Prime Time: A New Look At Aging

This is a good time to prepare for your departure

 “I know a fellow who says, ‘I’ve come to terms with death—other people’s.’” Thomas Grimm, a therapist, mentions this in his opening remarks during a workshop.

As a former clergyman, he describes death as life’s biggest adventure. “You need to think about it and plan for it. Nothing can be changed until it’s faced,” Grimm says.

No one attempts a joke about his subject matter and his last name, but humor abounds anyway amid older adults who appear willing to talk about a topic that’s often taboo.

A first step should be reconciliation, Grimm says. One of his patients reached it via a dream of photographing key people in his life. This paved the way for a discussion with Grimm about a sister with whom he’d had a falling out after the death of their father. “Write her a letter and express your feelings,” Grimm advised the man. “You don’t have to mail it.”

But the patient, a school teacher, felt so much better after writing a first draft that he sent a second version, then was thrilled by the phone call she made after reading it. The next night he tripped and fell at home and went to the hospital in a coma from which he never recovered.

“So make amends and take care of any unfinished business,” says Grimm. Think of affirmations about your life, a collection of your accomplishments, he recommends. Yes, you were taught that bragging is unseemly, but it’s healthy to find some things you’ve done that you feel positive about.

Mary says she feels good about how her 12 children turned out. Another plus: Because of her efforts, eleven of them reestablished relationships with their father after he initiated a divorce. Adeline could give herself a pat on the back for enriching the final years of an aunt and uncle with her presence and caring.

One woman tells how her husband described to the undertaker the funeral suit he’d chosen and even the handkerchief for his breast pocket, then she added, “Two weeks later he died.” After a long pause, the woman next to her says, “The moral is, don’t talk to the undertaker.”

It’s a big help to relatives and friends if you prepare for the last chapter. There’s the will and the trust. You should inform people where you keep the instructions about being buried or cremated, organ donations, the recipe for that prize-winning fudge. Describe the memorial service you want and who will officiate. 

Grimm once asked mourners to jot down their remembrances of a man whose service he was conducting. The widow read them in what proved to be a poignant, often joyful part of the service. 

Finally, you can create your own epitaph. It’s going to tough, though, to top these:
“This is all over my head”—Robert Benchley
“Involved in a plot”—Dorothy Parker (She also had suggested, “Excuse my dust.”)
“Over my dead body”—George S. Kaufman
“This one’s on me”—Milton Berle
“Here’s something I want to get off my chest”—William Haines

 

A little laughter helps a lot

George Burns said, “You can’t help getting older, but you don’t have to be old.” But how do you avoid the “old”? you may be wondering.

Gene Ahlf provides an answer you might find laughable: add more humor to your life. Research reveals that laughter, like exercise, reduces stress and promotes endorphins, which are a kind of chemical morale booster for the brain.  Ahlf, a California resident, incorporates chuckles when he’s golfing, skiing, biking or walking. He’s been married nearly 40 years and says humor is a necessity for a union lasting that long. His secret? “I don’t try to run her life, and I don’t try to run mine. When I mentioned to her that I’d never had an ulcer, she said, ‘No, but you’re probably a carrier.’”

Norman Cousins, an editor diagnosed as terminally ill, undertook a study of his painful condition and found that ten minutes of belly-bobbing laughter gave him two hours of uninterrupted sleep. He made visitors bring with them tapes of “Candid Camera” and Marx Brothers movies, after deciding that laughter possessed curative powers. He lived for years after leaving the hospital. His book, Anatomy of an Illness, helped inspire some hospital and nursing home staff members to supply patients reasons for smiles and chuckles. It’s a movement that deserves far wider practice.

“When one of life’s tragedies occurs, it’s entirely up to you whether you’re stressed or angry,” Ahlf says. A case in point: You wait at the deli counter ten minutes then find out everyone else has a number. Instead of flipping out, find the humor in the situation. 

Worry takes a toll because we can’t make decisions, Ahlf says. Try looking at a problem on a credibility scale from 1 to 9, he suggests. You’re staring into darkness  at 3 a.m. with a worry. Typically you’d start midway on the scale with a 5 rating, then, upon reviewing the facts and probabilities, you could lower the rating and realize the problem’s insignificant, or you may need to up the number, and determine that, yes, it’s a concern that you will do something about first thing in the morning. Either way, having reached a decision, you can turn over and saw some ZZZZ’s again.

He quotes Robert Frost, who wrote, “The reason worry kills more people than work is that more people worry than work.” When he tried resuming softball, Ahlf found he could still hit and run, but his arm told him his throwing days were over. It was like Rodney Dangerfield telling the doctor, “It hurts when I do that,” and the doctor replies, “Don’t do that.”  Limited athletic prowess provides some advantages. “When I drive a golf ball now I never lose sight of it,” Ahlf says.

He tells the story of the minister who asked his congregation, “How many of you want to go to heaven?” Everyone except a man in back raised a hand. “You, sir,” said the minister. “Don’t you want to go to heaven when you die?” The man replied, “Oh, when I die. I though you were gettin’ up a load now.”

After Ahlf experienced that most devastating of losses, the death of a child, he could in time look back to the happy moments with his daughter. “I steer myself that way.”

He sums up his message by recommending that you “Mobilize your body’s own natural healing resources with positive emotions. Apply liberal doses of humor in dealing with tragedy,” whether it be as minor as a spilled glass of water or the loss of a loved one.

 

Helping those who help seniors

From the Center for Aging Services Technologies (CAST) comes this report on helping caregivers:

Family caregivers are a critical component in elder home care. Employed caregivers carry an additional set of workplace demands that overlay their caregiving responsibilities, yet no supportive technology based applications exist for them. 

Through funding from the Dept of Commerce's Technology Opportunity Program (TOP), we developed and tested the first technology based system designed to support working caregivers concerned about older adults alone at home during the caregiver's worktime. Known as the Worker Interactive Networking (WIN) project, it innovatvely offered workplace Internet access via PC/PDA/cellphone to a uniquely integrated system providing a caregiver support group, resource linkages, and remote home monitoring of consenting elders. 

The home monitoring system consisted of 2 in. wireless event sensors unobtrusively placed in the home that sent data via a transponder that uploaded it to our server that filtered and updated status information in real time. Workers logged on to their personal webpage to see their relatives status at three levels, each with increasing specificity of information. If everything was fine, they saw a Green "OK", when a parameter neared its' limit, a Yellow "Watch" was displayed and if exceeded a Red "Alert" was shown. Alerts automatically triggered an e-mail notifying the caregiver. Caregivers could click on the alert or any of the non-alert screens to proceed further down for specific information on the status indicators such as when the elder got up, the last time they moved about, where they went, if they went into their pill box, or went out the door. 

After the caregivers/elders chose what to monitor, we used a "Nursense" (TM) assessment process to assess for and offer other preventive health and safety options. Endusers were given the control over the monitoring times and could change settings at any time or turn them off.

Tell a friend.

A credo for the elderly

“I should continue to weed the garden of my life, remove yesterday’s flowers and branches, and foster new growth.”

This is No. 7 in a list of nine personal responsibilities James L. Birren set for himself under an umbrella theme of “Resourceful Aging.” It merits emphasis because some people as they age become creatures of habit, comfortable in ruts whose ridges grow imperceptibly into walls. They may be reluctant to prune the branches of a friendship with someone whose interests no longer match their own or sever their membership in a group that’s grown dormant.

At the time he developed “My Responsibilities for My Old Age,” Birren headed the Borun Center for Gerontological Research at the University of California. Here’s the complete list:

1. I should honor my children and all children and foster their growth.
2. I should avoid becoming bitter if overlooked by the passing young and by events. May my spirit not be eroded by the acids of life.
3. I should continue to seek information and learning and avoid dogmatic positions and postures.
4. I should use the experience of my years for attaining fairness and justice for others.
5. I should foster my physical and mental health. Should I have poor health, I should cushion its impact so that it does not weigh unduly upon others.
6. I should manage prudently and with affection my relationship with others and also initiate the expression and caring for others.
7. I should continue to weed the garden of my life, remove yesterday’s flowers and branches, and foster new growth.
8. I should prepare others and myself for my death.
9. I should leave the land and its people better than I found them. May I plant seeds that will bloom off theirs in springs I will not see.

As you ponder these thoughts, keep in mind Ashleigh Brilliant’s observation: “Life can be good while it lasts, and it’s guaranteed to last your whole lifetime.”

 

Health tips for seniors

Forgetting to floss? If the answer is yes, trouble awaits. Periodontal infection may lead to heart disease, reports the American Academy of Periodontology. You can learn more by calling toll-free 1-800-FLOSS-EM or try an interactive website (www.perio.org), according to Seniority magazine. 

So you feel like the morning after—and you haven’t even been partying. You have company. Older adults reported experiencing an average of five minor health problems during a two-week period, in a study by the Non-prescription Drug Manufacturers Association. The most frequent complaints: arthritis, sleeping difficulties, muscle aches and pains, upset stomach, being overweight, headaches, colds, and bunions/corns/calluses. In 28 percent of the cases, the seniors gained relief from over-the-counter medicines, says the United Seniors Health Report. The other 72 percent? They evidently saw their doctors for a prescription or toughed it out.

Don’t dawdle when you make a left turn. Seniors rack up a high accident rate during the maneuver because they take too much time, reports the Journal of the American Geriatrics Society. The longer a driver takes, the greater the risk of a crash with a car coming toward you or from right or left. 

Constant worry about memory can actually impair it, says Dr. Barry Gordon of Johns Hopkins University’s Department of Neurology. Fear of dementia can deplete your self-confidence and depress you. For the majority of healthy people, lapses of memory after age 50 are simply part of the normal aging process. Memory problems can occur from stress, depression, fatigue, changes in hearing or vision, medications, a poor diet, excessive drinking, and illness unrelated to Alzheimer’s—all of which are treatable conditions, says the UC-Berkeley Wellness Letter.

An age-related drop in estrogen impacts men as well as women when it comes to osteoporosis, based on studies described at a San Francisco meeting of the International Bone and Mineral Society as reported in the New York Times. Until now, the general view was that low testosterone levels led to the condition, thus suggesting that osteoporosis is under-reported for men. So, gentlemen, as most women could inform you, here are the guidelines to avoid it: Stop smoking, limit the amount of alcohol and get off your duff and work out now and then. Take 1,500 mg of calcium per day (1,000 mg is O.K. to age 65). Get out in the sun at least 10 minutes a day or take 400 IU of vitamin D. For exercising, try walking, jogging, racquet sports or stair climbing. Pump some iron too.

For muscle soreness or arthritis, use one-half to one teaspoon of dry or fresh ginger cooked into recipes or in boiling water as tea. This is the advice of Dr. Neal Barnard, author of Foods that Fight Pain.  Also eat green leafy vegetables and beans. Avoid foods such as eggs, citrus fruits, meat, poultry and fish, wheat, dairy products, and chocolate (especially bad for migraine), he is quoted as saying in the Bottom Line newsletter.

Between 10 and 20 percent of seniors suffer from depression, according to a four-year study by the National Institute on Aging. Women are about twice as likely as men to develop depression, but are more likely to get treatment, says Seniority magazine. Men may mask their despondency by drinking; otherwise, depression rates among men and women would be closer. Doctors fail to diagnose the problem in half their patients who have depression. The good news is that psychotherapy, anti-depressants or a combination of both are successful in 80 percent of the clinical depression cases, the magazine says.

You're already a winner

In order to read what I'm writing here, you have mastered a set of tools (computer, mouse, internet, finding an address, etc.) that give you an advantage in staying self-reliant and independent.

A 2006 article titled 'Factors predicting the use of technology: Findings from the center for research and education on aging and technology enhancement (create)' and published in Psychology and Aging reports on a study of 1,204 individuals. "The successful adoption of technology is becoming increasingly important to functional independence. The present article reports findings from the Center for Research and Education on Aging and Technology Enhancement (CREATE) on the use of technology among community-dwelling adults."

This makes sense to me--learning anything new helps keep you flexible. Assuming you choose to learn something relevant to you, it should help you in concrete ways. Learning technology keeps you close to the present, and the tools themselves provide ways to communicate, solve problems and stay part of the world. Which means I will probably have to learn how (and even why) to use Twitter...

The article goes on to say, "All participants completed a battery that included measures of demographic characteristics, self-rated health, experience with technology, attitudes toward computers, and component cognitive abilities. Findings indicate that the older adults were less likely than younger adults to use technology in general, computers, and the World Wide Web. The results also indicate that computer anxiety, fluid intelligence, and crystallized intelligence were important predictors of the use of technology. The relationship between age and adoption of technology was mediated by cognitive abilities, computer self-efficacy, and computer anxiety."

So, yes, it's tougher to stay on top of things as we get older. But it's obviously worth it. So, I'll give you about 30 seconds to feel good about yourselves.... ready? Now go teach someone else how to do what you have learned. Pass it on.

Seniors need more and better hugs

Years ago, experts said a person needed four hugs a day for optimum emotional and physical health. Today, some say 12 per day is ideal.

Helen Colton says a lot of Americans are too inhibited to be good huggers, or to hug at all. As evidence, she describes the popular “A-frame” stance, clasping only heads and chests when engaging in a hug.

She’s also critical of the “Baby Burp,” in which the person pats you as though you needed burping. Then there’s the “Chimpanzee,” an alternate flapping of the hands on the back, which is the custom of chimps. A person employing the “Drumbeat Tattoo” beats a rat-a-tat-tat on your back.

When someone hugs Colton in these ways, “His hand talk says to me, ‘I’m not comfortable doing this.’ But when a hugger presses his palms with fingers closed on my back or rubs his hands up and down caressing my back, this makes me feel good. It says, ‘I like you. . .’”

In her book, The Gift of Touch, she maintains that hugs and touches are crucial in childhood and remain important as the years go by, helping us enjoy life, improving communication, and making us feel better when we’re ill or feeling blue or grief-stricken. We all have a hunger for tactile contact with one another, and many people suffer from malnutrition of the senses, she says.

Some people remain discomfited by “the still-powerful Puritan heritage that taught us to equate touching with sexuality,” she adds. An incest taboo causes them to stop cuddling their children or other relatives. “The closeness most of us yearn for in family life is not sexual,” says Colton, a family counselor and teacher of family relations. 

As we age, our skin changes, our palms lose some of their sensitivity. “However, tactile needs do not seem to change with aging—if anything they seem to increase,” says Ashley Montague, an anthropologist and the author of Touching: The Human Significance of the Skin.

“Because we are unwilling to face the fact of aging, we behave as if it isn't there,” he says, and this a main reason we do not understand the needs of the aged.

Tactile stimulation is the most important and neglected of these needs, Montague says. “One only has to observe the responses of older people to a caress, an embrace, a hand pat or clasp, to appreciate how vitally necessary such experiences are for their well-being.” These actions sometimes make the difference between life and death, he believes.

Massage also can make a difference. Studies show that it speeds the healing of wounds, reduces pain and improves the functioning of the immune system. At the Miami Touch Institute, 28 people each received a 20-minute massage twice a week. They returned to work more alert and completed math problems in half the time with 50 percent fewer errors. 

Paraplegics can walk with new device

A wheelchair-bound Israeli inventor, Amit Goffer, has invented an exoskeleton that paraplegics can use to move about. His 44-pound ReWalk prototype enables users to walk, sit and climb or descend stairs with the help of crutches, according to a June 2009 Popular Science magazine article.

The inventor sought a safe design that was energy-efficient enough to last for a full day. This meant a choice that prevented him from using it, because he’s paralyzed from the chest down and unable to use the energy-saving crutches.

A wristband controller enables the user to select the action mode. He or she “plants one of the crutches and leans forward in the walk mode, for example, and a tilt sensor in the ReWalk’s shoulder harness registers the motion,” the article said. “A computer in a backpack interprets this data and instructs electric motors in the hip and knee of one leg to move it forward. Another plant of the crutches and another lean, and the motors on the side swing the second leg ahead.” The unit stops when the user stands up straight.

The inventor says his next version will weigh about 30 pounds.

A bit more on Aubrey de Grey

Some time back, a reporter from MIT Review paid Aubrey de Grey, the man who thinks he can defeat aging, at his home in Cambridge. The longish article that resulted from that visit is well worth a read and can be found here.

Mr. de Grey thinks that aging consists of lots of little breakdowns that accumulate over time and cause the body's mechanism to deteriorate. He is optimistic that addressing each individual breakdown can stop aging--he thinks like an engineer, not a visionary.

For now, here's a summary of how he thinks aging can be addressed.

"De Grey calls his program Strategies for Engineered Negligible Senescence, which permits him to say that it makes SENS to embark upon it. Here, in no particular order, follow his seven horsemen of death and the formulations for the breaking of each animal and its rider. (Those seeking more detailed information might wish to consult de Grey's website: www.gen.cam.ac.uk/sens/index.html.)

1. Loss and atrophy or degeneration of cells. This element of aging is particularly important in tissues where cells cannot replace themselves as they die, such as the heart and brain. De Grey would treat it primarily by the introduction of growth factors to stimulate cell division or by periodic transfusion of stem cells specifically engineered to replace the types that have been lost.

2. Accumulation of cells that are not wanted. These are (a) fat cells, which tend to proliferate and not only replace muscle but also lead to diabetes by diminishing the body's ability to respond to the pancreatic hormone insulin, and (b) cells that have become senescent, which accumulate in the cartilage of our joints. Receptors on the surface of such cells are susceptible to immune bodies that de Grey believes scientists will in time learn how to generate, or to other compounds that may make the cells destroy themselves without affecting others that do not have those distinctive receptors.

3. Mutations in chromosomes. The most damaging consequence of cell mutation is the development of cancer. The immortality of cancer cells is related to the behavior of the telomere, the caplike structure found on the end of every chromosome, which decreases in length each time the cell divides and therefore seems to be involved with the cell's mortality. If we could eliminate the gene that makes telomerase -- the enzyme that maintains and lengthens telomeres -- the cancer cell would die. De Grey's solution for this problem is to replace a person's stem cells every 10 or so years with ones engineered not to carry that gene.

4. Mutations in mitochondria. Mitochondria are the micromachines that produce energy for the cell's activities. They contain small amounts of DNA, which are particularly susceptible to mutations since they are not housed in the chromosomes of the nucleus. De Grey proposes copying the genes (of which there are 13) from the mitochondrial DNA and then putting those copies into the DNA of the nucleus, where they will be far safer from mutation-causing influences.

5. The accumulation of "junk" within the cell. The junk in question is a collection of complex material that results from the cell's breakdown of large molecules. Intracellular structures called lysosomes are the primary microchambers for such breakdown; the junk tends to collect in them, causing problems in the function of certain types of cells. Atherosclerosis, hardening of the arteries, is the biggest manifestation of these complications. To solve this difficulty, de Grey proposes to provide the lysosomes with genes to produce the extra enzymes required to digest the unwelcome material. The source of these genes will be certain soil bacteria, an innovation based on the observation that ground that contains buried animal flesh does not show accumulation of degraded junk.

6. The accumulation of "junk" outside the cell. The fluid in which all cells are bathed -- called extracellular fluid -- may come to contain aggregates of protein material that it is incapable of breaking down. The result is the formation of a substance called amyloid, which is the material found in the brains of people with Alz heimer's disease. To counter this, de Grey proposes vaccination with an as-yet undeveloped substance that might stimulate the immune system to produce cells to engulf and eat the offending material.

7. Cross-links in proteins outside the cell. The extracellular fluid contains many flexible protein molecules that exist unchanged for long periods of time, whose function is to give certain tissues such qualities as elasticity, transparence, or high tensile strength. Over a lifetime, occasional chemical reactions gradually affect these molecules in ways that change their physical and/or chemical qualities. Among these changes is the development of chemical bonds called cross-links between molecules that had previously moved independently of one another. The result is a loss of elasticity or a thickening of the involved tissue. If the tissue is the wall of an artery, for example, the loss of distensibility may lead to high blood pressure. De Grey's solution to this problem is to attempt to identify chemicals or enzymes capable of breaking cross-links without injuring anything else.

It must be obvious that, even condensed and simplified as they are here, these seven factors are enormously complex biological problems with even more complex proposed solutions. At least some of those solutions may prove inadequate, and others may be impossible to implement. Moreover, de Grey's descriptions are sprinkled with such vague phrases as "growth factors" and "stimulate the immune system," which might prove to be little more than slogans, as when he invokes yet-to-be-discovered "chemicals or enzymes capable of breaking cross-links without injuring anything else." In addition, it must be emphasized that researchers have not come close to solving a single one of the seven problems. In the case of several, there have been promising results. Indeed, research on extracellular cross-links has already yielded several drug candidates: a company called Alteon, in Parsippany, NY, has begun clinical trials of molecules that it says can reverse the effects of some conditions associated with age. In the cases of some of the other problems de Grey identifies, however -- such as the prevention of telomere lengthening or the transfer of mitochondrial DNA to the nucleus -- it is fair to say that molecular biologists can only speculate about the day, if ever, when these attempts will come to fruition."

How seniors can alleviate arthritis pain

You’ve read about the health benefits of Omega 3. Here’s one more, according to Dr. Andrew Wiel: it helps reduce pain caused by arthritis, he states in the July 2009 issue of Prevention magazine.

Some of the best Omega 3 sources include wild Alaska salmon and other coldwater fish, freshly ground flaxseed, Omega 3-fortified eggs, and walnuts. He also recommends seasoning meals as often as possible with ginger and turmeric. Try to eat up to nine fruits and vegetables a day.

You’ll benefit, too, by eliminating polyunsaturated vegetable oils (especially corn and soy oils) and partially hydrogenated oils found in much margarine, vegetable shortenings, and processed foods with fats that promote inflammation.

If you suffer from rheumatoid arthritis, Dr. Weil notes that people who switched to a vegetarian diet noted a modest improvement in joint swelling.