Prime Time: A New Look At Aging

Try these memory tune-up ideas

Sometimes Carol Channing would tell an audience at her nightclub act to ask her questions about her life. One woman asked, “Do you remember the most embarrassing moment you ever had?”

“Yes, I do,” Channing answered. “Next question?”

That sort of savoir-faire—without embarrassment—is what Edith Manley urges when, for example, you stroll in from the family room, open the refrigerator door and forget what you came for.

“So what if you lock your keys in the car,” she says. “Lots of 16-year-olds lock their keys in the car, too.”

Short-term memory loss is like turning gray, needing glasses or requiring a hearing aid. It’s all a part of the aging process, she says.

Nonetheless, it’s vexing, but you can try some techniques to reduce the number of times when someone telephones and asks, “Where are you?” and you experience that sinking feeling as you realize you forgot to meet a friend somewhere.

“Get organized,” Manley suggests. She keeps giant-size, washable, current month and next-month calendars on a wall in her home. She also uses the refrigerator door magnets for notes and a cork board panel in another room. “Use all the memory aids you can find,” she says.

Intoxication does not do a whole lot for the brain’s memory compartment. In addition to the befuddlement booze bestrews, the impact of prescribed or over-the-counter drugs can start you wondering what state you live in. Malnutrition, depression and the couch potato syndrome also take their toll, Manley says.

So if a friend or relative becomes forgetful, “Don’t automatically conclude he or she is out of it,” she says. Check the person’s medication, her isolation, his eating habits.

While in New York, the actor James Cagney saw a man across the steet. “You see that fellow over there?” Cagney asked his wife. “He sat next to me in school. His name is Nathan Skidelsky. Though proud of her husband’s incredible memory, Mrs. Cagney replied, “Prove it.” Cagney went over and said hello. It really was Nathan Skidelsky. But he didn’t remember Jimmy Cagney.

A cause for celebrating is a memory category called “meaning association.” Why? It translates into wisdom, Manley says. All types of cultures going back to prehistoric times revered their elders because their wisdom guided, even rejuvenated the tribe or the community. But somehow that didn’t create a feeling of deja vu. Not in the U.S. of A.

 

Generous grandparents providing stimulus

Nearly two-thirds of the grandparents in the U.S. have given money to their grandchildren in the last five years. The average amount provided was $8,661, for a grand total of about $370.7 billion.

The financial support was discovered in a MetLife Mature Market Institute survey announced on July 14. Forty percent of the grandparents’ gifts covered general purposes and 26 percent went toward education. One out of four of the elders said they’d increased their giving to grandchildren because of the economic downturn.

“Grandparents prefer to help their children and grandchildren while they are alive, rather than leaving a lump sum in a will. . .” according to the institute’s 2009 Grandparents Poll.

Which brings to mind the axiom: The reason grandparents get along so well with grandchildren is they have a common enemy.

Another MetLife finding revealed that the grandparents with less income and net worth are giving a higher percentage than they did before the economy tanked. “And some of them are feeling the pinch, with more than one in five reporting that their generosity has had a negative impact on their own financial picture,” the survey report said.

The grandparents “clearly want to make sure their grandchildren are financially secure, [but] only a small percentage of those polled said they have talked to their grandchildren about the importance of hard work, saving for a rainy day, and intelligent use of credit,” said Sandra Timmermann, institute director.  Most of the ones who do offer advice suggest saving and investing early, and staying out of debt.

It’s possible that the reticent ones remember Harry Truman’s philosophy. “I have found the best way to give advice to your children is to find out what they want and then advise them to do it,” he said.

 

How technology can help with Alzheimer's disease

While we're waiting for Part 2 of Ted's story, let's see what technology has to offer regarding Alzheimer's Disease.

The first technology patent for dealing with Alzheimer's was filed in 1976, and it has been followed by more than 67,000 patents since then. A lot of time and attention is paid to this issue. More general research into the nature of prions (when prions malfunction it is thought to be either a cause or an effect of Alzheimer's) is also intense and ongoing. But it hasn't resulted in a cure, a vaccine or even too much in the way of effective therapies. One could come forward any moment, and I hope it does.

But existing technology can help both patients and caregivers:

"Innovative uses of high technology offer many exciting possibilities for earlier diagnosis, better care and improved quality of life for people with Alzheimer's and their family members", stated Maria Carrillo, PhD, director of Medical and Scientific Relations at the Alzheimer's Association. "We now are discovering ways to use available advanced technologies to save health care costs, ease caregiver stress, and help people with Alzheimer's live better, safer, more fulfilling lives."

"Most of the methods for diagnosis, treatment and care for Alzheimer's are based on techniques developed decades ago", stated Jeffrey Kaye, MD, chair of the Alzheimer's Association's Working Group on Technology (WGT). "We need to facilitate technology-based research and application in Alzheimer's, and bring the field up to date."

According to Dr. Kaye, who is professor of neurology and biomedical engineering at the Oregon Health and Science University (OHSU) School of Medicine in Portland, and director of the Oregon Center for Aging and Technology, a wide array of new technologies and methods for assessing and treating patients and helping families is emerging that take advantage of rapid developments in communications and monitoring technologies, such as biosensors and bodily diagnostics, activity sensors and behavioural diagnostics, displays, robotics and assistive devices.

Identifying memory and movement changes that are early signs of Alzheimer's may allow elders and their families to be pro-active about seeking diagnosis, initiating therapies and planning for the life changes that accompany the disease. Tamara Hayes, PhD, of OHSU, and colleagues focused their research on using unobtrusive technologies to monitor those changes in the home in a study called "A Novel Marker of Mild Cognitive Impairment" and funded by NIA/NIH.

Small motion sensors were used to continuously measure walking speed and overall activity in the home of seven healthy seniors and seven with mild cognitive impairment (MCI) for up to 60 consecutive weeks. The volunteers were not required to do anything except go about their daily business. Walking speed was estimated using sensors along a hall in each home.

The researchers found that the MCI participants had longer walking times than the healthy elderly group. Furthermore, the elders with MCI had more variability in their activity during the day, as compared to the healthy elders. These results are consistent with clinic-based studies of motor changes preceding dementia. However, unlike clinic-based studies in which the differences were identified using measures taken over many years, these differences were detectable in the home using unobtrusive assessment techniques after only four weeks of monitoring.

"Continuous assessment of key thinking, memory and movement skills provides an opportunity to identify early signs of impairment", Dr. Hayes stated. "This study provides the first indication of how continuous, unobtrusive monitoring may be used to assess clinically relevant motor behaviours that relate to cognitive change."

Maintaining cognitive performance is a key factor influencing elders' ability to live independently with a high quality of life. Taking advantage of growing use of computers by seniors, Holly Jimison, PhD, and colleagues from OHSU and Spry Learning Company have developed computer games that can monitor cognitive performance on a routine basis at home.

Glenn Smith, PhD, and colleagues from the Mayo Clinic-Rochester, Minnesota, observed that 30 to 40 percent of people with Alzheimer's are living alone at the time they are diagnosed. Dementia can impair a person's ability to properly take their medicine - known as "compliance" - and this issue regularly plays an important part in the decision to move patients to a residential care setting.

Dr. Smith's team investigated whether interactive video monitoring for persons with mild dementia who live alone, or who spend a significant amount of their day alone, could improve their ability to take medicine correctly and improve their mood in a study called "Telehealth Home Monitoring of Solitary Persons with Mild Dementia", funded by the Mayo Foundation, Minnesota Department of Human Services.

The researchers used two-way interactive video technology to provide virtual supervision of 12 patients with mild dementia. They contacted the participants each time they were to take their medications or have their meals. During the two-year study, more than 4000 contacts were made. Once per month, an independent evaluator went into the home to assess whether the patient had taken the appropriate amount of medication. The scientists compared their findings with 12 other participants who received no video monitoring.

In the video-monitored group, people took their medication correctly 81 percent of the time compared to 66 percent in the control group. Comparison of compliance from beginning of monitoring to the end of the programme revealed that video-monitored participants' compliance remained stable while unmonitored patients' compliance fell 12 percentage points, which is consistent with expectations for people with dementia.

Know the warning signs of Alzheimer's

For eleven years Jacqueline Marcell, then a television executive, pleaded with her elderly father to allow a caregiver to help him with her ailing mother, but after 55 years of loving each other he adamantly insisted on caring for her himself. Every caregiver Marcell hired eventually quit. “Jacqueline, I just can't work with your father,” one of them said. “His temper is impossible to handle. I don't think he’ll accept help until he's on his knees himself.”

When Marcell’s mother nearly died from an infection caused by her father’s inability to continue to care for her, Marcell flew from southern California to San Francisco to try to save her mother’s life, having no idea that in the process it would nearly end her own.

“I spent three months nursing my 82-pound mother back to relative health, while my father said he loved me one minute, but then he’d call me nasty names and throw me out of the house the next,” she says. “I was stunned to see him get so upset. Even running the washing machine could cause a tizzy and there was no way to reason with him. It was so heart wrenching to have my once-adoring father turn against me.”

But at the doctor’s office her father acted normal. “I couldn’t believe it when the doctor looked at me as if I was the crazy one,” Marcell says. The doctor didn’t even take her seriously when she reported that her father nearly electrocuted her mother. Luckily Marcell walked in three seconds before he plugged in a power strip that was soaking in a tub of water—along with her mother’s feet. “Later, I was furious to find out my father had instructed his doctor not to listen to anything I said, because I was just a liar and all I wanted was his money!” 

Marcell says her father had never laid a hand on her, but one day nearly choked her to death for adding HBO to his television, even though he had eagerly consented to it a few days before. “Terrified, I dialed 911 for the first time in my life and the police took him to the hospital for evaluation. I was so shocked when they released him right away, saying they couldn't find anything wrong with him. What’s even more astonishing is that similar incidents occurred three more times.”

Marcell refers to her situation as a Caregiver Catch 22. “I was trapped. I couldn't leave my mother alone with my father—she’d surely die from his inability to care for her. I couldn't get healthcare professionals to believe me. My father was always so darling and sane in front of them. I couldn't get medication to calm him, and even when I finally did, he refused to take it, threw it in my face, or flushed it down the toilet. Even when I found a caregiver, no one would put up with him very long. I couldn't place my mother in a nursing home—he’d just take her out. I couldn't put him in a home—he didn't qualify. They both refused assisted living.  Legally I couldn't force them. I became a prisoner in my parents' home for nearly a year trying to solve crisis after crisis, crying rivers daily, and infuriated with an unsympathetic medical system that wasn't helping me appropriately.” 

Part 2 of this story will appear tomorrow.

Roundup of interesting technology developments Part 2

We send you off to your weekend fun with more information about technology for seniors:

"GeckoSystems Intl. Corp.  announced today that they expect pent-up demand for their cost effective, home based eldercare personal robots. This new type of modern eldercare will postpone, if not eliminate, many elderly persons from having to endure the loneliness and loss of independence when living in nursing homes, and other assisted living facilities. Their families can now better manage the difficult decisions regarding independence they allow their now dependent aged parent while minimizing the concern and risk the adult caregiving child is willing to assume to enable an acceptable level of independence for their now dependent parent. GeckoSystems is a dynamic leader in the emerging Mobile Service Robot industry revolutionizing their development and usage with "Mobile Robot Solutions for Safety, Security and Service™."

"For the last several years, the US eldercare crisis is commonly portrayed as 'not happening' until the baby boomers reach the age of great reliance on their children and younger family members. The truth of the matter, since the US is the only country in the top ten of the world's industrialized nations without national healthcare, is that we really don't have solid statistics for our true 'bottom line' annual US eldercare costs. Many middle class baby boomers are presently suffering significant financial, time and emotional pressures attempting to care for their surviving WWII and Korean War era parents," observed Martin Spencer, President/CEO, GeckoSystems.

Not coincidentally, Gecko estimates the market for multi-tasking eldercare robots to reach $80 billion by 2013... I love the profit motive and hope they get rich helping seniors...

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And maybe tekkies will turn all seniors into die-hard video gamers: "WHEN Pip Carter and the team at St Andrew’s in Ballina developed a new interactive technology at the nursing home, they were only thinking of the benefits if would give to residents who aren’t able to leave their beds.

But the system, in which a video camera and other technology similar including an Xbox is used to relay events like church services and activites like bingo – with the residents being also able to join in by phone – has gained interest internationally."

"“Imagine the feeling of being a resident bed-bound and not being able to become involved in activities being carried out throughout the facility or being able to be part of church services which meet your spiritual needs in the later years of your life,” he wrote in the abstract submitted to the conference organisers.

“Advanced technology in care and assisted living will address many issues of isolation and inclusiveness and feeling part of a community again.”

He said technology in the past 50 years has become a fundamental part of our lifestyle.

“It is essential that organisations grow and develop new technologies for the very purpose of allowing people to once again feel alive and make life worth living,” he wrote.

He said he believed St Andrew’s is the first home of its size to use this kind of technology, which had a set-up cost of about $4000."

Roundup of interesting technology developments

One of the drugs used in suppressing immune reactions associated with transplants has proven to have another use--extending lifespan in mice. As noted in Discover,  "Laboratory mice who were given an immunosuppresant drug called rapamycin lived between 9 and 14 percent longer than mice who didn’t take the drug, according to a study in Nature. The drug, which was developed from bacteria found in Easter Island’s dirt, is the first pharmacological agent shown to enhance longevity in a mammal [Technology Review]. Even more remarkable, the mice weren’t given the drug until late middle age, showing rapamycin had effects even when taken later in life."

This contest in June passed unnoticed--entrepreneurs competed for a $10,000 prize for new products and services to help seniors: "The aging "have unmet needs that might be passed over by inventors," said Ruley Peh co-founder of the company that is based at Stanford University. "We're bringing technology to places and people where we think we can make a difference."

"Startups that target the aging are getting better, said Mary Furlong, a consultant and Santa Clara University business professor who started the competition - called the Silicon Valley Boomer Venture Summit - five years ago. Data about aging are improving, too.

Yet most businesses are still slow to the market, preferring instead to chase youth even though many Boomers try to defy their inevitable physical deterioration by living active lives."

"Other finalists for this year's $10,000 prize included companies that have improved hearing aids, chemotherapy, abdominal surgery and treatment for infections.

There were also five finalists for a $1,000 elevator-pitch prize, several revolving around technology to help seniors stay in touch with family, cut costs or find the best health care when they retire to foreign countries.

The winner, Live at Home Longer, has technology to help seniors stay independent."

Bringing live theater to seniors

Most of the students in Sharon Redman’s Concord, Calif., acting class early in 2005 were in the 55-plus category. “I thought these talented people could perform a play at the senior center,” she says.

From that modest idea has blossomed a nonprofit traveling group called The Vagabond Players made up of three dozen or so older adults. They perform four or five plays per year for mostly senior audiences in central Contra Costa County assisted living and retirement facilities, churches, clubs, and senior centers. Earlier this year, the troupe became the resident theater company for El Campanil Theatre in Antioch.

“During my acting days, I’d hear older actors at auditions lamenting that there were never enough roles for them, or that the plays weren’t appropriate for seniors,” says Redman. “I became convinced that a need existed for something like The Vagabond Players.”

Her acting class members confirmed these views when she proposed that they perform Robert McEnroe’s comedy, The Silver Whistle, at the Concord Senior Center. Activity directors at other places where seniors gather heard about the production and asked to be included.

Redman’s choices for follow-up plays that appeal to seniors included Arsenic and Old Lace, Social Security, and the troupe’s first musical, Funny, You Don’t Look Like a Grandmother. She is also the director of the El Campanil Children's Theatre, so it seemed a natural choice this summer to produce The Sound of Music.

The Vagabond Players members each pay $25 a year to belong. At the outset, they made donations, provided their own costumes, and persuaded friends to help. Redman’s generosity, plus modest donations from the facilities that host performances, also helped cover some of the initial expenses and royalties. Soon after obtaining nonprofit status, the group received grants from the Thomas J. Long and Dean and Margaret Lesher foundations.

Audiences relish the in-house performances. “We really appreciate your group bringing live theatre to our community,” said Donna Searfus, activity director of Stoneman Village in Pittsburg. “Some folks here hadn’t seen a live production in years, and for some this was their first experience.”

Redman’s motto is “It’s never too late.” She returned to college at the age of 56, began directing and performing a year later. In 2004, three theatre companies nominated her for Shellie Awards for her directing—a first in the 27 years since the Shellies began.

“My award is seeing nominations and awards for actors who have been in my plays,” she says.

How could technology help senior theater?

Using what is commonly called Web 2.0 tools (which are free or very low cost ways for non-professionals to communicate with each other), what could we build to help further the senior theater movement Ted wrote about directly below?

A weblog such as this one could keep tabs on what's going on.

New video cameras could record productions and even rehearsals, and post them on the Internet, using a site such as YouTube.

The Internet makes searching for government grants much easier--but where it might help even more is by sharing the results of those searches, again using a weblog.

A 'marketplace' where venues and theater groups could get in touch with each other is another natural for the Internet.

And of course, email lists can be used to remind prospective audience members of what's going on.

Ted and I could be persuaded to help...

Senior theater movement expands

When she first began counting in 1999, Bonnie Vorenberg found 79 senior theater groups operating in the U.S.  Today, the president of ArtAge Publications has tallied 768.

They range from amateur to professional, and some are independent while others are sponsored by senior centers, educational institutions, community theaters, and retirement communities. 

The most popular forms are readers theater and script-in-hand productions, Vorenberg says. “These help performers leap over the memorization hurdle.” Short plays are popular because actors have fewer lines to memorize and cast substitutions become easier. Also, the royalties cost less.

Some groups focus on educating audiences with issue-oriented plays dealing with aging awareness, Medicare, falls, relationships, conflicts with children, and health. Another popular approach is the use of the seniors’ own stories to create life histories. 

“The field is growing, but the present economic problems seem to be having an impact,” Vorenberg says. “There’s more competition for donations, and some people are going back to work.”

One helpful element in obtaining grants is a study by Dr. Gene Cohen of George Washington University. He discovered that “Active participation in the arts promoted mental and physical health” of mature adults. Older artists reported fewer doctor visits, lower levels of loneliness, higher morale, and better vision than non-participating counterparts.

New York’s Dorot University runs a program for home-bound seniors. Each week they link on a conference call to read plays. The drama experience helps participants form supportive, lasting friendships. In another innovative approach, a travel agency specializes in senior theater trips to New York, London and Chicago. 

Vorenberg’s directory of groups called Senior Theatre Connections includes this comment: “Why does senior theater work? Performers benefit, taxpayers see their money put to good use, and the younger generation suddenly has an emotional way to reconnect with their elders.”

Her web site www.seniortheatre.com lists 40 new plays and two collections tailored for older performers.

A prime time for seniors

If you or someone you love is over the age of 74, there is enough going on to keep you all very busy. New technology is rolling out and being tried. New clinical trials are occurring frequently to deal with a variety of serious diseases. Governments the world over are trying to find new wasy of accommodating the growing number of seniors.

Seniors (and their caretakers) who are pragmatic, pay attention to details and who understand that in times of great change there are winners and losers, will make sure their needs are met.

Seniors (and their caretakers) who believe the system will come to them in an inclusive movement to help them are liable to be disappointed--and disadvantaged. That strategy was probably correct--and more moral--during the past 50 years. But now it is time to claim what is yours by right.

In most cases, this will not mean you are taking something away from another deserving senior. It will mean you are getting what otherwise will not be used at all.

This difference in attitude may be more important that any of the technology toys I keep throwing in front of you. So get out there and get what you need.