Changing Aging

I used to think that I wanted to live to 100 or beyond.  If I’m enjoying life, I’m still for it.  But if moving my body makes me miserable and chronic illness rules my day, I’m pretty sure I’ll opt for slow medicine.

Is slow medicine something that is appealing to you or do you say ‘no way!’ . . . ?

Slow Medicine is an approach that encourages less aggressive and less costly care at the end of life.  It’s a strategy similar to hospice - focusing on comfort - not cure.  Kendal at Hanover, a senior community connected to Dartmouth Medical School, has become a leader in slow medicine.  According to a recent N.Y. Times story, which you can read on Kendal’s website here, most residents there don’t opt for “medical heroics,” the hugely expensive, pull-out-all-the-stop medical interventions  to keep people living.

I like how Hanover provides customer “choice” to the very end of life.  It seems like a very healthy approach to health care.

Costco Connection, the publication for Costco members nationally, recently interviewed Ecumen CEO Kathryn Roberts in an article about how technology is transforming aging and aging services.  You can read it here.  (Note: you’ll need Adobe Acrobat Reader)

Yoga.  Massage.  Tai Chi.  A salt-water pool.  Personal trainers.  Bike racks.  And a Wii machine.

What could be mistaken for an upscale spa or gym is actually a glimpse of the future of aging unfolding in Chisago City.    Read the Minneapolis Star Tribune article on the Vitalize! Wellness Centre at Ecumen’s Parmly LifePointes community.  Or see the Vitalize! video here.

This is a cool mission statement:

To transform a source (the knowledge, talent and skill of the region’s 50+ population) into a force for enriching our community by helping individuals find meaning and the means to contribute to the greater good.

It’s the mission of Coming of Age, a Philadephia collaboration of four partners:  Temple University’s Center for Intergenerational Learning, WHYY Wider Horizons, the United Way of Southeastern Pennsylvania, and  AARP Pennsylvania. 

Coming of Age has three objectives: 

1.  Helping people age 50+ plan for the future;

2.  Promoting 50+ volunteering, learning, and community leadership;

3.  Working with nonprofits to recruit, train, and retain 50+ volunteers.  

Coming of Age is a great model for other communities who want to seize opportunities of an unprecedented age wave.  It’s fresh, invigorating, inspiring, fun . . . It’s also drawing dollars . . . Atlantic Philanthropies recently gave it $1.8 million to expand in other parts of the U.S.. . . . .

Do you know of any other communities that are doing this?

An interesting new study on China’s “oldest old” has been released by Duke University researcher Dr. Matthew Dupre and is available in the American Journal of Public Health.  (note: you have to have a paid subscription to access it)  He did the research while at the University of North Carolina and is now at Duke University Medical Center. 

Highlights of the Chinese Longitudinal Healthy Longevity Study, which included a sample size of more than 13,000 people include:

- Fewer than 1 percent of of Chinese 80 and older are living in nursing homes.

- Most are free of chronic disease and not disabled or cognitively impaired.

- For urban men and women, living in larger households was associated with longevity, suggesting that residing with one’s children, or grandchildren, might extend lifespan.

- Most study participants said they “looked at the bright side.”

- Rural women - likely the most disadvantaged group in China - showed the greatest longevity benefit from being optimistic.  Most people in the survey have a positive outlook.

- Most also eat veggies, and a lot of them are poor, have little education and drink and smoke, challenging some of the advice we get in regard to living a long time.

Do you golf a lot?  According to this news from our friends in Sweden, golf can be a good investment for health.  So says a new study from the Swedish medical university Karolinska Institutet. The death rate for golfers is 40 per cent lower than for other people of the same sex, age and socioeconomic status, which correspond to a 5 year increase in life expectancy. Golfers with a low handicap are the safest.

It is a well-known fact that exercise is good for the health, but the expected health gains of particular activities are still largely unknown. A team of researchers from Karolinska Institutet has now presented a study of the health effects of golf – a low-intensity form of exercise in which over 600,000 Swedes engage.

The study, which is published in Scandinavian Journal of Medicine & Science in Sports, is based on data from 300,000 Swedish golfers and shows that golf has beneficial health effects. The death rate amongst golfers is 40 per cent lower than the rest of the population, which equates to an increased life expectancy of five years.

Professor Anders Ahlbom, who has led the study with Bahman Farahmand is not surprised at the result, as he believes that there are several aspects of the game that are proved to be good for the health.

“A round of golf means being outside for four or five hours, walking at a fast pace for six to seven kilometres, something which is known to be good for the health,” he says. “People play golf into old age, and there are also positive social and psychological aspects to the game that can be of help.”

The study does not rule out that other factors than the actual playing, such as a generally healthy lifestyle, are also behind the lower death rate observed amongst golfers. However, the researchers believe it is likely that the playing of the game in itself has a significant impact on health.

Golf players have a lower death rate regardless of sex, age and social group. The effect is greater for golfers from blue-collar professions than for those from white-collar professions. The lowest rates are found in the group of players with the lowest handicap (i.e. the best golfers).

“Maintaining a low handicap involves playing a lot, so this supports the idea that it is largely the game itself that is good for the health,” says Professor Ahlbom.

Changing Aging recently sat down with Dr. Andrew E. Scharlach, of the University of California at Berkeley, where he holds the Eugene and Rose Kleiner Chair in Aging. He also serves as Director of the Center for the Advanced Study of Aging Services, which conducts research designed to inform development of innovative and effective services for older adults.  It recently sponsored an international web-based conference on “Creating Aging-Friendly Communities” and  technical support through an ongoing “Community of Practice” is available here.

Dr. Scharlach, who also serves as a gubernatorial appointee on the California Commission on Aging, has published extensively on the needs of older adults and their families, particularly with regard to long-term care services, work and family responsibilities, bereavement, and gerontological social work education.

In addition to more than 40 articles, he is the author of Elder Care and the Work Force: Blueprint for Action (with B. Lowe and E. Schneider; Lexington Books, Controversial Issues in Aging (with L. Kaye; Allyn & Bacon), and Families and Work: New Directions in the Twenty-First Century (with K. Fredriksen-Goldsen; Oxford University Press).

 What are the biggest changes that you think we’ll see in U.S. community planning as it relates to preparing for vital aging communities?

 We’re going to and already are seeing older consumers more involved in the planning process in communities. Aging friendly initiatives and products will become the norm.  You’re going to see much more universal design in housing development.  You’re also going to see products that look good, have good design and that are functional.  Michael Graves, the renowned designer, is creating good and functional design of shower heads, tea pots and other products used in everyday life.  That will become more widespread in architecture and other community infrastructure.

How do you see senior housing changing for the age wave?

I see several different areas for change.  I think you’re going to see more housing that’s built for a lifetime, e.g., universal design.  That’s going to lead to communities that are more intergenerational.  I think senior housing providers also will move more outside of their traditional bricks and mortar, where they help create virtual senior communities by delivering services to people in their home.  Technology is going to play a much greater role.  We’re already starting to see that with sensor monitoring in people’s homes.  That technology is going to have to increase because we’re going have many fewer caregivers. I also think there will be more peer support and less reliance on family care.  Communities that are known as “good places to grow old” are where people will want to live.

What are examples of U.S. communities you’ve seen that “get it” when it comes creating aging-friendly communities?

There are a number of communities that are seeing aging as an asset and working to be livable for a lifetime in different ways. Atlanta has a large initiative called Aging Atlanta, which is part of their regional planning and is focused on making Atlanta a place people want to stay.  The University of Indiana has a Center for Aging and Community under the direction of Dr. Philip Stafford that has been doing a lot of work in this area to help communities become lifespan communities.  Fremont, California, is another one that is doing community-wide work to help people live and stay in Fremont to the end of life.

 

By 2050, the U.S. will have more than a half million centenarians.  Assuming a shortage in professional caregivers, how do you see family care changing for this unprecedented demographic shift?

Technology is going to have to play a critical role.  Robotics are going to take on some roles that were traditionally done by humans.  You’re also going to have nurses checking in with patients by video or by computer via sensors.  We’re going to have to think very locally.  Neighbors are going to have to look out for neighbors.  Community design also is essential for this.  Buildings have to be easy to live in and easy to navigate for people who have disabilities.  You can start to see how the unprecedented age wave in the U.S. will impact just about every area of our society.  Communities can’t plan in silos.  There are a lot of interconnections and intergenerational ties to this.

 What do you want old age to look like for you?

I want to be socially connected.  I’d like minimal physical impediments, and I want to be able to maintain meaningful activities and relationships without undue pressure to maintain the functional levels of earlier years. There’s this image in America that to age well, you have to be jumping out of airplanes or running marathons. Not true. Healthy, successful aging is about enjoying life – not speed or intensity.

 

The Sunday New York Times featured Ecumen customer Helen Trost in an interesting article on technology enhancing independence, seniors being able to stay in their own home and involving family members across long distances. You can read more about technology Ecumen is using to enhance customers’ independence here.

The Washington Post calls Time Goes By “the quintessential seniors’ blog,”  . . . AARP calls its author Ronni Bennett (in the cool photo montage above), “the dean of older bloggers,”  . . . And we’re fortunate to have her insights today at Ecumen’s Changing Aging blog.

For more than 25 years Ronni, who says “Age is a gift,” was a radio and television producer, working on such programs as 20/20 and the The Barbara Walters Specials on ABC and for shows on Lifetime TV, NBC, PBS and CBS.  In 1996, as the Internet was in its infancy, Ronni was named the first managing editor at cbsnews.com.  It was there that the seeds of Time Goes By began to grow.  Today she’s changing aging in America from her home in Maine where she authors her groundbreaking blog.  Thank you to Ronni for taking time with us.

Why did you start blogging?

After six or eight years of researching aging in my spare time, I had accumulated thousands of pages of notes and articles along with a small library of books on aging and wanted to organize what I’d learned. I had also been following what was, in 2003, the nascent blogging phenomenon and thought it would be a good format for writing about ‘what it’s really like to get old’ which is the subtitle of my blog.

Hardly anyone was writing online about aging back then and what existed - online and in print - was about 95 percent negative; all about decline, disease and debility. I knew getting old couldn’t possibly be as bad as that so while not being a Pollyanna about it, I wanted to explore what is good about aging.

How much time do you spend on Time Goes By?

It’s a seven-day-a-week job. I have a couple dozen Google Alerts of key words and phrases that keep me up on what’s being written about aging, aging news, research, etc. I also subscribe to email newsletters relating to geriatrics, technology, government, public policy, employment, age discrimination, caregiving, etc., so there’s a lot of reading and assimilating to do. Then the writing.

I post to Time Goes By six days a week and I also keep a secondary blog, The Elder Storytelling Place, for which I rarely write, but edit and publish stories elders submit. I put in a lot more time on these than I did on regular jobs before I retired from the workplace.

What kind of impact do you think the blogosphere is going to have on how we view aging in America?

There’s a famous New Yorker cartoon from about a dozen years ago showing two dogs sitting at a computer. One says to the other: ‘On the internet, no one knows you’re a dog.’ Well, no one knows your age either, unless you tell them, so one’s thoughts, opinions and writing can more easily be judged on their merit rather than being dismissed for being written by a 70-year-ol. Or a 20-year-old, for that matter.

However, I always give my age, when appropriate, on my blog and I urge other elders to do it too so that readers become accustomed to finding stories of interest from 60-and 70- and 80-year-olds and beyond. The United States is a profoundly ageist country in which, for years, elders have been marginalized in media, the workforce and most of the culture as though, when we get old, we forget everything we ever learned. But we still have much to contribute if people will let us, and perhaps within the blogosphere we - the young and the old - might discover what we have in common.

Does growing older fascinate you, or scare you, or something else?  Why?

For most of my life, I never thought about getting old. I think our mid-years are so busy with careers, home, child-raising that there’s little time to consider our approaching later years. In my case, I was 55 when I looked around the room where I worked at cbsnews.com for one of the writers I needed to speak with. As I gazed over the faces, I had a startling moment of recognition: I was older than every person in the room by decades, old enough in some cases to be their grandmother.

Over the next few weeks, I noticed it again and again and realized I knew nothing about what getting old is like. A cursory look at the popular press, newspapers and magazines, gave me nothing except the debility and decline I mentioned above and I thought if it was going to be THAT bad, I might as well shoot myself.

But I couldn’t make myself believe that it would necessarily be so terrible. I was smarter, sharper, better at my job than I had ever been. I was more comfortable in my own skin. I was happier with myself than when I was younger. How could being 55 and even older be the awful thing it is made out to be, I wondered, when I felt so good.

Because youth is considered the gold standard of life in the United States, getting old is a great mystery and it fascinates me. And the goal of my blog is to lift the veil on that mystery and find out what it’s really like.

How do you see the age wave - the unprecedented number of older people - changing how we view aging in America?

Well, I haven’t made up my mind about that. On the one hand, with more elders around, everyone else has to become more familiar with us and see the trade-offs that are made. I can’t run as fast or jump as high as I once could, but I’m smarter, more experienced and have a lot better judgment than when I was young.

On the other hand, I worry that there will be a generational conflict. There is no denying that as old people become a larger percentage of the population, some people will see the need to care for those who need it as a drain on resources.

Nevertheless, things will need to change. With fewer people in the generations coming up behind the baby boomers, finally corporate America will NEED to employ old people longer just to get the work of the country done. Life expectancy increased by 30 years during the 20th century and we are much healthier than our parents’ and grandparents’ generations.  So there is no reason old people should be shoved out of the workplace at 60 or 65 as they are now, and there are signs that corporate America is beginning to recognize this.

The generations need one another and I hope that will help change the ageist atmosphere we live in now.

Do you see the media changing how it views and depicts aging?

A little, but not much yet. This is so because most of the media is run by young people and they don’t understand old people. Our interests and concerns change as we get older, but the media treats us mostly as slightly dotty, none too bright and the youth and beauty police keep insisting that we do everything possible to pretend to be younger than we are. The ad agencies and TV and movie producers need to employ some 60- and 70-year-olds to get it right.

There are a few more magazines, such as More and ELDR aimed at older people, and that’s good except that they may be becoming kind of a ghetto of old people media. And Oprah Winfrey, who has millions of fans and is considered the queen of daytime television, spends a great amount of time on her show pursuing the pretense of youth. Oprah is 54 years old. She should be wise enough by now to use her media power to help people accept aging as a normal stage of life, promote its dignity, recognize the value of elders and help integrate them into the mainstream.

Which are you enjoying more - your career in your 30s or your work today?

I had a wonderful career in television. I traveled the world on someone else’s dime, worked with kings and queens and movie stars and heads of state, and learned a lot of things I would never have otherwise known. And then, after a couple of decades, I was given the opportunity to work in a burgeoning new medium, the internet, when it was brand new.

During all those years, I never thought much about what I’d do when I wasn’t employed in the workforce anymore. I suppose I expected to do that until I die, but a bit of age discrimination in the workplace got in the way. I hadn’t intended, when I started Time Goes By, to make it a late-life career, but it morphed into that. It’s allowed me to meet people from all over the world, get to the know the tech community and participate in the blogging world beyond turning out a blog post each day, attending and speaking at conferences and, perhaps, making some small difference in how elders are perceived and treated.

So I can’t say I enjoy one more than the other, but how lucky for me that the internet and blogging came along just when I needed it.

Last week was a busy, interesting time on Capitol Hill in the area of “Changing Aging in America.” 

Three different hearings (one including Ecumen)  . . . all highlighting the need for holistic aging public policy in America - no planning in silos - so that the United States rides the age wave and people have the independence, quality of life and safety that they desire and deserve.

Justice Sandra Day O’Connor testified before the U.S. Senate Special Committee on Aging urging Congress to take a more active role in the research and treatment of Americans with Alzheimer’s Disease  Justice O’Connor’s husband John has it, and another person is getting it every 72 seconds.  Her testimony is here.

Kathy Bakkenist, Ecumen COO and senior vice president of strategy and operations, testified on technology to support family caregiving in a U.S. House briefing led by Rep. Patrick Kennedy (D-RI) and the National Alliance for Caregiving.  You can read Kathy’s testimony here.

And the House Committee on Energy and Commerce held a hearing about rogue nursing homes (which should be eliminated from existence).  You can read more about it here.