Category Archives: 50+ Health

Living the Good Life Rent-Free

Perhaps you want to explore a new place for weeks or months without paying for a hotel but you don’t like the idea of an exchange where you have strangers living in your house. Consider a position as a property caretaker or house-sitter, which allows you to stay in someone’s home for free in return for providing a small service, such as pet care, gardening, or property management. In addition to free housing, some caretaker positions offer a stipend, while others may even include a salary and benefits.

Caretaking could offer more exotic surroundings than typical tourist fare. A recent issue of the Caretaker Gazette advertised a salaried position for a retired couple to maintain a private lodge in the wilderness of southwest Alaska—some experience with small motors and cutting firewood is helpful. Another gig: three months in Sedona, Arizona, looking after three cats and a garden. Does a five-week housesit in Hawaii, on a property bordered by rain forests, sound appealing? You must be willing to care for a cat, six dogs and fish tanks, and water young plants.

The most comprehensive listing of property caretaker positions is published by a friend of 2Young2Retire, The Caretaker Gazette. Since 1983, the newsletter has been published in print every two months, and is also now online with email updates sent to subscribers. For more information, contact Gary Dunn via the website: www.caretaker.org.

Paul G. Ward
President

Chair Yoga: Seated Postures for Everybody

When Michelle Obama does yoga as part of her recent President’s Council on Fitness initiative, you know yoga has gone mainstream.  In the 15 years I’ve been a practitioner (including the last 12 as a Kripalu Yoga-certified instructor), I’ve seen yoga grow from the culture of the ashram, dependent on the guru-disciple relationship, to a billion dollar industry of conferences, workshops, star yogis, fashion clothing, DVDs, books and the like.  Pick up a copy of Yoga Journal and the cover will likely feature a well-toned yogi in spandex performing one of the more difficult postures.  I love YJ for the useful articles and professional advice I usually find there, but I wonder how many people get turned off by those daunting covers.

“I can’t do yoga; I’m too inflexible.”  If I had a dime for everyone who says this when they discover what I do…  The reality is, people who sit in chairs most of the time (and that’s nearly everyone in the West) are likely to be inflexible, and not just in the body.  My Burmese grandmother grew up sitting on the floor, with her legs crossed yogi-style or hunkered down, with her arms wrapped around her knees.  In her eighties, she had the body of a much younger person, was up with the dawn to meditate, and active all day long.  She didn’t do frailty.

The sedentary lifestyle of our desk-bound, television-addicted population reinforces more of the same behaviors.  So the very idea of getting down on a yoga mat starts to sound more and more impossible.   But yoga has been evolving in other ways that open up its tangible benefits to more of the population, particularly older people who want to maintain good health, preserve their independence, and forestall the so-called diseases of aging.  It is no accident that some of the greatest yogi masters are robust well into their 80’s and beyond.

Last weekend, I became certified in Chair Yoga, a form that adapts many classic yoga postures to the seated position and makes the benefits of yoga available to a much larger population including older adults.  Chair Yoga, as developed by Lakshmi Voelker who has devoted most of her life and career to yoga, delivers the benefits of yoga, including flexibility, strength, improved circulation, and mental focus, to anyone able to sit in a chair, including those in wheelchairs.  In her three and a half day workshop at Discovery Yoga in St. Augustine, Florida, 23 eager students — yoga instructors, physical therapists, Reiki masters and others — learned seated variations of postures like Mountain (Tadasana), Half Moon (Ardha Chandrasana), Tree (Vrkshana) and the Warriors at varying levels of challenge.   We learned how to add 1- and 2-lb. weights to increase the fitness challenge.  And we experimented with double chair and partner-assisted postures.  We were encouraged to replace some or all of our personal practice with chair yoga to improve our skills as instructors.  The biggest surprise was not how well these postures could be adapted for the chair, but how physically challenging they are, even for the young and fit.

Even if you have a yoga practice and/or other fitness routine, there are times when mat practice is not feasible.  You can practice chair yoga at your desk at home or work, on the train/plane/bus or in a car (not while driving!)  If you are recovering from an illness or injury, chair yoga can help you resume your normal fitness activities sooner.  You can even do chair yoga while you’re watching television.  Don’t just sit there!

Sweating the Big Stuff

Sound familiar?  You are (blissfully) unaware of the aging process until one morning, you are standing at the bathroom mirror brushing your teeth as usual, and whoa! this strange person stares back at you.  Your eyes may be as sharp as ever, the expression in them the same, but your features seem to be slouching in a Southerly direction.  (French women seem to enjoy special dispensation from these facts of life.)

For some folks, women mostly but not exclusively, this new old face is enough to send ripples of panic through the whole body.  Before you know it, you’re Googling anti-wrinkle creams, Botox treatments, and/or face lifts.  (Yes, I admit I went as far as to check out the non-surgical options, see The Perricone Prescription.  The good news: it is based on an anti-inflammatory diet and boosts one’s general health and well-being.)   If you are past your fifth decade, you may personally know women (and maybe a few men) of a certain age who have submitted their tissues to the surgeon’s knife.  While I respect the right to make this choice, ‘nip-and-tuck’  isn’t in my future.

Of course, I’m not in the entertainment business where my wrinkles could directly affect my livelihood.  And I don’t plan to run for political office, ditto.  If Sarah Palin looked like Golda Meir, goes one recent joke, would we even be having this conversation?  The truth is, whatever we do cosmetically, we will all end up looking something like Golda Meir (or Mike Wallace) if we’re lucky enough to live that long.   But honestly, would you choose youth and beauty over a reputation for doing good work; passionate support of worthwhile causes; spreading joy; being trustworthy; being a good parent/grandparent/friend or any number of other qualities you value?

In The Curious Case of Benjamin Button, a baby is born old and grows younger each year until he ceases to exist.  The tragedy was that he was moving through life in the opposite direction from everyone else, including the love of his life.  It wasn’t so much an compelling story-into-film as a cautionary tale.   In the world of the imagination, maybe we can fool Mother Nature.  In real life, not so much.  The aging face that looks back at you by dawn’s early light is a reminder that it’s time.  Time to cultivate a sense of self deeper than your skin.  If we — especially we women, weren’t so caught up in how the world sees and judges us (our faces, our clothes, our homes), we might be putting more attention on things like, let’s see, the epidemic of violence against women; the threats to our basic rights to clean water, air, education, health care; what kind of world we appear to be leaving to our grandchildren.  We could be sweating the Big Stuff.

V-Day: A Movement to End Violence Against Women and Girls

The Center for Public Integrity

Aging Without Mr. Right

Nearly one in six elderly unmarried women age 60 and over (17 percent) was poor in 2008, and 16 percent of those 75 and older were poor. (Unmarried Women Hit Hard by Poverty, Center for American Progress)

I was on the phone not long ago with a friend, I’ll call her Arlene, who has been absent from my life for some time.  Because she works two jobs (it was 2.5 for awhile), we had been playing phone tag for the last few days and that may also be why we’ve been out of touch.  We caught up with each other because I was housebound, beginning the infamous ‘prep’ for a colonoscopy.  I might have to end the conversation abruptly, I told her, but would call her back.  We shared a laugh over that.  She is a few years younger than I am and is yet to have this routine procedure.  In fact, she had not seen a doctor or had any kind of screening for a long time. “I haven’t had health insurance for ten years. I couldn’t afford it.”

What’s wrong with this picture?  A lot, both on the micro and macro levels.  My friend is well-educated and has worked in the entertainment industry for her entire career, holding glamorous jobs — or so they seemed to me — at some of the best companies on both coasts.  We were both in our 50s when we met, and she thought the future would continue in a direction commensurate with her education, talent, experience, and good looks.  She fully expected to continue to live in a home she owned, in an urban area with all the arts and culture she was used to. She was my idea of an independent woman: not looking for a man to complete her, but not against the possibility that Mr. Right could turn up.

So far this hasn’t happened, and she appears to have grown comfortable with aging as a single woman.  And according to an AARP study, many older women would agree, see: The Secret Lives of Single Women. What isn’t such a rosy picture is what aging as a single woman might mean to her financial future, especially if she becomes ill or disabled.  Mothers of single daughters (I am one), listen up!

Arlene’s is a familiar enough story: as her industry began to contract, she lost better jobs to younger people.  This is systemic, apparently, and not just at the level of female superstar who disappear from the screen at a certain age (Meryl Streep the obvious exception). Over the last few years, Arlene has mostly worked freelance and so health insurance has been beyond her means.  “Who would have ever thought I would be looking forward to Social Security and Medicare?!” she asks.  Until she reaches the age of eligibility for these benefits (and possibly even when she does), she will likely remain one of the working poor: healthy (fortunately) enough to work, able to pay her bills (just), saving nothing, and earning too much to qualify for Medicaid.  It’s a tough situation for anyone, but worst if you’re a woman and earn less to begin with.

Sexism combined with ageism might have done my friend in, except for her remarkable resilience, sense of humor, and the support of  female friends of which she has in abundance.  Friends for company, advice, conversation, comfort and sometimes financial help.  Arlene doesn’t expect a fix from inside the Beltway.  She’ll keep working; she’ll eat right, exercise, keep herself healthy; she might relocate where housing and living costs are lower.  She’s nobody’s fool.  Those of us who are happily partnered need to look out for our single sisters of a certain age as well as our unmarried daughters of an independent mindset.  And I’m not talking about finding them a date for Saturday night.

Resources:

Unmarried Women Hit Hard by Poverty

Wiser (Women’s Institute for a Secure Retirement)

Women Work!

The Deadly Comfort Zone

Singer and songwriter, Paul Simon has a line in his wonderful poem set to music, American Tune, that has always resonated with me. “For we’ve lived so well, so long…” it goes, and later in another verse, he cautions, “…you can’t be forever blessed.”  We have been blessed here,  in the safe, secure, wealthy nations of the developed world.  And as we grow older, it seems that we have also been lulled to sleep, cradled in our comfort zones, dead to the world.

What happened to our thirst to learn and discover new things we had as children?   Think about your grandchildren in their first year, taking those tentative steps, wanting to touch, taste, smell everything.  We were all like that once.  Then, gradually, without our noticing, we started craving something else — safety, security, the known world — even to the point of shrinking our aspirations to fit into what was comfortable, predictable, easy.  In the process, we have sacrificed resilience and resourcefulness, the ability to adapt to changing circumstances upon which our survival as a species depended.  We gave up, and opted for ‘assisted living’ long before our time (if there is ever a time).

Even if you recognize some part of yourself here, the situation is reversible.  True, the bell tolls for us all.  But in the meantime, what is there to stop us from making the most of the ‘life we are given‘ to borrow from a title of a wonderful book by George Leonard and Michael Murphy, pioneers of the human potential movement and founders of Esalen Institute in Big Sur, California.

Published in 1995, this workbook for Leonard and Murphy’s Intergral Transformative Practice, remains a prototype, indeed a classic, of the self-help genre.  It weaves together proven practices: exercise, diet, daily affirmations, and community, into a program that is both rigorous and enjoyable.  (ITP groups continue to form today).  Here’s a quote from novelist, James Agee, that sets the book’s tone: “I believe that every human being is potentially capable, within his ‘limits,’ of fully ‘realizing’ his potentialities; that … his being cheated and choked of it, is infinitely the ghastliest, commonest, and most inclusive of all the crimes of which the human world can accuse itself.”

Is waking up hard to do?  Perhaps.  But clinging to the deadly comfort zone is a far worse choice.  Conclude Leonard and Murphy: “We believe that by the very nature of things, each of us carries a spark of divinity in every cell and that we have the potential to manifest powers of body, mind, heart, and soul beyond our present ability to imagine. We believe that a society could find no better primary intention, no more appropriate compass course for its programs and policies, than the realization of every citizen’s positive potential.”  Amen.  And go for it!

More information:

Excerpt from The Life We Are Given
Integral Transformative Practice Workshops
Esalen Institute in Big Sur, California

World Cafe – a conversational process for breakthrough thinking.

Institute of Noetic Sciences


How to Survive Medical Care

A guy walks into the doctor’s office …

While there has been little to laugh about in the healthcare debate, it has caused a spike in jokes on late night television and the Internet.  Gallows humor, you might say.  But here’s something you should know about that is no laughing matter: getting sick (or sicker) as the result of medical treatment, aka iatrogenic illness, is on the rise.  In 2000, a presidential task force labeled medical errors a ‘national problem of epidemic proportions,’ and put the cost at $29 billion annually. The Institute of Medicine’s report, To Err is Human: Building a Safer Health System, released the same year concludes errors during hospitalization kill between 44,000 and 98,000 people each year.

Then there is the problem of antibiotic resistance caused by “inappropriate or improper use of antibiotics by physicians,” according to Dr. Philip Tierno, director of clinical microbiology and diagnostic immunology at NYU Medical Center. Dr Tierno finds that of the 90 million prescriptions written for antibiotics, “50 million are absolutely unnecessary or inappropriate.”  Could be why antibiotic-resistant staph (MRSA) is a major problem for hospitals.

So how can you protect yourself?  Short of taking the approach of a friend of ours who steers clear of hospitals and doctors entirely, you can do two things.  1. Make self-care and preserving your health a top priority, and 2. If you need medical care and/or are hospitalized, resist becoming “a passive, dependent, childlike person who will not question or oppose authority,” says Lawrence LeShan, Ph.D., psychologist, author and pioneer in the psychotherapy of cancer support.

Here are more tips adapted from How to Survive in a Hospital from Dr. LeShan:

Have a friend or relative who can be your advocate (or be an advocate for your hospitalized elder).  An advocate is someone who is not afraid to make a fuss and ask difficult questions.  For example:

  • Who is the physician overall in charge of the case?  Make sure that there is someone who has an overview of the patient and the symptoms.
  • What is the diagnosis, and how certain of it is the physician?
  • What is the usual course of the disease, both with and without therapy?
  • What are the side effects of the therapy?
  • What alternatives exist?

When tests are prescribed, it will be important to know how painful they will be, what side effects they will have, and most important – whether they will make a difference. Will the physician’s course of action change depending on the results of the test(s)? If not, there is no reason to proceed.

More information:

Kimberly-Clark Health Care’s website on Healthcare-Associated Infections (HAI) http://www.haiwatchnews.com/
American Iatrogenic Association

Go Online, Get Happy and Healthy!

A report just released by the PHOENIX CENTER POLICY PAPER SERIES indicates that Internet usage can significantly reduce depression among older adults.  Of course, since I’m writing this and you’re reading it, we are in the minority of older adults who are already online (42% of people over 65).  Chances are you, like me, regularly use the Internet to manage your money and health, keep up with the news, shop and share stuff.   You may also have joined one of the many social networks and now have a host of online friends.  You stay in touch with distant family and friends, sending photos and your favorite You Tube videos.  For me, all of this now seems as natural as breathing and I have to remind myself how relatively new the marvelous Internet is.  But I didn’t know that I was also keeping myself — and the economy — healthy by doing all these things until I came across this report.

Here are some interesting facts about depression and the older population:

  • latelife depression affects about six million Americans age 65 and older
  • depression is estimated to cost the United States about $100 billion
  • included in this figure is direct medical cost (31%) and latelife suicide (7%)

Here’s an excerpt of the the abstract:

The American Recovery and Reinvestment Act of 2009 directs over $7 billion to expand broadband Internet availability and adoption in the United States. One target of such funding is the elderly population, a group of Americans for which broadband adoption is relatively low. An interesting question is what benefits do such efforts
afford? We employ a dataset of over 7,000 elderly retired persons to evaluate the role of Internet use on mental well-being…using the eight-point depression scale developed by the Center for Epidemiologic Studies (CES-D)…All procedures indicate a positive contribution of Internet use to mental well-being of elderly Americans, and estimates indicate that Internet use leads to about a 20% reduction in depression classification.

On the chance that Pseudo-R2 Analysis of Matching Algorithms are your thing, the full report is available in a pdf file,  see link in opening line.

In the meantime, do your patriotic duty.  Surf on!  And invite the Internet holdouts among your buddies to jump in.  The water’s fine.

Medicare: Good Enough

I wouldn’t want to be Senator Bill Nelson of Florida these days, or one of those nice young aides who answer his phones. After Humana frightened its Medicare Advantage partners with a letter suggesting their benefits would be threatened by Medicare reforms, Senator Nelson’s office was flooded with anxious calls.  You can tell when an issue really hits home in America.  We buzz with every kind of information and misinformation.  It’s the democratic process and I wouldn’t have it any other way.  But it hasn’t been easy to find well-reasoned, non-partisan arguments on the volatile subject of health care reform, and what often filters down into lay language can be truly scary.  Take a sampling from the postings on your own Facebook page.  You may be shocked at the misinformed, if not completely irrational, positions taken by people from whom you might expect better.

We’ve been to Senator Nelson’s office in West Palm Beach to express support for single payer (the option advocated by Physicians for a National Health Program) and we’ve stood on the sidewalk holding a sign and waving to passing cars.  As Medicare recipients with an AARP  Medigap policy, we already enjoy benefits most Americans envy.  Our kids and younger friends would love to have what we have, and we think they should.  With Medicare, we get health care that is as good as it gets south of the Canadian border.   It’s good enough, and so are the health care systems in Canada, the UK and any number of other countries where health care is considered a basic right.  Good enough, not perfect.

I’m no expert on health care reform, but I know enough to recognize politically-motivated malarkey when I see it.  And I know a sound argument when I encounter one:  Here are two articles well worth your time and attention:

Atul Gawande’s The Cost Conundrum, The New Yorker, June 1, 2009, offers a model system in a Texas town.  Dr. Gawande’s book Better is also excellent.

Theodore Roszak, Medicare for All, Los Angeles Times, September 21, 2009 makes a compelling argument based on his own recent experiences with Medicare.  The Making of an Elder Culture is Theodore Roszak’s latest book.

Forestalling Frailty

A friend has been spending many hours at assisted living and nursing facilities lately, looking for the right fit for an elder in his family who can no longer do for herself.  I preceded him in this difficult and often heart-breaking task a few years ago, so I completely agree with his observation about residents of these specialized forms of housing for older adults: nearly everyone is there not because they are ill but because they are frail.

The medical term, frailty syndrome is “a condition, seen particularly in older patients, characterized by low functional reserve, easy tiring, decrease of libido, mood disturbance, accelerated osteoporosis, decreased muscle strength, and high susceptibility to disease.”  Note that, absent heart disease or cancer, these are symptoms rather than disease itself, and every one of them is preventable and possibly even reversible by a regimen of physical exercise, social engagement and mental stimulation.  It is shocking that, in a culture that loves self-improvement, we grow more neglectful of these basics of good health as we age.

In his article for Aging Today, Is Our Healthcare System Ready for the Age Wave?, gerontologist and best-selling author, Ken Dychtwald, offers a four-part proposal that could, if implemented, improve lives of elder Americans and significantly reduce the unsustainable cost of caring for people who are frail rather than ill.  The item that resonates with me in particular is about lifestyle choices.  It is no secret that personal behavior can postpone many of the so-called diseases of aging indefinitely.  Self-care can and must be a priority.  We owe it to ourselves, our children and grandchildren, and to society, to keep ourselves as healthy as we can be so that longevity is a gift that keeps giving.

President’s Council on Physical Fitness

Forestalling Frailty from WebMD

Senior Olympics for 70-year-old

Getting Hip Via the Internet

Symptoms are God’s way of telling us that we need to pay attention to our bodies.  So when Howard began to experience severe pain and weakness in his lower back, he immediately sought medical help.  He went from one specialist to another, was prescribed painkillers and physical therapy, which helped some, but the problem didn’t clear up.  Then our own general practitioner, an MD and homeopathic physician, came up with the correct diagnosis: It’s your hips. It made perfect sense: he was 72; he had been athletic most of his life, a tennis player and runner, both of which are notoriously hard on the hip joints.

The next step will be familiar to many of you: Howard turned to the Internet to research hip replacement options.  Some 122 million Americans — 56% of the population — are doing just that, according to a Center for Studying Health System Change report.  And while the so-called ‘elderly’ 65 and older trail their younger counterparts in using the Internet to seek advice on their health, this remains one of the fastest growing categories of Internet use.  Take Web MD, for example (we do!), which has a handy symptom checker that can either compel you to seek immediate medical advice if your symptoms are not worrisome enough in themselves, or calm you down enough to think clearly.  As a smart person of a certain age, you don’t need a professional to recognize that chest pain, shortness of breath and/or dizziness require emergency response.

Howard’s story has a good outcome.  He remembered having read that tennis star, Jimmy Connors, was back on the courts after having a hip replaced.  So he Googled “Jimmy Connors’s hip” and voila! Jimmy’s New Hip, a website with all the information he needed about the Wright CONSERVE Total Hip.  Intrigued, he next researched (using the Internet again) who in our area of South Florida was working with this hip replacement system  He discovered that a young surgeon named Vincent Fowble was regularly performing this surgery at Jupiter Medical Center.  Several appointments, consultations and X-Rays later, Howard was scheduled for the first of two hip replacement surgeries that have essentially gotten him back on the tennis court. Without the Internet, this would have taken longer, and cost him time and more pain.

You may have heard that some MDs look askance at self-diagnosing and, if you were to proceed to act on that information alone, you’re running a risk of getting it wrong.  Like I tell my yoga students, while yoga offers many health benefits, it is not intended as a substitute for competent medical advice.  Ditto, the Internet.