THE ELDERLY

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kmaherali
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Post by kmaherali »

November 29, 2007

WORK & FAMILY
By SUE SHELLENBARGER

Remote Control: Frail Seniors
Embrace Home Monitoring

November 29, 2007; Page D1

Work and Family columnist Sue Shellenbarger learns about new home-monitoring technologies that may allow doctors and families to track the medical condition of seniors from afar.

When John Fowlkes's adult daughter suggested installing an electronic monitoring system in his apartment to oversee his well-being from afar, "I was very skeptical," he says. To Mr. Fowlkes, 86, who has an active social life including an 80-year-old girlfriend, the idea evoked thoughts of Big Brother.

Mindful that a younger friend had fallen at home and lain on the floor for hours before anyone came to help, Mr. Fowlkes, of Raleigh, N.C., gave in. To his surprise, he found the setup "makes you feel more secure."

Overseeing the aged from afar is a hot issue for working caregivers, and the technology needed to do so is available. But policy makers and others have long fretted that seniors would resist electronic monitoring as an invasion of privacy.

Now, Big Brother has arrived -- and seniors are rolling out the welcome mat. As vendors make in-home monitoring systems widely available, seniors are mounting little resistance, and many are embracing the gadgetry as an aid to remaining independent.

Home-monitoring customers total a few thousand nationwide, according to half a dozen monitoring companies I surveyed. The most common systems use wireless motion or contact sensors on doorways, windows, walls, ceilings, cabinets, refrigerators, appliances or beds to track seniors' movements. Temperature sensors gauge heat and air conditioning. If an elderly person enters the bathroom and doesn't come out, or other typical activity patterns aren't recorded in the home, word can be sent to family members, 24-hour response workers or both. The systems also offer hand-held or wearable "panic buttons."

The QuietCare system used by Mr. Fowlkes is monitored by response workers. His daughter, Alisa Washington, who lives nearby, receives email updates several times a day at work. She says it gives her "much greater peace of mind."

• Sue Shellenbarger answers readers' questions2.
Seniors draw the line at some kinds of surveillance. Many protest against the presence of video cameras, says Majd Alwan, who conducted several small studies of monitoring systems as a professor at the University of Virginia. They see motion and contact sensors as less invasive, says Dr. Alwan, now director of the Center for Aging Services Technologies, Washington, D.C., a nonprofit research group.

Also, most seniors need time to get used to the idea. When 94-year-old Christine Martin's son Marty suggested monitoring her in her Sarasota, Fla., home, she objected at first, saying "she didn't want anything spying on her," says Mr. Martin, Buford, Ga.

Nevertheless, if technology helps delay the time when a senior must be admitted to a nursing home, Dr. Alwan's research found, a large majority of seniors are willing to accept it. Ms. Martin cherishes her independence; she also remembers a sad mishap involving her late sister, who died at home but wasn't found until two days later. Soon, she agreed to monitoring, and found she likes it. Knowing Marty "can tell when I'm getting up in the morning," Ms. Martin says, "I feel safer."

TALKING POINTS


To raise the subject of home monitoring with seniors:
• Explain how the technology will help
• Involve them in decision making
• Give them a chance to get used to the idea
• Present it as an aid to remaining independent
Source: Wendy Rogers, Georgia Institute of Technology
Among a total of about 80 seniors in Dr. Alwan's studies, only one mounted any lasting resistance to being monitored; after the research was complete, many protested when the systems were removed from their homes, Dr. Alwan says. The setups also reduced caregiver strain without reducing the time family members spent with elders.

Costs of various systems range from $99 to several thousand dollars to install, plus about $35 to $150 a month. Systems range from simple sensors to video cameras and teleconferencing or even a dedicated WebTV channel to post family news (offered by GrandCare Systems, West Bend, Wis.). The QuietCare system is sold by Living Independently, New York. Other vendors include Alarm.com, McLean, Va.; Caregiver Technologies, Oklahoma City; and Community Management Initiative, Green Bay, Wis.

Also, a growing number of assisted-living facilities are installing monitoring systems to help staff oversee residents, and some allow families remote access to the data gathered.

More elaborate technology is in the works. Researchers at Oregon Health & Science University, Portland, are working on home systems that track changes in seniors' physical and cognitive abilities over time, lining up wall sensors to track seniors' walking speed and computer kiosks to engage them regularly in cognitive tests and games. Such long-term data could provide early warning of such conditions as dementia, says Tamara Hayes, an assistant professor, biomedical engineering.
Write to Sue Shellenbarger at sue.shellenbarger@...3
URL for this article:
http://online.wsj.com/article/SB119630438176707457.html


Hyperlinks in this Article:
(1) http://online.wsj.com/article/SB119630941657407636.html
(2) http://online.wsj.com/article/SB119630941657407636.html
(3) mailto:sue.shellenbarger@...
kmaherali
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Post by kmaherali »

January 6, 2008
AIDS Patients Face Downside of Living Longer
By JANE GROSS
http://www.nytimes.com/2008/01/06/healt ... m+BkuJZa7w

CHICAGO — John Holloway received a diagnosis of AIDS nearly two decades ago, when the disease was a speedy death sentence and treatment a distant dream.

Yet at 59 he is alive, thanks to a cocktail of drugs that changed the course of an epidemic. But with longevity has come a host of unexpected medical conditions, which challenge the prevailing view of AIDS as a manageable, chronic disease.

Mr. Holloway, who lives in a housing complex designed for the frail elderly, suffers from complex health problems usually associated with advanced age: chronic obstructive pulmonary disease, diabetes, kidney failure, a bleeding ulcer, severe depression, rectal cancer and the lingering effects of a broken hip.

Those illnesses, more severe than his 84-year-old father’s, are not what Mr. Holloway expected when lifesaving antiretroviral drugs became the standard of care in the mid-1990s.

The drugs gave Mr. Holloway back his future.

But at what cost?

That is the question, heretical to some, that is now being voiced by scientists, doctors and patients encountering a constellation of ailments showing up prematurely or in disproportionate numbers among the first wave of AIDS survivors to reach late middle age.

There have been only small, inconclusive studies on the causes of aging-related health problems among AIDS patients.

Without definitive research, which has just begun, that second wave of suffering could be a coincidence, although it is hard to find anyone who thinks so.

Instead, experts are coming to believe that the immune system and organs of long-term survivors took an irreversible beating before the advent of lifesaving drugs and that those very drugs then produced additional complications because of their toxicity — a one-two punch.

“The sum total of illnesses can become overwhelming,” said Charles A. Emlet, an associate professor at the University of Washington at Tacoma and a leading H.I.V. and aging researcher, who sees new collaborations between specialists that will improve care.

“AIDS is a very serious disease, but longtime survivors have come to grips with it,” Dr. Emlet continued, explaining that while some patients experienced unpleasant side effects from the antiretrovirals, a vast majority found a cocktail they could tolerate. “Then all of a sudden they are bombarded with a whole new round of insults, which complicate their medical regime and have the potential of being life threatening. That undermines their sense of stability and makes it much more difficult to adjust.”

The graying of the AIDS epidemic has increased interest in the connection between AIDS and cardiovascular disease, certain cancers, diabetes, osteoporosis and depression. The number of people 50 and older living with H.I.V., the virus that causes AIDS, has increased 77 percent from 2001 to 2005, according to the federal Centers for Disease Control, and they now represent more than a quarter of all cases in the United States.

The most comprehensive research has come from the AIDS Community Research Initiative of America, which has studied 1,000 long-term survivors in New York City, and the Multi-Site AIDS Cohort Study, financed by the National Institutes of Health, which has followed 2,000 subjects nationwide for the past 25 years.

The Acria study, published in 2006, examined psychological, not medical, issues and found unusual rates of depression and isolation among older people with AIDS.

The Multi-Site AIDS Cohort Study, or MACS, will directly examine the intersection of AIDS and aging over the next five years. Dr. John Phair, a principal investigator for the study, which has health data from both infected and uninfected men, said “prolonged survival” coupled with the “naturally occurring health issues” of old age raised pressing research questions: “Which health issues are a direct result of aging, which are a direct result of H.I.V. and what role do H.I.V. meds play?”

The MACS investigators, and other researchers, defend the slow pace of research as a function of numbers. The first generation of AIDS patients, in the mid-1980s, had no effective treatments for a decade, and died in overwhelming numbers, leaving few survivors to study.

Those survivors, like Mr. Holloway, gaunt from chemotherapy and radiation and mostly housebound, lurch from crisis to crisis. Mr. Holloway says his adjustment strategy is simple: “Deal with it.” Still he notes, ruefully, that his father has no medical complaints other than arthritis, failing eyesight and slight hearing loss.

“I look at how gracefully he’s aged, and I wish I understood what was happening to my body,” Mr. Holloway said during a recent home visit from his case manager at the Howard Brown Health Center here, a gay, lesbian and transgender organization. The case manager, Lisa Katona, could soothe but not inform him. “Nobody’s sure what causes what,” Ms. Katona told Mr. Holloway. “You folks are the first to go through this and we’re learning as we go.”

Mr. Holloway is uncomplaining even in the face of pneumonia and a 40-pound weight loss, both associated with his cancer treatment. Has the cost been too high? He says it has not, “considering the alternatives.”

Halfway across the country, Jeff, 56-year-old New Yorker who was found to have AIDS in 1987, said he asks himself that question often.

Jeff, who asked that he not be fully identified, has had one hip replacement because of a condition called avascular necrosis, the death of cells from inadequate blood supply, and needs another to avoid a wheelchair. Many experts think that avascular necrosis is caused by the steroids many early AIDS sufferers took for pneumonia.

“The virus is under control, and I should be in a state of ecstasy,” he said, “but I can’t even tie my own shoe laces and get up and down the subway stairs. ”

His bones are spongy from osteoporosis, a disorder that afflicts many postmenopausal women but rarely middle-aged men, except some with AIDS. No research has explained the unusual incidence.

In addition, Jeff has Parkinson’s disease, which is causing tremors and memory lapses.

He is in an AIDS support group at SAGE, a social service agency for older gay men and lesbians. His fellow group members also say they find the illnesses associated with age more taxing than the H.I.V. infection. One 69-year-old member of the group, for example, has had several heart attacks and triple bypass surgery, and his doctor predicts that heart disease is more likely to kill him than AIDS.

Cardiovascular disease and diabetes are associated with a condition called lipodystrophy, which redistributes fat, leaving the face and lower extremities wasted, the belly distended and the back humped. In addition, lipodystrophy raises cholesterol levels and causes glucose intolerance, which is especially dangerous to black people, who are already predisposed to heart disease and diabetes.

At Rivington House, a residence for AIDS patients on the Lower East Side of Manhattan, Dr. Sheree Starrett, the medical director, said that neither heart disease nor diabetes was “terribly hard to treat, except that every time you add more meds there is more chance of something else going wrong.”

Statins, for instance, which are the drug of choice for high cholesterol, are bad for people with abnormal liver function, also a greater risk among blacks. Many AIDS patients have end-stage liver disease, either from intravenous drug use or alcohol abuse. Among Dr. Starrett’s AIDS patients is 58-year-old Dominga Montanez, whose first husband died of AIDS and whose second husband is also infected.

“My liver is acting up, my diabetes is out of control and I fractured my spine” because of osteoporosis, Ms. Montanez said. “To me, the new things are worse than the AIDS.”

There are no data that compare the incidence, age of onset and cause of geriatric diseases in the general population with the long-term survivors of H.I.V. infection. But physicians and researchers say that they do not see people in their mid-50s, absent AIDS, with hip replacements associated with vascular necrosis, heart disease or diabetes related to lipodystrophy, or osteoporosis without the usual risk factors.

“All we can do right now is make inferences from thing to thing to thing,” said Dr. Tom Barrett, medical director of Howard Brown. “They might have gotten some of these diseases anyway. But the rates and the timing, and the association with certain drugs, makes everyone feel this is a different problem.”

One theory about why research on AIDS and aging has barely begun is “the rapid increase in numbers,” Dr. Emlet said. The federal disease centers’ most recent surveillance data, from 33 states that meet certain reporting criteria, showed that the number of people 50 and older with AIDS or H.I.V. infection was 115,871 in 2005, nearly double the 64,445 in 2001.

Another is the routine exclusion of older people from drug trials by big pharmaceutical companies. The studies are designed to measure safety and efficacy but generally not long-term side effects.

Those explanations do not satisfy Larry Kramer, founder of several AIDS advocacy groups. Mr. Kramer, 73 and a long-term survivor, said he had always suspected “it was only a matter of time before stuff like this happened” given the potency of the antiretroviral drugs. “How long will the human body be able to tolerate that constant bombardment?” he asked. “Well, we are now seeing that many bodies can’t. Once again, just as we thought we were out of the woods, sort of, we have good reason again to be really scared.”

The lack of research also limits a patient’s care. Dr. Barrett says the incidence of osteoporosis warrants routine screening. Medicare, Medicaid and private insurers, however, will not cover bone density tests for middle-aged men.

Marty Weinstein, 55 and infected since 1982, has had a pacemaker installed, has been found to have osteoporosis, and has been treated for anal cancer and medicated for severe depression — all in the last year. He also has cognitive deficits.

A former professor of psychology in Chicago, he presses his doctors about cause and effect. Sometimes they offer a hypothesis, he said, but never a certain explanation.

“I know the first concern was keeping us alive,” Mr. Weinstein said. “But now that so many people are going to live longer lives, how are we going to get them through this emotionally and physically?”
kmaherali
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Post by kmaherali »

Prayer on Moving to Senior Housing


Well, Lord, the day has come. In many ways I dreaded leaving my home, my security. And now I have to give up some of my privacy and life with other old people.

Help me even now to accept these people as I find them--boring at times, stimulating, and excessively talkative. Help me remember that all these strange people are loved by you. Deliver me from being snappy at meals with people who are cranky -- they may be in pain. If someone wants to confide a problem, help me listen. And may I reach out to those when I feel the urge to strike out.

As I leave my home, give me a sense of call, even as you called old Abraham and Sarah when they left their home on a new journey of faith. If I can love my neighbor there, then I have a mission. Amen.
kmaherali
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Post by kmaherali »

The Story of 'The Patient'
My mother had trouble adjusting to her new life in a nursing home, so I told her a story I knew she could relate to.
By Ellie Braun-Haley

The transition from living in your own home and directing every aspect of your life to being confined to a wheelchair and being dependent on others for everything, is a traumatic change.

Five months after Mother's 91st birthday my mother fell and this one single incident changed Mother's life.

She was in the hospital for months and then moved to a nursing facility. We knew she would never go home again and then came the day when she too knew it. When I visited my mother I recognized she was putting up a brave front, yet I knew inwardly she was questioning her own value.

She was completely helpless, confined to a bed unless someone moved her to a wheelchair. The sinks were not even set up for wheelchairs so she had difficulty even brushing her own teeth. Closets held her clothing up high, as if she had elastic arms. Her legs would barely respond to lift or shift and her conversations indicated she felt as useless as those legs.

Mother was wondering why she was still on this earth. Four infections had drained her to the point where she no longer read or did crossword puzzles or played cards with herself. Wishing to stimulate her interest in something I asked her if I could read a short story to her. She nodded her consent and laid her head back on the pillow.

I told her the story of The Patient...

* * *

The Patient was bedridden and only able to chat a bit and smile. All the nurses looked forward to going into The Patient's room because they were overworked, tired and in need of something -- perhaps the milk of human kindness.

In The Patient's room they fed on the warmth of the smile they received. Each person was uplifted by the good cheer, gentle words, and by the abundant and concerned thoughtfulness of this one senior Patient.

There were some in the hospital who yelled and whined. There were some who cried and others who literally abused the staff with slapping, biting and harsh words, but not The Patient.

No, when the staff entered the room of The Patient it was as if they knew they would find sanctuary! All understood, in this room, with this one Patient, they would always be uplifted.

Cleaning staff, nurses, even doctors fed on the endless supply of benevolence dished out by The Patient, and The Patient, in turn, seemed to understand how very valuable this kind of service was to everyone. The Patient understood her calling, and realized she was needed!

* * *

As I finished telling the story, a light seemed to go on within mother, and she exclaimed, "Goodness, the staff here all say they like coming into my room because I am so cheerful. I never thought about the impact of it before."

It was as if a heavy load had lifted from Mother's shoulders and she looked more relaxed than she had in a long time.

Mother's children have always known she blesses many lives with her loving disposition. How wonderful for mother to now understand her actions make a big difference and her very presence is a gift to many.

Now and then I have heard a saying "grow where you are planted." It dawned on me that mother was growing in a new way. God impressed upon me to tell Mother the story of The Patient and I realized immediately this was indeed the answer to helping her understand her worth.
kmaherali
Posts: 25106
Joined: Thu Mar 27, 2003 3:01 pm

Post by kmaherali »

March 2, 2008
Golden Opportunities
Tapping Into Homes Can Be Pitfall for the Elderly
By CHARLES DUHIGG

Erika Baker was 67 years old, divorced and worried about her job when a saleswoman showed up at her door in late 2006.

A reverse mortgage, the saleswoman explained, would give Ms. Baker instant access to hundreds of thousands of dollars tied up in the value of her home. Such a loan, typically available only to homeowners in their 60s and older, would not have to be repaid until Ms. Baker moved out, the saleswoman said.

And if she never moved, the loan would be settled by selling her house after she died. “Your Home Pays You Cash!” read a brochure the saleswoman left behind.

Ms. Baker, who lives just outside San Diego, jumped at the offer, borrowing a little more than $200,000 through a company called Senior American Funding.

Then the problems began. The saleswoman pressured her to put the proceeds of the loan into complex investments that put her money out of reach, Ms. Baker said. She received only about $33,000 in cash, far less than she needed for her final years.

“I thought this was a safe way to make sure I’d never run out of money,” Ms. Baker said. “Then everything became so confusing. No matter where I turned for help, it seemed like things got worse.”

As the United States has become an older nation, reverse mortgages have grown into a $20-billion-a-year industry, with elderly homeowners taking out more than 132,000 such loans in 2007, an increase of more than 270 percent from two years earlier. In surveys, many borrowers say reverse mortgages have improved their lives and provided money they needed for retirement.

But hundreds of people who have sought reverse mortgages — in lawsuits, surveys and conversations with elder-care advocates — have complained about high-pressure or unethical sales tactics they say steered them toward loans with very high fees. Some say they were tricked into putting proceeds of their loans into unprofitable investments, while sales agents pocketed rich commissions.

“Every scam artist is getting into this business,” said Prescott Cole, an elder-care advocate who has worked with numerous reverse mortgage borrowers. “Because reverse mortgages are so complicated and give you money up front, years can pass before a senior realizes they’ve lost everything.”

Reverse mortgage lenders and brokers dispute those accusations, noting that the loans are heavily regulated and have helped hundreds of thousands of people.

“For a lot of elderly people, their only real asset is their house,” said Peter Bell, president of the National Reverse Mortgage Lenders Association, a trade group. “A reverse mortgage is one of the few ways someone can access wealth that’s otherwise out of reach, while still living in their house for as long as they want.”

However, some borrowers find their wealth is still out of grasp, even after they have sought a reverse mortgage.

For example, Senior American Funding, the company that sold Ms. Baker her loan, has been sued three times in the last 13 months by clients who said they were misled. (Two of those cases were settled out of court for undisclosed sums. The third, filed by Ms. Baker in California state court last month, is pending.)

The company, which is licensed in 16 states, has originated mortgages worth more than $100 million since 2004.

“We never pressure clients,” said one of the company’s founders, Matthew Copley. “We just try to make sure they know about their options.”

However, a former sales agent, Hani Shenoda, and an agent who still works at the company who spoke on the condition of anonymity because of fear of retribution, said in interviews that managers at Senior American Funding encouraged them to pressure older homeowners into unwise loans and investments. The company disputes that assertion.

On Tuesday, after being contacted by a reporter, Senior American Funding announced it would no longer sell combinations of loans and investments like the one Ms. Baker had bought.

“When we make mistakes, we address them as responsibly as we can,” Mr. Copley added.

Ms. Baker owned a home worth about $600,000 but was living paycheck to paycheck, teaching child-rearing skills to low-income mothers for about $400 a week, when she was told in 2006 that her job was ending.

Months earlier, she had received a mailing from Senior American Funding, one of the hundreds of reverse mortgage companies that have emerged in the last several years. She scheduled an appointment with a saleswoman named Laurie Spencer. (Ms. Spencer no longer works at Senior American Funding, according to the company, and could not be located.)

“This saleswoman was so friendly and personable,” Ms. Baker said. “It was like God had sent me a friend to tell me how to survive.”

In the kitchen of the home, where Ms. Baker displays watercolors of dolphins and flowers she has painted, the saleswoman recommended a loan of $218,900, with a variable interest rate initially set at 6.57 percent.

Because reverse mortgages do not require borrowers to make immediate repayments, the interest charges are added to the debt every day, and the total amount owed grows over time. The saleswoman did not explain that within 10 years, Ms. Baker’s $218,900 loan could grow to as much as $400,000, Ms. Baker said. That debt would be paid by selling the house when she moved out or died.

The saleswoman also did not emphasize the high fees, Ms. Baker said. The loan’s fees cost her $17,100 — almost 8 percent of the total loan — which was paid out of the proceeds as soon as the loan closed.

To ensure that borrowers know such details, the federal government requires them to speak to an independent adviser before closing a reverse mortgage.

“We make potential borrowers talk to a counselor to make sure they understand what they are doing,” said Renée Shadel, an investigator with the Washington state attorney general’s office. “These can be great loans for some people, but only if they understand them.”

But critics say these counseling sessions are often brief and unhelpful. Some elderly borrowers, for instance, said their sessions lasted only 10 minutes, rather than the 60 to 90 minutes most counselors say they need to explain the loans.

Critics say some sessions are so brief because reverse mortgage companies are paying for the advice. One of the largest reverse mortgage counseling companies, Money Management International, often asks lenders to pay for providing advice to the lender’s clients, according to a company spokeswoman.

Money Management International, which is a nonprofit company, received $900,000 from reverse lenders last year. By regulation, counselors may not charge clients, though they are allowed to seek support from lenders.

“Anytime anyone gives a counselor a donation, they expect a quid pro quo,” said Buz Zeman, a reverse mortgage counselor with Housing Options Provided for the Elderly, a nonprofit group financed by government grants. “The point of counseling is to make people consider other options. That’s difficult if you feel like your next paycheck relies on convincing someone to get the loan.”

A spokeswoman for Money Management International says it seeks payments from lenders because government grants do not cover costs. The group’s counselors educate clients only about how loans work and do not recommend whether to proceed, she said, adding that the average time a counselor spends with a client is 58 minutes.

“There is no quid pro quo relationship with lenders,” a Money Management International spokeswoman, Catherine Williams, said in an e-mail message, adding that clients receive the same advice whether a lender pays for the session or not. “Funding is not tied to the outcome of any case.”

Even when lenders do not pay for counseling, it can still prove unhelpful. Ms. Baker’s counseling session, which was provided by an agency that does not accept money from lenders, lasted only about a half hour, and she walked away from the conversation still confused, she said.

Then the saleswoman persuaded her to sign the loan forms.

After the reverse mortgage closed, Ms. Baker used the proceeds to pay off a $68,000 traditional mortgage on her home, and she put about $33,000 into various savings accounts.

The remaining $100,000 was used to purchase, at the saleswoman’s urging, two deferred annuities — complex contracts that offer monthly income in exchange for a large lump-sum payment.

Those annuities prohibited Ms. Baker from gaining access to most of her funds for seven years unless she paid a stiff penalty.

Moreover, the annuities were likely to cost her money rather than pay her. Annuities are so complex that it is impossible to forecast precisely how much Ms. Baker will receive from them. However, based on recent payout data for similar products, she will probably earn about $520 a month from her annuities for the rest of her life. Ms. Baker’s mortgage debt is increasing by about $600 a month as the interest compounds on the money she used to purchase those annuities.

If Ms. Baker collected monthly income from her annuities for 10 years, she could receive $62,400. However, the debt she would owe over that period would likely increase by $79,000 to $300,000, depending on how her loan’s interest rate changed.

“Buying an annuity with the proceeds of a reverse mortgage is incredibly dangerous,” said Mr. Cole, a critic of reverse mortgages. Indeed, the practice is so troublesome that many annuity companies and states either tightly regulate or forbid it.

The salespeople at Senior American Funding were richly rewarded for their sales: the company received about $8,750 in commissions from Ms. Baker’s annuities, and $7,200 for processing her reverse mortgage.

Last month, Ms. Baker sued Senior American Funding, accusing it of fraud and elder abuse.

Mr. Copley, the Senior American Funding co-founder, defended the company’s actions and said Ms. Baker consented to every transaction.

However, Mr. Copley conceded that Ms. Baker was given documents with inaccurate numbers and that sales agents, including him, at the time did not fully understand the products they were selling her.

“If we made mistakes, I’m sorry,” he said.

Other lenders have also been accused of pushing older homeowners into unwise deals.

A survey released last year by AARP, formerly known as the American Association of Retired Persons, of more than 1,500 reverse mortgage borrowers found that almost one in 10 were urged to buy other financial products, like annuities.

Lawsuits against reverse mortgage companies, including the nation’s largest, Financial Freedom Senior Funding, contend that those firms helped pressure older Americans into bad investments.

In court filings, companies have denied those claims.

“Financial Freedom is not involved in selling annuities, does not recommend annuities, and won’t even allow borrowers to use reverse mortgage proceeds to buy an annuity at closing,” said Joel Schiffman, the company’s general counsel. “We only pursue a reverse mortgage when it is in a senior’s best interest.”

Some regulators and lawmakers, however, have said that more safeguards are needed, including giving borrowers more information about alternatives to reverse mortgages, disclosing fees more clearly and providing more government money to counselors, so that they do not seek payments from lenders.

New laws governing reverse mortgages are under consideration in Congress, though lobbyists for some lenders are mounting strong opposition, Congressional staff members say.

For Ms. Baker, now 68, such safeguards would come too late. She says she wakes up in the night, terrified there will not be enough money for food, gas or anything else. To cut her grocery bill, she stopped buying meat and fresh vegetables.

“Before, at least I knew my house was safe, and that no one would take that away from me,” she said. “Now, I don’t know if there is anything I can count on.”
kmaherali
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Post by kmaherali »

Pill to fight old age not fiction: scientist

Jodie Sinnema
Edmonton Journal

Sunday, March 16, 2008

For centuries, dreamers have searched for the elixir of life, the fountain of youth and the philosopher's stone.

Their goal has often been greeted with skepticism and associated with magic, sorcery and science fiction.

But Harvard medical school scientist David Sinclair -- whose breakthrough research about red wine bringing longer life has been picked up by Jay Leno, Newsweek and Fortune magazine -- believes a pill is just on the horizon that will keep diseases at bay and allow us to become centenarians with the energy of 40-year-olds.

"I'm quite certain it's going to happen," said Sinclair, a molecular biologist who will present his research at two University of Alberta lectures, this Tuesday and Wednesday.

"This is a radical way of doing medicine where we're preventing diseases so that these animals in our lab, and hopefully humans one day, live longer, but only because they're not getting diseases that kill them."

Right now, Sinclair's "perilously glitzy anti-aging science," as Fortune magazine describes it, is being tested in clinical trials on humans, who take pills containing a immensely concentrated form of a molecule found in red wine to treat diabetes and hold back aging.

"We're talking about a future where your doctor could prescribe a pill to treat your diabetes, and as a side-effect, you will have many more years free of heart disease and cancer and even Alzheimer's as a result of taking this pill," Sinclair said in a telephone interview.

Such drugs were theoretically impossible 20 years ago, but then scientists discovered aging is regulated by genes -- a regulation that could be mimicked with technology and chemicals.

Sinclair found that resveratrol, a molecule found in red-wine grapes, triggered certain cells to live longer. When the molecule was fed to fish, their lifespan increased 59 per cent, equivalent to a human living to age 194.

Mice that ate food laced with resveratrol had the physiology of lean mice and reduced their risk of death by 30 per cent. Later research found they could run marathons without training.

© The Calgary Herald 2008
kmaherali
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Post by kmaherali »

Aging Fabulously
Author Marianne Williamson on how getting older may be the most potent spiritual opportunity you've ever had.
http://www.beliefnet.com/story/230/story_23071.html
Interview by Valerie Reiss

Marianne Williamson is a best-selling author, former minister, Course in Miracles teacher, speaker, and peace advocate. Now 55, she has turned her fierce yet compassionate gaze to conscious aging in her new book, "The Age of Miracles: Embracing the New Midlife." She talks to Beliefnet about how we can reclaim our inherent fabulousness and what the Boomers need to be doing in their pivotal next chapter--for themselves and the planet.

What inspired you to write a book about aging?
My soul has been grappling for several years with no longer being young. One of the shocks of a 50th birthday is realizing the fundamental fact that your youth is irrevocably over. In our society, as people pass out of young adulthood, they tend to relate to themselves more in terms of what they are no longer than what they are now, and that’s psychologically low-grade devastating.

Why do you think people are doing that?
[In midlife] it's as though we have a second puberty. In the first, the persona of the child fades away and the young adult begins to emerge. A wise culture knows to mark this for a child through a coming-of-age ceremony of some kind. Otherwise, the child is moved to subconsciously mark it anyway, often dysfunctionally. It could be body piercing, immoderate sex, drugs, etc.

The second puberty is similar. If we do not create an honorable marking, then that’s what the proverbial midlife crisis is. Somebody running out and doing something crazy or, in women, often an unacknowledged depression.

In the second puberty, you start reaching back in time. We need to create a psychic container to grieve, let go, forgive, and reconcile. Otherwise there’s too much baggage and we can't enter this new phase.
Look at sexuality. In the first puberty, it's like "Yippee! I got it now." Well, in the second puberty, it’s grieving an aspect of it that you don’t have anymore. Now, don’t get me wrong. It’s not like you don’t have something equally fabulous.

I remember I was walking through a store and I saw clothes a 25-year-old would wear. And the conversation in my head was, “I’m not young and fabulous anymore.” But, immediately, there was a voice that said, “No, you can be older and fabulous.” In other words, still just as fabulous, but in a different way.

Can you talk about the moment in the book when you’re looking in the mirror?
Most people, men and women, have had the experience of being 45, 50, 55, looking at a picture of themselves when they were young and thinking, “I thought that was inadequate?” When I realized I was thinking, “If only I was younger, it would be better,” I began to think about what was really true when I was younger. When I was younger, I was thinking, “If only I had another job, it would better. If I only lived in another place, it would be better. If only I was in a different relationship, it would be better.”

So, the real issue was not age. The real issue was the mind struggling against itself.

What makes people feel and look old?
Stress, grief, pain, suffering. By the time we're 45 or 40, few people are unscathed. We all fall down. The issue is not who falls down, it’s who gets back up and how. The new midlife is where you realize that even your failures make you more beautiful and are turned spiritually into success if you became a better person because of them. You became a more humble person. You became a more merciful and compassionate person.

This internal work is so necessary because, at a certain point, you either do this work and transform the energy, or you’re weighed down. You can look at people in their 50s and you can almost tell which choice they made, consciously or subconsciously.

And what if you find yourself with this hardened crust? Is it hopeless?
Absolutely not. First, you have to admit it and recognize it. You can be 20 and carrying around a lot of character defects, fooling a lot of people. But you get to a certain age where your racket is obvious. You have a choice. You can just saunter into this next phase of your life with this racket that’s pathetic and painful and aging and disease or you can realize, this is my spiritual initiation, and you do the work. Some people are saying, “I can’t rise up because of my husband who left me 20 years ago.” Well, who’s the real enemy there? The person who left you or the person inside you who’s let 20 years pass without getting over it?

Right.
So, you carry that hardness and that bitterness. From a consciousness perspective, there’s no mystery why love is not just rushing in. And so, there’s forgiveness of self. There's forgiveness of others. There’s allowing our failures to become our medicine because of what we learned.

How do we deal with our aging physical self?
As a woman, who wishes we didn’t have the same thighs that we had twenty years ago, or the same rear end or that our breasts were in the same place? Who doesn’t think wistfully about all that? You can’t just pretend that you don’t. You have to grieve it. Then, something else happens that’s pretty wonderful. I say in the book, “You can’t hold your leg up as high in aerobics class anymore, but you can lift your eyebrow in a way you couldn’t in those days.”

For myself, if I am trying to work on my body because I’m trying to make it what it used to be, I’m filled with angst and stress. But, if I’m working on my body to be a hip and cool and fabulous 55-year-old, it’s a whole different energy and a whole different joy in the process. My chances of even approaching what I used to be are far greater. You’re affirming life, you’re not staving off death. You’re living in the present.

How are the Baby Boomers changing what aging means?
The Boomers thought we were going to make the world much better. If we are honest with ourselves, as if we as a collective were in therapy, we would have to face the truth that, on our watch, things got much worse. The generation that thought that we were going to replace guns with flowers has, more than any generation in history, replaced flowers with guns.

We have one more chapter of our history in this lifetime. If we don’t get it right, we will die having gotten it wrong. For anyone who reaches a certain age, you don’t want to die feeling it was all for nothing. The Jewish prayer book says how sad is he who dies not having sung his song.

There is a confluence here--just at the time our generation feels, “I want to be a sane grownup,” we are living at a moment where, if a critical mass of people don’t become sane grownups, like, very quickly, there is going to be global catastrophe.

So, it’s really the opposite of retirement.
You better believe it. A friend of mine said to me, “Oh, I get it. Don’t retire, re-fire.” In the past you might “do a little something just to stay busy.” This is a whole different thing. This is people going, “You know what? No matter how flashy my career was, it just taught me what I need to do what’s really important.”

Do you have recommendations for people who want to transform for the next step in life?
People want step one, step two, step three. That’s not how a life changes. A life changes because you go, “Oh, wow. I get it.” And that is followed by something else that happens, and you go, “Right.” It’s layers of understanding.

When I was younger, Otis Redding sang "Sittin’ on the Dock of the Bay," with the lyric, "sitting here resting my bones." And I thought that was silly because who rests their bones? So, years later, one day I hear myself saying to my daughter, “Honey, you go outside. Mommy’s going to just sit here and rest her bones.” I freaked out. I panicked. It’s like, it’s all over if I’m resting my bones.

I did this whole study within myself of what it meant that I was sitting down, and I thought about the Buddhist meditation, which I used to do, in which the goal was to enjoy sitting. When you’re younger, there is this hormonally-based adrenaline rush pulsing through your veins that makes it difficult to achieve a quiet mind and a quiet body.

Later, the evolutionary process is such that you find you’re just sitting there and it means something. If in fact the highest, most powerful work is the work of consciousness, then what we could do from our rocking chairs could literally rock the world.

Our generation is becoming contemplative. We are becoming reflective. I look back on so many of the mistakes I made. I would not have made them had I not been moving so fast.

So, we all become yogis by default.
That’s the thing--or we don’t. If we don’t, it’s called a slow cruise to death, and it can be really rough. That’s exactly the point. You either become a yogi or you become pathetic.

How are you taking care of your body and your spiritual practices? How has that changed as you’ve gotten older?
I’ve just taken it more seriously because there’s a higher price to pay for not doing it. At a certain period of life, your karma is more instant. That which you get right bears even greater fruit, and that which you get wrong bears harsher consequences--your ability to forgive, your ability to let go, or your physical exercise or yoga or whatever.

What's the most important spiritual practice?
Pray. The second most important thing, meditate. Third most important thing, do physical exercise and yoga. Then, the fourth most important thing, if moved to do so, read my book.

Do you feel like you’re reinventing yourself for a second life?
Reinvention doesn’t really say it for me. Nature doesn’t reinvent itself every spring. It does what it does. God invents you. As you get older, the spiritual opportunity is to drop that which is false and to reclaim your true self. T.S. Eliot in "Four Quartets" says, “You’re always going home. You’re going back home.” So, it’s not so much that you’re going forward, you’re coming full circle. You are dropping this artificial self that accumulated--the burdens, the disappointments, the fears, the falsehoods.

When I was younger, I didn’t understand how Emily Dickinson basically never left town and could know so much, but I do now. Everything is here.When you’re younger, you just want to go out and get rich--whatever that means. When you’re older, you realize that the issue is to know how rich life is. I think that’s where our nation needs to go, too, because this gargantuan drive to just expand is unsustainable.

That’s what I feel I’m going through in my life. I’m sitting in a room now, and I look at this lamp, and I remember I bought it in Los Angeles. Those silver candlesticks, they were my grandmother's. That bowl, my mother brought to me from Paris. That little ivory piece my girlfriend Victoria gave me for my birthday. That book over there my publisher gave me when I wrote "A Woman’s Worth." That statue over there, the board of directors of the church I was at gave me.

You realize, oh, my goodness, there’s so much in what’s here because once you’ve lived enough, it’s these things that matter. It’s not getting more. It’s learning to just be in such joy with what you have.

Is there anything I haven’t asked you that you would want to tell Beliefnet readers?
When the mirror is no longer telling you what you thought you would like to hear and the culture is no longer telling you what you thought you would like to hear, sometimes that’s when you finally have ears for what God wants to say to you. That’s when you hear him say things sweeter than the mirror ever told you and sweeter than the culture ever told you. That’s when you finally realize that you are loved, and you finally realize you are enough.

When you have really allowed that in, you emerge into a different place within yourself, and from that place life rocks.
kmaherali
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Post by kmaherali »

Old age, to the unlearned, is winter; to the learned, it’s harvest time.

-Yiddish saying
kmaherali
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Post by kmaherali »

http://www.nytimes.com/2008/05/20/healt ... ef=science

May 20, 2008
Older Brain Really May Be a Wiser Brain
By SARA REISTAD-LONG

When older people can no longer remember names at a cocktail party, they tend to think that their brainpower is declining. But a growing number of studies suggest that this assumption is often wrong.

Instead, the research finds, the aging brain is simply taking in more data and trying to sift through a clutter of information, often to its long-term benefit.

The studies are analyzed in a new edition of a neurology book, “Progress in Brain Research.”

Some brains do deteriorate with age. Alzheimer’s disease, for example, strikes 13 percent of Americans 65 and older. But for most aging adults, the authors say, much of what occurs is a gradually widening focus of attention that makes it more difficult to latch onto just one fact, like a name or a telephone number. Although that can be frustrating, it is often useful.

“It may be that distractibility is not, in fact, a bad thing,” said Shelley H. Carson, a psychology researcher at Harvard whose work was cited in the book. “It may increase the amount of information available to the conscious mind.”

For example, in studies where subjects are asked to read passages that are interrupted with unexpected words or phrases, adults 60 and older work much more slowly than college students. Although the students plow through the texts at a consistent speed regardless of what the out-of-place words mean, older people slow down even more when the words are related to the topic at hand. That indicates that they are not just stumbling over the extra information, but are taking it in and processing it.

When both groups were later asked questions for which the out-of-place words might be answers, the older adults responded much better than the students.

“For the young people, it’s as if the distraction never happened,” said an author of the review, Lynn Hasher, a professor of psychology at the University of Toronto and a senior scientist at the Rotman Research Institute. “But for older adults, because they’ve retained all this extra data, they’re now suddenly the better problem solvers. They can transfer the information they’ve soaked up from one situation to another.”

Such tendencies can yield big advantages in the real world, where it is not always clear what information is important, or will become important. A seemingly irrelevant point or suggestion in a memo can take on new meaning if the original plan changes. Or extra details that stole your attention, like others’ yawning and fidgeting, may help you assess the speaker’s real impact.

“A broad attention span may enable older adults to ultimately know more about a situation and the indirect message of what’s going on than their younger peers,” Dr. Hasher said. “We believe that this characteristic may play a significant role in why we think of older people as wiser.”

In a 2003 study at Harvard, Dr. Carson and other researchers tested students’ ability to tune out irrelevant information when exposed to a barrage of stimuli. The more creative the students were thought to be, determined by a questionnaire on past achievements, the more trouble they had ignoring the unwanted data. A reduced ability to filter and set priorities, the scientists concluded, could contribute to original thinking.

This phenomenon, Dr. Carson said, is often linked to a decreased activity in the prefrontal cortex. Studies have found that people who suffered an injury or disease that lowered activity in that region became more interested in creative pursuits.

Jacqui Smith, a professor of psychology and research professor at the Institute for Social Research at the University of Michigan, who was not involved in the current research, said there was a word for what results when the mind is able to assimilate data and put it in its proper place — wisdom.

“These findings are all very consistent with the context we’re building for what wisdom is,” she said. “If older people are taking in more information from a situation, and they’re then able to combine it with their comparatively greater store of general knowledge, they’re going to have a nice advantage.”
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Aging Body, Unchanging Spirit
Integrative medicine expert Andrew Weil talks about what we have to gain by embracing the aging process rather than fighting it.

http://www.beliefnet.com/story/181/stor ... mc_id=NL44

Interview by Lisa Schneider


Andrew Weil, M.D., a graduate of Harvard Medical School, serves as director of the Program in Integrative Medicine at the University of Arizona, and is the author of "Spontaneous Healing," "Eight Weeks to Optimum Health," among other bestsellers. In his latest book, "Healthy Aging," Weil encourages readers to embrace, rather than deny or fight, the aging process (and explains why he believes so-called "anti-aging" products do not work anyway). He spoke with Beliefnet about the spiritual virtues of aging, why no one should be afraid of getting older, the benefits of meditation, and how he feels about his famous white beard.

You write that aging can be "a catalyst for spiritual growth." How?

Aging as path to spiritual awakening
In the book, I used an example of the legend of the Buddha's enlightenment. When he was the young prince Siddhartha, he was kept by his father in a fantasy palace where he wasn't supposed to see anything that suggested aging and death or anything unpleasant. Then he goes out of the palace and the first thing he sees is an old man. Subsequently, he sees a corpse, a sick man, and a monk-these four sights or visitations are what really stimulated him on the path of enlightenment. So I think there is a way in which awareness and mortality and aging are certainly the most powerful reminders that we're moving in that direction; it can be a profound spiritual awakening.

I also quoted Carl Jung, who said that he thought that the major focus of the second half of life should be mortality and that anything that took away from that was in the direction of not being mentally healthy. I think in our society we see so much denial of aging and ways that people try to pretend to themselves that aging is not happening and I worry about that being a not-healthy direction. I think a common correlation we see as people become older is that they have greater interest in things spiritual or non-physical.

What do you think is at the heart of our fear of aging?

I think the root is the fear of death, which is the great mystery; it's what we don't understand and I think that's really why people turn to religion, turn to spiritual paths, to come to grips with mortality. And aging is a constant reminder that we're moving in that direction. So I think that's the root fear. Then on top of that, I think there are more specific fears: the fear of losing independence, losing pleasure in life, things of that sort.

How can we overcome these fears?

Well, I think by facing them squarely and being honest about them, that's the first step. It is very helpful to seek out people who are examples of healthy aging and see what they have to teach us. Information is a very powerful antidote to fear, having truthful information.

In terms of spirituality, are there particular things that people can do?

Well, I think there are a lot of things that people can do to attend to their spiritual health and well-being. Some of the suggestions I've made over the years include bringing fresh flowers into your house, listening to music that elevates your spirits, reading spiritual literature-inspirational literature that has that effect, seeking out the company of people in whose presence you feel more elevated, spending more time in nature. I think there is an endless list of what people can do.

On a personal level, what does aging mean to you? Is it something you look forward to?

Well, I certainly am not going to deny the aging process. I really want to think about its challenges, particularly how I want to spend my last years, and I'm in discussion with some contemporaries. We've had a lot of thoughts about trying to custom-design some kind of living facility for ourselves in which we all have our private spaces but will be able to do some things communally. That's one example of some ways I'm thinking.

Your beard is such an iconic part of your image, and you write that you have no interest in dyeing it. Do you think of it as a way to keep you mindful of the aging process?

Why I like my white beard
I think so. I started getting white in my beard long ago, I think maybe in my late 30s, the first gray hairs showed up in it so it's something I've lived with and watched for a long time. But I rather like the way it is now. It's a white beard-I think it gives me more authority, and I think a lot of people look at me as a Santa Claus figure. That's fine with me.

You write about many things that become better with age. Can you share an example?

Aging is like whiskey
I had a lot of fun writing about that since I hadn't seen it in print before. The examples I used were whiskey, wine, cheese, trees, violins, antiques. If you look at whiskey, aging of whiskey smoothes out rawness and greenness, it adds depth and complexity and smoothness, it adds flavors, it concentrates what's desirable. At the same time, there is the evaporation of what's less consequential and I think it's fairly easy to see analogies in human life with that process. Aging can increase value by concentrating what is most worthy and by allowing what's inconsequential to dissipate. It can smooth out roughness, add depth of character, so I just find it a useful exercise to think what aging brings out in these other areas of our experience that makes us willing to pay more money for old versions.

So you would recommend that people concerned about aging should explore these positive aspects?

Absolutely. I think in this culture especially, we are so programmed to see aging as a catastrophe and to look only at the negatives and I think it would be extremely helpful if we could look for the positive aspects as well. And I think it's exactly these positive qualities for which elders are revered in other cultures, in many traditional cultures. I think we've just got way off the beam here.

A few weeks ago I had lunch with a scientist-a very hardcore scientist who surprised me by saying that he was 80. I would have guessed his age at 62, so he was doing it very well. He said that one of the qualities that he had observed in himself that had gotten better with age was pattern recognition. When something new came by, he was better able to recognize it and know how to deal with it. And the reason he said was obviously that he's got more stored in his memories, so when something happens, he's got more against which to compare it. Therefore, he knows how to maneuver through the world better than he did when he was younger. That's just an example of something that gets better with age that we just don't hear discussed.

You make a distinction between age-related diseases and the natural aging process.

Absolutely. The main question that I tackled in writing "Healthy Aging" was, is age-related disease synonymous with aging? Does getting old necessarily mean getting sick? And I think the answer clearly is 'no'. It is possible to reduce the risk and delay the onset of age-related disease so the goal is to live long and well and then have a rapid drop-off at the end.

Many consumers are seduced by the claims of anti-aging products. What do you hope your own products, through Origins, can do for people?

The products I develop for Origins are emphatically not anti-aging products. They're not represented that way, they're not sold that way. These are anti-inflammatory products that can improve the health and the resistance of the skin and thereby its appearance.

I have developed products for several reasons: First, I had to identify needs in the marketplace for them and I think with skin products, there clearly was a need. Second, Origins is a company that I feel very philosophically aligned with. We have the same ideas about nature and health. Third, and most important, I wanted to find a way to develop a revenue stream to support integrative medicine education, which is really my mission. So the way that I've set all of this up is that I don't get profits from these products; my profits go to a foundation which is giving grants to institutions that are doing integrative medicine education, so it's a kind of Paul Newman model.

Can you tell us about your own spiritual path?

I was raised in a Reform Jewish household. I did not find that that really answered my spiritual hunger and needs.

How old were you when you figured that out?

I think in my teens, and then when I was 17, I traveled around the world. I went to a great international school and I lived with native families in many countries and I think that really gave me a great interest in other cultures. It got me very interested in Asian culture and I began being interested in Eastern religion, which certainly got me interested in meditation. I would say if there's any body of philosophy that I'm drawn to, it's Buddhist philosophy, although not necessarily Buddhism as a religion or as an institutional system.

How has meditation helped you?

How meditation has helped me
I have had a meditation practice for a very long time. I still find it hard but in looking back, I think meditation has, first of all, really helped stabilize my moods. I think it has also increased my concentration and made it easier for me to be more mindful in all the things that I do in daily life and I think it's made me more aware of my non-physical self.

One of the questions that I ask readers in the book is to think about the part of you that does not change as you get older. On some level, I feel the same now at 63 as I did when I was six, and I'm curious about that. What is that unchanging part of ourselves? I think that's spirit.

You mention prayer a couple of times in the book, but don't really get into it very much. Do you think prayer can help people in the same way that meditation does?

I think it can. I generally make a distinction between spirituality and religion, and my advice is mostly in what I would call the spiritual realm. Because prayer is more associated with religious practice, I don't discuss as much, but I think it certainly can serve that function.

I've also been very interested in the use of mantra, which occurs in many spiritual and religious traditions-repetition of sacred syllables or phrases as a way of centering the mind.

You don't believe in stress "reduction".

There is no such thing as stress "reduction"
Right, because I think that stress is really a constant of human life, and I also think it's a mistake to imagine we have a corner on it in the modern Western world. I think that at any time you live, life is stressful. The forms may change from age to age and culture to culture, but what we can do is learn ways of managing stress or protecting our bodies and minds from its most harmful effects. So I think that's better called stress management.

Do you find that one reason people are attracted to alternative health practices is because they feel more empowered by these approaches than they do with mainstream Western medicine?

I couldn't agree more with that. This is something I've been saying for a long time, and it represents a social-cultural change. People want to be more in charge of their own lives and destinies, and they're not willing to be passive recipients of authoritarian care in medicine. We see this in other areas of society as well, so I think this is an underlying change in world psyche.

I think one of the real secrets of happiness and success in life is to understand that while we can't control what happens to us, we can control how we react to events.

****
Aging & Health: Useful Resources

http://www.beliefnet.com/healthandheali ... mc_id=NL44

***
Eight Steps to Aging Gracefully
Recommendations for enhancing spiritual health and well-being.
By Andrew Weil, M. D.

Reprinted from "Healthy Aging" by Andrew Weil, published by Knopf.

Pay attention to your breath. Many cultures identify breath with spirit, seeing the breath cycle as the movement of spirit in the physical body.. Simply minding the breath is a way of expanding consciousness beyond the ego, of experiencing transcendence.

Connect with nature. You can do this by walking or sitting in a natural setting; a city park will do just fine. Allow yourself to slow down, drop your usual routines, and just absorb the influence of the place.

Make a list of people in your life in whose company you feel more alive, happy, and optimistic. Make an effort to spend more time with them. Our spiritual selves resonate with others, and that connection is a healing.

Bring flowers into your home and enjoy their beauty.

Listen to music that you find inspirational and uplifting.

Admire a work of art that raises your spirits: a painting, sculpture, or work of architecture.

Reach out and try to resume connection with someone from whom you are estranged; practice forgiveness.

Do some sort of service work. Give some of your time and energy to help others. The possibilities are endless but do not include just writing a check to charity.

The suggestions above are intended to help you become more aware of your spiritual self. Any activity that makes you feel more alive, more connected to others and to nature, less isolated, more comfortable with change, is beneficial. It will enhance your physical and mental health. It will help you accept the fact of your aging. It will help you to age gracefully.

***
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Post by kmaherali »

The 10 Brainiest Places to Retire
by Liz Wolgemuth
Thursday, June 5, 2008provided by
US News & World Report

Just because you hit your 60s, it doesn't mean your brain starts to power down. Just the opposite. Your noodle needs more stimulation than ever, and, finally, you have the time to supply the required intellectual input. And picking a place to retire can be key to that process. For retirees who have no desire to stop learning—and that's, like, pretty much everyone—there are plenty of American communities that boast thriving intellectual centers where cultural activities keep residents (and their brains) as busy and interested as they want to be.

What makes the difference? A city with a large local university might offer a colorful slate of arts or educational events nearly every evening. Some suburbs have found a way to create unique learning opportunities for residents, who still have an easy route into the neighboring metropolis.

More from USNews.com:

• Quiz: Test Your Smarts About the Brainiest Places

• Gallery: The 10 Brainiest Places to Retire

• Best Places to Retire

U.S. News consulted our list of more than 1,000 Best Places to Retire and came up with 10 retirement destinations that attract highly educated folks. (And you can use Best Places to Retire to do more than seek out intellectual excitement: A search tool allows you to build your own list of retirement spots based on your personal preferences, including region, climate, healthcare, recreational and cultural activities, and other factors.)

One brainy spot that won't surprise: Berkeley, Calif., where residents might head for a screening of a film on urban organic farming in Cuba at the local Unitarian Universalist congregation, attend a University of California-Berkeley professor's speech on counterinsurgency in Iraq, or get a tour of the UC Botanical Garden. While traditional bingo is on tap at the South Berkeley Senior Center, residents can also learn a less common skill like self-acupressure or take a class on the millinery arts, says director Larry Taylor.

Across the map in Chapel Hill, N.C., residents might spend their evenings paddling out in kayaks to watch the stars with an astronomy educator from the Morehead Planetarium and Science Center at the University of North Carolina-Chapel Hill.

Boulder, Colo., may be best known for its environmental-protection efforts and green savvy, but this city offers its residents a wealth of cultural activities. Albert Boggess, former project scientist for the Hubble Space Telescope, and his wife, Nancy, also a former research scientist for NASA, retired to Boulder in 1994, drawn by both the climate and an academic community that included many of their colleagues. "It's a university town, which is important to us, and there are all sorts of activities which come with that automatically," Albert Boggess says. "There's lots of good music here, both classical music and popular music. And that appeals to us."


BERKELEY, CALIF. A shopper walks past a sculpture in the Fourth Street Shopping District.
Berkeley Convention and Visitors Bureau
Upper St. Clair, Pa., is near Pittsburgh and has 29 area colleges, including Carnegie Mellon University, while the quintessential college town of Ann Arbor, Mich., offers an array of intellectual and cultural programs through the University of Michigan's Osher Lifelong Learning Institute.

West Lafayette, Ind., is home to Purdue University, which hosts lectures and brings in ballets and plays—"a variety of different programs that you wouldn't necessarily normally get in this size community," says Joann Wade, president of the Lafayette-West Lafayette Convention and Visitors Bureau. The city's nearly 29,000 permanent residents can also get "bigger-city opportunities," Wade says, by driving an hour to Indianapolis or two hours to Chicago.

Hoboken, N.J., and Brookline, Mass., also have the big-city experience close at hand. Hoboken is just across the Hudson River from Manhattan, while many Brookline residents commute the short distance to work in Boston's medical centers and universities.

Some suburbs have a main attraction all their own. Reston, Va., was developed as a planned community or "new town" in the 1960s, and it's only a half-hour drive to Washington, D.C., and its panoply of world-class museums. Out west, Lake Oswego, Ore., hugs the city of Portland but also offers culture and beauty of its own, making the most of its 405-acre lake.

The brainiest places to retire:
Ann Arbor, Mich.
Berkeley, Calif.
Boulder, Colo.
Brookline, Mass.
Chapel Hill, N.C.
Hoboken, N.J.
Lake Oswego, Ore.
Reston, Va.
Upper St. Clair, Pa.
West Lafayette, Ind.
Copyrighted, U.S.News & World Report, L.P. All rights reserved.
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Post by kmaherali »

India's elderly face growing neglect

By Tinku Ray
BBC News, Delhi

There are more than 70 million pensioners in India

In India's financial capital, Mumbai (Bombay), Laxmibai Laxmidas Paleja lies on a low cot with a thin sheet over her.

She's 92 and very frail and there are obvious bruises on her face. She also has swelling around her eyes, nose and mouth.

"My grandson and my daughter-in-law started abusing me. And they said, 'I'll kill you, I'll kill you'," she says.

"I'm old. I couldn't defend myself. I was bleeding all over. I've got bruises all over my body. Then they just bundled me in a car and dumped me here at my daughter's house."

Grandson Vinay Paleja denies the accusation.


Laxmibai Paleja's face is covered in bruises

"No, I never touched my grandmother. She hurt herself and I don't know why she's making these accusations against us."

While recovering at her daughter's house, Laxmibai Paleja says she now has nothing.

She agreed to sell her land and gold to pay for medical treatment for herself and her son. But none of the money was used for the purpose, she says.

The case will probably go to court, but getting to this stage takes a long time in India. Laxmibai Paleja may not even be alive by the time it is resolved.

Rising abuse

There has been a steady rise recently in reports of cases of elderly being abused, harassed and abandoned in India.

Traditionally older people has been revered in India, signified by the touching of their feet by the younger generation.

They have to make up their mind if they want criminal action - but then they will have to forget their family ties

Kewal Singh, Delhi police

Prime ministers and presidents have almost always been senior citizens.

Joint family systems - where three or more generations lived under one roof - were a strong support network for the elderly.

But more children are now leaving their parental homes to set up their own.

Sociologists say the pressures of modern life and the more individualistic aspirations of the young are among reasons why the elderly are being abandoned or, in some cases, abused.

Alarmed by what's happening to some of the elderly, the Indian government recently introduced a new law.

The Maintenance and Welfare of Parents and Senior Citizens Bill provides for up to three months' imprisonment for those who do not take care of their parents.

Court orders will also be used to force children to pay maintenance for their elderly parents.

HelpAge India is the biggest non-governmental organisation in the country which campaigns for the rights of the elderly.

It recently launched a helpline in Delhi which has received hundreds of calls since its inception.

The organisation's own research suggests nearly 40% of senior citizens living with their families are facing emotional or physical abuse.

But only one in six cases comes to light, the study showed.

Kewal Singh, of the senior citizens' cell at Delhi police, says it is not easy for parents to prosecute their children.

"First they have to make up their mind if they want criminal action. But then they will have to forget their family ties," he says.

"But if they want to maintain and retain those family ties, then the situation will be different. There's always a conflict between the law and emotions in these circumstances."

Left to die

The problem is not confined to India's cities.

I travelled to the southern state of Tamil Nadu, to a town called Erode. Last year a 75-year-old grandmother, Chinnamal Palaniappan, was found on a rubbish dump just outside the town.

She had allegedly been dumped there by her grandsons and died a few days later.

Palaniappan's daughter, Tulsi, and her husband live in a one-room house with a thatched roof.


The government is building more than 600 old people's homes

There are two beds, electricity and a government gifted free colour television. But it is obvious their home is the poorest in the neighbourhood.

"My mother was living comfortably with us for a very long period and all of a sudden on one particular night she went mad and she kept on talking through the night," Tulsi says.

"I got annoyed and told her not to shout or speak further. But she wouldn't stop. Suddenly I found her missing and heard she had walked out of the house.

"We did not do anything, people have cooked up stories. My mother was mentally unbalanced," Tulsi insists.

Law steps in

Poverty and search for work are two main reasons rural elders are being left behind. So many of them have to rely on charities for food and medical help.

There are more than 70 million senior citizens in India and the figure is set to grow to well over a 100 million in the next 25 years.

Consequently, the number of old age homes is growing dramatically.

The government has ordered the construction of more than 600 across the country.

This is the first project of its kind undertaken by the government - a sign that it has already recognised the reality that more elderly people will need assistance in the future.

The government also hopes the new law will act as a deterrent.

But Matthew Cherian, chief executive of HelpAge India, says it is not going to prevent families from breaking up.

"You're not going to get back to the joint family system. We have to get into more and more old age homes.

"At HelpAge India, 30 years ago when we started supporting old age homes, everybody said this was a Western concept. Today everybody accepts this is not a Western concept, this is the reality."

BBC News
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http://newoldage.blogs.nytimes.com/2008 ... s/#more-26

July 1, 2008, 10:15 am
Our Parents, Ourselves
By Jane Gross


Jane Gross’s mother, Estelle Gross, at a nursing home in Riverdale, N.Y., in 2002.

Jim’s mother-in-law has fallen again. For the fourth time this year.
He and his wife meet the ambulance at the emergency room, then try to keep the frightened, old woman distracted through the long wait. They check her into the hospital with several broken bones and an unsteady heartbeat. They spend days at her side, jolly her through the rigors of rehab and finally take her back to her apartment, as they have so many times before.

Along the way, the 60-something couple, friends of mine in Los Angeles, learn which pain medications make an 87-year-old woman delirious and which leave her in a stupor. They learn that Medicare covers orthopedic surgery but not long-term care at home. They learn about stage-three bedsores. They learn that out-of-town siblings can be summoned for a few days respite but don’t fully grasp the relentlessness of the caregiving task.

Nobody wants the old woman to die, but her misery is a heavy blanket muffling many lives. Each mad dash to the ER, each hospitalization, takes a toll. On top of the cost of assisted living, Jim’s mother-in-law needs private duty home care, or else the next fall could be her last. But what happens if and when even 24/7 help isn’t enough? A nursing home? Who pays, at upwards of $100,000 a year? And how long will the money last?
These are the trials many of us face during the final years of our parents’ lives, as we lurch, ignorant, from crisis to crisis. When my brother and I began this journey with my mother, who went from feisty independence to utter reliance on her children in a matter of months, we were making it up as we went along.

We knew nothing about entitlement programs. What do you mean Medicare doesn’t cover the cost of home care or assisted living or a nursing home? We knew nothing about the advantages and disadvantages of hiring companions and aides through agencies or word-of-mouth. What do you mean that the agency aide needs permission from a supervisor before picking my mother off the floor if she falls?

We knew nothing about hospital discharge planning. What do you mean she has to leave tomorrow when we have no place to take her? We knew nothing about geriatric medicine. What do you mean emergency rooms and intensive care units can cause a form of psychosis in the elderly, or that a catheter can lead to an undiagnosed urinary tract infection and even death?

We knew nothing about Medicaid spend-downs, continuing care retirement communities, in-hospital versus out-of-hospital do-not-resuscitate orders, Hoyer lifts, motorized wheelchairs or assistive devices for people who can neither speak nor type. We knew nothing about “pre-need consultants” who handle advance payment for the funerals of people who aren’t dead yet, or “feeders” whose job it is to spoon pureed food into the mouths of once-dignified men and women.

At the time, between 2000 and 2003, my brother and I felt terribly isolated. As leading edge baby boomers and the children of older parents, we were the first of our friends to go through the drawn-out process of watching a mother or father grow more helpless with each passing day until the role reversal put us squarely in charge of everything. Once in charge, we had to rely on each other as never before — sometimes perfectly in synch, other times at each other’s throats.

At work, the assistance available to new parents did not readily extend to our situation, which was as laborious as child care but without the joy or the promise for the future. When I asked for a four-day week here at The New York Times, exhausted from my dual labors, the person in charge of such matters, who readily agreed, noted that I was the first employee to make such a request but surely wouldn’t be the last.

How right he was. Today, in the newsroom at The Times and at places of business everywhere, middle-aged men and women in growing numbers are juggling their jobs, their parents’ increasing needs, frequent emergencies and all the other moving parts of their lives. They look stunned and very tired. I remember it well. Because I chose to write about aging and caregiving in the wake of my mother’s death, gaining a level of expertise I didn’t have when I needed it, they come to me with questions.

How can they find a reliable home health aide? What should they look for in an assisted living community? How long is the waiting list at top-notch nursing homes? How onerous is the paperwork for applying for Medicaid? Is it worth spending money for the guidance of a geriatric case manager? How do you persuade a parent that it is no longer safe to drive, or that the time has come for live-in help at home? What can be done about siblings who won’t carry their weight? Or about siblings who disagree over end-of-life or financial decisions?

The experience of fielding those questions inspired this blog. I intend for it to be a source of information and community for grown children faced with these new responsibilities, for the elderly adjusting to unwelcome limitations and dependency, to employers interested in easing the burden, for professionals in the field and for anyone else who wants to chime in. Whining is permitted. Wisdom, and humor, are especially welcome.
But most of all, I hope you will tell me, and each other, what problems you face and how you have solved them; what changes in American health care policy, in the workplace and in the community would make your lives easier; what has surprised and inspired you; and how your family has changed, for better or worse, as a result of this intergenerational experience.
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July 5, 2008
As Gas Prices Soar, Elderly Face Cuts in Aid
By JOHN LELAND

SOUTH HAVEN, Mich. — Early last month, Jeanne Fair, 62, got her first hot meals delivered to her home in this lake town in the sparsely populated southwestern part of the state. Then after two deliveries the meals stopped because gas prices had made the delivery too expensive.

“They called and said I was outside of the delivery area,” said Mrs. Fair, who is homebound and has not been able to use her left arm since a stroke in 1997.

Faced with soaring gasoline prices, agencies around the country that provide services to the elderly say they are having to cut back on programs like Meals on Wheels, transportation assistance and home care, especially in rural areas that depend on volunteers who provide their own gas. In a recent survey by the National Association of Area Agencies on Aging, more than half said they had already cut back on programs because of gas costs, and 90 percent said they expected to make cuts in the 2009 fiscal year.

“I’ve never seen the increase in need at this level,” said Robert McFalls, chief executive of the Area Agency on Aging in Palm Beach, Fla., whose office has a waiting list of 1,500 people. Volunteers who deliver meals or drive the elderly to medical appointments have cut back their miles, Mr. McFalls said.

Public agencies of all kinds are struggling with the new math of higher gas prices, lower property and sales tax revenues and increases in the minimum wage. Some communities have cut school bus routes, police patrols, traveling libraries and lawn maintenance. The St. Paul Police Department is encouraging officers to use horses and bikes. A number of state agencies, including those in Utah, are going to four-day workweeks to save energy costs and reduce commuting expenses for their employees.

But older poor people and those who are homebound are doubly squeezed by rising gas and food prices, because they rely not just on social service agencies, but also on volunteers.

In the survey of agencies, more than 70 percent said it was more difficult to recruit and keep volunteers.

Mrs. Fair, who has limited mobility because of diabetes, lives on $642 per month in Social Security widow’s benefits, and relies on care from her son, who often works odd hours, especially during blueberry season. “He says, ‘You belong in a nursing home; I can’t take care of you,’ ” Mrs. Fair said.

The delivered meals allowed her to eat at regular hours, which helped her control her blood sugar levels, she said. Last year she lost her balance during a change in blood sugar and spent a month in a nursing home.

With no meal delivery in her area, Mrs. Fair said her home aide, who comes three times a week, must pick up frozen meals from a center in the next town.

“If my aide can’t get the meals, maybe I can get my pastor to pick them up,” Mrs. Fair said. “I can’t travel even to the drop-off center.”

Val J. Halamandaris, president of the National Association for Home Care and Hospice, said that rising fuel prices had become a significant burden for the 7,000 agencies represented by his group, with some forced to close and others compelled to shrink their service areas or reduce face-to-face visits with patients.

A recent survey by the group concluded that home health and hospice workers drove 4.8 billion miles in 2006 to serve 12 million clients. “If we lose these agencies in rural areas, we’ll never get them back,” Mr. Halamandaris said.

The agencies, which have suffered from Medicare cuts in recent years, are lobbying Congress to account for fuel inflation in reimbursement rates and to reinstate special increases for providers in rural areas, a program that expired in 2006.

In Union, Mich., a town among flat corn and soybean farms near the Indiana border, Bill Harman, 77, relies on a home aide to take care of his wife, Evelyn, who is 85 and has Alzheimer’s disease. Mr. Harman has had to use a wheelchair since 2000 because of hip problems.

But the aide, Katie Clark, 26, may have to give up the job. She lives 25 miles away and drives 700 miles a week to provide twice-daily visits, helping Mrs. Harman dress in the morning and get to bed at night, feeding her, doing chores around the house. “And putting up with a grumpy old man,” she said jokingly to Mr. Harman. Her weekly income of $250 is being eaten up by gas expenses, which come to $100 a week.

“Some weeks I have to borrow money to get here,” said Ms. Clark, a single mother of two, adding, “They’re just like family to me.”

Agencies say they are facing a shortage of home aides, because the jobs have low pay and often require long drives for a few hours of work. “They can’t make any money,” said Laurence Schmidt, administrator for the Oswego County Office for the Aging, in rural northwest New York. “So they’ll get jobs in nursing homes, where they can drive to one place and work a full shift. That is a statewide problem.”

Mr. Harman said that he thought a previous aide might have abused his wife, but that Mrs. Harman was comfortable with Ms. Clark. On a recent afternoon, Mrs. Harman called Ms. Clark “honey”; Ms. Clark, walking Mrs. Harman to the bathroom, kissed her nose. Mrs. Harman said she was going home. Ms. Clark said, “You are home, silly.”

For her work, Ms. Clark receives $9 an hour. If she leaves, Mr. Harman said, he could not care for his wife.

He said that when they married, she raised his five children as if they were her own. When Mrs. Harman started to develop Alzheimer’s 8 or 10 years ago, he said, “I promised her, ‘Don’t worry, I’ll take care of you as long as I can.’ ”

Without an aide, he said, he would have to put his wife in a nursing home, and probably need to live in one himself.

For many isolated older people, home delivery of meals provides not just nutrition but also regular contact with the outside world, said Elaine Eubank, president of CareLink, a nonprofit agency that serves elderly people in six counties in Arkansas, delivering 480,181 meals to 18,000 people last year. Because of gas prices, Ms. Eubank said, one center in Monroe County had closed its kitchen, and others were delivering frozen meals two days a week.

Mary Margaret Cox, executive director of Meals on Wheels in Greeley, Colo., which serves meals to 300 people a day, said that her agency was trying to avoid shifting to frozen meals, but that it was getting hard to recruit students and teachers who volunteer during the summer.

“Most don’t have anyone else checking up on them daily,” Mrs. Cox said of her clients. “If we do more frozen meals, they’ll lose that daily contact.”

Many agencies said their revenues — which come from state, federal and private sources — were not keeping up with their increased expenses. “We’ve had one increase from Medicaid in 11 years,” Ms. Eubank said. “But home care and Meals on Wheels keep people at home for a fraction of the cost of a nursing home. The state pays for care once they’re in a nursing home. So our cuts may cost more than they save.”

Sandra Prediger, 70, who still drives a car, said higher gas prices hit her every time she needed to go to the doctor. From her senior apartment in South Haven, she was barely able to pay her bills before gas prices rose.

“I try to help some of the ladies around here, driving them to doctors or to the store,” Miss Prediger said, but a round trip to her doctor or the beauty shop now costs $26 in gas. She has had to ask her friends to pay half. “I hate to ask,’’ she said, “because they have less than me.”

Her Social Security check arrives on the third of the month. For the few days before, her local gas station lets her write a postdated check to fill up.

On July 2, Miss Prediger had no money and owed money to the gas station. “In a few minutes,” she said, “my friend Shirley will probably call and say, ‘Can you take me to Wal-Mart to get needles for my diabetes?’ What else can I do?”

Barbara Blumka, 67, of Buchanan, Mich., said she would continue delivering 15 or 16 meals a week though she could not afford it. She is driving a Dodge Caravan, a “gas guzzler,” she said.

“I see these people’s faces,” said Ms. Blumka, who gets her meals at a senior center. “They’re so appreciative. I think of all the people who took care of my mother in the nursing home. This is my way of giving thanks.”

Christine Vanlandingham, development officer for the three-county Area Agency on Aging, said that in three to six months, the agency would have to start cutting meal deliveries to clients who get them now.

But Ms. Blumka will continue to help the homebound. Her nieces and nephews were buying her an adult tricycle for other travels. “It’s neon blue,” she said. “I’ll ride it to the senior center.”

Kevin Sack contributed reporting from Atlanta.
kmaherali
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Six Tips for Caregivers

By Jessica C. Kraft

Caring for another doesn't mean you should forget to care for yourself. Take good care of yourself, and you'll be able to give your family member the loving care he or she deserves. Follow these tips to make sure you don't neglect your health.

Reprinted with permission from Positive Thinking magazine.

http://www.beliefnet.com/gallery/tipsfo ... ?pgIndex=0

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Caregivers: What's In a Name?
Will and I both bristle at the term 'caregiver.' But what should we call what we do for our parents?
By Lilit Marcus


My friend Will's father has cancer. This means that after many years of not speaking to each other, Will is now the person responsible for his father's treatment. Will, needless to say, hates it. He's been coming to me for advice, and I finally realized why: my father is deaf, so like Will, I care for my father, albeit in a very different way.

Both of my parents are hearing-impaired. Growing up, I had different chores from other kids. My friends had to take out the trash or help wash dishes; I had to translate for my parents at the bank or make phone calls for them. I was lucky enough to grow up with two parents who loved me, treated me well, and gave me every advantage they could. As for Will, he wasn't so lucky. He came of age with an alcoholic for a father. Now, more than 20 years later, Will is finding himself responsible for a man he had tried to cut out of his life.

When Will first came to talk to me, he referred to himself as his father's "caretaker," although he claims he meant to say "caregiver." I'm not sure if the word choice was as unintentional as he seems to think. "Caretaker" is a word I usually associate with someone who cares for an old country estate, or for a garden. "Caregiver" is a word for someone who is responsible for the care of a person. Considering the relationship—or lack thereof—Will and his dad have had throughout the years, I don't find it surprising that Will talks about caring for his dad the way some people talk about weeding a garden or cleaning out storm drains. Plain and simple, it's his obligation, and not his desire.

I also don't consider myself a caregiver, but not for the same reason as Will. And we're not the only ones who don't like the term--a recent survey in "Today's Caregiver" magazine showed that some 70 percent of their readers responded negatively to the word "caregiver." To me, "caregiving" indicates helping people who may not be able to help themselves. My parents survived just fine before I was born, and they've survived just fine since my younger sister and I left the nest. If pressed, I might say that I "help out" my parents. But for some reason the word "caregiving" doesn't fit.

My parents spent many years taking care of my basic needs, and now, I'm returning the favor in a smaller way. I see translating for them as a quick way to help make things go more smoothly, not as any huge burden.

The Fifth Commandment is "honor thy father and thy mother." This word "honor" can mean different things to different people. I see interpreting for my parents as a simple way to honor them, to show respect for them, to help them, and to be a dutiful daughter. This commandment says that it is our job, our godly obligation, to attend to our parents. Just as my mother helped me learn to walk, I help her to communicate. They once helped me, and now I help them. It's a way of coming full circle, an age-old narrative. Parents care for children, and then the children grow up to care for their parents. That is why families are the backbone of our society. They guarantee that someone always has a support network.

As I listened to him more and more, I realized I don't know how—or even if—the Fifth Commandment applies to Will's situation. Sure, we should honor our parents, but what happens if they don't also honor us? I had parents who raised me well. Will had an alcoholic father who was mostly checked out of his son's life. Should Will have to be the better person and honor someone who never honored him? Or is his father's cancer a kind of karmic retribution? Part of why I've always bristled against the word "caregiver" is that a caregiver can be any number of people, like a live-in nurse or a kindly neighbor. I see family as being on an entirely separate level. Where love exists, there is no giving or taking.

Meanwhile, though, no one person is able to do everything. Will is feeling strained by the money, time, and focus that his father's illness requires, not to mention the existing tension in their relationship. Where Will has an endless list of tasks to complete, I have a list of ways my family can supplement each other. For example, my father is great with money and balancing the checkbook. I'm not. So he helps me do my taxes and gives me advice about my finances. I don't see that as a form of caregiving—I see it as my dad being my dad. To me, that's what family is all about--each person contributing in their own way and helping each other when they can.

If I had to define my role around my parents, it would simply be "daughter." I'm honoring them, as the Fifth Commandment instructs me to do. If anything, we're all caring for each other, the way a family was intended to work. The reason Will's family isn't working the same way is because he has to be the child and the parent.

From the Book of Exodus, the Fifth Commandment is about honoring thy parents. But from the Book of Matthew, there's another appropriate verse: "love thy neighbor." With this in mind, I realize that there's more that I can—and should—do for Will than hash out what to name his caretaking/giving duties. The truth is, I can never fully understand Will or his father or their relationship to each other. Even though he and I may feel very differently about our parents, our opinions are the result of different experiences and backgrounds. But what I can do is love Will for the person he has become, despite the difficulties he endured in the past. What I can do is find the things we have in common, and become his caregiver—or caretaker, or friend--whatever he needs, whenever he needs it.

Lilit Marcus is an assistant editor at Beliefnet and a blogger.

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http://www.beliefnet.com/story/224/story_22485_2.html

How to Be a Fearless Caregiver
The editor-in-chief of Today's Caregiver magazine shares how his own caregiving experiences inspired him to work with others.
Interview by Lilit Marcus

Gary Barg has dedicated his life to helping caregivers across the country. He is the founder and editor-in-chief of Today's Caregiver magazine and the author of "The Fearless Caregiver." He organizes and hosts the Fearless Caregiver conferences, which have featured celebrities like Clay Aiken, Leeza Gibbons, Montel Williams, and Dana Reeve. He spoke to Beliefnet about living a balanced life, the role of spirituality in caregiving, and what it truly means to be 'fearless.'


Why did you start "Today's Caregiver?"

I got into it the hard way, actually. I was a long distance caregiver for my grandparents, helping my mom who was three states away. And I bet I was coming home once every six weeks just to see how things were, try to help out. But the truth is, you really can't tell what's going on unless you're right in the middle of it.

And so, I went home for two weeks to help her out and see what I could do. The first minute I got there, we were dealing with issue after issue. My grandfather's condition was changing, and so his care setting had to change. My mom was having problems with the insurance company wasn't feeling so good. It was just two weeks of this pain and fear and uncertainty.

I remember sitting with her the last night before I was going to go back to Atlanta and I said I was so glad that I was with her that particular two weeks because of all we went through. She looked at me dumbfounded because, because what for me was intensity I had never felt before, to her was normal.

It occurred to me there had to be a better way.

How would you characterize the average caregiver?

Well, average is a hard word to use for caregivers.

Generally speaking, it is pretty traditional. It's an adult who's caring for their parent, either living down the street or across the country. It is somebody who has really taken on the personal responsibility of making sure that a loved one is cared for as best as possible, shepherded through the healthcare system and making sure that, everything they do has to do with better care for their loved one.

You know, A statistic came out a few years ago from Stanford that said that, when somebody has a loved one living with cognitive impairment, 30 percent of them will die before their loved ones do.

How can we prevent that from happening?

Part of what we try to do is really educate the caregiver, make sure that the caregiver sees that they're really a member of their loved ones' professional care team--there's the doctor and the therapist and the nurse practitioner and the nutritionist. The way to actually help ourselves as we help our loved ones is to realize that we need to learn everything we can about our loved ones' care, about their situation, about the medical procedures and other members of their team. And we need to realize that we have a tremendous amount of responsibility and should get a lot of respect from the other members of the care team.

A side benefit of that is, as we get involved, as we see that we have certain powers, as we become, you know, what I like to call the fearless caregiver, we get more involved and we go to support groups and we go to conferences and we stay up on things. And we get motivated and literally take ourselves, a lot of times, out of the depression spiral that ends up killing us.

I'm sure you've heard of the phenomenon known as "caregiver stress," the caregiver being so focused on the person they're caring for that they forget about themselves. What are some tips that you would give to a caregiver who feels overwhelmed and doesn't know how to take care of themselves?

Job one for any caregiver is to make sure that they're cared for first. You know, it's the old story, I know you've heard it, about being in an airplane when the oxygen mask comes down. You have to put yours on first before you can help the other person.

The first thing you have to do is really look around your community and see who's out there looking to support you. There's all sorts of organizations, there's support groups, even if you're in a more rural area, there are a lot of telephone or web support [groups].

Stopping to make sure that you eat well is not selfish. It's not taking your eye off the ball. The core principle of caring for your loved one, of being a successful caregiver, is making sure that you stay healthy so you can care for your loved one as best as humanly possible.

There are times when a sick or injured person who's being taken care of resents that there's a person who has to come in and help them with things they used to be able to do for themselves. How can you, in that situation, care for the person and still let them feel empowered?

One of the biggest challenges you get is where somebody who basically has been handling a lot of the decision-making for a family now is not able to do any of it.

I think if at all possible, and obviously we're not talking about end-stage Alzheimer's or a situation where cognitive function is not a part of the picture, you need honest, open communication.

And if you can't actually do that without getting support, get support. Stay focused and stay aware and you realize that, as painful as it is for you, it is painful for your loved one as well.

Some people feel that, if you have money, that instantly gives you many more options for caregiving, whether that's being able to afford to not work or to hire a person or anything else. Do you see this problem?

I've done probably 75 interviews with major corporate heads and celebrities--people who seem like they should never be a problem with money. And they have the same fears and challenges and panic and pain that any caregiver does.

Obviously, it may be silly for me to say that money doesn't solve some part of it. I think that the great equalizer is not isolating yourself, and not sitting there thinking that nobody's going through what you're going through, and that there's no support and that nobody can help you.

Because, I think as you look around, there's a lot of opportunity for caregivers, at any financial juncture in their lives, to get support. There's monies available through the government. A lot of the area Agency on Aging organizations have some solutions. The Alzheimer's Association has some solutions.

Also, you can do what we call a reverse gift list. You sit down and think of 10 people who would do any manageable, bite-sized, easy thing to help that you would do for them and they'd do for you.

For example, when a neighbor goes to the store, maybe they'll stop by, pick up your grocery list and some money and go out and get groceries for you while they're getting their own. Maybe you have someone at work that you really like. Maybe they'll come by once a month and have dinner and talk about anything but caregiving.

If you come up with 10 people who would do those easy, manageable things that you'd do for them and they'd do for you, and you ask them for this support, 9 out of 10 times they're simply going to say yes because they're looking to find something to help you.

We need to create ourselves almost as a corporation: Caring For Mama, Inc. And in that corporation you have to look at your resources, and you have to look at people who can offer you services. And you have to look at what kind of support you can get that's available in your community and take advantage of every single bit of it. And that's when you're a fearless caregiver.

One thing that can come up is, if you get stressed or you're busy or you have a lot going on while you're a caregiver, often the person you're taking care of notices that. How do you show them that caregiving's not a burden?

It's that honest and open communication. Whatever you think you're hiding from your loved one, you're not and you're just making it worse. And even if you're dealing with a situation where there is cognitive impairment, the last thing that somebody ever loses recognition of is love.

One of the biggest, I think, challenges with caregiving is we want to make sure that everybody is happy. And sometimes you need to do certain things that's better for your loved one, and you have to get our or you need to get help or you need to have somebody come in in your place. Sometimes you just have to explain it and then make it happen.

We ran a piece called The Reluctant Caregiver that deals with a person caring for a relative they have been estranged from. How do you cope with caring for a person who has been out of your life for a long period of time or who you still have anger with?

It happens so much. One of the challenges is to face yourself and see what you're capable of, what you think that you're able to handle and you're able to do, because now you're dealing in as frank and honest a relationship as you can be with somebody when you're their caregiver.

If you're stuck, and you're there, and it must be you, you cannot isolate yourself. You cannot fume. You cannot sit there and let it kill you.

You have to find a support group, stay involved, stay communicating. And again, if you can't communicate with your loved one, make sure that you're involved in the communicating with other caregivers who can help you through it.

You spoke earlier about words that you don't think should be associated with care-giving, like fear or frustration. Today's Caregiver did a study about words that caregivers don't like and number one was "caregiver". Why do you think that is, and what other words could you use?

According to the National Family of Caregivers Association, the challenge of care-giving or supporting caregivers is that self-identification is the biggest barrier. If you go in a community and you say, "we're here to support caregivers" they say, "I'm not a caregiver. I resent that. I am a daughter or I am a son or I'm a parent. I'm doing what I'm doing out of love. I don't need a new title."

Although I've had caregiver.com and created Today's Caregiver magazine 13 years ago, I'm not so crazy about the word, either. People might think you're talking about professional caregivers, and think you might be talking about family caregivers.

I don't really put as much stock on the word except as a way to identify the context of what we're talking about. Until a better one pops up, the word is caregiver.

One unfortunate reality is that often whoever you're caring for ultimately might pass away. How can caregivers cope when that happens?

There are steps to grieve past the passing of a loved one after you've cared for them. Until you actually go through those steps, that [death] will be something that will always haunt you.

I firmly believe that bereavement groups are important. Aftercare is a huge issue. I don't want anybody to be forced to walk away from their feelings now that someone who was such a big part of your life for so many years is gone. People need the glide path. They need to stay among people who are caregiving. It's very, very important to make sure that that part of their life just didn't end abruptly.

What role do spirituality and faith play in caregiving?

In my experience, people have either renewed their faith, recommitted to their faith, or have a greater belief in the connectiveness of themselves with the world and with their own higher powers.

And you might think that counterintuitive, because all these terrible things are happening that you might think, "Oh, there is no God. There no greater being. There is no bigger reason."

I would hesitate to guess that there's hardly any caregiver out there who hasn't become stronger to their faith due to what they're going through as a family caregiver.

I think that's where a caregiver's strength is. I think that's where the greatest, honest--most honest connection between you and your higher powers are is when you're needed the most. And that the great things that'll happen are greater. You need your spirituality more than any other time in your life. And generally speaking, it's there for you.

Lilit Marcus is an assistant editor at Beliefnet and does not consider herself a caregiver.
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Guide to Caring for a Parent with Alzheimer's

The complex world of caring for your ill parent means practicing love, acceptance, and sometimes even yelling at God.

By Virginia Stem Owens

I had never seen the logic in asking "Why me?" when some calamity befell me. Couldn't one just as reasonably ask "Why not me?" But when my mother began to show signs of dementia from Alzheimer's disease, I found myself asking on her behalf, "Why her?" If ever a person did not deserve such a fate, it was my mother. She was a good, generous, funny, loving person who had already suffered a number of tribulations in her life.

But deserving has little to do with disease. Like the rain, it falls on the just and the unjust. And, as suddenly as a summer thunderstorm, my mother's care fell to me as she declined into dementia and finally to death over a seven-year period. In this country, millions of people are living through similar experiences. Knowing my own desperation while I tried to help both my parents during those years, I've gathered some expectations, suggestions, and nuggets of wisdom that might help others.

Start the Guide...
http://www.beliefnet.com/gallery/caring ... ?pgIndex=1

Adapted from "Caring for Mother: A Daughter's Long Goodbye." © 2007 Virginia Stem Owens. Published by Westminster John Knox Press. Used with permission.
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July 20, 2008
Op-Ed Columnist
Geezers Doing Good
By NICHOLAS D. KRISTOF

This month Bill Gates starts his new full-time career as a humanitarian, leaving behind the software bugs to swat the kind that cause malaria.

We often think of those trying to save the world as bright-eyed young people, but Mr. Gates is part of a booming trend: the “encore career” as a substitute for retirement. Definitions are still in flux, but an encore career typically aims to provide a dose of personal satisfaction by “giving back.”

Some 78 million American baby boomers are now beginning to retire, and one survey this year by a research institute found that half of boomers are interested in starting such new careers with a positive social impact. If we boomers decide to use our retirement to change the world, rather than our golf game, our dodderdom will have consequences for society every bit as profound as our youth did.

One example of this trend is Peter Agre, a medical doctor who won the Nobel Prize for Chemistry in 2003 for research on ... on ... well, on something to do with cell membranes that I still don’t understand. Dr. Agre could have run his lab indefinitely but was restless to assume a challenge that would more directly affect society.

He thought about politics, but ended up taking on a fancy administrative position at Duke University, thinking he could help shape students and education. Then he became restless again, and this year he took a substantial pay cut to head the Malaria Research Institute at Johns Hopkins University.

“It wasn’t a matter of being a Mother Teresa,” Dr. Agre said. “It was a matter of, ‘Boy, that sounds like fun!’ ”

Yet he concedes — a little bashfully — that there is also a thrill at the possibility of helping overcome malaria, one of the great scourges of humanity. These days, Dr. Agre presides over a team of 20 scientists working on everything from designing malaria vaccines to engineering a malaria-resistant mosquito that in theory could outcompete others if released in the wild.

Marc Freedman, author of a book called “Encore: Finding Work that Matters in the Second Half of Life,” notes that adolescence is a relatively modern concept; until the 19th century teenagers normally were treated as adults. In the same way, he says, a new life stage is emerging — the period of 10, 20 or even 30 years after one’s main career is completed but before infirmity sets in.

The best things that graying do-gooders bring to philanthropy is their management experience and Rolodexes. Bill and Melinda Gates are most noted for showering billions of dollars on public health, but perhaps just as important has been the hard-nosed business sensibility they invoke, demanding metrics to demonstrate that particular approaches are cost-effective.

Aside from Mr. Gates and Dr. Agre, another general in the war on malaria is Rob Mather, a British management consultant who — thank heaven! — isn’t very handy with a TV remote. Mr. Mather was trying to turn off his set in June 2003 when he accidentally flipped to another channel and was riveted by the image of a 5-year-old girl who was struggling to overcome severe burns all over her body.

Mr. Mather suggested to several friends that they swim as a fund-raiser for the girl. Because Mr. Mather is relentless, the swim ended up involving 10,000 people in 73 countries and raised hundreds of thousands of dollars.

Bowled over by the possibilities of mobilizing people for good causes, Mr. Mather set up a swim the next year to raise money against malaria — and this time 250,000 participated. He left the business world and founded a group called Against Malaria, now one of the world’s leading organizations battling the disease.

Mr. Mather browbeats businesses into donating services and covering overhead — “we have 17 legal firms working for us, and we’ve never paid a legal bill” — so every dollar donated to the organization ends up actually used to buy bed nets for families that can’t afford them.

He said he had just received e-mail about an African village that had 387 cases of malaria per month before the bed nets were distributed and seven cases per month afterward. Mr. Mather’s work has resulted in hundreds of thousands of bed nets being shipped abroad to save lives so far — all of which he finds rather more fulfilling than his previous, more lucrative career.

If more people take on encore careers like that, the boomers who arrived on the scene by igniting a sexual revolution could leave by staging a give-back revolution. Boomers just may be remembered more for what they did in their 60s than for what they did in the Sixties.

I invite you to comment on this column on my blog, www.nytimes.com/ontheground, and join me on Facebook at www.facebook.com/kristof.
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Aging population places demands on society

The Economist


Tuesday, August 05, 2008


As any amateur futurologist can tell you, the rich world is rapidly getting older. By 2050, more than a quarter of the developed world's population will be over 65.

At the moment, that group makes up about a sixth of the rich-world population, and only about 25 per cent of them are over 80. In 2050, the octogenarians and their elders will comprise 40 per cent of the 65-plus cohort in wealthy countries.

This greying of the prosperous parts of the world has long been foreseen, if not very well prepared for. Much less well known is the fact that well-off countries are far from alone in facing the prospect of an aging population.

Babies born today in poorish countries such as Thailand or Jamaica can reasonably expect to live into their 70s. And as more and more Indians and Chinese escape from poverty, they too will have much longer spans.

By 2050, the percentage of the Indian population over 80 will have risen fivefold, and the same segment in China will have gone up six times.

Such changes happen for two reasons: people's general health is better, meaning they wear out later, and preventable deaths of the relatively young are, in fact, prevented. As anti-retroviral treatment for HIV-AIDS becomes more common, childbirth safer and malaria more treatable, people will die at a more advanced age.

By 2050, close to 80 per cent of all deaths in the world are expected to occur in people who are older than 60.

While people 59 or under die in any number of dramatic ways, people on the other side of 60 face three possibilities which between them carry off most of the elderly, whatever their economic circumstances. Each peaks in a different decade, and each produces a different sort of end of life.

The first is cancer: most victims function reasonably well before entering a steep decline. Cancer deaths peak at 65-plus, and more and more sufferers recover. If they do, two other clouds appear on the horizon. One of these is chronic organ failure and the other is frailty, dementia and decline.

Chronic problems with an organ -- usually heart disease or emphysema -- bring a gradual decline punctuated by severe episodes, such as a heart attack or lung failure.

Dementia or frailty can mean a long, poor-quality end of life. As more cures are found for cancer, and sensible types give up smoking and bacon, more people will find that a slow decline is the meagre reward for their virtuous behaviour. That applies to developing countries as well as rich ones.

There has never been a bigger need for cheap, effective treatment for diseases of the old, such as Alzheimer's, or for easier access to pain relief and reliable care.

© The Calgary Herald 2008
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September 2, 2008
Doubts Grow Over Flu Vaccine in Elderly
By BRENDA GOODMAN

http://www.nytimes.com/2008/09/02/healt ... nted=print

The influenza vaccine, which has been strongly recommended for people over 65 for more than four decades, is losing its reputation as an effective way to ward off the virus in the elderly.

A growing number of immunologists and epidemiologists say the vaccine probably does not work very well for people over 70, the group that accounts for three-fourths of all flu deaths.

The latest blow was a study in The Lancet last month that called into question much of the statistical evidence for the vaccine’s effectiveness.

The authors said previous studies had measured the wrong thing: not any actual protection against the flu virus but a fundamental difference between the kinds of people who get vaccines and those who do not.

This contention is far from universally accepted. And even skeptics say that until more effective measures are found, older people should continue to be vaccinated, because some protection against the flu is better than none.

Still, the Lancet article has reignited a longstanding debate over claims that the vaccine prevents thousands of hospitalizations and deaths in older people. “The whole notion of who needs the vaccine and why is changing before our eyes,” said Peter Doshi, a doctoral candidate at M.I.T. who published a paper on the historical impact of influenza in May in The American Journal of Public Health.

The Lancet paper, by Michael L. Jackson and colleagues at the Group Health Center for Health Studies in Seattle, was based on an analysis of medical charts of thousands of elderly members of an H.M.O.

The study found that people who were healthy and conscientious about staying well were the most likely to get an annual flu shot. Those who are frail may have trouble bathing or dressing on their own and are less likely to get to their doctor’s office or a clinic to receive the vaccine. They are also more likely to be closer to death.

Dr. David K. Shay of the Centers for Disease Control and Prevention, a co-author of a commentary that accompanied Dr. Jackson’s study, agreed that these measures of health and frailty “were not incorporated into early estimations of the vaccine’s effectiveness” and could well have skewed the findings.

Not everyone is sold on the significance of the Lancet study. “I think this is another study that provides interesting findings and raises questions,” said Dr. Kristin Nichol, chief of medicine at the Veterans Affairs hospital in Minneapolis. “I don’t think we know yet what the final word is on influenza vaccinations in the elderly.

“I really feel, and I feel very strongly about this, that the public health message should be that vaccines are effective,” she continued. “I don’t think that science is necessarily best hashed out in the media.”

Dozens of studies since 1960 have supported the view that the vaccine is a powerful protector of the elderly, cutting their risk of dying in winter from any cause by almost 50 percent and reducing the risk of hospitalization by nearly 30 percent.

Those findings came from observational studies, in which scientists make inferences about the effect of a treatment on a population by comparing what happens to a group that has the treatment with what happens to an apparently similar group that does not.

There has been only one large study that compared the flu vaccine with a placebo for two random groups of older people in which neither the patients nor the scientists knew which group was receiving which injection. It came to a different conclusion from the observational studies.

Conducted by Dutch researchers and published in 1994 in The Journal of the American Medical Association, it found that in those 60 to 69, the vaccine prevented influenza about 57 percent of the time. In those over 70, the vaccine prevented the flu just 23 percent of the time, though the estimate is imprecise because the study was not designed to look at this age group.

But the influenza vaccine was never put through more placebo-controlled trials, which are considered the gold standard in medical evidence. “I think the evidence base we have leaned on is not valid,” said Lone Simonsen, an epidemiologist and visiting professor at the George Washington University School of Public Health and Health Services in Washington who was not connected with the Lancet study.

In 2005, Dr. Simonsen, who was then at the National Institute of Allergy and Infectious Diseases in Bethesda, Md., published a paper in The Archives of Internal Medicine that found something odd: even though the percentage of older people who got an annual flu shot more than tripled from 1980 to 2001, there was no corresponding drop in the death rate.

That paper included one of the first estimates of how many deaths are actually caused by the flu — a number hard to pin down because doctors seldom confirm flu in their patients with lab tests. Using a statistical model and the best available data, Dr. Simonsen found that influenza probably causes just 5 to 10 percent of all winter deaths in the elderly. But earlier studies had found that the flu vaccine cut an elderly person’s risk of dying by 50 percent.

“You don’t have to do a whole lot of math to realize that doesn’t add up,” said Dr. Lisa A. Jackson of the Group Health Center for Health Studies in Seattle, who has also studied the effectiveness of the flu vaccine in the elderly.

Dr. Jackson at first tried to tease out underlying differences between vaccinated and unvaccinated elderly people by using medical codes — a numerical shorthand that doctors use to classify and record what is wrong with their patients. She and other researchers reasoned that patients with codes for cancer or heart disease, for example, might be very sick, thus skewing the results. When they adjusted for those codes, however, the differences between the vaccinated and unvaccinated groups became even more pronounced. The vaccine looked even more protective.

It was Michael L. Jackson’s thesis project, at the University of Washington, that revealed the flaw in using the codes to differentiate patients.

For the project, Mr. Jackson (no relation to Lisa Jackson) and three other researchers spent almost three years reading medical charts and examining X-rays. They discovered that health-conscious people were more likely to get medical codes for things like heart disease and cancer simply because they went to the doctor more often. But when Mr. Jackson adjusted for measures of frailty — things like lung function, whether people needed help bathing or dressing, and what kinds of medications they took — he found that vaccination had little effect on older people’s risk for pneumonia, the most dangerous complication of the flu.

That finding has a biological basis. Vaccines work by priming the immune system to recognize and respond to incoming threats. Because the immune system slows down with age, older adults do not respond as well to vaccines as younger adults.

A recent study by Dr. Wilbur H. Chen and colleagues at the Center for Vaccine Development at the University of Maryland School of Medicine found that elderly participants needed four times the amount of antigens given in a standard dose of the flu vaccine to have the same kind of immune response as healthy adults under 40. They presented their findings in May at the Annual Conference on Vaccine Research in Baltimore.

Despite these findings, Dr. Shay said the C.D.C. had no plans to change its vaccine recommendations, though he added that the agency had financed studies to look for more effective influenza vaccines for the elderly.

Dr. Simonsen, the epidemiologist at George Washington, said the new research made common-sense infection-control measures — like avoiding other sick people and frequent hand washing — more important than ever. Still, she added, “The vaccine is still important. Thirty percent protection is better than zero percent.”
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September 30, 2008
Violations Reported at 94% of Nursing Homes
By ROBERT PEAR

WASHINGTON — More than 90 percent of nursing homes were cited for violations of federal health and safety standards last year, and for-profit homes were more likely to have problems than other types of nursing homes, federal investigators say in a report issued on Monday.

About 17 percent of nursing homes had deficiencies that caused “actual harm or immediate jeopardy” to patients, said the report, by Daniel R. Levinson, the inspector general of the Department of Health and Human Services.

Problems included infected bedsores, medication mix-ups, poor nutrition, and abuse and neglect of patients.

Inspectors received 37,150 complaints about conditions in nursing homes last year, and they substantiated 39 percent of them, the report said. About one-fifth of the complaints verified by federal and state authorities involved the abuse or neglect of patients.

About two-thirds of nursing homes are owned by for-profit companies, while 27 percent are owned by nonprofit organizations and 6 percent by government entities, the report said.

The inspector general said 94 percent of for-profit nursing homes were cited for deficiencies last year, compared with 88 percent of nonprofit homes and 91 percent of government homes.

“For-profit nursing homes had a higher average number of deficiencies than the other types of nursing homes,” Mr. Levinson said. “In 2007, for-profit nursing homes averaged 7.6 deficiencies per home, while not-for-profit and government homes averaged 5.7 and 6.3, respectively.”

On Monday, Mr. Levinson issued a compliance guide for nursing homes that says some homes “have systematically failed to provide staff in sufficient numbers and with appropriate clinical expertise to serve their residents.”

Researchers have found that people receive better care at homes with a higher ratio of nursing staff members to patients.

The inspector general said he had found some cases in which nursing homes billed Medicare and Medicaid for services that “were not provided, or were so wholly deficient that they amounted to no care at all.”

Bruce A. Yarwood, president of the American Health Care Association, a trade group, said: “We know we have to do a better job. We have been doing a better job, in treating pressure sores, managing pain and reducing the use of physical restraints.”

Mr. Yarwood said that the inspection system was broken. “It does not reliably measure quality,” he said. “It does not create any positive incentives.”

More than 1.5 million people live in the nation’s 15,000 nursing homes. The homes are typically inspected once a year and must meet federal standards as a condition of participating in Medicaid and Medicare, which cover more than two-thirds of their residents, at a cost of more than $75 billion a year.

Deficiency rates varied widely among states. The proportion of nursing homes cited for deficiencies ranged from 76 percent in Rhode Island to 100 percent in Alaska, Idaho, Wyoming and the District of Columbia.

The average number of deficiencies also varied, from 2.5 deficiencies per nursing home in Rhode Island to 13.3 per home in Delaware.

Mr. Yarwood said: “Inspectors are subjective and inconsistent. They interpret federal standards in different ways.”

In December, the Bush administration plans to begin using a five-star system to describe the overall quality of care. The best homes will get five stars. The rankings will be published on a federal Web site.

Medicare pays a fixed daily amount for each nursing home resident, with higher payments for patients who are more severely ill. Mr. Levinson said some nursing homes had improperly classified patients or overstated the severity of their illnesses so the homes could claim larger Medicare payments.
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November 22, 2008
In Housing Slump, Elderly Forgo Assisted Living
By JACK HEALY

The housing crisis has kept thousands of older Americans who need support and care from moving into retirement communities or assisted-living centers, effectively stranding them in their own homes.

Without selling their houses or condominiums, many cannot buy into retirement homes that require a payment of $100,000 to $500,000 just to move in. So they are scratching themselves off waiting lists, canceling plans with packing services and staying put, in houses that fit well 30 years ago, but over the years have become lonely, too large or too treacherous to navigate.

“It is part of the hidden problem of the recession,” said Larry Minnix, president of the American Association of Homes and Services for the Aging. “Every neighborhood, every family’s got them.”

Facilities that have watched their waiting lists wither and their occupancy rates fall in the last year are now scrambling to bring people through their doors. Some assisted-living centers have called in real estate agents to teach prospective residents about online advertising and how to clean and preen their homes for showings. Others have set up programs with banks to provide bridge loans to homeowners, or are discounting apartments and offering low-interest loans.

The Cedar Community, which provides a range of housing for the elderly in West Bend, Wis., has seen independent-living occupancy rates drop by 4 percent this year. There were so many people waiting for their homes to sell that the facility decided, in some cases, to let new residents pay month-to-month until they could unload their houses and use the proceeds on the facility’s entry deposit.

“We’ve never done that before,” said Tracey MacGregor, a spokeswoman at Cedar Community.

But for people like Ruth Scher, 85, selling their home is a critical first step before moving on, or moving anywhere. Ms. Scher put her two-bedroom condominium in Delray Beach, Fla., on the market last year, but no one has made an offer.

In the 34 years since she moved to South Florida, Ms. Scher’s husband has died, the siblings who moved south from New York to join her have died, and her friends have moved away. She is recovering from a fall that broke her clavicle and suffers from arthritis in one shoulder, and she says it is time to move back.

“It’s lonesome,” Ms. Scher said. “So many other people have passed away or moved away. It’s very lonely. The children would love me to come up and I would love to, but I just can’t sell.”

Ms. Scher hoped to move to a retirement community in Cornwall, N.Y., where she has friends. But in the year her home sat on the market, she could not even find a broker willing to sell the property, she said. She finally de-listed her condominium.

“They tell you, ‘We’re sorry, we can’t get any people to come and look,’ ” Ms. Scher said. “If I can’t sell here, I can’t go nowhere.”

There is no way to say how many older Americans are in similar straits, as no statistics track how many of America’s 4.27 million unsold homes are owned by people 65 or older. But industry groups and administrators at retirement homes call the problem a growing one, which worsened as the financial crisis spread from real estate to lending markets. It has been felt worst in regions hit hardest by the housing bust.

“It remains to be seen whether we have a short-term stress, or whether we’re facing a crisis,” said Mr. Minnix, of the Association of Homes and Services for the Aging. “We’re into brand new territory here. It is deeper and potentially broader.”

Across the country, occupancy rates for independent and assisted-living facilities have fallen slightly in the last year, by about 2 percent through the middle of 2008, according to the National Investment Center for the Seniors Housing and Care Industry.

But the problem is playing out acutely in hard-hit areas like Florida, where the vacancy rate at some facilities is up 20 percent to 30 percent over last year, said Paul Williams, director of government relations for the Assisted Living Federation of America. At Luther Manor, a retiree community in Milwaukee, the number of residents moving into independent living has dropped 20 percent this year. In southern Ohio, 65 percent of the people who visited the Bristol Village retirement community this year said they could not buy a unit because their homes were still hanging around their necks.

For these businesses, each occupied room generates thousands of dollars each year. Retirement condos charge monthly fees ranging from a few hundred dollars to $5,000, while the average price for private-pay care in assisted living is $3,013 per month, or $36,156 per year, according to a MetLife study.

At the Crosby Commons assisted-living center in Shelton, Conn., where waiting lists that once ran two years or more have shrunk to six months, some residents who moved before selling their homes are spending through their savings as they wait, said Lois Poultney, the center’s director. One resident had to move from Crosby’s free-market homes to its subsidized rent-controlled apartments, Ms. Poultney said.

“I’m hearing it over and over again: ‘Mom needs to sell her house before she can afford to move in,’ ” she said.

There are signs some families and retirees are turning to adult day care services as a stopgap. Providers say their business has spiked as people look for an alternative to continuing care or home aides to provide food, companionship and therapeutic services. But Mr. Williams of the Assisted Living Federation said that people who need more day-to-day care, those who have trouble getting up stairs or who need someone to check on them, were taking a risk by staying at home.

“When they’re coming in at 85, they’re coming in very frail and needing services,” he said. “They can’t wait this out. They need the care when they need the care. That’s the scary part. You have people putting it off when they need care right now.”

For Katherine Styberg, 84, that moment of realization came when she slipped on a patch of ice in February and fractured a vertebra. She has to use a cane when she walks now, and she says she has been thinking about how she lives alone, and if she fell in her two-bedroom condominium in Milwaukee, no one could catch her or help her up.

The real estate broker calls Ms. Styberg a day before bringing potential buyers to see her apartment, and a few have come to look around, but no one has made an offer yet.

As parents linger in their homes, they say their children start to worry. Some adult children are even facing financial hardships if they cannot sell their parents’ homes.

In April, Ruth Swessel, 84, of Milwaukee, had a stroke that aggravated the effects of her aging, leaving her unable to follow “Meet the Press” or read the political magazines she once loved. Her daughter, Laura Westling, had to put her into skilled care, and the family began the process of selling Ms. Swessel’s house to pay for the facility’s $60,000 annual cost.

The house has been sitting on the market since the summer, and Ms. Swessel’s family has lowered the price twice, to $174,500 from $189,900, but they have not been able to close a deal. Her children are spending her investments to pay for her care, but Ms. Westling said they did not know what they would do once that money ran out.

“It’s not easy,” she said.

As stock markets have slid in the last year, homes have become a more critical source of wealth for retirees who have watched their mutual funds and 401(k) accounts hollow out. Next to accrued Social Security benefits, housing is the single greatest asset for people 60 to 70 years old, making up 22 percent of their total wealth and outweighing investments and pensions, according to the Center for Retirement Research. For retirees like Herman McHan, who watched the value of his mutual funds fall to $35,000, from $70,000, or Sylvia Merlin, whose portfolio has lost nearly $200,000 of value, owning an interminably on-the-market home compounds the worries of their dwindling investments.

For Ms. Merlin, it is a disconcerting place to be at age 93. She said she and her late husband, Al, had lived modestly to raise their four children, taking one vacation a year, to the Jersey Shore. She is on oxygen now, and finds it harder to get around her fifth-floor apartment outside of Philadelphia. The doorman’s wife takes her to the hairdresser on Fridays, but Ms. Merlin said she wanted more consistent care.

“I’m going to be 94, and I need help,” she said. “Making the bed is difficult. I need a little help taking a shower. Those things are difficult. I was a great cook, but I really don’t cook anymore. I bought the TV dinners, and they’re pretty lousy.”

No one has made an offer on her condominium, and Ms. Merlin said the retirement home had refunded the $1,000 deposit on the $130,000 unit she hoped to buy. Now, instead of moving, she said she had decided to stay.

“I just couldn’t go anywhere until I sold my apartment,” she said. “I and a lot of other oldsters are stuck.”
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Brain-booster drugs may sharpen aging minds

Drug improves learning, memory in middle-aged rats

By Sharon Kirkey, Canwest News ServiceFebruary 16, 2009

A drug used for stroke patients may help sharpen middle-aged brains, researchers are reporting.

In the latest development in the quest for cognitive enhancers, researchers found the drug Fasudil significantly improves learning and memory in middle-aged rats.

If proven in humans, the drug may one day help blunt the impact of normal aging "or even enhance learning and memory throughout the life span," the American Psychological Association said in an announcing the findings, published in the February issue of the journal Behavioral Neuroscience.

"I do think that we are going to move into that area,"says lead author Matthew Huentelman, an investigator at the non-profit Translational Genomics Research Institute in Phoenix, Arizona.

"Really, we stumbled on this drug, and what do we do with it? Our drug is only supposed to be used for sick people. Can it be used for healthy individuals as well? It's a tough question."

University students are already using Ritalin and other prescription amphetamines to boost their grades. A survey by Nature, a top science magazine, last year revealed one-fifth of its global readership admitted to using "cognition-enhancing" drugs to help them concentrate. And seven prominent neuroscientists and ethicists recently argued in the same journal that not only is the trend likely to grow, but that "mentally competent adults" should be free to use safe cognitive enhancements with-out being made out to be felons.

But is using brain enhancers to boost productivity and give people a competitive edge cheating, like doping in sports?Would workers need protection from pressure from employers to "enhance?"

Several drugs now being tested in humans may help stave off normal, age-related memory decline in healthy people, and many drugs used to treat psychiatric and neurological problems can also increase how quickly and accurately people think.

The Arizona study began several years ago, when researchers identified a gene that plays a role in memory in humans. Next they looked for drugs that affect the gene's function. They tested Fasudil, a drug that improves blood flow to the brain, in rats.

The dosed rats performed significantly better on water maze testing learning and memory than rats given a saline solution. The doped rodents performed more like four-month old rats, or the equivalent of a teenager in human years.

"It was a pretty significant improvement in their memory performance," Huentelman says. There were no side-effects, and the drug has been shown to be safe and well tolerated when used in humans. The findings, and the relative safety of the drug, support its potential as a "cognitive enhancer in humans," the researchers report.

Huentelman worries about cognitive-enhancers creeping into high schools and colleges, but if the drugs can push out the onset of Alzheimer's disease or other dementias by even five years, "that's a massive impact.

"To me, aging is the worst disease, because it happens to all of us.

"Improving our ability to age, aging more gracefully as they famously say, is a benefit for all."

Four of the researchers hold stock in the drug company that owns the rights to develop this drug.

© Copyright (c) The Calgary Herald
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Post by kmaherali »

When an old lady died in the geriatric ward of a small hospital near Dundee , Scotland , it was believed that she had nothing left of any value.
Later, when the nurses were going through her meager possessions, they
found this poem. Its quality and content so impressed the staff that
copies were made and distributed to every nurse in the hospital.
One nurse took her copy to Ireland. The old lady's sole bequest to
posterity has since appeared in the Christmas edition of the News
Magazine of the North Ireland Assn. for Mental Health. A slide presentation has also been made based on her simple, but eloquent
poem. And this little old Scottish lady, with nothing left to give to the world, is now the author of this 'anonymous' poem winging across the Internet:
------- ----------------------------------------------------



Crabby Old Woman


What do you see, nurses?
What do you see?
What are you thinking,
When you're looking at me?


A crabby old woman,
Not very wise,
Uncertain of habit,
With faraway eyes..


Who dribbles her food,
And makes no reply,
When you say in a loud voice,
'I do wish you'd try!'


Who seems not to notice,
The things that you do,
And forever is losing,
A stocking or shoe

Who, resisting or not
Lets you do as you will,
With bathing and feeding,
The long day to fill?

Is that what you're thinking?
Is that what you see?
Then open your eyes, nurse,
You're not looking at me.

I'll tell you who I am,
As I sit here so still,
As I do at your bidding,
As I eat at your will.

I'm a small child of ten,
With a father and mother,
Brothers and sisters,
Who love one another.

A young girl of sixteen,
With wings on her feet,
Dreaming that soon now,
A lover she'll meet.

A bride soon at twenty,
My heart gives a leap,
As I make the vows
That I promised to keep.

At twenty-five now,
I have young of my own,
Who need me to guide,
And a secure happy home.

A woman of thirty,
My young now grown fast,
Bound to each other,
With ties that should last.

At forty, my young sons,
Have grown and are gone,
But my man's beside me,
To see I don't mourn.

At fifty once more,
Babies play round my knee,
Again we know children,
My loved one and me.

Dark days are upon me,
My husband is dead,
I look at the future,
I shudder with dread.

For my young are all rearing
Young of their own,
And I think of the years,
And the love that I've known.

I'm now an old woman,
And nature is cruel,
'Tis jest to make old age,
Look like a fool.

The body, it crumbles,
Grace and vigour depart,
There is now a stone
Where I once had a heart...

But inside this old carcass,
A young girl still dwells,
And now and again,
My battered heart swells.

I remember the joys,
I remember the pain,
And I'm loving and living
Life over again.

I think of the years,
All too few, gone too fast,
And accept the stark fact
That nothing can last.

So open your eyes, people,
Open and see,
Not a crabby old woman;
Look closer - see ME!!


Remember this poem when you next meet an old person who you might brush aside without looking at the young soul within.

We will all, one day, be there, too!

PLEASE SHARE THIS POEM.

IT'S SOMETHING WE ALL NEED TO READ.

And don't forget the crabby old men either.
kmaherali
Posts: 25106
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Post by kmaherali »

Healthy, aging brains don't need puzzles

Everyday life just fine for keeping sharp, says study

ReutersFebruary 19, 2009

Healthy older people spending money on computer games and websites to ward off mental decline are giving their wallets more of a workout than their brain, according to a U.S. study.

Dr. Peter J. Snyder of Lifespan Affiliated Hospitals in Providence, R. I., reviewed the scientific evidence for the benefits of these "brain exercise"programs says but found they did not live up to expectations.

"These marketed products don't confer any additional benefit over and above being socially and intellectually active in one's normal daily life," Snyder told Reuters Health.

"There are some things that we could be doing that have much more rigorous data to support their application."

However, Snyder and his team note in the journal Alzheimer's&Dementia that types of "brain training" are known to help people with memory problems function better, but their benefits for those who don't have measurable cognitive impairment isn't clear.

Meanwhile, Snyder said in an interview, the market for these products has swelled from$2 million US in 2005 to an estimated $225 million this year.

To review evidence on the benefits of cognitive training for healthy older people, Snyder and his colleagues analyzed 10 randomized controlled trials of a variety of approaches, ranging from a popular computer-based program to individualized piano lessons.

While there was some evidence that brain training helped people's immediate performance on tasks related to the training, there was no evidence that the effects could be generalized to other areas of mental function, Snyder and his colleagues found. Further, just half of the studies included extended followup, so evidence for long-term benefits was slim.

The findings don't mean that brain training isn't helpful for people who have memory problems, Snyder told Reuters Health, nor are they definitive proof that brain exercise can't help keep healthy people's wits sharp.

But social and intellectual engagement in day-to-day life, from reading to grandchildren to doing crossword puzzles, is "probably just as effective or more effective" than any formal brain exercise program, he added.

Further, he pointed out, these activities are free.

Snyder said there is strong scientific evidence that being physically active every day preserves cognitive function. Because cardiovascular disease and Type 2 diabetes are both known to contribute to mental decline, he added, exercising and taking other steps to maintain heart health and a healthy weight will help keep the brain healthy, too.

© Copyright (c) The Calgary Herald

http://www.calgaryherald.com/Health/Hea ... story.html
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Post by kmaherali »

March 31, 2009
Treating an Illness Is One Thing. What About a Patient With Many?
By SIRI CARPENTER

Mazie Piccolo has so many health problems it’s hard to keep track. Congestive heart failure makes her short of breath and causes her legs to swell. An abnormal heart rhythm raises her risk for stroke. Arthritis in her knees makes it hard for her to get around, and she can no longer drive.

Mrs. Piccolo, 84, of Rosedale, Md., also has osteoporosis, and she has fallen several times in the past few years, once breaking her pelvis. On top of all these medical ailments and others — high cholesterol, high blood pressure, gastric reflux — she has a history of depression, and it is sometimes hard for her to care for her husband, who is even frailer than she is.

Strictly by the book, Mrs. Piccolo should be taking 13 different medications — an expensive, confusing cocktail that has proved too much for her to manage. Other medications that might be advisable cause intolerable side effects, and the more drugs she takes, the greater the risk of dangerous drug interactions.

What is striking about her predicament is not how rare it is, but how common. Two-thirds of people over age 65, and almost three-quarters of people over 80, have multiple chronic health conditions, and 68 percent of Medicare spending goes to people who have five or more chronic diseases.

As a group, patients like Mrs. Piccolo fare poorly by any measure. They linger in hospitals longer, experience more serious preventable health complications and die younger than patients with less complex medical profiles.

Yet people with multiple health problems — a condition known as multimorbidity — are largely overlooked both in medical research and in the nation’s clinics and hospitals. The default position is to treat complicated patients as collections of malfunctioning body parts rather than as whole human beings.

“Very often, there is nobody looking at the big picture or recognizing that what is best for the disease may not be best for the patient,” said Dr. Mary E. Tinetti, a geriatrician at the Yale School of Medicine.

And treating one disease in isolation, she added, can make another disease worse. In controlling diabetes, for example, doctors often seek to reduce levels of a blood-sugar marker called hemoglobin A1C. “But we know that for some people with complicated diseases, that’s not always the best move,” Dr. Tinetti said.

Mrs. Piccolo is being treated by Dr. Cynthia M. Boyd, a Johns Hopkins University geriatrician whose research focuses on patients with multiple chronic conditions.

“Doing right by patients like this is tremendously challenging,” Dr. Boyd said. “Would she get the most benefit from lowering her blood pressure or cholesterol level, or from being treated for her osteoporosis, or from taking warfarin for stroke prevention? Or is it more important to treat her depression so she can manage her overall health better, or to try to improve her ability to physically get around?”

The medical file for Fred Powledge, 74, is four inches thick, with more than a dozen current diagnoses, including diabetes, gout, chronic obstructive pulmonary disease, compressed vertebrae, three replacement joints, two replacement eye lenses and arthritis.

Mr. Powledge, a Maryland writer, takes almost a dozen pills a day, as ordered by six physicians.

“Good luck and a lot of sleuthing on my part have given me doctors whom I trust and who are mostly aware of interactions among the drugs they prescribe,” he said in an e-mail message. “But what’s missing is someone who can look at the big picture and see my health as a whole.

“That falls to me alone, with the help of my very wise wife and frequent visits to reliable Web sites,” he continued. “As our population ages, we need some kind of overseer to juggle all the diagnoses and prescriptions and look for conflicts and duplications. This would also help to counteract the notion in many people’s minds that the doctor knows best — because often the doctor doesn’t.”

In a medical system geared toward individual organs and diseases, there is no champion for patients with multiple illnesses — no National Institute on Multimorbidity, no charity Race for the Multimorbidity Cure, no celebrity pressuring Capitol Hill for more research.

And because studies involving uncomplicated populations are cheapest and easiest to interpret, patients with multiple diseases are routinely shut out of drug trials. A 2007 study found that 81 percent of the randomized trials published in the most prestigious medical journals excluded patients because of coexisting medical problems.

“We often don’t know what the real safety or efficacy is for patients with multiple illnesses,” said Dr. W. Douglas Weaver, president of the American College of Cardiology.

Pharmaceutical companies are required to study how well particular drugs and medical devices work in the real world, after they’ve gotten government approval. In theory, such post-marketing studies should shed light on how best to treat patients who have complex medical problems. But the studies tend to include only a small fraction of patients receiving treatment, Dr. Weaver said.

Comprehensive data registries that track all patients at a given hospital or clinic are more promising, he said. But he added that unless the federal government stepped in to support such registries and pay doctors for participating, they might not be sustainable.

Because so little research includes complicated patients, physicians have little scientific evidence on which to base their care. In a 2005 study, Dr. Boyd and colleagues analyzed influential, evidence-based clinical practice guidelines used to treat nine of the most common chronic diseases, among them osteoporosis, arthritis, Type 2 diabetes and high cholesterol.

Fewer than half the guidelines specifically addressed patients with multiple illnesses, and most were limited to patients with only one coexisting disease or a small number of closely related diseases. “We’re so far away from having perfect evidence about how to help patients with complex health problems,” Dr. Boyd said.

Lacking solid guidance, doctors make their best guesses about whether a particular guideline is applicable to the patient, said Gerard F. Anderson, a professor of health policy and management at the Bloomberg School of Public Health at Johns Hopkins. And “their best guesses,” he went on, “vary all over the map.”

Time pressures intensify the doctors’ predicament. A typical 15-minute appointment leaves too little time to weigh the risks and benefits of a complex treatment plan, much less to fully consider the patient’s preferences and priorities.

“We don’t actually know how to weigh evidence across diseases,” said Dr. Boyd, of Johns Hopkins, “and we also don’t know the best ways of communicating to patients what we do and don’t know.”

Quality-improvement measures, which tie doctors’ compensation to how closely they follow evidence-based practice guidelines, further complicate matters, and some worry that they provide a financial incentive for physicians to sacrifice individualized decision-making.

“Doctors know that it’s not right for someone to be on 15, 18, 20 medications,” said Dr. Tinetti, the Yale geriatrician. “But they’re being told that that’s what’s necessary in order to treat each of the diseases that the patients in front of them have.”

Changing that will require a major investment in research, guidelines and quality measures that include the kinds of complicated cases doctors see every day.

“I think everyone realizes that we need to figure out how to integrate care for our elderly patients with multiple chronic conditions,” said Dr. Ardis D. Hoven, an internist in Lexington, Ky., who is a trustee of the American Medical Association. “But we’ve got a long way to go. We’re just now beginning to verbalize this.”

http://www.nytimes.com/2009/03/31/healt ... nted=print
kmaherali
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Post by kmaherali »

http://www.nytimes.com/pages/business/r ... ?th&emc=th

Skills to Learn, to Restart Earnings
By JOHN LELAND

Tyrone Turner for The New York Times
ANOTHER DAY Faye Milbourne, a former Verizon worker who went back to school to become a teacher, waits for students to arrive at an elementary school in Virginia Beach.

Finding their retirement nest eggs short, many are doing whatever it takes to start a second career.

Slide Show: Back in School Again
A Quest for a Home, Put on Hold
By JODI RUDOREN
Her next move was supposed to be her last, but her well-laid plans to enter a retirement community have been frustrated by the sagging market.

Experienced, Eager to Serve, Will Travel
By ELIZABETH POPE
Within two days of President Obama’s Inaugural Address, online applications to the Peace Corps spiked, and many older Americans have responded to the call to serve.

A Move to Expand Volunteer Ranks | How to Enlist
Calling for Financial Advice . . . and Reassurance
By CHARLES DELAFUENTE
Hotlines provided by employers or groups they belong to have experienced a spike in activity from callers seeking mostly long-term advice.

More Are Spending Less to Get Away From It All
By STEFANI JACKENTHAL
While this may seem like a peculiar time to take a dream vacation, the prices are right if you have the cash.

Slide Show: Travel Deals for Tough Times
Doctors Are Opting Out of Medicare
By JULIE CONNELLY
Many people, just as they become eligible for Medicare, discover that the insurance rug has been pulled out from under them.

Times Topics: Medicare
Protecting Retirement Accounts From Creditors
By DEBORAH L. JACOBS
Even at today’s depressed values, it’s important to protect your retirement accounts from creditors.

*****
Over-55s urged to join Say Go! fitness scheme
2:33pm Thursday 2nd April 2009

RESIDENTS aged over 55 are being urged to take up fitness activities aimed at promoting healthy lifestyles for older people.

The Say Go! scheme covers a range of activities at different venues across the borough, including sports, dance and yoga lessons.

It is organised by Age Concern Barnet, with funding from Barnet Council and Sport England.

The classes are run in partnership with a number of faith and community groups, including the Barnet African Caribbean Association, Barnet Asian Old People's Association and the Anand Day Centre, but anyone aged over 55 is welcome to attend.

A new ten-week course of tai chi was launched on Tuesday, aimed specifically at members of the borough's Ismaili Muslim community, to be held at the North London Jamatkhana, in East End Road, Finchley.

The classes will take place during the day and also offer a chance for members to socialise after the session.

Councillor Lynne Hillan, cabinet member for community services, said: "The Say Go! scheme provides a very important service for older people living in Barnet and helps to work towards the council's corporate priority of a strong and healthy borough.

"I hope that many of our residents aged over 55 take the opportunity to take part in one or more of the Say Go! classes as they continue to be rolled out and enhanced throughout the coming year."

For more information visit the council website at barnet.gov.uk/activities-for-older-people or call the council on 020 8359 2000.

Alternatively, call Lisa Dubow at Age Concern Barnet on 020 8346 0542 or by emailing lisa-finchley.acb@btconnect.com.

http://www.times-series.co.uk/news/4256272.print/
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Post by kmaherali »

Canada faces serious crisis in elderly care: study

Seniors likely to double in 25 years

By Teresa Smith, Canwest News ServiceMay 31, 2009 7:25 AM

Canada will soon face a serious crisis in caring for the elderly unless policymakers act now to head it off, says a Carleton University researcher.

Gabrielle Mason, a PhD student in political science, says lifestyle changes combined with an aging population are about to create a serious elder-care crunch in Canada.

Mason said that policymakers should keep "Canada's aging society in mind so that the (government) can adjust and design infrastructure, policies, plans and resources which celebrate increased longevity and reduce dependencies on family."

By 2015 there will be more people in Canada over the age of 65 than under the age of 15, according to Statistics Canada's most recent population projections. And the number of seniors is expected to double over the next 25 years. "Canadian citizens deserve and should expect good quality of life in their elder years," said Mason. "A minimum level of care shouldn't be considered a luxury."

Mason argued that investing in services now to help the elderly find care will dramatically cut costs to taxpayers later on.

She suggested several reasons a crisis is looming. Most elderly people in Canada are currently cared for by their family, but the traditional caregivers-- younger, female family members--now have full-time jobs and are less able to look after their relatives. Also, baby boomers who married and had children later in life or had fewer children and moved frequently may live far away from their kids and have no one nearby to care for them.

Reasonably healthy elderly people may simply need help with shopping or heavy housework, as well as emotional support. But those with more serious physical and mental impairments may require 24-hour care.

In her research, Mason found that 90 per cent of Canadians would prefer to spend their final years at home, favouring help from formal services over family care.

"Relying on family members' help for care often evokes feelings of indebtedness and clashes with closely held ideas about independence and self-reliance," she wrote.

The Senate committee on aging, which submitted its final report in April, found that caring for clients who are permitted to stay at home costs less per year than caring for those who must enter a care facility --even when the informal caregiving work of family members is allocated a financial cost.

They found that a patient in community care will cost about $37,000 per year, compared to $87,000 in a facility.

© Copyright (c) The Calgary Herald
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Post by kmaherali »

Elderly woman trapped by toilet rescued after a week

Herald News ServicesJuly 29, 2009

An Australian woman was stuck in her toilet for a week before neighbours heard her cries for help, officials said Tuesday.

The 67-year-old Queensland woman was found on Sunday, seven days after she became trapped, the state community safety department said.

"Firefighters accessed the woman and freed her. Paramedics treated the woman and transported her to Ipswich Hospital," the department said in a statement.

A departmental spokeswoman told Brisbane's Courier Mail newspaper that the rescuers had trouble reaching the woman because she was so tightly wedged by the lavatory, with a foot stuck on either side.

"The lady was manoeuvred to one side to free her. The door swings inward and she had her feet wedged on either side of the toilet," the spokeswoman said.

"She was very dehydrated but she was conscious."

Michael Hibberd, the neighbour who heard her cries for help, said it was a reminder for people to check up on the elderly.

"Not necessarily keep an eye on them 24/7, but just make a note of their movements and what not," he told ABC radio.

A hospital spokesperson told the Courier Mail the woman will remain in hospital for "some time."

© Copyright (c) The Calgary Herald

http://www.calgaryherald.com/story_prin ... 7&sponsor=
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Post by kmaherali »

Robot pets companions for elderly?

By Farah Master, Reuters

August 21, 2009

Artificial cats and other man-made companions could be keeping Britain's elderly company within three years if society can be persuaded to start experimenting with robots.

A report by the Royal Academy of Engineering published on Thursday shows robot soldiers and surgery devices are rapidly being developed, but the legal and ethical debate is lagging.

"This is not constrained by the technological possibility of it so much as by the desire to do it--and that is bound up with all sorts of social factors," said Prof. Will Stewart of Southampton University, who contributed to the report.

As well as robotic pets, autonomous systems could be morphed into robot babysitters, artificial therapists and social or even sexual companions.

With Britain's elderly population set to grow about 50 per cent by 2020, robotic companions could also help monitor the health of Britain's increasingly grey population.

"It is not a complete replacement for your kid calling you once a week. What you want is continuous attention and that is very difficult," said Stewart.

A robotic pet could help raise the alarm in the case of an accident, monitor fridge contents, and voice prompts could remind them to switch off the heating.

The ethical challenges facing a robotic revolution include concerns that artificial pets or helpers could lead to social isolation for the elderly.

© Copyright (c) The Calgary Herald

http://www.calgaryherald.com/story_prin ... 9&sponsor=
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Post by kmaherali »

September 19, 2009
Helping the Aged Leave Nursing Homes for a Home
By JOHN LELAND

PHILADELPHIA — Walter Brown never wanted to live in a nursing home, but when he had a stroke two years ago, he saw little choice. Mr. Brown, 72, could not walk, use his left arm or transfer himself into his wheelchair.

“It was like being in jail,” Mr. Brown said on a recent afternoon. “In the nursing home you’ve got to do what they say when they say it, go to bed when they tell you, eat what they want you to eat. The food was terrible.”

But recently state workers helped Mr. Brown find a two-bedroom apartment in public housing here, which he shares with his daughter. “It just makes me more relaxed, more confident in myself,” he said, speaking with some difficulty, but with a broad smile. “More confident in the future.”

A growing number of states are reaching out to people like Mr. Brown, who have been in nursing homes for more than six months, aiming to disprove the notion that once people have settled into a nursing home, they will be there forever. Since 2007, Medicaid has teamed up with 29 states to finance such programs, enabling the low-income elderly and people with disabilities to receive many services in their own homes.

The program in Pennsylvania provides up to $4,000 in moving expenses, including a furniture allowance and modifications to the apartment, and Mr. Brown has a home health aide every morning and a care manager to arrange for services like physical therapy. The new programs, financed largely by $1.75 billion from Medicaid, are a sharp departure from past practices, where Medicaid practically steered people into nursing homes.

“Medicaid has had an institutional bias in favor of nursing homes,” even for people who do not need them, said Gene Coffey, a staff lawyer at the nonprofit National Senior Citizens Law Center. “Federal law requires states to provide nursing home services. They don’t have to provide home or community-based services.”

For Mr. Brown, the transition to his own home has changed his life, he said. Now, with his motorized wheelchair, he travels the city on public buses, visiting friends in other neighborhoods.

“It’s a great feeling,” he said. “In the nursing home I got up at 5 o’clock in the morning, then the rest of the day was just watching the TV or my VCR. I wanted to be able to get out and see people, see the world. I didn’t want to be confined. Now I go where I want to go.”

States and the federal government hope to save money, though research about cost savings has so far been inconclusive. A recent study by researchers at the University of California, San Francisco, found that home care costs taxpayers $44,000 a year less than a nursing home stay — though this number cannot be used to estimate total savings, because often home-based services replace family care, not nursing home care.

About 1.5 million Americans are living in nursing homes.

“It’s amazing how quickly people can end up in a nursing home,” said Jean Janik, the director of community living options at the nonprofit Philadelphia Corporation for Aging. “Say you’re a single man and have a stroke, and need to go into a nursing home to rehab. You’re elderly so you don’t quite bounce back quickly. After 60 days, Medicare doesn’t pay any longer, so you need a Medicaid grant to stay in the nursing home. Then your Social Security will go to the nursing home.”

Many lose their apartments and regular support from family members, Ms. Janik said.

“We meet people who say, ‘I went to the hospital and next thing I know, here I am. I don’t know what happened to my apartment.’ ” Ms. Janik added, “We go and check, and it’s not in their name. Especially if they don’t have a strong family support system in place. A lot of people just think, Uncle Joe fell and broke his hip and now he’s in a nursing home, so be it, that’s where he’ll be. People don’t realize they can get services in their home.”

Each participating state has designed its own program, called Money Follows the Person. The federal government, which shares Medicaid costs, provides extra financing for the first year.

Some experts worry that the programs will end up transferring some of the expenses of caring for the elderly or the disabled to their family members.

Carol Irvin, a senior researcher at Mathematica Policy Research has been contracted by Medicare and Medicaid Services to study the costs of the program in its first five years.

“It could be shifting costs onto a person’s relatives,” Ms. Irvin said. “But even if it’s not saving money, a lot of people believe living in the community is the right thing for individuals.”

Elizabeth Kamara, 72, spent 18 months in a nursing home after having her left foot amputated because of diabetes. Mrs. Kamara can get around using a walker, but in the nursing home she spent whole days in a wheelchair.

“I just let people do things for me,” she said. “They say, ‘If you fall, we’ll get in trouble. Please sit down.’ ”

Mrs. Kamara has moved into a independent living facility, where she cooks dishes from her native Sierra Leone and navigates the hallways on her own. She gives herself insulin injections and gets a friend to drive her to doctors’ appointments. An aide comes twice a week to help clean. “This is my home; I’m free,” she said. “In the nursing home it was two persons in one room. Here I have my privacy. I can get my hair done, my nails done.”

Susan C. Reinhard, a senior vice president of the AARP Public Policy Institute, said of Money Follows the Person: “It’s gotten Congress’s attention, and shown that people can leave a nursing home. That is a wake-up.”

For Esther Pinckney, 88, who ended up in a nursing home after a stroke, moving out has been literally a breath of fresh air. Ms. Pinckney now lives in a bright subsidized apartment where home aides visit twice a day.

“What didn’t I like about the nursing home?” she asked recently. “What would you like about smell, smell, smell, morning, noon and night?”

Because Ms. Pinckney lost her apartment and furniture while she was in the nursing home, the Philadelphia Corporation for Aging bought her new furniture and a microwave oven. Before, she said, her Social Security check went to the nursing home; now she pays 30 percent of her check for her rent. “I couldn’t even buy a soda,” Ms. Pinckney said. “You want to be independent, don’t you? That’s what I wanted.”

Life on her own has not been perfect, she admitted. Aides often fail to show up or spend their time talking on the telephone.

But her pastor takes her to church four times a week, and she can go to stores near her building. If her health should fail again, she said, she did not like to think about going back into a nursing home.

“Don’t mention it,” she said, her face tightening. “I don’t want to do that.”

http://www.nytimes.com/2009/09/19/healt ... &th&emc=th
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