Education As Preventative Medicine

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I always enjoy “meeting” someone on the internet who seems to hold the same views that I do and just recently, I came across an interesting article, Lifelong Learning and Wellness One Component to the Enlightened Gerosphere, in which the author, Paul David Nussbaum, Ph.D., Director, Neurobehavioral Services at St. John Center in Mars, Pennsylvania, put forth the suggestion that just as exercise and healthy eating are preventative, education can be a means of avoiding the dreaded Alzheimer’s.  As he writes:

Imagine an America where health insurance companies paid for attendance at church or synagogue, enrollment in higher education, residence within technologically advanced homes (smart homes) which can relay health information directly to the primary care physician, and even sustained employment. This approach to wellness stands in sharp contrast to the current model that incentivizes annual, invasive procedures such as a pap smear. While these ideas may render a humorous response, we must remember that the total dollar allocation for health care in this country is approximately one trillion dollars, and that one third (33%), or 300 billion dollars, of that total cost is for services delivered to the older adult. Despite this, Medicare and Medicaid are financially unstable. Imagine running a business in which you invest 300 billion dollars and yet the business is bankrupt! Perhaps we are not approaching the care of older Americans in a proper manner!”

I totally agree with Dr. Nussbaum’s assessment that nursing homes are not an answer, as I have written in previous posts, but because he writes it so eloquently, I will share what he writes:

Older Americans do not need high technology medicine, should not be treated in acute care centers as they suffer chronic illness, should not be forced to choose a nursing home, and should not be forced to retire or withdraw from a personal role and purpose. Instead, older Americans should have access to geriatricians who are afforded the same status of primary care physician as are pediatricians, should have access to a chronic care system, should be afforded multiple long term care options which do not include institutionalization and consequent family/financial death. Further, older Americans should be incentivized (financially) to remain well by promoting the social/human factors of health listed above.

I have championed the need to end the existence of nursing homes in the United States as I believe they represent the neglect of a great country to care for a vulnerable and needy segment of our population. Nursing and other services can be delivered without the cement walls of an institution. Nursing homes were built post-World War II and represented a warehousing model of care. Think about where nursing homes are located and you can understand the resulting removal of individuals from the vitality of life. My beliefs have nothing to do with the quality care and hard work that occurs every day in most of our nursing homes. In contrast, the United States must awaken to the fact that nearly one third of Americans would rather die than enter a nursing home, and the market has demonstrated consistently that potential employees seek work elsewhere— human beings do not want to live or work in nursing homes!

Again, Dr. Nussbaum so nicely summarizes the reality of aging in our society today:

Today, the United States has an extremely primitive understanding of aging. Our country maintains a negative perception about getting older, one that reflects a genuine misunderstanding of the facts regarding aging. For example, our entire social and legislative policy is based on an invalid age-threshold of 65. Clearly, we need to increase this age-threshold to reflect more accurately the expected lifespan of Americans. Most people are not aware that age 65 was employed for social benefits by Chancellor Bismarck in Germany over 100 years ago.  Americans believe that advanced age leads to poverty, illness, Alzheimer’s disease, nursing home placement, depression, and loneliness. These entrenched perceptions exist despite facts that nearly 70% of older adults (those living beyond 65) are independent, financially stable, happy, healthy, and productive. Further, the vast majority of older Americans do not have Alzheimer’s and do not live in nursing homes.

So my blog is entitled “education as preventative medicine”  Where does this part of the article begin.  Right here!  Dr. Nussbaum states that

Fortunately, researchers interested in neurodegenerative disorders such as Alzheimer’s disease (AD) which affects four million Americans, and costs the country 100 billion dollars annually in direct care and 30 billion dollars in indirect care related to caregiver illness, have underscored the importance of education as a potential preventative factor against AD. Multiple studies have demonstrated a reduced risk of AD for those with advanced education. The neurobiological explanation of this has been labeled Reserve Theory. Essentially, information which is learned must be processed by our brains, itself a physiological event. Such learning promotes development of new neurons and neural pathways. The theory advances that with increased cell density and cell volume, a progressive disease such as AD will not impact the brain or will impact the brain at a later age because the disease will have to destroy a greater number of cells to manifest clinically. The increased volume of cells in the brain provide a reserve to fight off invading diseases such as AD. Interestingly, the Reserve Theory has been advanced for other etiologies of dementia besides AD.

Although there is more in Dr. Nussbaum’s article on studies demonstrating more proof, I would refer the reader’s to his article, as I have reached my word quota for this particular blog.  Thank you, Dr. Nussbaum.

Copyright Yvonne Behrens 2014

 

 

 

 

 

Do Economics Influence Attitudes Towards Aging?

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I have been working on a power point presentation entitled “One Size Does Not Fit All.”  The presentation will focus on how the cultural  mores of the aging population in our country are beginning to influence how we, as a culture, need to respond.

While doing research on this project, I am finding some very interesting studies.  One in particular struck a chord:  How economics influences our attitude towards aging.

Early studies which focused on socioeconomic predictors found that higher levels of economic development and industrialization are associated with less favorable attitudes towards aging and a lower societal status of older adults (e.g., Simmons, 1945Arnhoff, et al., 1964Maxwell, 1970Bengtson, Dowd, Smith, & Inkeles, 1975Palmore & Manton, 1974).

Why would this be?  Well, first off, the more money there is, the easier it is to “put an elderly away.”   In this country, retirement communities have sprung up all over and have, in fact, become an accepted part of the aging process.  This, in turn, means that grandchildren do not have a lot of opportunities to spend with their grandparents.  If the grandparent is not a regular part of the child’s environment, what sort of rapport can develop between the two individuals?  The less youth has an opportunity to interact with older citizens, the more likely they will develop a disdain for the apparent fogginess they encounter and even the inability to close the cultural gap that naturally exists between the energy of youth and the less energetic elder.

On the other hand, if a child grows up with [a] grandparent(s) in which the grandparent(s) [is] a very dynamic part of their world, their attitude will be very different.  There will be a bond.  There will be a sense of love.  They will actually see that Grandma or Grandpa has many sides to their personality.  They might even have the opportunity to see how grandma or grandpa change as they age and recognize that this is the natural order of things.

In turn, if the grandparent(s) [is] in a retirement community and the family visits them once a week, usually on a Sunday after church or brunch and the kid is in a strange environment, still in his/her church clothes witnessing a forced situation of having to make conversation, how much relating can really occur?  Most children don’t think to ask their grandparent what their life was like when they were younger.  So they sit there, feeling awkward in front of a virtually old stranger, just waiting for the moment when they can get up to leave to go home.

(Cowgill, 19721986) argues that industrialization has undermined the societal status of older adults and with the break up of the traditional extended family through urbanization, has shifted the value of the elder’s means of production and experienced based knowledge to a much lower rung.  Although in some circles, modernization theory is considered an oversimplification, I find that there is enough within the studies that validate the argument that modernization has had a negative influence in society’s general attitude towards its aging population.

In a study done by Corinna E. Löckenhoff, National Institute on Aging, Baltimore, USA, the researchers approached their study with the following predictions:

In general, we predicted that perceptions about aspects of aging that are strongly linked to biological changes (i.e., physical aging and changes in fluid cognitive abilities) would show less variation across cultures and fewer associations with culture-level variables than perceptions of socioemotional aspects of aging (e.g., family relations and life satisfaction) and societal views of the aging process. For culture-level associations with socioeconomic characteristics, we expected to replicate previous research indicating that advanced development is associated with less favorable perceptions of aging.

Their findings confirmed this.  Utilizing Dutch Sociologist, Geert Hofstede’s value dimensions:

participants from cultures with greater Uncertainty Avoidance* reported more negative societal views of aging. Uncertainty Avoidance was also associated with less favorable expectations about age-related changes in family authority and life satisfaction. Further, participants from cultures higher in Power Distance** reported less favorable views of age-related changes in knowledge and wisdom.

Although this is a large topic of which only a small piece is reviewed in this blog entry, it just is another indication of how we need to re-think aging and bring it back as part of the mix.

 

* the concept of Uncertainty Avoidance deals with a society’s tolerance of ambiguity and uncertainty.  The more structured a society is, ie, Germany, the less comfortable its citizenry is with ambiguity.

** Power Distance refers to how those individuals who are less powerful within an entity (whether a society or a family) accept and expect inequality in the power structure with which they find themselves.

 

 

 

 

 

 

Boomers, The Plastic Fantastic Generation

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As a boomer, I am part of the generation that implemented the “turn on, tune in, drop out” approach to life.  There seemed to be a major rejection of what existed before.  In fact, there was a social revolution of sorts, and not just in the United States, but on a global level.  We believed we were a turning point in the way things were done.  We were the future and the future was not going to look anything like the past.  Yet it turns out that most of us did not end up changing anything at all, at least in one area that we had purported to reject: consumerism.  In fact, our generation has done more to increase the strength of the consumer society than any previous generation before us.

Ironically,

….baby boomers are the wealthiest generation in U.S. history, both earning and consuming more than any other age group.12• Baby boomers have amassed $3.7 trillion in total earnings, as compared to the $1.6 trillion generated by the preceding generation.

How can that be?  Weren’t we the ones who recognized that materialism could not give us the true nourishment of spiritual and emotional needs?  Yet, our generation has been the most workaholic generation ever.  We have seen more wars fought during our existence than there ever have been fought before.  We have watched as the use of automobiles and the means by which they operate, fossil fuels, have increased to an amount unimaginable forty years ago.  It has been during our lifetime that the concept of time has narrowed into practical non-existence.  And, although our energy levels seem higher than those of previous generations, our health may not necessarily be better.  In the end, it has been during our lifetime that materialism has become so ensconced that we take for granted running to a store to purchase something we need, two or three times a day, having electricity at the click of a switch, and pretty much anything we want secured through paper money or a plastic card.

Now I am not advocating that our childish approach to rejecting the previous generation’s world was to be commended.  But there were some good things that did come out of “the movement.”  And since there are always two sides to a coin, let’s look at those.  The advancements that have occurred in this period of time have catapulted us into a world our great-grandparents would not be able to recognize.  Social sensitivities and environmental sensitivities increased.  Discrimination decreased.  But again because there are two sides to the coin of life, it seems as though the tolls that our advancements have taken on the environment are unprecedented.  Communication abilities are at a level we could not have imagined twenty years ago and our ties around the world make cultures that once were considered foreign, our neighbors.  Advancements in Science continue apace.  We are re-defining the aging process, or at least pushing it back by a good dozen years.  And hopefully, we will come up with a way to maintain our earth and all her gifts to us before we destroy her and thereby ourselves.

But with regard to consumerism, I still don’t understand how we ended up taking a left turn instead of the right turn we thought we were taking…..

 

Aging and Single: A Trend in the U.S.

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The boomers are all over the map when it comes to marriage, divorce, grandparenting, new parenting, gay parenting, adoptaparenting.  But one trend that seems to be growing by virtue of divorce is the aging single person.  I personally do not understand this trend.  Having just entered the world of “widowhood” choosing to go it alone is something I have a hard time grokking.  I do understand that there are all sorts of reasons why people separate.  But I also wonder, whether in our throw-away society, many of these separations might occur without long-term thought about consequences.  For example,  are people afraid that they will end up as caregivers?  My question then becomes: who is going to take care of them when they can no longer take care of themselves?

According to an article written by for The New York Times,

Over the past 20 years, the divorce rate among baby boomers has surged by more than 50 percent, even as divorce rates over all have stabilized nationally. At the same time, more adults are remaining single. The shift is changing the traditional portrait of older Americans: About a third of adults ages 46 through 64 were divorced, separated or had never been married in 2010, compared with 13 percent in 1970, according to an analysis of recently released census data conducted by demographers at Bowling Green State University, in Ohio.

At some point, I think that we will have to recognize that we need to work together.  The fraying and continual fraying of relationships in, at least the United States, as exemplified with the above statistics, not to mention our political system, has got to reverse itself.  Our good friend William H. Frey, demographer at the Brookings Institution states:

that many unmarried baby boomers will confront greater economic hardships than their married parents and grandparents, and their married counterparts. Many members of this generation, which has been battered by the recession, have fewer children and thinner financial cushions in savings and pensions.

Susan L. Brown, co-director of the National Center for Family & Marriage Research at Bowling Green State, said the trend would transform the lives of many older people.

The elderly, who have traditionally relied on spouses for their care, will increasingly struggle to fend for themselves. And federal and local governments will have to shoulder much of the cost of their care. Unmarried baby boomers are five times more likely to live in poverty than their married counterparts, statistics show. They are also three times as likely to receive food stamps, public assistance or disability payments.

I am sure there are many single people that these statistics do not reflect.  However, with these realities looming, we are really going to have to work to come up with a viable alternative to aging in marriage as well as aging alone.  Marriage is not easy to maintain.  And with all the distractions keeping us from each other, ie, television, computers, etc.,  it is easy to believe that one is no longer living with someone one feels connected to.  On the other hand, if one once felt love for that person, there might still be something there worth cultivating and helping to grow.

For many, having financial independence is also a determinant as to whether a person remains in a relationship.  However, when we use that as the criteria, we may be making a big mistake in deciding to go it alone, unless, of course, we made poor choices to start.  Yet, I can’t help but reflect that the “idea” of having the freedom to determine your own schedule may seem worth the separation, that freedom is short lived; particularly if one is in their ’50′s when they decide to seek that freedom because anything can happen in a moment to make one become totally dependent on somebody else and this time it could be a total stranger — a stranger who will only care for you until the money runs out rather than an intimate who will take care of you out of love or obligation or both.  And yes, I know, these are generalities and life is nuanced.  And the reality is still that people are going it alone either by choice or by circumstances.  So that is why I am suggesting that we put our heads together and figure out a way not to grow old alone.

© Yvonne Behrens

“The Choice to Die or Live Life as a Ghost”

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Michael Wolff of the New York Magazine wrote an article called “A Life Worth Ending.”   His topic?  The approach that our modern society takes towards aging and death.   His focus?  His personal journey dealing with the healthcare system and his mother.

His ability, through his choice of words, to bring the topic front and center is as rich as the questions he poses in the topic he explores.  For example, read how he describes aging in our affluent society, in which death has become the ultimate frontier to tame and subjugate:

Age is one of the great modern adventures, a technological marvel—we’re given several more youthful-ish decades if we take care of ourselves. Almost nobody, at least openly, sees this for its ultimate, dismaying, unintended consequence: [emphasis added] By promoting longevity and technologically inhibiting death, we have created a new biological status held by an ever-growing part of the nation, a no-exit state that persists longer and longer, one that is nearly as remote from life as death, but which, unlike death, requires vast service, indentured servitude really, and resources.  ……

This is not anomalous; this is the norm.

Mr. Wolff writes of the irony that:

The longer you live the longer it will take to die. The better you have lived the worse you may die. The healthier you are—through careful diet, diligent exercise, and attentive medical scrutiny—the harder it is to die. Part of the advance in life expectancy is that we have technologically inhibited the ultimate event. We have fought natural causes to almost a draw. If you eliminate smokers, drinkers, other substance abusers, the obese, and the fatally ill, you are left with a rapidly growing demographic segment peculiarly resistant to death’s appointment—though far, far, far from healthy.

Seventy percent of those older than 80 have a chronic disability, according to one study; 53 percent in this group have at least one severe disability; and 36 percent have moderate to severe cognitive impairments; you definitely don’t want to know what’s considered to be a moderate impairment.

Phew!  What have we done?  How did we go from acknowledging that death is a part of life and there is no way around it to believing that if we only do……then we will live longer and, hey, don’t we want to do that?  Sure, we all clutch at the idea of dying.  It is inherent to our nature.   Moving into an unknown is scary and death is the biggest unknown.  But does that warrant doing everything, at any cost to avoid it?  It really does seem that by doing everything to avoid it, we actually have created a nightmarish extension that includes all sorts of physical and mental break downs and more and more frequent visits to the hospital.

In Mr. Wolff’s case, his mother started to decline physically and mentally sometime in her ’80′s.  As Mr. Wolff found out:

There is a precept here, which no doctor quite spells out: Once it has begun, it has begun; decline follows decline; incident precedes incident. Here’s the medical language: “A decrement in capacity occurs.”

The system has been created that encourages families to follow one course of action after another to delay the eventuality that this “decrement in capacity” will ultimately lead.  And so we are creating a citizenry of individuals who have no quality of life but live on because the natural breakdown of body and/or mind is delayed with round the clock attention (at unbelievable costs).  Pharmaceuticals intervene to prevent the stroke or the heart attack or the pneumonia that might otherwise allow a person who has entered into a state of decremental capacity to leave this world with some dignity.

I lived this with my mother-in-law, a brilliant, vivacious human being who at the age of 93 started to develop memory loss.

Focusing back on Mr. Wolff’s reflections:

From a young and healthy perspective, we tend to look at dementia as merely ­Alzheimer’s—a cancerlike bullet, an unfortunate genetic fate, which, with luck, we’ll avoid. In fact, Alzheimer’s is just one form—not, as it happens, my mother’s—of the ­ever-more-encompassing conditions of cognitive collapse that are the partners and the price of longevity.

There are now more than 5 million demented Americans. By 2050, upward of 15 million of us will have lost our minds.
Speaking of price: This year, the costs of dementia care will be $200 billion. By 2050, $1 trillion.

That is the thing that you begin to terrifyingly appreciate: Dementia is not absence; it is not a nonstate; it actually could be a condition of more rather than less feeling, one that, with its lack of clarity and logic, must be a kind of constant nightmare.

As Mr. Wolff and his family chose to do, so did my husband and I: We put my mother-in-law in a very homey like assisted living facility just before her 95th birthday.  The first year was actually quite good.  The local owners very much wanted to create a home-like environment.  But then they decided to expand which adversely affected their original home.  And like Mr. Wolff, we also learned:

That assistance in an assisted-living facility, even as you increase it and pay more for it, is really not much more than kind words and attendance, opened doors, a bit of laundry, and your medications delivered to you. If there is a need for real assistance of almost any kind that involves any sort of calibration of concern, of dealing with the real complications and existential issues of aging people, then 911 is invariably called. This is quite a brilliant business model: All responsibility and liability is posthaste shifted to public emergency services and the health-care system.

The rate of hospitalization for all other age groups is declining or holding steady, but for people over 65 it’s skyrocketed. The elderly use 50 percent of all hospital days, according to one study. Emergency rooms, …. the land of the elderly, and their first step into the hospital system—where, as Medscape matter-of-factly explains, the “inability to recognize normal aging changes … raises the chances of iatrogenic illness.” Iatrogenic illnesses being the ones caused by hospitals or doctors.

In Minkie’s case, she developed pneumonia while in the assisted living facility.  In the old days, before immediate intervention and antibiotics, she probably would have died peacefully and the horror of her memory loss would not have plagued us for another six years.  But in our modern society, off to the hospital she went, tubes and catheter inserted (I was told this was done automatically because nurses did not have time to take elderly patients to the bathroom every time they needed to go.  Of course, the consequences of stretching the muscles by inserting a catheter — itself a painful procedure — is never addressed by those who do it and the family is not given a choice).

And so we found that for any real care, this was no longer the place to keep our parent.  We were lucky.  We had a friend who was a CNA.  She had just lost her father and had the extra space in her house.  She asked us if we would feel comfortable having Minkie move in.  We said yes.  She lived right down the street from us and so we became the modern model of an extended family.  She and her housemates and my husband and me.  Five people with our friend and us doing most of the care, but all being able to continue with our daily responsibilities without too much taxation on any one person.   Also, at this stage, Minkie was no longer moving on her own, which made her care much more manageable and less dangerous.

Back to Mr. Wolf’s story.  His mother had been living for years, unaffected by a potentially detrimental heart situation.  At some point, she had expressed shortness of breath at the assisted living facility in which she resided and they sent her off to the hospital.  Her cardiologist decided she should have surgery:

…. now that she was showing symptoms that might suddenly kill her, why not operate and reach for another few good years? What’s to lose? That was the sudden reasoning and scenario.

My siblings and I must take the blame here. It did not once occur to us to say: “You want to do major heart surgery on an 84-year-old woman showing progressive signs of dementia? What are you, nuts?”

This is not quite true: My brother expressed doubts, but since he was off in Maui, and therefore unable to appreciate the reality of, well, the reality of being near, we discounted his view. And my mother protested. Her wishes have always been properly expressed, volubly and in writing: She urgently did not want to end up where she ultimately has ended up. She had enough sense left to resist—sitting in the hospital writing panicky, beseeching, ­Herzog-like notes, to anyone who might listen—but of course who listens to a woman who scribbles such notes?

The truth is you’re so relieved that someone else has a plan, and that the professionals with the plan seem matter-of-fact and unconcerned, that you disregard even obvious fallacies of logic: [in this case] that the choice is between life as it was before the operation and death, instead of between life after the operation and death. (emphasis added).

So often, I find that people, myself included, although much less so than the average, walk into their territory (the healthcare industry’s territory) and listen to them spout something that may make no sense, but they are the experts, right?  We nod our heads, and walk out with the decision made.  When my husband had heart surgery, the cardiologist suggested that he start taking Lipitor.  I objected, citing all the side effects.  My husband pointed out that he did not have a history of high cholesterol.  The doctor replied with, “Yes, but you had heart surgery.”  His nurse practitioner added in helpful tones: “Lipitor prevents death.”  (You can imagine how I responded to that statement!).  My husband ended up taking the Lipitor.

As for Mr. Wolff and his story, when they confronted the medical team about the fact that their parent had deteriorated so badly and asked why they had not been better informed of this possible outcome:

Here’s what the surgeon said, defending himself, in perfect Catch-22-ese, against the recriminations that followed the stark and dramatic postoperative decline in my mother’s “quality-of-life baseline”: “I visited your mom before the procedure and fully informed her of the risks of such a surgery to someone showing signs of dementia.”

Six weeks and something like $250,000 in hospital bills later (paid by Medicare—or, that is, by you), she was returned, a shadow being, to 86th Street and her assisted-living apartment.

At the publication of his article, his mother was still alive, still living her shadow existence with occasional moments of clarity.  I doubt that this will ever change.  It certainly did not with my mother-in-law.

Would we have done things differently?  Maybe.  I don’t know.  Would Minkie have chosen to stay alive in a half state?  I don’t think so.  But by the time she ended up in her half state, she was no longer the same person.  We have made advancements in our medical care.  But hand in hand with the advancements has developed this  fallacy that lives should be saved no matter the cost.  And so, I end with Mr. Wolff’s conclusions:

I do not know how death panels ever got such a bad name. Perhaps they should have been called deliverance panels. What I would not do for a fair-minded body to whom I might plead for my mother’s end.

The alternative is nuts: to look forward to paying trillions and to bankrupting the nation as well as our souls as we endure the suffering of our parents and our inability to help them get where they’re going. The single greatest pressure on health care is the disproportionate resources devoted to the elderly, to not just the old, but to the old old, and yet no one says what all old children of old parents know: This is not just wrongheaded but steals the life from everyone involved.

…. My bet is that, even in America, even as screwed up as our health care is, we baby-boomers watching our parents’ long and agonizing deaths won’t do this to ourselves. We will surely, we must surely, find a better, cheaper, quicker, kinder way out.

© Yvonne Behrens 2012

 

 

 

 

 

 

Beauty Has Become Skin Deep

plastic surgery © Photographer - James C. Mutter

We are all cognizant of the fact that beauty is associated with youth.  When did this association begin?  Well, one could argue that it has always been true.  What has not always been true, however, has been media’s influence on our perception of ourselves and what we feel we need to do in order to fit media’s definition of beauty.

In previous articles, I have focussed on our youth oriented society.  I have reflected on how those Clairol ads that came out in the ’60′s not only spoke to our mothers, but to us.  As small children, we also heard, “wash that grey away and “he” will start to pay attention to you again.”  I know those are not exactly how the ads went, but the intent of the ads were that.  And so  we grew up with this idea that grey was for losers and hair coloring helped women look younger and thereby win their man, the day, their self-esteem.

Interestingly, female vanity makes us want to look good, but it is this same vanity that might make us hesitate to mess with our faces through plastic surgery (minor through botox injections or major by going under the knife).

When I see the ads on television today, in which this tired jowly looking woman stares back at me and then the next picture shows this very same woman looking ten years younger, air-brushing and make-up aside (note it is always a still picture), I wonder how that image affects the younger ones looking at the same ad?  Clearly in a way that makes them think it is acceptable for them to mess with their faces.

Over the past decade, botox and facelifts have gone mainstream. Now the ads state that if you are going to go under the knife, it is better to start earlier, because then there is less messing around which in turn allows the whole process to look more natural, and, boom, the industry has captured younger women.  Thus, of late, it has become “in” for younger women to get botox injections and or face lifts.   This in turn allows the older women less of the stigma hoop to jump because now it really is no longer associated with age, but with looking good and “feeling good about myself.”  If the young are doing it, hey, I am not doing it because I am getting old.  I am doing it because it is the THING to do!

And who wouldn’t want to remain beautiful or have a chance at beauty?  But then again, beauty defined by what criteria?

As k stated in an article entitled “Trends in the Beauty Industry Over the Past 10 Years”  in About.com

By spending billions of dollars exhorting anti-aging products and using super-skinny, airbrushed models and celebrities to pitch them, the beauty industry has created An Ideal Woman in the minds of anyone who watches TV or picks up a magazine. The Ideal Woman is thin with flawless skin, no matter her age. And she has drawerfuls of products that miraculously make her that way.

In this day and age, beauty goes hand in hand with youth, so yes, I believe it’s a distorted image for women. So many people are obsessing more than ever about their jowls falling or lines appearing. It’s turning people to cosmetic surgery.

According to the American Society for Aesthetic Plastic Surgery (ASAPS – 2010), 9.9 billion cosmetic interventions were performed in the United States in 2009.  Of these, 85 percent were non-surgical.  The largest consumer group for these procedures were white women between the ages of 35 and 50.  The second largest was white women between the ages of 51-64.  And the American Society of Plastic Surgeons (ASPS – 2009) reports that there was a 537 percent increase in the numbers of Botox procedures performed between 2000 and 2008.

I am not necessarily thrilled at the sagging of my features.  Yet, I do wonder how much of that has to do with media influence.  How much has that to do with my own fear of aging and being pushed aside.  Moreover, I have seen too many women totally destroy the way they look by going under the knife or who have this unnatural look induced by Botox injections. Ultimately, without these interventions, one might look older, but one might be more beautiful in their aging face than in their plastic one.  Certainly, the beauty reflected in the naturally aging face would have to be more than skin deep.

I would love to hear from readers as to what you think about this new wave at staying young.

What is this Website All About?

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Recently, a friend who is a social media guru, told me that my site did not effectively communicate what my message was.

Being a person who is aging in a society wherein aging is looked at in negative terms,  I decided to begin a website that explored all those aspects of life/society that affect the aging person, positively and negatively.  I am interested in exploring a more positive outlook towards aging.  Baby Boomers make up a large percentage of the population.  We should be working together to pro-actively create twilight years more to our making and liking, not follow, like sheep, society’s definition of what aging is all about.

Where does the story begin?  In some societies, the elderly are venerated.  In other societies, they are taken care of.  In our society, unbelievable amounts of energy and money are expended to avoid the aging process and to avoid death.

The real problem with all of this is that gerontology is looked on as dealing with “old” people and our concept of “old” is decrepit , demented, incontinent. Until we reach “old” (at least in our society) no one wants to deal with “old” and so the image of “old” continues to be perpetuated in the above fashion.

People need to recognize that those of us who don’t age, die. In other words, unless something else takes us away, we are all going to age. Unless those of us who are aging now (but are denying that fact, other than to laugh about “senior moments” or complain about the “new aches and pains,”) take responsibility for this fact, buy into it and prepare for it, we will not have the infrastructure in place to deal with it properly (which is where we are today in our society). Time for a paradigm shift. Unless the baby boomers (46-66) create that paradigm shift, we will have quite a mess on our hands.

Why do I say that we will have a mess on our hands?  In sheer numbers, the baby boomers outnumber those following them.  Studies show that younger folk do not seem to be attracted to service oriented jobs.  The traditional definition of family has been expanded to several parents/siblings/grandparents by virtue of high number of divorces and re-marriages, which will also have an impact on care-giving.  Not only that, but we, beginning with our parents, are the highest users of pharmaceutical drugs, all of which have some side effect which causes some other problem which necessitates taking more pharmaceutical drugs.

Now all of this is glorious news for the health care industry (note the word industry — their term, not mine).  What better scenario for profits than having an individual with a chronic illness who is totally dependent on the health care system?  And better yet, particularly for the insurance companies [-- one part of the triage that makes up the health care industry, the other two being pharmaceuticals and hospitals/doctors --]  is a person who is on medicare and has all these chronic problems because then 80% of the cost for their care is covered by Medicare.

This is a scenario that I find dismaying and will speak out against again and again.  We should never have allowed a service industry to become a profit making industry.  When we did, health no longer became the focus — profits did.  Making money did.  And when that happened, individuals’ health became compromised by the very system that claims to be proponents for health.

So in a nutshell, this website will (mostly) focus on our aging process and those steps we can take to better prepare ourselves (boomers corner) and it will focus on the health care industry by presenting articles that demonstrate the need for a major overhaul of that industry in the hopes of recapturing its original intent: health. (Health Blog).

At least for now…..

I would appreciate any thoughts you may wish to share with regard to this.

© Yvonne Behrens  2012

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More on Self-Esteem and SGS 2012 Conference

womeninprison_th

[editors note:  I have had some major computer problems these past three weeks.  Have had to upgrade and thus also lost things.....ah!]

Springtime — and between the gardens and the fruit trees and the honey bees and this website and house things and ….and….and, oh yes, for a very impatient person, all the waiting and in a world where immediate is the name of the game, too much time has gone by since my last entry wherein I promised to let you, the reader, know how the conference and our workshop went at the  2012 Southern Gerontological Society Conference in Nashville, TN.  As it had been in Richmond, two years ago, there were some very excellent presentations.  Not as many participants, however, which was a bit of a disappointment.

Denise Scruggs, and I gave a workshop entitled: “Promoting Self-Esteem Among Older Adults”  It went well.  We generated quite a bit of discussion and very positive input.   We are planning to take the project to the next level: More research to wrap the topic up and then workshops to introduce into facilities and/or individuals.

With regard to the topic of self-esteem, because it is subjective, it is difficult to measure.  There was a measuring instrument created by Dr. Morris H. Rosenberg in 1965 that psychologists continue to use to this day as the most effective measuring instrument.  Yes, there is a core schema or self-concept that is mostly maintained throughout life and that core self-concept can basically be one of high or low self-esteem.  But throughout life, one’s self-esteem can be affected by circumstances.  Thus, the topic is not cut and dry.

On the topic of self-esteem among the elderly, a fascinating presentation, “Predictors of Prison Adjustment Among Older Women” was given by Lori Farney, MA, who did a study on women in prison.  Her conclusion among several shared: prison life erodes inmates self-esteem causing depression and a sense of hopelessness.   She told a story of a woman who had been incarcerated for over 17 years when she had met her.  She was in prison for having killed her abusive spouse.  She was up for parole.  Her son came and she had several other individuals speaking on her behalf.  Her son spoke about how his mother had done what she had done to protect herself and her children.  There seemed to be a positive response.  But then this woman, age 65, received a letter denying her parole and stating that her case would be reviewed in three years.  What hope is left for this woman?  Hope is very much a characteristic of individuals with healthy self-esteems.

As Ms. Farney shares:

Older women also have to deal with ageism which many describe as “inescapable” behind bars.  they cannot cover their grey or thinning hair. they may lose their teeth and be unable to have them replaced.  One woman who had a problem with facial hair had taken to shaving since waxes and tweezers were unavailable. And as one woman said, “Getting an age appropriate bra is impossible.”

Ms. Farney continues:

Since older women have more emotional and physical health problems, they may be viewed with suspicion or apathy. Older women are often extremely afraid of getting sick in prison and needing prison healthcare which they often view as unsympathetic and inept. Their greatest fear is often dying in prison. Many women in prison have suffered sexual abuse before incarceration. Strip searches and the constant threat of being seen in a state of undress are particularly deleterious to these women.

Stark realities that we may not be exposed to as often in our society were we are “free” to color our hair or “work” on ourselves to avoid “looking” our age.  But Ms. Farney’s exposure and her sharing certainly were sober reminders that self-esteem can be adversely affected in certain environments, particularly in the aging process, when we become more vulnerable. 

There were many sessions which I was not able to attend but which I would have liked to attend or seen.  I was interested in all of the ones that I would associate with the loss of self-esteem.  For example, there were several poster sessions that focused on how life changes might affect one’s outlook:  “Mental Health Effects of Farm work for Farmers and Farm Couples over Age 50″ and “An Examination of Body image and Disordered Eating among Older Males” and “The Effect of Transition into Spousal Bereavement on Mental Health of Middle and Older Adults ” and “Age Differences in Coping Strategies Among Women in Later Adulthood.”  All in their ways touched on the question of self-esteem.  A pilot program on “Media Images of Aging: The New Ageism and Self-Esteem” is exploring whether media, in its attempt to draw in the aging boomer market, may be adversely affecting a normally aging person’s sense of self by their “youthful” aging advertising.

Sessions at the conference were diverse.  So many topics to choose from.  So little time!  However, the common theme was the aging person in our society and all those areas that might impact their experience of aging, whether it might be the aging of children with intellectual challenges born in the ’50′s and ’60′s or focusing on how to create age friendly cities and what different cities are doing around the country.

One area of major concern is the fact that younger people are not gravitating towards gerontology as a career.  (for the next article).

© Yvonne Behrens  2012

 

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Aging in a Youth Focused Society

Aging Actress with Face Lift

Last week, along with five other experts in the field of aging, I was invited to give a presentation to employees of the County of Roanoke in Virginia.  My presentation focused on aging in a youth-oriented society.

Aging Actress with Face Lift

Most people in our society dread the idea of aging and/or dying.  Either or both are inevitable parts of our life experience and the sooner we acknowledge this, the better prepared we will be when it catches up with us.  Because we do not want to confront our aging process or death, we enable the medical and beauty industries to make millions.   In the end, however, these two realities of life will triumph.

In my presentation last week, I covered the many different ways in which we can better prepare ourselves for the “twilight” years.  We need to face our aging and become friends with it.  This is not an easy thing to do in our youth focused society.  The first step to altering our feelings about aging is to recognize just how much society, through media, advertising, and Hollywood enhances a negative view of aging (I will write more extensively on this in a later blog).

During my presentation, I showed a favorite video (see below)in which a couple, Richard and Alice Matzkin, decided to confront their aging process.  I really love this video and their story.  I think I resonate with it so much because, just as all of us who are noticing more wrinkles on our face, or more aches in our joints or whatever aging indicators are starting to take over, their initial fear and upset may seem familiar.  Over and above the familiarity of their initial reaction, however, was the positive approach they decided to take in confronting their aging process.

I suggested to my audience that the time to plan for one’s later years should be when they have the energy and motivation to take the actions that are needed to establish an environment that will enable them to age gracefully.  This is when one can handle remodeling, if that is the decision.  A universally designed space can allow parents and children as well as couples who may have a disability to interact with their environment fully.  Not only should we be reflecting on our personal spaces, but also the larger areas in which we reside.

Liveable communities, the concept that neighborhoods have easy access to shopping, medical care, parks, entertainment, transportation, and safety, along with affordable housing, is another idea that can only benefit everyone across the generations, whether young professionals, parents, or the elderly.  But the time when we have the energy to solicit our local politicians is before we get to that point in our aging process.

If one has decided that they will go the retirement community route, one should take the time to visit several before making a decision.  Each community has its own personality.  Ask to see all levels of care since the assisted living and nursing care will be your environment in your more vulnerable stages.

Communes are familiar to the baby boomer generation and it might be worth exploring the idea of sharing home space, or at least share with neighbors expenses for those tasks that become more difficult for us to accomplish as we age.

My hope is that the audience came away with an understanding that we can be pro-active in how our older years will unroll before us and it does not have to be all negative.

© Yvonne Behrens, M.Ed  2011

Aging: The West’s New Pariah

Elderly-woman
Portrait of old woman sitting by a window.

Image via Wikipedia

The other day I was speaking with a very successful 50-something realtor and I asked her what she thought about aging.  Her response: “The topic depresses me.”  Hmm.  That sounded like a very familiar answer.  “Yes,” I replied, “The way our country has dealt with the aging issue has been rather depressing.  But you and I are at an age when we can still effect change and can re-create a paradigm that has only been in place for approximately 50 years.”

Prior to World War II, the elderly remained at home, surrounded by their families, participating in the day-to-day activities.  After World War II, our nation focused on mobility and youth as the image it wanted to project.  Not a lot of room for the elderly within that picture.

So what did we do?  We created a band-aid fix: the retirement/nursing home.  It certainly is one way to deal with all the ‘old’ people “left behind” in our fast-paced ever forward looking society where “New!”, “New!”, “New!” gets shouted out every time one turns around.  But as any of us who has interacted with these homes knows, the isolation and humiliation that can be caused by being in a space that is not your own and being taken care of by strangers is, well, depressing.

This is not to say that individuals do not make friends in these homes or become very close to their caregivers.  As with everything, there are many scenarios that can occur within one picture.  However,  one has to wonder at a system in which those employees who interact most intimately with the resident by helping them get dressed, showered, toileted, and fed are also the lowest paid in the hierarchy.

One outcome of our society’s focus on mobility and youth is that many of us have gone into denial about our aging process.  Baby boomers and older are spending a lot of time trying to look and be younger whether through plastic surgery or keeping fit.  I don’t think it is bad to remain youthful and strive to remain active in our day-to-day life.  What I have an issue with is the co-opting of the image of youth as the only game out there.

Another outcome is that the health industry has started to focus on the aging population and is doing everything to keep the aging process at bay to the extent of now referring to aging as a disease -“Is Aging a Disease?”

Aging a disease?  I always thought that aging was part of the cycle of life, a cycle we see reflected in everything around us.  The tree blossoms in Spring, leafs out in Summer, starts to loose leaves in Fall, and stands starkly against the Winter landscape.  Each period has its own special beauty and we don’t usually associate this normal process with disease.  Wow!  Ultimately, I believe that our buying into the idea that aging is a disease will allow a whole new branch of the pharmaceutical industry to — do I dare say –blossom, but I don’t know that this will keep the “bogey man aging” out of our lives.  It will just push it back by a number of years and I think the jury is still out on whether this is a good or bad thing [see: Aging: The New Financial Industry]

Nope, folks, aging is part of the process of life and the sooner we acknowledge this, the more empowered we will be to create an older age to our liking.  Does this sound like a negative statement?  If it does, know that this is how much you have been “brainwashed” into looking at old age as an anomaly rather than a normal part of the cycle of life.

In all aspects of our society, there is a reverence to youth from advertising to the image that the e-world projects, to the products that are sold, even to the way we parent.  But by allowing advertisers, for example, to tell us what we want, how we want it, and when we want it, we do a disservice to ourselves and those who are still oblivious to the aging process.

Here is another article that speaks to this “Aging Successfully

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