Category Archives: 50+ Health

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.

Second Annual Positive Aging Conference

Here’s some very good news. Positive aging — a discipline that focuses on mature creativity, adult development, lifelong learning, and the opportunities available to older people — is fast becoming a movement, with its own conferences, speakers, books, and experts. Last year, the first Positive Aging Conference was held at Eckerd College in St. Petersburg, FL, and drew over 200 professionals in the field of aging. This year, we got word from author Richard Leider (his Something to Live For: Finding Your Way in the Second Half of Life is just out), one of the conference organizers and speakers, that the second annual Positive Aging Conference will welcome both professionals and members of the public.

You might want to take advantage of ithis important shift if you live in or near Minneapolis where the conference is being held, November 12, at the University of Minnesota’s Center for Spirituality and Healing. For those of you not in the area, check with the organizers about simulcasts that will be taking place around the country at various host sites. For information about a simulcast in South Florida, contact me: and/or watch this space for more information as plans firm up.

“They take Medicaid, they’re near my house and they have an opening.”

Criteria for choosing a nursing home for a father suffering the symptoms of dementia? Apparently so, for John and Wendy (Philip Seymour Hoffman and Laura Linney), two estranged and deeply competitive siblings, brought together by a problem that is, or should be, front of mind for anyone with an elder in the family or who hopes to be one some day. Heartbreaking, gritty and beautifully acted (Linney is an Academy Award nominee for her role) Savages, is right on target in depicting the bleak landscape of a typical nursing home, complete with screwball and futile attempts at gaiety, i.e. the changing, nursery-school seasonal motifs, as well as the explosive pressure and the wacky behavior it generates.

Item: in her own when-the-going-gets-tough-the-tough-go-shopping moment, Wendy attempts to make the barracks-like accommodation more homey for Dad (Philip Bosco). We see her hanging sheer curtains to hide the institutional blinds, plumping up the pillows, and plugging in a lava lamp as a final touch. Not long after, when she finds a cushion she had bought for her father in the firm grip of another resident, she snatches it away while the elderly woman wails. Gut-wrenching.

The film is also a reminder that housing our elders — and one day, ourselves — should the ability to perform many tasks of daily life become too difficult, is a challenge for an entire family, and for the larger community. Except in the most extreme circumstances that demand 24/7 care, there are better, less expensive alternatives to a nursing home (recent figure for South Florida: $5,000/month). It comes as no surprise that most older people want to live as independently as possible in surroundings that are familiar — who wouldn’t? So it is encouraging to find models like the concierge program in Boston’s Beacon Hill Village beginning to proliferate in other cities. The program gives subscribers age 50 and older who live in the neighborhood, access to an array of services for a fee, everything from cleaning and shopping assistance, to car service for a doctor’s appointment or night on the town.

For lower income elders living in subsidized housing, needed services at reasonable cost are available through a program created in South Florida by 2006 Purpose Prize winner, Conchy Bretos. It is in demand nationwide. After she appeared on the Today Show, Ms. Bretos, an experienced lobbyist, activist and executive administrator of special population programs, returned to her desk to find her in-box jammed with over 3,000 email messages.

The Eden Alternative, founded in 1991 by Dr. William Thomas, a Harvard-educated physician and geriatrician, focuses on de-institutionalizing the culture and environment of today’s nursing homes and other long term care institutions. To date, it has trained over 15,000 Eden Associates and now claims over 300 registered homes, in the U.S., Canada, and Australia.

Savages has been called a black comedy. We see it as a wake up call. The long term care insurance that is being marketed relentlessly to older Americans is only as good as the facilities and staff available. We need fresh, innovative thinking sooner rather than later. We need activism.

Live Long and Well

Have good work to do, and a brisk walk to it.
– Delfinio Lujan, merchant, herbalist
This simple recipe for a long and good life comes from a centenarian, one of the Living Treasures of Santa Fe, NM. It pretty much sums up our philosophy at 2young2retire. Work you enjoy is a health maintenance strategy and life extender. If what you are doing is also something that contributes to the good of society, so much the better. As it turns out, socially significant work is where the opportunities are — in teaching and health care, to name two. And many people 50 and older are feeling the call to make a positive difference.
But even you wouldn’t characterize your work as a form of giving back, if you keep working past the age when you are ’supposed’ to retire, you are giving back. Here’s why. You are likely to stay in good health for much longer. Everyone has a story about a relative or friend who retired and began to decline. The other side of the coin is that people who work — whatever their reason for doing so — have far fewer visits to the doctor. Maybe feeling relevant and necessary is good for us in ways that can’t be measured by medical science today. But given the high cost of medical care, every year you avoid needing it, is a blessing to you personally, and a gift to society and future generations.
Get Physical
The second part of the quote underlines a key ingredient for health maintenance after age 50: vigorous physical activity every day for the rest of your life. If you are lucky enough to live a mile or two from your place of work, you’ve got a head start. You can’t help but notice how urban dwellers tend to be much trimmer and fitter than those of us who are dependent on a vehicle for every errand.
If you work at home, you have to be that much more disciplined about exercise, making sure whatever you choose is fun, so you’ll want to keep doing it, yet challenging enough to make a difference to your cardiovascular system. Most people need about 28 days to get into a new habit of biking, swimming, weight work, yoga, tai chi or Pilates — three ideal practices for the mature body — every day.
Commuters, start campaigning for a fitness break at work. Most of the best employers have added gyms and instructors. It’s a rare executive these days who doesn’t understand the relationship between exercise and better morale and productivity. Take a page from a centenarian’s playbook, and plan to make good use of your own century on Earth.

Leaving Life to Chance? Don’t!

In her New York Times article, Training to be Old, Claudia Deutsch interviews experts on the subject of how well, or badly, many of us are preparing for a span of years roughly equivalent to those spent building family and career. Here’s a comment that is worth your attention: “With the first wave of baby boomers already in their 60s, gerontologists are bracing for a tsunami of disgruntled postretirees who have left the psychic and physical aspects of aging to chance.”

If this describes you, don’t panic. Help with transition is available, although given the numbers — 78 million baby boomers alone — we have a long way to go to meet the need. Programs are beginning to turn up at local JCCs, YM/Ws and other social services groups. Look for a Next Chapter group or Transition Network (for women 50+) in your area. A lot of authors are jumping on the later life advice bandwagon. That’s not a bad place to start your inquiry.

You can expect financial planners to continue to focus on what they are trained to do — help you to manage your tangible assets so they will last as long as you do. But many have begun to adopt and train for a more comprehensive approach, perhaps because clients are demanding it. In our neck of the woods, 2young2retire has already certified one financial planner to facilitate the 2young2retire course and another is currently enrolled in the training. Facilitator Training is open only to people who have professional credentials, e.g. life/career/transition coaches, career counselors, social workers.

The 2young2retire course itself is a good model for what is possible. It asks a six (or eight) week commitment from participants to inquire into the important issues we’ll all face in a longer life span: staying healthy, smarter money management, ‘encore’ careers, entrepreneurial opportunities, community service, and intelligent travel. You reflect, you explore, you plan, you write down your plans. Good things happen.

Hungry for a ‘purpose-driven job’ in the second half of life? The MetLife Foundation/Civic Ventures Community College Encore Career Grants of $25,000 are designed to encourage community colleges to develop programs that help boomers transition into encore careers in healthcare, education and the social services where the jobs are many and qualified people few. Do good. Do well.

The Big Squeeze

If you belong to the Big Chill generation, welcome to the Big Squeeze.

A parent has become elderly and dependent on you. Whether physically, financially or emotionally, it all adds up to the same: you have switched roles. At the same time, your spouse, partner or child becomes needy — surgery, illness, layoff, or other life-altering event.

There you are, in a role few would choose willingly: squeezed between competing needs, pulled between the desire to do the right thing for those you love, and the need to take care of yourself so you can do the right thing.

Even if you have caring family and friends — and be grateful if you do — it can be a difficult period to get through. Some days are a blur of doing. On a good day, you feel like Chris Bliss, the amazing comedian who keeps three balls moving in time to the Beatles’ Golden Slumbers. Sometimes, it feel like a three ring circus, especially if you are working — even part-time — or have other obligations (who doesn’t?) You may feel happy to be ‘the strong one.’ You may feel satisfied, proud, almost heroic. But mostly, at the end of the day, you’re depleted. Send in the clowns, please!

A few things you could try to take care of the default caregiver you’ve become.

  • Humor. As Norman Cousins famously discovered, laughter is great medicine. “A good way to jog internally,” he called it.
  • Sit down for every meal.
  • Take a nap even if you are not a naturally napper.
  • Take deep breaths when you start to feel impatient or irritated and ask the person for whom you are providing care, to do the same.
  • Load up your Ipod or CD player with the music you really love and listen to it a lot.
  • Get exercise, preferably in the fresh air. Start an exercise program if you’ve been putting it off.
  • Keep the door open to all offers of help in whatever form they come.
  • Get a massage, manicure, facial. Whatever makes you feel cared for.
  • Keep visualizing the people you are caring for as the babies they once were.

Leap! She Says

“If you wish to persuade me, you might think my thoughts, feel my feelings, and speak my words.” — Attributed to Cicero

To a degree, good books do this, which is why they generate an instant buzz and word of mouth, why they tend to be remembered, the way people tend to remember Sara Davidson’s Loose Change, her landmark book of coming of age in the 70s.

Davidson’s new book, Leap! What Will We Do with the Rest of Our Lives?, will also find an audience and have legs, we predict. The excerpt, published earlier in Newsweek, gives you an indication why we think so. She writes not as a keen observer and journalist, although she is both, but from inside 50+ angst, “the narrows, the rough passage to the next part of life.” Work dries up. Suddenly, despite awards and recognition for her hit shows, she “can’t get arrested.” Her nest empties and her lover leaves.

The narrows will no doubt ring a bell for many within the baby boom generation and for those of us who came before, although we may not have been quite so open about our vulnerabilities. Davidson’s candor is bracing. We, who have made a project of telling the good news about aging, admit that a lot of it is confusing, difficult and painful, and we don’t have very good guides about how to do it well.

Leap! What Will We Do with the Rest of Our Lives? will help. Although its focus is on the more aware, accomplished, successful segment of the boomer cohort who have the luxury of choice about their ‘next life,’ there are plenty of ah ha! moments for anyone willing to take some risks about the future. And a lot that will touch you and make you smile and nod in recognition. Davidson’s interviews with Carly Simon on her comeback; self-help guru, Joan Boryshenko on her fourth marriage; with Tom Hayden, about ‘putting [one’s] career drives down,’ and his former wife, Jane Fonda; with Bernard Lietaer (creator of the Euro); and with Jac Holzman, founder of Elektra Records, stand out for this reader. Holzman’s advice mirrors the 2young2retire credo:

“You don’t have to figure it all out. Pick something and do it. Take a look at what’s out there and see what you’d like to stand next to. Or if you don’t see anything . . . Wait till lightning strikes…Because it always does.” Amen.

Say What?

Hearing impairment is going to be a huge problem/opportunity, depending on who you talk to. We shouldn’t be so surprised if we’ve been blasting our ear drums with loud music for a few decades. The good news is, these days you can get yourself fitted out with some really cool hearing aids that are programmed for your particular range of impairment. And then, get this, reprogrammed when you need it.

This doesn’t come cheap — starting at about $1500 each for CIC (completely in the canal) aids that are molded to the contours of your ear and nearly invisible when inserted — and to date, insurance doesn’t cover the cost. But they are well worth it. I speak from experience.

Here are a few things I noticed that alerted me to the problem, and might help you decide to get your hearing tested:

1. I was having difficulty discriminating between certain sounds in a crowd, e.g. at a party, restaurant, or large meeting. I heard ambient sounds — music, traffic and so on — but would confuse words and be struggling to get the sense of what was being communicated from the context.

2. People would have to repeat things.

3. I “heard” better when people were facing me, so unconsciously I’d already begun to read lips. Isn’t the human body/mind amazing?

4. Noise started to bother me less — a good thing!

5. But I had the most difficulty discriminating the higher frequency sounds, like the speech of women and my grandchildren. In fact, I noticed that my grandchildren would stand right in front of me, picking up on my disability long before adults did (those smart kids!)

If any of these symptoms seem familiar, make an appointment with an ENT specialist and audiologist, pronto. Don’t let embarrassment over a hearing impairment lead to social isolation. These days, we’re all walking around wired in some fashion — IPods, headphones, cell phones, etc. — so what’s the big deal?

And don’t make the mistake I did, purchasing one aid on a wait-and-see basis. At my last check up, the loss in my ear that is fitted with a CIC was minimal. The other, uncorrected ear, was significantly higher. Now I wear one in each ear, and I’m getting much more than I’m missing. As all the experts tell you, no instrument will restore your normal hearing. Who knows what the future will bring in new medical technology? But in the meantime, don’t accept hearing impairment as something you just have to live with. You don’t.

Hearing better might make you feisty enough to start lobbying for getting hearing aids covered (along with dental and optical treatments) by insurance. Say what!

Stayin’ Alive

A number of years ago, a study published in the British Medical Journal showed a 20 percent spike in heart attacks at the beginning of the work week, and that men were particularly susceptible. The Monday morning heart attack syndrome suggested it was a return to work after a weekend of leisure that could be a killer. The composition of that leisure, of course, could make an important difference. Vigorous exercise or a six-pack in front of the tube? Nonetheless, according to Harvard Men’s Health Watch, “Stress is the likely explanation for the Monday peak in cardiac risk. Retirees may retain the responses they learned in their working years, and they are certainly susceptible to the hustle and bustle of a Monday morning.”

It’s enough to make you hit the snooze button and pull the covers over your head. Or perhaps take that early retirement package and hit the beach.

But wait. An equally compelling argument has been surfacing that correlates work — that is, work you enjoy, at a pace that you set yourself — with staying healthy. We’ve all heard anecdotes about hard-charging people who retire then become ill and die within a short time. In an earlier post, we mentioned the Shell Oil study of 3,500 employees which showed that people who retired at 55 died earlier than those who stayed on the job until 65. The question that always comes up is, was ill-health a factor in the choice of early retirement?

A study from the National Bureau of Economic Research concludes that “complete retirement leads to a 23-29 percent increase in difficulties associated with mobility and daily activity, an eight-percent increase in illness conditions, and an 11-percent decline in mental health.” Could help explain the well-documented fact that white males over 65 also have the highest suicide rate.

No doubt more research that will clear up causal links between retirement and premature mortality is needed. But we’re persuaded that among all the other benefits it provides — identity, meaning, community, structure, a sense of self-worth, an income — good work is one way to stay alive.  TGIM — Thank God, It’s Monday.