need a new spokesman? Magic will do that for a man, fictional or real - and when it comes to appearance, there's no magic like the movie-star kind.

Read the full review here.

What do you think? What actors or roles do you think provide a positive portrayal of aging? And what about the double-standard for female actors?

Posted by Dr. Bill Thomas on November 27, 2007 10:54 AM |Permalink |Comments (2)

November 15, 2007

Never Too Old for the Tooth Fairy

A guest-post from the UMBC’s Kavan Peterson:

The closest thing China has to a tooth fairy might be Dwayne Arola, an engineering professor from the University of Maryland, Baltimore County who has a thing for Asian choppers.

Prof. Arola is an innovative engineer here at UMBC who may be the Baby Boom generation’s best hope for maintaining a healthy set of teeth into later life. The Baltimore Sun’s Chris Emery explains in a news story today:

Not long ago, Arola returned from a trip to Shanghai with a plastic lunch box containing a dozen prime specimens from Chinese dental patients - large, cavity-free wisdom teeth - destined to endure a regimen of abuse that he once reserved for aircraft parts.

How the Chinese molars hold up under Arola's stress tests may explain why Chinese teeth are more brittle than American teeth. Ultimately, that knowledge might lead to a dental Fountain of Youth: a high-tech process to make old teeth young again, and less prone to cracking under pressure.

"We are trying to figure out how fast cracks grow and why they grow faster in older people," said Arola, 41. "Ultimately, we'd like to figure out how to arrest those cracks."

Bravo Prof. Arola! While exploitative anti-aging industries are making billions of dollars peddling farcical fountain of youth products that often harm people, it’s refreshing to see someone genuinely working to improve the quality of life for older adults.

Read more here about what inspired Prof. Arola -- an aerospace engineer by training – to tackle one of the brittlest facts of aging – teeth.

Posted by Kavan Peterson on November 15, 2007 10:58 AM |Permalink |Comments (0)

November 9, 2007

Power Up Friday

Dr. Al Power guest blogs on Fridays here at ChangingAging.org.

Musician, Physician and all around great guy, he dropped me a note concerning quotes from women about aging.

One comment comes to mind. I recently facilitated a Management Team Retreat for St. John's and we had an hour when we were addressed by elders from St. John's Meadows. One of the elders, Margaret Thirtle, is 92 and worked for many years for the Sibley's Corporation. During that time, she oversaw the visits of almost 200 celebrities to Rochester. Margaret told us that one such celeb, Gloria Swanson, "gave me some advice I'll never forget: She said, 'After 40, my dear, always sit with your back to the light!'"

Posted by Dr. Bill Thomas on November 9, 2007 11:19 AM |Permalink |Comments (2)

Trigger Finger

All right, you've seen the picture. Write your own caption and leave it in the comments. Then you can go here and find out what it's really all about.

Posted by Dr. Bill Thomas on November 9, 2007 6:40 AM |Permalink |Comments (3)

November 2, 2007

Eyes Wide Shut

Last week a new national poll on long-term care in the 2008 elections was released. Commissioned by Genworth Financial, the fieldwork was done by Public Opinion Strategies and the Mellman Group it included this little gem...

- Nearly 7 in 10 Americans have not made any plans for their own, a spouse’s or another relative’s long-term care needs. Yet, over half of those surveyed have had a loved one who needed a form of long-term care.

Nicole and Tom are likely to be able to pay out of pocket for whatever kind of long-term care they, or the people they love, might need. Rolling in the bucks does not and can not, however, gurantee a life worth living. (Anyone seen Howard Hughes around lately?)

If you are reading this blog then you are very unlikely to be a multi-millionaire, international star of stage and screen.

The wealth that flesh and blood human beings need to need to live into advanced old age (or with a chronic disabling illness or injury) and retain personal dignity and autonomy must come in two forms...

1) Financial Capital. You know, the bacon (as in "bring home"), bread, dough, cabbage, lettuce, kale, folding green, long green, mazuma, moolah, oscar, pap, plaster, rivets, scratch, spondulicks, bone, buck, bullet, case note, clam, coconut, frogskin, lizard, peso, rock, scrip, simoleon, denaro, folding dead presidents-- cash.

2) Social Capital. This is one creative approach to the generation and investment of social capital.

Both kinds of wealth are necessary and neither is sufficient.

Posted by Dr. Bill Thomas on November 2, 2007 6:44 AM |Permalink |Comments (4)

October 26, 2007

Endless Tales of Woe

nursing%20home.jpg
Those who know me and my work know I'm an insufferable optimist and am whole-heartedly dedicated to reversing the most intractably pessimistic aspect of our culture -- how we feel about AGING.

But, even my cheerful demeanor blanches every morning when I open my Google-New-Alerts for the two most unfortunate words in the LTC lexicon -- "Nursing Home."

Here is a sample of today's news:

Man Dies Trying To Escape Nursing Home CHICAGO -- A 66-year-old man died after falling from a second-story window at a Northwest Side nursing home Wednesday morning.
Kiril Kirilov, who may have suffered from mental disabilities, attempted to exit Harmony Nursing and Rehabilitation Center from a second floor window via bedsheets he tied together, according to an Albany Park District police officer.

ARE YOU KIDDING ME?

But wait -- it gets worse:

Seniors Fear Losing Independence, Moving Into Nursing Home More Than DEATH
Senior citizens fear moving into a nursing home and losing their independence more than death, according to a new research study, “Aging in Place in America,” commissioned by Clarity and The EAR Foundation.

Tragic, and painfully true. I will write more about this terrible reality soon. Click here to read the full study posted at MyHearingHealth.com.

However, there was one gem out of more than a dozen articles today on abuse, neglect and fraud:

'Home Again' will aid seniors who wish to move out of nursing home
TERRE HAUTE — A new program called “Home Again” will provide rental assistance to seniors on Medicaid who desire to move from a nursing home back into a more independent and affordable community setting.

If you're looking for another ray of hope, go to www.edenalt.org

Posted by Dr. Bill Thomas on October 26, 2007 10:24 AM |Permalink |Comments (6)

October 13, 2007

Pro-Aging: Bare Skin Edition

YOUTH=BEAUTY
AGE= UGLY

These are the equations that drive ALMOST all of our media, advertising and (too often) art.

Dove deserves kudos for challenging these assumptions and doing so with flair and style.

How AdFormula sees it...

Six, over-50 gorgeous women do their best 'calender girl' homage in this controversial campaign titled pro age campaign ,designed and executed by their time tested agency O&M,posing buck naked in the ad, which was banned from airing( see the tvc here) and landed Dove in all the mess,because it "showed too much skin". The positive side as I see it, is that it was the first time, that a brand, that took on skin care, was talking to women about aging in a positive tone...Dove, the global beauty brand, boldly challenged the “only young-is-beautiful” stereotype with this Campaign which aimed to sell pro aging (and not anti aging) products . Designed to expose what our anti-aging society has been hiding, proage celebrates women of 50+ by showing their honest, real beauty.

Posted by Dr. Bill Thomas on October 13, 2007 7:48 AM |Permalink |Comments (1)

October 11, 2007

McArdle Care

Megan McArdle--currently blogging at the Atlantic-- continues to defend a post, which she initially posted at her previous bloggy home.

...as a class, the old and sick have some culpability in their ill health. They didn't eat right or excercise; they smoked; they didn't go to the doctor as often as they ought; they drank to much, or took drugs, or sped, or engaged in dangerous sports. Again, in individual cases this will not be true; but as a class, the old and sick bear some of the responsibility for their own ill health, while younger, healthier people have almost no causal role in the ill-health of others.
Perhaps they deserve it by virtue of suffering? But again, most of them are suffering because they have gotten old, often in high style. The young of today have two possible outcomes:

1) They will be old and sick too, in which case they are no less deserving of our concern than today's old and sick

2) They won't ever get to be old and sick, which is even worse than being old and sick.

As a class, the old and sick are already luckier than the young and healthy. Again, for individuals within that class--those with desperate congenital conditions, for example--this is not the case. But I'm not sure it's terribly compelling to argue that we should massively disadvantage a large group of people in order to massively advantage another, equally large group of people, all to help out the few who are needy, or deserving, or unlucky.

Emphasis added.

Translation: The old and sick are mostly to blame for their oldness and sickness so why should the young and healthy have to carry their burden when they are not to blame?

Left unasked (and unanswered) is the question, "Who helped the youth and healthy grow up young and healthy? Or did they simply spring from the Earth with no help from any other living beings?

Can anyone guess Ms. McArdle's age? Maybe this photo will help.

Will we still need her? Will we still feed her, when she's 64?

Posted by Dr. Bill Thomas on October 11, 2007 8:12 AM |Permalink |Comments (2)

October 9, 2007

The Blue Screen of Death

I am not sure how I feel about the makers of Windows TM becoming the holders of America's health information.* Here is a quick summary. The company toots its own horn here.

* This blog is written on a Mac G5. I'm just sayin'.

Posted by Dr. Bill Thomas on October 9, 2007 6:45 AM |Permalink |Comments (0)

October 8, 2007

Drive to Vote

The Brad Blog reports on a speech by John Tanner, the Chief of the Voting Section of the Civil Rights Division, U.S. Department of Justice. The videotape was rolling when Chief Tanner cut loose with views on how new laws requiring voters to show a photo ID will impact elders.

He allows that its "a shame" that older voters may be disenfranchised by new Photo ID restrictions at the polls because many don't have driver's licenses, however, minorities don't have to worry quite as much.

Why?

Because "minorities don't become elderly the way white people do. They die first."

In Chief Tanner's world, old brown people don't even exist so I guess they can hardly be expected to vote.

Nice. Real nice.

In case you were wondering about John Tanner here is a quick sketch...

As a teenager growing up in Birmingham, Alabama, in the 1960s, John Tanner found himself in the middle of the battleground over civil rights in America. "That was what was happening in Birmingham, it was sort of the center of the world," said Tanner, who is now chief of the Voting Rights Section of the United States Department of Justice's Civil Rights Division, in a Nov. 9 speech in the Chesterfield Smith Ceremonial Classroom, sponsored by the American Constitution Society. "Civil rights in Birmingham, Alabama in the 1960s was everything. That's what everyone talked about all the time. You were pretty much on one side or the other. And I was on the other."

The full text of the Tanner profile quoted above can be found here.

Posted by Dr. Bill Thomas on October 8, 2007 9:39 PM |Permalink |Comments (0)

Smack Down

The Gimp Parade lays a smack down on private, for-profit investors who are, increasingly speculating in the nursing home real estate market. Blogger Kay Olsen highlights the following from the recent New York Times article that covered this issue.

"The typical nursing home acquired by a large investment company before 2006 scored worse than national rates in 12 of 14 indicators that regulators use to track ailments of long-term residents. Those ailments include bedsores and easily preventable infections, as well as the need to be restrained. Before they were acquired by private investors, many of those homes scored at or above national averages in similar measurements."

What does she want to do about this?

"One of the demands of ADAPT at the recent sit-in at the Chicago headquarters of the American Medical Association [see the AMA's policy on the use of restraints in nursing homes here-- WHT] was that doctors divest themselves of financial interest in the nursing homes they recommend to their clients."

I agree with and support ADAPT's position on the divestment issue.

"While there is a movement by aging Boomers gaining steam to make nursing and assisted living institutions into communities where people can go to live happily instead of going there to wither of neglect and die, a key factor in the injustices visited upon the people who end up in these homes is that continued institutionalization with minimal service and minimal care financially benefits someone else."

When you get down to it, the paragraph above is the core of a moral argument against health care as a purely profit-driven "marketplace" and for the enlargement and preservation of human dignity and freedom of choice as a fundamental human right.

When the profits of corporations in the medical-industrial sector come to take precedence over the life and death needs of ordinary citizens we have a prescription for disaster.

Posted by Dr. Bill Thomas on October 8, 2007 2:40 PM |Permalink |Comments (0)

October 5, 2007

Sedated

ChangingAging reader/commenter Margie Buck writes:

Thanks for the update on the new blog site. I loved the youtube Ramones "sedated". Will share it with many. look forward to seeing you all in Columbus OHIO (The Eden Alternative International Conference will be held in Columbus in June of 2008-- WHT)

So without further ado, here is the thoroughly up-to-date remake of the Ramone's classic "I Wanna Be Sedated."

Enjoy.

Posted by Dr. Bill Thomas on October 5, 2007 1:11 PM |Permalink |Comments (0)

Exhibit A: Why Oh Why is Health Care Reform so Hard to Do?

Let's say that Congress decided to get behind some incremental changes in one part of our medical industrial economy. It could even get all optimistic and cool and call its package of proposals the “CHAMP Act.” The bill might, for example, improve coverage and benefits for children, extend Transitional Medical Assistance for people enrolled in “Welfare to Work” programs and, make it easier for elders to continue using community-based Adult Day Service Programs. Well that's exactly what it did and the AMA , AARP and National Association of Children's Hospitals have all applauded this legislation. Nice huh?

Oh, there is one more thing, CHAMP also...

“Takes into account recommendations from the non-partisan Medicare
Payment Advisory Commission, the bill refines payments for a variety of
institutional providers including skilled nursing facilities, rehabilitation
facilities, long-term care hospitals, cancer hospitals and rural and small urban
hospitals.”

It turns out that the nation's for-profit nursing home chains (and their defenders in Washington) are just not that into the cancellation of multi-billion dollar funding increases in their future revenues.

"The CHAMP Act, as it now stands in the House Ways and Means Committee, is highly detrimental to the long term care needs of 'America's Greatest Generation' as well as future generations - contrary to the claims being made by its proponents," stated Bruce Yarwood, President and CEO of AHCA.

So what does a big-time Washington lobbyist do?

WHY%20Ad.jpg
How about running attack ads directed specifically at freshman Representatives who dared voted against the perceived interests of the nursing home industry? Here is the ad being run against Tim Walz in Minnesota's First Congressional District.

Congressman's Walz's is pushing back against the nursing home industry's fearmongering.

“For too long, these private insurance companies and big nursing home chains have reaped the benefits of Medicare overpayments, and when I voted for the CHAMP Act, I voted for legislation that will help the most vulnerable of our community: our low-income children and seniors.

The people of the First District don’t have to buy expensive and deceptive ads. They don’t have to hire expensive lobbyists. People in southern Minnesota can be confident that I have and will continue to cast votes that are in the interest of our children and seniors, no matter how many full page, color ads costing thousands of dollars the special interest groups can buy.”

Read the full text of his statement here.

So what's new? Congress withdraws promised increases in the nursing home industry's funding stream. The industry's lobby lashes out at the CHAMP Act's Congressional supporters (especially freshmen). Little changes. Another battle is won, lost or drawn.

It is easy to see that the American medical industry is huge and exceptionally powerful. Each component of that industry holds a laser focus on its own needs first and foremost. Each component has its own individual war chest that it can you to attack elected officials who refuse to do its bidding.

It is also easy to see that the public supports fundamental change in our health care system. Hundreds of millions of people can see and are appalled by the waste, the injustice and the failure to produce the quality health care outcomes enjoyed by citizens of other industrial nations. Despite the urgent need for reform, nothing happens.

It turns out that attack ad is asking the right question: “Why?”

A few years back, Jonathon Rauch wrote a brilliant book (Demosclerosis) that explained the paradox of popular support for change being stymied by gridlocked inaction.

Scott London captured the the crux of Rauch's argument nicely...

“In a stable, democratic society, pressure groups inevitably form to persuade government to redistribute resources their way... Taken one at a time, these benefits have practically no effect on society as a whole, so no countervailing group arises to stop the waste. But, taken as a whole, group demands gradually sap the effectiveness and flexibility of government to the point where no program can be cut and no subsidy eliminated without arousing vehement opposition from some group or another. As the number of interest- groups in a society increases, and as the benefits secured by groups accumulate, the economy rigidifies. By locking out competition and locking in subsidies, interest-groups capture resources that could be put to better use elsewhere.”

As a physician, I believe that this kind of insightful diagnosis is a starting point for action. I believe that our national health care policy is being held strangled by a powerful industrial complex. The only thing that can break its grip is a counter-force of educated citizens who can see past the spin, the self-serving distortion and the outright hypocrisy--- and are willing to stand together and fight.

When I was in medical school a fellow student started his third year (the most challenging phase of medical school) by posting a sign on his dorm room door. It read: “I must therefore I can.” Today I would amend that statement. “We must therefore we can.” In fact it's already happening. Take a look at VOTER Mel Strand's counter-attack on lobbyist-generated attack ads running in his hometown paper.

Posted by Dr. Bill Thomas on October 5, 2007 8:45 AM |Permalink |Comments (2)

October 4, 2007

(Not So) Gray Hair

This is a nifty example of almost (but not really) getting it.

You begin with some pretty "far out" and "crazy" talk like this from an AP article on the to "Gray or Not to Gray" controversy...

"Kathy Kolbe, a Phoenix-based public speaker and consultant to corporations on human instincts, is one of the comparatively few gray-haired women in business. After alternating between dyed and not, she declares herself now “permanently gray” after concluding it is an advantage in more ways than one.

"She noticed she got lots of offers of help on her business travels when gray peeked through — from hoisting bags into overhead bins on airplanes to other assistance — and “pretty much nobody offered help” when it was hidden.

“So I let the whole head go gray and, voila, doors magically opened,” said Kolbe, 65.

She senses the “look of wisdom” also has a positive impact on both employees and clients."

Then you talk about what you do...

"Gray Hair Management currently provides professional coaching to managers and executives to help them win the race for a new opportunity using unique techniques and processes."

Then you go with the visuals because, after all, every picture tells a story don't it.

Umm. Nice photo. Where's the Gray Hair?

Posted by Dr. Bill Thomas on October 4, 2007 2:31 PM |Permalink |Comments (4)

October 3, 2007

They Can't Help It

I was just going back over the summary of research from the Ohio State press office. I can't believe I missed it the first time but the headline for the press release...

Older people are more prejudiced -- and they can't help it

... is almost exactly the opposite of what the researcher claims and the data show.

Wow. Somebody blew that one.

Still they did get the story placed in Newsweek and the Newsweek story was much better than the press release.

I'm just sayin'

Posted by Dr. Bill Thomas on October 3, 2007 1:58 PM |Permalink |Comments (0)

September 24, 2007

Kaboom: NYT lowers the boom on for-profit nursing homes

Sunday's NYT pulls back the curtain on the practice of "flipping" nursing homes for profit. There is money to be made and some people are making lots of money. No problem there, this America after all and making a buck is an honored tradition. No, the problem is that there are real problems with safety, quality and dignity. The article can also be read as a cautionary tale regarding health care as a profit making activity. In my opinion, the best starting point is health care as a right not an industry. Click here to read the full article.

Posted by Dr. Bill Thomas on September 24, 2007 2:47 PM |Permalink |Comments (0)

September 18, 2007

King Lear

The first ever Erickson School Masters of Aging Services class kicks into gear next week and I am team teaching the Aging 600 class with Judah Ronch. Our course looks at issues and controversies in aging and uses Shakespeare's tragedy "King Lear" as an central element of the course. I am going to be blogging on my experience with the class all semester and wanted to kick off the topic with a nice online illustrated story version of the play. You can also listen to me discuss Lear on NPR by clicking here.

Posted by Dr. Bill Thomas on September 18, 2007 1:02 PM |Permalink |Comments (0)

Eden Up North

I found this nice article on the success of one Eden Alternative long-term care organization, the Burquitlam Lions Care Centre in British Columbia. Read the full article here

Eden%20Intergen.jpg

Posted by Dr. Bill Thomas on September 18, 2007 11:00 AM |Permalink |Comments (0)

September 17, 2007

Health Care Organizations Stress Their Employees

Nurses agree, this is not exactly news.

Posted by Dr. Bill Thomas on September 17, 2007 3:11 PM |Permalink |Comments (0)

Good Old Medicines

Opened my mailbox today (the real metal kind of mailbox at the end of the driveway) and found an interesting article in the most recent edition of the AMA News. "Trials of Treating the Elderly" offers a nice introduction to the risks new drugs pose to older patients.

The Money Quote:

"Older participants are not usually recruited for clinical trials, leaving the path to proven treatments littered with uncertainty."

New drugs are tested on sample populations that consist-- mostly-- of younger people. So when the drug is approved and comes to market (and the advertisements hit the airwaves) the older people who are the first to use that new drug are, in a frighteningly real way, to much larger risks with much less information than younger patients.

When it comes to prescription drugs newer is not always better. The "seven-year rule" suggests that (except in extraordinary circumstances) older patients should avoid medications that have been on the market for less than seven years.

Posted by Dr. Bill Thomas on September 17, 2007 2:44 PM |Permalink |Comments (0)

September 10, 2007

Time Gets it Wrong

A report on national service by one of our national news magazines is a good thing but what message do Time's editors choose to emphasize with the cover art?

National Service is, or could be, a good thing. (Full disclosure, I never served in the military, Peace Corp, Vista or any other kind of National Service myself.) The problem is that the magazine slants its National Service coverage toward the issue of youth and service and away from what elders are already doing to advance the common good. This framing is consistent with the dominant cultural theme which says: "Old Age Equals Decline." If that was true (and it is not) then the only hope for our society would lie with the young. In fact, we live in a time when there is an unprecedented opportunity for young and old to be together, work together and make change together.

The model who sat as Rockwell's model is now an 83 year old grandmother. The iconic image of the original "Rosie the Riveter" remains powerful image because, even six decades after it was made, it retains the capacity to remind us that some things are worth struggling for and sometimes the struggle for the good can be found close to home-- in our own neighborhoods and communities.

So- in the spirit of Time's Rosie Remix, I have a challenge for UMBC's Visual Arts/Graphics Majors--- Make me a remix of the Time cover that gives that poor woman on the cover a mighty mane of Gray Hair and some wrinkles. Send your Remixes to me at wthomas@umbc.edu and be sure to put "Remix" in the Subject line. I will post the best of them on this blog.

Posted by Dr. Bill Thomas on September 10, 2007 9:13 AM |Permalink |Comments (0)

August 30, 2007

Who is Dr. Bill Thomas?

Dr. Bill Thomas is an international authority on geriatric medicine and eldercare. He is a professor at the Erickson School at the University of Maryland, Baltimore County and has been heavily involved in the culture change movement to promote elderhood as an honorable and valuable position in our society. Click here to read more.
Eldertopia and the New Old Age

Dr. Bill Thomas: Eldercare, aging and us

Dr. Bill Thomas speaking at the 2007 Pioneer Conference, Part 1:

Dr. Bill Thomas at the 2007 Pioneer Conference Part 2:

What Is Old Age For?
by William Thomas

Old age is humanity's greatest invention, and on an even deeper level, it invented us. Old age transformed the way our most distant ancestors gave birth, reared their young, lived together, and fed themselves. Later it propelled the development of culture, language, and society.

Humans are primates, and among all primates we are most closely related to chimpanzees. We hold 98 percent of our genetic code in common with them. Yet a comparison of human and chimp life cycles reveals some unexpected differences.

Human beings can live twice as long as our nearest relatives—surprising in itself. Astonishing, however, is that all of this additional longevity follows the loss of fertility. Chimp and human females become fertile at nearly the same age and remain fertile for about four decades. For the aging chimpanzee, death follows hard on the heels of the loss of fertility. The human female possesses a nearly 50-year longevity bonus that follows the end of fertility. Our post-reproductive longevity exists because it affords our species a unique and powerful competitive advantage. Hidden within this extraordinary elongation of life is the story of who we are and how we came to be.

The first grandmother
One million years ago on the plains of Africa, a hominid child cries out from hunger. Her mother has recently given birth and is distracted by the needs of her helpless infant. The delivery was long and difficult and much blood was lost. The mother barely has the strength to nurse her infant. She can neither feed nor care for her older child. The mother of the new mother, the grandmother of the crying child, is moved to act. Thus was the first tentative step taken down the long road that led to the development of the modern human being. The deliberate enlistment of grandparents into the work of rearing the young stands as a defining characteristic of Homo sapiens.

Substantial advantages accrue to offspring who can be cared for by two generations of adults. The extra food and attention significantly improve survival rates. University College researchers in London found that in Gambia, infant mortality rates dropped by 50 percent if the maternal grandmother was present in the household (interestingly, no benefit was found when the paternal grandmother was in residence). Ruth Mace, one of the researchers, noted that the presence or absence of the father had no bearing on infant survival: “If the grandmother dies, you notice it; if the father does, you don't.”

Research in India has found similar results. Surely the grandmothers' contributions of time, energy, and material resources across generational lines are important, but that is not all there is to it. Humans, in particular humans living in active multigenerational families and communities, benefit from intergenerational affection.

The genius of human longevity
The development of menopause and the refinement of grandparenting played a critical role in the physical evolution of the modern human, but the story does not stop there. About 40,000 years ago, another remarkable round of adaptations changed how people lived. Homo sapiens generalized the benefits of grandparenthood by linking old age to the work of social evolution. The development of human culture—its refinement, storage, and transmission—was woven into the fabric of old age.

An African proverb says, “The death of an old person is like the loss of a library.” In these words are embedded the important role given to older adults in many African cultures. After a person has productively lived his or her life as an adult in the community, he or she is honored by initiation into the elder circle. This usually happens around the age of 65.

These elders, now masters of the school of life, have the responsibility for facilitating the transition from childhood to adulthood of new generations. They are responsible for and oversee the process of initiation. The idea of elders as “library” also reveals the fact that only the elders have full access to the tribe's knowledge base. The elders safeguard the highest secrets of the tribe and protect its medicine and inner technologies. They incarnate the wisdom of the society, which they happily share, often in the form of storytelling.

Anyone in the last half of life can attest to the difficulties, the aching joints, the fading eyesight. What is open to interpretation is the meaning of these changes. What if they are understood as a form of preparation (not unlike adolescence) for a new life as an elder of the community?

The physical decline that comes with aging actually cements the relationship between old and young. Indeed, an old man still capable of stalking, killing, and butchering a mastodon would have little inclination to spend hours doting on grandchildren, telling them stories, and instructing them in the ways of their people. An old woman still capable of producing young of her own would hardly be inclined to pour time, love, and attention into the lives of her grandchildren. The physiological changes that accompany old age, and upon which contemporary society heaps unlimited scorn, are actually essential preconditions for a socially productive old age.

Human elders have long been known as peacemakers, and for good reason. The physical changes that accompany advancing age make conflict, armed and otherwise, worthless to the old. Like statesmen serving their final terms in office, elders are freed from the tactical maneuvering that defines the struggle for adult rank and prestige. It is this freedom that allows them to put forth unique interpretations of the problems faced by their families and communities. The awareness of one's mortality that normally arises in late life—and so terrifies adults—opens new perspectives for elders on the world in which they live.

Being an elder
The promises of the current anti-aging fad perpetuate an illusion of unlimited longevity. This strengthens the characteristic adult devotion to doing, having, and getting. The result is an underdeveloped, increasingly dysfunctional population of developmentally delayed adults who are prone to catastrophic errors of judgment. The mania for
having and getting diminishes the value of stewardship in our culture. The preservation of resources for the benefit of those yet to be born, or even for the common good of those living now, is airily dismissed as simple-minded idealism. At the root of it all is the adult fantasy of unlimited time, unlimited wealth, unlimited resources, and unlimited information.

Adulthood itself is a right and fine thing. I am an adult. I love adulthood. I find daily pleasure in living as an adult and have no interest in returning to the childhood I have outgrown. Nor am I ready to enter into an elderhood that requires perspective, experience, and judgment that I do not yet possess. Adulthood, rightly understood, provides us with a productive, potentially glorious interlude between youth and old age. The problems begin when we conceive of it as a permanent necessity, an apex of human experience that must be defended and enlarged no matter what the cost.

Adulthood is chained to the rock of doing. When two adults meet, it is rare for more than a minute to pass before one of them pops the question, “What do you do?” Adults inhabit a world of tasks and schedules, payments, obligations, and jobs that need to be done. Yet in all this busy doing, they may ignore deeper questions of whether those tasks are worth doing and whether they foster meaningful relationships. These are questions not of doing but of being.

Doing and being are best thought of as two sides of one coin. As humans age, the action-oriented strategies of DOING-being give way to the indirect and subtle influence of BEING-doing.

Consider how adults and elders bake cookies. The adult tends to approach cookie baking as one more item on a long list of things to do. The children are either banished from the proceedings or—if the adult is feeling particularly guilty about a perceived deficit in the “quality time with the children” account—the children will be included, with some apprehension. The cookies are baked with dispatch, and dire warnings about eating raw cookie dough (possibly salmonella) are issued along with lessons about the virtue of cleaning up as you go.

The elder is much more likely to want to bake cookies than to have to bake cookies. As a result, children are more than welcome. Eating raw cookie dough? “Never mind what your mother says; go right ahead.” Flour, sugar, and eggs are used with abandon. Bizarre and experimental cookie shapes are welcomed. The crucial difference between the adult and the elder is that the former is fixated on the doing while the latter seeks the being. The adult cares about the cookies and is happy to log some quality time if possible. The elder cares about the relationship and is content with the cookies no matter how they turn out.

The central social and cultural challenges of our time revolve around the malignant enlargement of adulthood and the adult obsession with DOING-being. Adulthood, intoxicated by its own might, is intent on remaking youth and old age in its image. It has already defined the best child as the most precocious child. The wunderkind mimics adult behaviors and styles of work and learning. Likewise, adulthood demands that those who would remain worthy defy their age and continue to think, walk, talk, look, and work like adults.

Liberating elders
In 21st century America, only two categories of people still face routine and even permanent institutionalization—criminals and the elderly. In the last half of the 20th century, prisons and nursing homes both experienced a steady rise in the number of inmates. The true nature of the nursing home is especially obvious to those schooled in the ways of institutions. One prisoner wrote to tell me how much the nursing homes where he visited his grandmother reminded him of prison, and I have received many communications like this one from a former nursing home resident:

I have recently returned from “rehabilitation care” in a nursing home. I have pretty severe cerebral palsy and had breast cancer surgery. The nursing home environment did more to slow the healing process than help. I got a terrifying glimpse into a future in such facilities. I would rather die than have to exist in such a place where residents are neglected, ignored, patronized, infantilized, demeaned, where the environment is chaotic, noisy, cold, clinical, even psychotic.

Early advocates for the aged understandably concentrated their efforts on eradicating the mistreatment of the old. They were among the first to speak openly against the agism and overt bigotry practiced toward the aged. The much broader effort to liberate elders and elderhood, however, has yet to be truly begun. Such a crusade is necessary not because it can right wrongs that are visited on older people (although it can) but because it is the essential precondition for a new culture committed to a better quality of life for people of all ages.

The elder-guided society (I call it Eldertopia) is and should be run by the vigorous adults of the time. Elders should intervene at critical points to ensure that the adults take into account perspectives that are too easily ignored by those gripped by the fever of rank and wealth.

Since 1900, the percentage of Americans over age 65 has more than tripled, and those who reached age 65 in 1998 could expect to live on average another 17.8 years. Far from being ravenous locusts determined to consume an ever-increasing share of scarce resources, our growing number of elders represents an unprecedented windfall. I believe that the elders of our time form the only force capable of returning adulthood to healthier bounds. Consider the gifts a liberated elderhood could offer our society.

Elders have always made important contributions to the young of their families and communities. For thousands of years, relationships between young and old have made life better for both groups. In Eldertopia, all school construction and remodeling projects would include housing and community services for elders.

Elder councils could provide a balancing perspective that considers the long-term consequences of any proposed action. The topics addressed might well include matters that the conventional political system would rather sweep under the rug.
Elders have long spoken for Earth, its living creatures, and the children who are yet to be born. Eldertopia would have an Elder Conservation Corps that would tackle projects that strengthen the health and vitality of the natural world.

Any honest accounting of the potential influence of elders and elderhood must address the contributions not only of fit and energetic elders. It must recognize the contributions that people who are weak, ill, infirm, dependent, demented, disabled, and dying can make to this struggle. The old and frail are able to surmount the dizzy bustle that clings to the young—to enter a time and place in which the spiritual and emotional dimensions of human life take precedence over the humdrum workings (and failings) of organs, tissues, and systems. This is among the most admirable of all human endeavors. What the old and frail do is show us the way. They provide us with greater insight into and a clearer perspective on the human condition.

The most elder-rich period of human history is upon us. How we regard and make use of this windfall of elders will define the world in which we live.

Adapted from What Are Old People For? How Elders Will Save the World, by William H. Thomas, M.D., copyright 2004. Used by permission of VanderWyk & Burnham (www.VandB.com), Acton, Massachusetts. All rights reserved. William Thomas is a geriatrician who created the Eden Alternative and the Green House Project .

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February 15, 2009

ChangingAging.org Redesign -- Please Bookmark!

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February 9, 2009

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Power Up Friday

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Power Up Friday

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Power Up Friday

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December 15, 2008

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Meld, Merge, Mosaic

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December 9, 2008

Monkhouse Tuesday: Oma – one more time

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Monkhouse Tuesday: Oma – one more time

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November 28, 2008

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November 19, 2008

Time Lapse Aging

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November 17, 2008

Monkhouse Mondays: Europe's Last Witch Hunt