Mental Wellness In The Elderly

TODAY IS WEDNESDAY, MAY 16, 2012

Wednesday, May 4, 2011 at 10:00 AM EDT

Mental Wellness In The Elderly

America’s elder population is 40 million and growing; living longer and dealing with sickness and loss. And now, going into therapy to help. We’ll listen.

(Marcel Oosterwijk/Flickr)

America’s elder population is exploding — doubling between the year 2000 and 2030.

Already, 40 million Americans are 65-plus. By 2030 it will be more than 70 million — almost 20 percent of the population.

Some will be vigorous and in the workforce, or on the golf course, well past that time of their parents and grandparents. But all will face the challenges of aging. Eventual losses of capacity, friends, loved ones.

And then there’s death to deal with. How do we do all that?

This hour On Point: a doctor who works with the aging on the best path through.

- Tom Ashbrook

Guest:

Dr. Marc Agronin is a geriatric psychiatrist and medical director for mental health and clinical research at Miami Jewish Health Systems. He’s author of “How We Age: A Doctor’s Journey Into The Heart of Growing Old.”

Excerpt: How We Age
By Dr. Marc Agronin

Trees

A magnificent date palm tree stands a few paces outside of my office window. Beholding its thickly ribbed and fern-bearded trunk and majestic crown of fronds, I understand why eighteenth century Swedish doctor and botanist Carl Linnaeus labeled palm trees the “princes” of the plant kingdom. Like the tree outside my window, Jacobo was a prince of a man—a robust and bearded figure with a perpetual smile. He used to visit me often to teach me Spanish and to talk about his life both before and long after he had fled Cuba. My office was a refuge for him, a bower of books and papers that made him feel at home, as if surrounded by his own library. Over time he even planted parts of himself in my bookshelves with select volumes he brought as gifts. Several years ago he proudly presented me with a copy of his own recently completed magnum opus, Lógica Transcendente, the product of decades of deep thought and several years of diligent work in his study. Unlike most of the older men and women who visit me in my office, Jacobo was not a patient; he was my friend.

In my profession such a friendship is not unusual for me, even when the difference in ages spans thirty to fifty years and a generation or two. I still marvel at how both the content of our conversations and the mutual regard rarely betrayed our ages. I had first met Jacobo seemingly by chance—although he would argue that nothing is by chance—during my first year as the psychiatrist at the nursing home.

While tending to several consults one afternoon, I walked by the bearded, garrulous figure of Jacobo speaking in an animated tone in Spanish to his daughter. They had arrived that day to visit a beloved family member. We exchanged greetings and sort of tumbled over each other in conversation as I tried in my halting Spanish to welcome him to the “Home,” as we called it. Before I knew it, Jacobo had designated himself my personal Spanish tutor, and I suddenly had an eighty-year-old friend with whom to discuss history, religion, and the meaning of life.

Mahogany Tree

The parking lot outside the nursing home in which I work is surrounded by mahogany trees. They appear as sentries along the walkways and parking spaces, with thin, angled trunks, wizened barks, and small-leafed crowns that provide only limited, dappled shade. These trees are young, however, because the mature West Indian mahogany that once grew in abundance throughout South Florida can average up to eighteen feet in circumference and soar to more than seventy feet, earning the moniker “King of the Forest.” Most captivating is the woody mahogany seedpod, which from the outside resembles a small brownish-gray potato. Once opened, however, it reveals an intricate, five-chambered array of winged seeds imbued with the rich reddish-brown color that makes mahogany such a desirable wood.

Like these trees, my patients surround and guard the passageways around the nursing home, sharing an outward appearance of frailty but containing within lustrous seeds of history and wisdom that have been spread, year after year, throughout the lives of so many others. I have grown close to these patients, even though the time I know them is short because I lose to death almost as many as I gain each year. They are patients, not friends, although sometimes the lines between can get blurry. This is one unique feature of working with the elderly that every doctor discovers with time. Even when attending to the strictest boundaries in the doctor-patient relationship, the burden of illness and the proximity of death force a special bond with patient and family. At that point small decisions, such as a medication dose or a lab test, can have far-reaching consequences.

In geriatrics, facing the death of so many patients is part of the job. Clinical decisions are often shaped by this reality, as maximal gains from therapies are necessary in minimal time frames. The emotional toll varies, but the loss of a patient who is closer to the line of friend evokes a greater level of grief. I have noticed, however, that the practice of medicine has evolved away from this line, in some ways making it easier to bear these losses. In her book How Doctors Think, Kathryn Montgomery describes how medicine has increasingly become a business transaction between strangers; the more objective and scientific it has become, “the more easily it can be commodified, detached from a caring physician, and judged by its ‘product,’ health.” She does not, however, propose a “medicine of friends,” despite how attractive the virtue of friendship may be to the doctor-patient relationship. For example, she notes that many physicians value the moments of deep connection with patients and their families that sometimes occur during crises as antidotes to “the alienation and detachment of medicine understood as a science.” Although friendship between doctor and patient is a lofty ideal and serves a rhetorical purpose in juxtaposition to a medicine of strangers, Montgomery asserts that such friendships are fraught with risks and ethical concerns.

Instead, as a middle ground Montgomery proposes a “medicine of neighbors”: “Neighborliness implies a duty, especially in time of need, but a limited duty that leaves considerable room for both self-preservation and performance above and beyond its call.” This proposed metaphor for the doctor-patient relationship is valuable, especially as it stipulates “attention and respect” for patients without the emotions and obligations of friendship, which can be intrusive and burdensome for doctor and patient alike. At the same time, however, the very presence of extant or impending losses, hovering over both doctor and older patient, sometimes demands something more than just a good neighbor.

Apple Tree

During a visit with Jacobo one spring, he appeared tired and depressed. After an hour of conversation, however, he was en-livened, and I felt reassured that all was well. Several weeks passed and I didn’t hear from him; I called but got no answer. I persisted, and a weakened voice finally answered the phone: “Mi amigo, no estoy bien. I am not well,” he told me. I was alarmed and insisted, “Jacobo, I must see you soon!” The next day Jacobo came to my office, unable to walk, with an aide pushing him in a wheelchair. The color was drained from his skin, and he appeared gaunt and exhausted. We barely spoke as I beheld his image. The timelessness of our friendship had suddenly hit the reality of aging, and I knew he was dying. At that moment my friend became my patient, and I quickly made arrangements for Jacobo to go straight into the hospital. Within two weeks Jacobo was gone, drifting off to eternal sleep one morning as his liver shut down from an unknown malignancy. It was a startling departure to me, as I had previously tried to deny that, despite our close friendship, Jacobo’s eighty-five years always meant that death was not far off.

And so it was with our friendship, a refuge of time we spent together that was unknowingly and perilously a little way away from the end. Jacobo knew this better than I did. He was an incredibly spiritual man who believed with certainty that God created the world and that it was logic, not just emotion or spirit, that could bring this understanding. But when he once spoke of death to me, it was not logic but pure poetry: “When I die,” he offered with a mischievous smile, “perhaps I will be buried close to an apple tree, and I will reach out and pluck a fruit from the branch.” I looked at him and chuckled, then reassured us both that there were no trees in the near future. But the image remained in me—this gleaming apple, the symbol of all the worldly knowledge that Jacobo so eagerly sought.

As much as I agree wholeheartedly with Montgomery, I must confess what I, and many of my colleagues, have learned: Sometimes older patients become friends and older friends become patients, either way driven by the nearness of death, which eventually comes, often stealthily, and fells another soul from our practice. We are left as the final witnesses to a life long lived, once full of dreams and memories planted lovingly in this world. This is a special honor, one that grows with time if we are able to hold fast to it:

Beloved, gaze in thine own heart,
The holy tree is growing there;
From joy the holy branches start,
And all the trembling flowers they bear.

Brett

A reduction in sensory function seems to impair people a bit as they age; they don’t see as well, hear as well, generally lose quite a lot of their sense of taste, have olfactory system problems, and so on…it seems to me that these impairments, along with conditions such as vascular disease, diabetes, etc., can contribute greatly to disrupting an elderly person’s mental wellness. When these different factors manifest themselves in very pronounced ways, it can be quite disorienting and can prompt confusion, irritability, pain, loss of energy and, ultimately, loss of the desire to embrace life in a healthy manner. (I think this is why we revere elderly people so much who possess a positive outlook.)

Also, as was mentioned, while dealing with loss is part and parcel with what it means to be a human being, loss becomes much more at the forefront of an elderly person’s mind than what would normally be considered healthy. And, each loss becomes a symbol. My parents have recently lost two of their best friends (a couple of similar background with whom they spent many happy times). Their dog of 12 years died about two years ago (after watching them grieve for a couple of days as if their only son had been killed in a car accident or something, I got them a puppy; this seemed to pull them right out of their vortex of grief). My mother has been dealing with cancer for a couple of years; my father is recovering from hip replacement surgery and a heart attack. I’m sure the losses they’ve suffered in the past two years emphasize a sense of their own mortality, as would be the case in any of us; however, the sense of death being imminent to a person in his/her 80′s, say, is much more profound than in someone my age (55).

My parents are very pragmatic about their aging, especially my mom, and my dad cues off of her strength. My fear is that she’ll go before he does and then he will turn into a person lost in a torpor of depression.

Annfarr

My mother died recently at 91. She had a constellation of medical problems, but maintained her good humor throughout. The nurses who cared for her were wonderful. But the young make doctors were dismissive of this required scholar as a human being and seemed to believe it was her responsibility to give up and die.
Tina

Brett, Your Dad has a perceptive, caring, and, I’m pretty sure, loving son. That said, it does seem to be the case that many elderly men are almost at-one-with their wives, even though the wives sometimes exhibit an extra part of their personalities that seems separate from the duo. Even with profound Alzheimer’s, my Dad’s love and attachment to my mom was also profoundly evident. I’m thinking that your perceptiveness and caring will help you all. Your writing was very moving when Tom read it today.

Cory

Two great topics today. Kudos to you, On Point.
Cory

The combination of working with the elderly for many years and the mental and physical changes I have begun to see in myself leave me fearful of aging. I am also afraid of the effect the coarsening of our society on the lives of the elderly.

One thing I think contributes to a sort of disconnect for the elderly is what I call “the VCR effect”. Remember the joke about grandma or grandpa being unable to work their VCR? I think at a certain age we become less able to adapt to new technologies. My personal line may be somewhere between PC’s and cell phones and all the new hand held devices and notepads. It all contributes to a sense of life passing you by.

Tina

“I am also afraid of the effect the coarsening of our society on the lives of the elderly.” Cory, I like your post. I don’t know exactly what you mean by this quote, but I responded to it. When I read the word, “coarsening”, I think of how much our society is addicted to looking for the beautiful and the sexy, even when the beautiful & sexy have trashy mouths and/or are drunk or stoned. I used to think people were friendly. Then I got sick & started losing my hair, including my eyelashes. It is amazing to see how much of one’s own “look” is based on hairline and eyelashes. I haven’t gotten fat, but my cancer is in my bones, and I pay dearly if I try to exercise, so I have gotten wider. It is AMAZING to see how differently people treat me now. I am either invisible to them, or they do not want to look at me at all. Many males will not look me in the eyes any longer. It is very hurtful when it’s happening. If I’m wearing my ball cap, that can change — it is quite stunning, really, but it is because the ball cap makes my eyelashlessness less visible (hats=headaches). In other words, I think I’ve got several years’ worth of proof that people are indeed coarse — they hold the door for me if they think I am young and healthy looking; but when I am older and sick, it’s Get Out Of My Way, Lady! This is particularly interesting when I am using my cane, which is pretty much all the time now. I am perceptive, so I’m pretty sure I’m right on this. In other words, just when there ARE more young people who are beautiful (better maternal nutrition; fluoride in the water & toothpaste; Title IX for girls; non-fat products, including ice cream!), people only want that; their impatience and disrespect for anyone showing the signs of age or illness is on the rampage. That’s how I interpret “the coarsening of our society”. I was NOT like that when I was younger; in fact, I always sought out older people; sadly, many of them have passed away now.

I very much appreciate this topic. I DO think that the doctor guest did not give nearly enough time to aging when there is PHYSICAL IMPAIRMENT. If I weren’t sick, I’d be in excellent health! Is that an oxymoron? No. It’s just that I used to do everything right to BE healthy; but somehow I got cancer & then it came back. They say that I am lucky it is in my bones & not in my organs; but life is NOT the same with cancer in my bones. This can even be very socially isolating. A walking group was just forming in my neighborhood, but I couldn’t join because of my cancer in my bones. Forget that I used to walk fast 3-4 days a week, just loving it. But more sadly, no one wants to just walk with me at MY pace because people need to walk fast to get their exercise in, and they only have so much time. Do you see WHY I love this NPR site! We discuss THE WORLD, and none of us knows or cares if the others can ‘catch up”!!!

Zeno

I think a lack of community with independence causes mental decline in everyone, but add aging to that and the decline is accelerated. Today’s society of disposable people at any age, and the sedentary isolation and that technology has created in the industrialized world consigning each individual to a cubicle until they die is a waste of human potential and equates to languishing in solitary confinement in a highly medicated state.
Ellen Dibble

I am wondering, based on the selection up top from Agronin’s book, whether the relationship between doctors (especially psychologically oriented professionals) and elderly patients is the focus, or mental wellness separate from that. I suspect most individuals who reach old age know how to sustain their mental health without seeking assistance from medical professionals. I know one can be hung out to dry as one’s health unravels, and one’s ability to surf the community for co-conspirators in life’s rage (sorry, it’s coming to me that way) is diminished as energy and abilities are depleted.
So Brett’s solution of a dog is so terrific. I was thinking of that the other day when a TV show featured the training of rescue dogs, and the reward for any dog? “All a dog really wants is to have fun.” Horsing around, not food, is the appropriate reward. To me, as you get older, you get the right to reclaim that basic wiring that seeks fun. The serious part of life has taken us inevitably off the cliff. We might as well play.
I thought of this the other day comparing notes with a woman in her mid-70s undergoing a many-months medical treatment similar to mine. She said she’s lost 10 pounds; I said I’d gained 10 pounds. Somehow it sprang to our minds at the same moment that I had found her lost pounds. A very satisfying moment settled in, like jointly catching a Frisbee. The simultaneity was the thrill. That’s what life is about, catching things like that, right out of the blue. I was definitely channeling my inner dog, and doubt it would have happened any younger, not the same way. Others in the room could see this too and contemplate how to propagate the phenomenon, we being basically strangers, neither young nor healthy, having a blast. I hope this muscle strengthens as we age.

Tina

Ellen! Oh! What a BRILLIANT post! I’m copying it & keeping it!!!

Ellen Dibble

Hi, Tina. Thanks.
I read today’s topics off the web before I turned in last night, which probably sort of queued up that little anecdote in my head. I find myself looking “down” at myself now at times as if I were my 15-year-old self, partly answering all the questions my 15-year-old self wanted to know. I don’t think I did the reverse, wondering how I might seem to myself, as the story goes, “when I’m 64.” Not that I didn’t care, but it didn’t matter somehow. But I do care how that kid judges me. An oldster once told me the reason the Greeks gave that we can’t see the future is because it would terrify us, and I see that. The journey through time of any life this long is…

wauch

What do we expect when one of our major goals is to always and forever look to extend average lifespans of Americans? Eventually we will or are already extending lifespans into a range that invariably is successively expensive and inevitably detrimental to the stability of our health care system. Living forever is not a beneficial mission!
http://www.tedauch.com
http://adpopulum.net/

http://gregorycamp.wordpress.com/ Greg Camp

At what age are you volunteering to die?

wauch

Look I am only saying that dying is natural and our fear of it and obsession with avoiding reading about it or experiencing it is a little weird and definetely extremely costly to us today and our children long-term. The longer we decide to raise the average lifespan the longer we prolong dealing with structural health care problems and avoiding the issues related to childhood mortality which it seems would be of greater concern.

http://gregorycamp.wordpress.com/ Greg Camp

We have reatively low infant and child mortality. I don’t see that you’re going to get older people to volunteer to die to lower those numbers a bit. Remember, that age group votes far more often than any other.

Ellen Dibble

We just have to hope they stay connected so that they vote on the basis of something other than long-form birth certificates, for instance. And also, make sure that their skills are used, not wasted. “Use it or lose it” must apply to lots of aspects of life, including those skills most owned by seniors.
Tina

I beg to differ! I don’t know the exact statistics, but as a developed nation, we have one of the HIGHER child mortality rates! And shame on us!!!

Ellen Dibble

I read in one of the national magazines a few months ago that a global study of happiness revealed that across all cultures there is a smile chart, with happiness lowest in the 40s and 50s. People tend to get happier, all over the world, as they head into old age. The chart did not head back down to scowl at any point, but I’m beginning to wonder.
Joan Countryman

Check out the continuing care retirement communities of the Kendal Corporation: together, transforming the experience of aging.

Cory

Did you have to pay for this advertisement?
Cory

Ain’t capitalism grand!

Audrey in JP

When my 94-year-old grandmother was in a nursing home she said she hated being around “all these old people” too. But she wasn’t denying her own old age, she was just longing to be around young people, full of life.

Nancy Adams-Cogan

My mother-in-law was quite isolated at home, and hated moving into long term care, but enjoyed relationships with many of the younger caregivers there. Lots of gentle teasing and laughter, along with concern for her wellbeing.
Tina

I had to be in a nursing home for three weeks after I had my hip replacement. There were some brilliant elderly people, but they were few in number, and I know — because they told me — that the people who were brilliant and who knew that they were there in that nursing home for the rest of their lives were depressed. They had so few people to talk to; and some of the people they enjoyed meeting died soon after their friendship began. This had already happened to several of them. The CNAs had to be DRAGGED into helping with the most basic of human needs. NO nursing home should EVER be allowed to have CNAs serve meals, because when they are serving meals, they cannot help with other things. For the people there long-term, they know that this means that they will lose their dignity at some point. We have put money over human dignity! And, when family shows up, the CNAs disappear! It is NOT the family members whose job it is to help with certain things — they are PAYING for that help; yet, the CNAs take the opportunity to look like they are busy elsewhere when family shows up, even when the CNAs are NOT busy elsewhere! I saw this at my dad’s and my mom’s nursing homes, and I saw this when I had my hip rehab!!! The CNAs are NOT paid enough; that should change!!!; in the meantime, they SHOULD be available to do their jobs!

Cory

I’m a CNA, and you’d be suprised at the things we do. Laundry, custodial work, maintenance, cooking. Caring for patients/residents is sadly only one of our many duties. All the people I know doing this job WISH we had more time with our resident/patients. Always remember, it is about money. Owners would have to pay for more employees if CNA’s didn’t do all this side work.

BTW, beware of privately owned nursing facilities. They are often owned by investors who view grandma and grandpa as a revenue stream as opposed to people. If you do go to a privately owned facility, lean towards those owned by former RN’s or people with experience in the industry.

Tina

Thanks for the tips, Cory! I did see both; the CNAs who literally knew how to get out of work; and those who were over-worked. I agree that the cost would be higher to do things the right way, but it should be: the CNAs should make more money per hour, AND there should be more staff so that workers aren’t asked to do too many things at once, ALL of which are essential! This is one of the areas where we SHOULD be spending our money, as opposed to other priorities we’ve chosen.

Yar

What about the economics of 70 million people turning 65 in the next 20 years? It seems to me that Dr. Marc Agronin has a privileged view. We have a generation that face retirement without enough resources to carry them through this stage of their life. This is true even for those that have their health. Economic security is the biggest risk to the boomer generation. What about the person who has a negative net worth on their 65th birthday? We don’t have an answer so we don’t ask the question.

ThresherK

Don’t forget the “Plumber’s Crack”: Our “brutally honest” leaders, who wish to raise the SocSec retirement age, talk about increased life expectancy.

That increased life expectancy is really weighted toward the well off (i.e. white-collar workers) The ones who’ve been manually laboring for at least forty years of their lives? Not so much.

Tina

Manual laborers DO risk their physical health over years of working, but just so you know: office-work can be extremely detrimental to your health. Cervical spondylosis at the neck (an extreme osteoarthritis at the neck) is bad enough, but there are two even worse conditions that can occur especially because spondylosis is often misdiagnosed as carpal tunnel syndrome or as the fibromyalgia it can cause. The third level spondyl-??? condition is paralyzing. Also, weight gain, from low exercise for so many hours per day, can cause diabetes and heart and circulatory issues, some of them deadly. Office work is NOT benign!!

Edith

This is the issue i was going to bring up by calling in, but couldn’t get through. My parents are both 87, lived what my brother and I call the “Ozzie and Harriet” life where they could live comfortably on just one income. My Dad worked for the same company his entire career and retired with a good pension and health insurance. Now they live happily in a retirement home that offers them every comfort and lots of social life and as much activity as they want. They are guaranteed a spot in the adjacent nursing home when and if the time comes. My brother and I, however, both nearing retirement and with spouses also working, have to wonder if our money will last long enough, if we will be able to afford adequate health care (even with insurance.) In short, will we be able to be as comfortable as our parents?

Christine

There is an entire industry being built around the fear of aging. Aside from the multi-million dollar plastic surgery industry, there are countless supplements people are encouraged to take and books and mental exercises people are encouraged to do to stave off the possibility of dementia. Most are probably not effective. Exercise and maintaining a healthy weight, not smoking, and limiting alcohol consumption will keep you healthy. But nothing will keep you from aging. Where is there anything that encourages us to accept aging as a part of life? That sees aging — not as a disease — not to be avoided at all cost, but to be embraced for its own gifts.
mel

My experience with aging relatives shows a completely different reality than the one represented on this show & by the comments so far. Every one of them has experienced a rapid decline in cognitive abilities in their 80′s regardless of lifestyle or living situation. This is also accompanied by physical deterioration. I would describe their mental states as “child-like”. It doesn’t surprise me that this population would appear to have high rates of “satisfaction”, because their view of life has become so unsophisticated. All are or have lived in continuing care communities, with lots of stimulation and assistance, so isolation or lack of stimulation is not the issue.

ThresherK

Funny you should mention child-like; as my dad, getting to well up there, shamelessly swiped this from a comic whose name he won’t divulge:

“Your first birthday party is like your last one: You wonder who all these people are and why they’re making a fuss over you, you can’t control your ‘functions’, and you don’t have any teeth.”

Ellen Dibble

The internet is a huge help in terms of memory. If you can remember any related words, you can probably get the rest of whatever it is. Yesterday, there was white powder found at a local courthouse. After a certain powwow, the word anthrax was irretrievable. I googled white powder, Massachusetts, and eventually found anthrax. Well, it turned out to be something like Cremora, but by that time, the staff had enjoyed a day off.
Ellen Dibble

The internet is a huge help in terms of memory. If you can remember any related words, you can probably get the rest of whatever it is. Yesterday, there was white powder found at a local courthouse. After a certain powwow, the word anthrax was irretrievable. I googled white powder, Massachusetts, and eventually found anthrax. Well, it turned out to be something like Cremora, but by that time, the staff had enjoyed a day off.
Joe

I don’t mean to be a downer, but to what extent are we trying to make old age look better merely because the aging population is growing so quickly? That is, the elderly population is going to become a very valuable demographic, so of course we want to make them feel better about their declining years. Perhaps I am too cynical.

Tina

No, you’re not being too cynical. As much as I appreciate this show, the doctor did NOT mention the real PHYSICAL ILLNESSES that people can get if they are fortunate enough to still be alive by the time they reach 65.

Joe

I don’t mean to be a downer, but to what extent are we trying to make old age look better merely because the aging population is growing so quickly? That is, the elderly population is going to become a very valuable demographic, so of course we want to make them feel better about their declining years. Perhaps I am too cynical.
Charlie Mc

“Smell the roses” is the advice many give as suggested activity for retired senior citizens. There is wisdom in this. This expresses the zen wisdom which teaches us to live in the present moment, no matter how old we are. to breathe, and focus on the here, the now, the this and on the within and without of breathing. We term a very happy experience as an ecstacy, a standing outside our selves and focusing on others.
From 14-40 years old, we tend to be living in the future with worry, or in the past with guilt. In our later years we begin to see that time and space are not permanent gifts to us, but that the present moment is the best experience we have in this life, of eternity. The world desperately needs to appreciate the help which meditation can bring to one’s life, whatever the religious persuasion may happen to be.
Joyce

What happens when there are not considerate and understanding care givers. A recent hospital visit for my 93 year old mother who is fortunately of sound mind had physicians treating her as “expendable” and talking down to her and even ignoring her and talking “above” her to family and not addressing her as a person.

Tina

My brother had a spinal cord injury when he was only 38. He lived for 15 miraculous years with C2-C3 quadriplegia, working most weekdays! Yet, he had many physical consequences from his disease; these kept piling up as the years went on. Then, in 2002, I was visiting him in one hospital and my mom in another. The doctors in both hospitals acted just as you say, to my brother and mom AND to me. The attitude of the doctors was such that I thought that both my brother and mother had several years of life left, altho of even lower quality. Actually, both had medical signs that indicated that they both would die within six months; but the doctors didn’t let me know in any way that would have made sense to me, actually in any way at all. Therefore, once I thought the crisis was over, plus a little more time, I left Florida for my home, child and job in New England. Had I known what I could have if the doctors hadn’t been so __________ (I don’t even HAVE the word!!), I would have asked for a leave from my job and stayed down there with them!!! I missed both of their passings by just a few hours because I couldn’t get a flight down there in time. I will forever hate the one doctor in particular.

Joyce

The attitudes of many, many people, and of the news broadcast these days, going on and on about the elder population growing and requiring more and more health care, often makes me feel as though it is expected of me to apologize for becoming older, for having become disabled, and for not being rich enough to not have to tap into any government funds. Should older people pick an age where they know to clock out of this world so that we are not burdening anyone???

Tina

No! In a thoughtful, civilized, humane society, people AND their government would prepare for these eventualities.

Audrey

My mom is 87 and in an assisted living facility. We have been blessed because she’s got a new lease on life. The social interactions, the brain stimulation, the exercise she gets just from going from activity to activity, have made her happier and more herself. The most important thing for her is that she sees me and her granddaughter several times a week. The people in her facility who do best are those whose families are active and loving parts of their lives. We need not to avoid our loved ones as they age in an effort to deny our own aging.
Ellen Dibble

Was it the first caller who spoke of all the pieces beginning to fit together? I missed some, but let me reiterate. Maybe I was dense when I was younger, but neither politics nor history nor much of anything had a comprehensive template that would hold it together for me. Now, almost 50 years after formal education, everything is beginning to “fit” in almost every sphere. I wonder, with gluttony, if I’ll have time to “get” the full picture before I die, and what is appropriate to do with that kind of understanding. I wonder how many others have this experience. Another would be the justice system. I transcribe for the courts. The law has always seemed obscure to me, in its particulars, but after a few decades, being able to ignore the parts that don’t appeal to me, things are falling into position in ways I can imagine are specific to my own life and experience. It begins to be a responsibility: to wield your personality and grow it, in ways that could never happen in the years of child-rearing and great busy-ness.

nj

Even in high school, these words resonated with me. Moreso now…

“In and out of the garbage pail.
Put I my creation,
Be it lively, be it stale.
Sadnes or elation.
Joy and sorrow as I had
Will be re-inspected;
Feeling sane and being mad,
Taken or rejected
Junk and chaos, come to halt!
“Stead of wild confusion,
Form a meaningful gestalt
At my life’s conclusion.”

—Fritz Perls, Gestalt therapist, In and Out of the Garbage Pail

Nan

My sibs and I are in the throes of this right now – watching as our parents’ world becomes more and more constricted due to ill health, watching them become more quiet and withdrawn as they grapple with the fact that they can no longer “do-for” themselves. Medical advances can be wonderful, but I think we as patients, health care providers and caregivers must be mindful of the whole patient and their quality of life – not just whether “we can beat this thing.” We are also seeing a sense of guilt that many things are landing on us due to lack of planning over the past few years.

We hope to have them moved soon to a community which will allow them to be as independent as possible, while offering them the ease of knowing that shopping, meal prep, laundry, cleaning etc are no longer tasks to be managed (badly).

What this has shown us is that we all must plan not only for retirement, but also for retirement 2.0 – that level where you can no longer be independent.

Tina

Sadly, our family’s experiences with these facilities were NOT good; and, once my dad had his Alzheimer’s diagnosis, many facilities had a legal right to reject him from residency!!! The other places were filled up. Finally, we found a place that would accept him. It looked to be very nice, altho we feared that TOO much money was spent on extra fancy decorating. Then, after three days there, it was apparent: the staff had not changed his clothes, including his underclothes in over three days!!! That is criminal neglect, especially in someone with Alzheimer’s! We took him out of there immediately. Then, another place had a spot — they were so “down home”, that spots only opened up when someone passed away. That was the sad realization — the answer to our prayers came from another person’s passing.

All this took years; I had to travel thousands of miles and had to work a reduced job to help out, because a better job would not have allowed me the time off — especially the emergency time off — that I needed. Kid in one state; parents in another 1500 miles away. I’m sure other people know this situation.

I’m really fed up with this country – all these schemes, especially the business schemes for solutions to these problems. We do NOT need to re-invent the wheel: the Scandinavian countries have this all worked out, but NO, we have to do it the scheming Capitalistic way, even though the humanism required of these situations does NOT match up with the profit motive!! I am speaking from personal experience, from several family members involvement!
nj

Yes, but what does it mean to “plan for” “retirement”?

There will be those without the financial means for whom not working isn’t an option. And others (many?) who will have to rely primarily (or only) on Social Security when their productive working life is over. And others who may well have no family to rely on in their later years.

Please, what does “planning” look like in those cases?

Carol

Wonderful show! I’m helping to organize my 30th college reunion at a women’s college this year. We are all just entering our 50′s, the tail end of the baby boom. We’ve embraced our life stage, in a way that has created community. Expecting to live longer healthy, active lives, we’ve accepted some limits associated with aging, but embrace new possibilities to put our life experience to work. There’s a wonderful book, called “Inventing the Rest of our Lives-Women in Second Adulthood,” written by Suzanne Braun Levine, that takes this topic on beautifully. She describes us as “the first generation of women nurtured on a recognition of women’s independence; that gives us the chutzpah to go for a Second Adulthood.” She also describes a “Fertile Void,” a time of transition that can be difficult, as we transition from expectations of younger years to more liberating, energizing outlook for relaunching into healthy aging. Very interesting reading. Lots of research on the brain, longevity in the works, too. Our generation will keep the conversation going. Thank you for hosting this show!

Tina

Carol, I am SORRY to load this on you — I MEAN that! But many of you slightly younger Baby Boomers are having so much fun and delight with your circumstances that you do NOT want to see what your slightly older brothers and sisters need in terms of companionship, let alone help! And, I can’t see it changing. You’ve earned this new play time, WHY would you stop to walk more slowly with the person affected by illness? I don’t mean this personally, but generationally, I AM speaking a truth! Those of us who went thru earlier periods of economic downturn such that we could only have one child, or maybe no children, have little help from kids, who might not even live nearby. We just finished helping our parents in their final years while raising teens. Now, we look around, and everyone is playing, and no one wants to be bogged down by helping the person who needs milk from the store or just company as she walks down the street with her cane. WHY would you know to think about helping and joining in in this way? Television is all about 25 year olds, so our stories are not being told. When I was younger, I did seek out old people as friends and acquaintances, but that is because the leading edge of the Boomers was a slightly different group: we didn’t have many kids just slightly older than we were (World War II: few babies), but we DID have grandparents right near by or close to us by way of letters. That is sometimes why I post honest but truthfully- negative issues (from my life and the lives of those I know) here — it IS a forum. I do apologize for doing my indicting on top of your positive piece; please remember, this is not about you personally.

Donna Blackman-Baxter

My mom is 91, dad is 92. Mother’s is physical and mental health has deteriorated drastically; my father is her primary caregiver. He has always been a man of great faith and demonstrates this by laughing with my mom, singing with her (she still tries to harmonize with his beautiful tenor voice), having her read aloud, etc. Of course, our concern is that he is wearing his beautiful self out. Thank you for this wonderful program!
mel

A couple of things, Mel is a girl’s name too — and I am indeed a woman. Also Alzheimer’s not in the picture at all. It’s just a case of losing the ability to think clearly, understand issues and make decisions. It is no wonder the elderly are “easy prey” to fraud. My husband has had to “rescue” relatives from perfectly legal but foolhardy financial decisions. They have lost the ability to reason. Heaven forbid this is the population that the Republicans think are going to make reasoned decisions about health care providers in the future
Ellen Dibble

I read that the physicians who are happiest in their work are the ones working with the elderly. This was a revelation to me. Agronin is explaining about Medicare and why we don’t have enough gerontologists. It’s a political issue to start to address now.
Ellen Dibble

I read that the physicians who are happiest in their work are the ones working with the elderly. This was a revelation to me. Agronin is explaining about Medicare and why we don’t have enough gerontologists. It’s a political issue to start to address now.
pnsret

My husband is 97.5 today. He still drives and flies his own plane. He’s presently involved with reorganizing a flying organization of pilots who have to be a pilot-in-command on their 80th birthday to join (over 800 members at this time) and an organization formed to save the airport where he keeps his plane. To say the least he’s aged well and mentally runs circles around most, including me, but physically he has difficulty walking. My complaint is that it is so difficult to find a geriatric doctor where we live. Most of his doctors take one look at him and are amazed. He, of course, wants the doctors to see him as doing well (a man thing I think), so the doctors don’t probe to get a feel for what problems he may have and more importantly help him to overcome the problems. I have my opinion as to what would help physically, but you know how that goes coming from the spouse! I am 71.5 today (we share the same birthday) and we’ve been married 40.5 years.
Annemie

I fully accept loss, death , decline ( I am 70) , but how do we live with the knowledge of what is coming, what is already here: climate change, irreversible damage to the oceans and all of nature? Until now we could live ( and die) in the knowledge that nature will go on as it has for the last 10.000 years, but now that is not so. The existential rug has been pulled out from under. How to have any contentment when one sees what is already under 3way? What future for the coming generations?

Annemie

Ellen Dibble

Annemie, I know exactly what you mean. I feel that way too. And it comes to me more every day that the older half of our population are going to have to take the lead in making the powers-that-be focus and figure out solutions. I think it’s particularly the responsibility of the generation that is no longer reproducing and struggling for their own particular share of wealth or their particular share of fame and renown. On beyond the kind of issues of passion and identity and status that seem to me to often warp the “agendas” of the younger among us, we the older are going to have to watch out for the generations beyond the immediate vision of those alive today.
Mobilize. Organize. Shoulder this issue or set of issues as ours. The depth and breadth of it is daunting, but younger people maybe don’t take a long enough view, so our limitations are different from their limitations. We have a distinct role.

Dan from Burlington, VT

Hi Tom,
I am currently in the midst of dealing with the heartbreaking experience of my parents nearing the end of life. My father recently succumbed to a painful death resulting from age related illnesses including alzheimers disease. At the same time my mother entered a nursing home due to an injury. She can never return to independent living and has become very resistant to her new home, which she considers to be a prison. Due to her social economic status she is in a low quality facility with minimum care to it’s crowded population. It is just a very discouraging experience each time I make my weekly visits to my mother. I feel little hope that our country will be able to handle the quickly growing population of seniors in the same situation as my mother’s. My question is: what is America going to do to to deal with this crisis? It makes me very afraid to face aging as I am experiencing the tragic reality of how society handles those who can no longer care for themselves. Thank you for your help and for your show, of which I am a devoted, daily enthusiast.

Dr. May

Dan, I am going thru the same thing. I can’t just leave my practice to attend to Dad. But as family doctor, I can tell you that what they have is a bare minimum safety net. I do medical missions, and can tell you that what we have in America is superior to at least 3/4 of the world, even if it is bare minimum. We need to consider this as a societal imperative before we get there. One of the FIRST things to consider is that the generations coming after us may not even be able to provide this level of care.

http://www.facebook.com/people/Lindsey-Piper/505805418 Lindsey Piper

My wife Allison and I are moving from Boston to a cohousing project in Belfast, ME. One of the major reasons we are moving into cohousing is to be able to expose ourselves and our children to a much broader age range of our neighbors. We have several elderly couples moving in who we are so excited to learn from. These are people who have decades upon decades of experience- in farming, in bird watching, in homesteading, in sewing, cooking, everything you can possibly imagine. Becoming their friends will enrich all our lives tremendously and help us learn skills that would have taken us so much longer if we hadn’t taken advantage of their knowledge and experience. On their end, we will be there to help stave off the loneliness that so many elderly experience in our culture. We can help them take care of their homes and more physically demanding chores to keep them out of nursing homes as long as possible.

Tina

I am so happy to hear this! I’ve always loved the idea of cohousing, but never studied it myself. I did know a couple in RI who hoped to live in cohousing — this was maybe in the 1990′s — but they couldn’t get past zoning rebuffs. I really don’t know about the legal hurdles cohousing must get past; I don’t know if it goes state by state. I wish you the very best — this sounds FABULOUS, and you sound so ready to fully participate! Congratulations to you and your family! Thanks for being pioneers. Maybe you’ll keep us posted when On Point’s topics are close enough to make your updates “on point”!

Nancy Adams-Cogan

Type your comment here.Thank you for presenting this important topic for our working minds. I spent 14 years in my late 50s and 60s as a chaplain deployed to geriatric outpatient clinics in university health care. During those years I learned much about how to age gracefully (and how not to). Working with the spiritual wellbeing of elders and their families convinced me that attitude is prime in maintaining spirit and that, paraphrasing Vaclav Havel, hope is conviction that what we have done and what we do today matters. At 76, I visit patients on a reduced schedule, enjoy poetry writing groups, and publish chapbooks, several of which are related to the changes, aches and joys of aging. In short – continuing gratitude is more than a platitude.
Nancy Adams-Cogan
Ellen

Love your program today. I am 71, still work as Dir. of a non-profit. lead a meditation group, counsel people from 15 yrs. to their 50′s, am writing a book, all (most) of my friends are in their 40′s and 50′s, still love my husband of 22 yrs., good relationship with my adult children. I have had some health problems but find that my active life helps me to not surrender to those. Most people think I am in my 50′s, ( I look it, still work out and can outdo some 20-30 yrs. younger. I am more comfortable in my skin, know why I’m here, and where I am going, I do not fear age or dying.
thank you
Ellen
Lacy Phillips

I don’t remember my grandparents as young people. They were past retirement age when I was born and we’re all amazed at how independent they continue to be as they enter their 90′s. My grandpa served in the Pacific in the Navy during WWII, but never spoke about his military experience. He was always the quiet type, but when I married last year to a man who had served in the Navy during the first Gulf War, my grandpa suddenly started telling us old war stories and bringing out pictures from his time in the service during our visits. I have found my grandpa to be much more talkative in the past few years and I attribute a lot of this to the fact that the family finally convinced him to use his veteran’s benefits to obtain a pair of hearing aids. I knew he’d lost a lot of his hearing in the war, but I think now that perhaps he’s been missing out on a lot because of his inability to hear what was happening around him.

Lacy Phillips

I was also going to say that I think he had a general fear of the VA hospital and doctors in general, which is why it took us years to convince him to seek treatment for his hearing loss.

Tina

A friend of mine was severely injured during the Vietnam War. You’ve gotten your dad past that first hurdle. I’m just writing to say that my friend has always felt that he received excellent care from the VA. He also has found that some non-VA doctors treat him very well out of respect for his VA status. If you dad has any lingering fears, maybe let him know of this man’s experience!

Louis

An important point about the PACE system is that it is really only available to medicaid eligible. In other words you have to be poor to be enrolled in this better system of prevention and care.
Clare

I heard on this program and have heard elsewhere that perhaps many older people suffering from depression had experienced this earlier. The implication is that well, one shouldn’t worry so much about this prospect. But the rates of depression in the general population are high, what are helpful suggestions for those who HAVE experienced depression earlier in life? I don’t think anyone really knows the consequences of lifetime use of antidepressants and the eventual effect in older age, right?

Sofia

Just because you’re depressed at a younger age doesn’t mean you’ll be depressed late in life. But a lot of the depression in the elderly is new, though. People develop undiagnosed thyroid conditions, or “walking” pneumonia or other medical conditions, and their bodies metabolize medications differently, and that can all affect mood. That’s why geriatricians are important. Dosages of medicines are not the same, pound for pound, in the elderly as in someone the same weight who’s younger. Pediatricians and geriatricians are tuned into not just sizes of their patients, but the specialized, developmental changes that affect the development of diseases, their courses, the associated moods and affeects, and their effective treatments.

http://www.facebook.com/profile.php?id=548583579 Stephen Cox

let me tell you something.. I live in Florida too. And it all boils down to money. Your edler years can be wonderful if you aren’t living medicare check to check. And having to skip meals to pay your rent or electric bill.

I also work with the elderly. And I see it all the time. It’s a shame, cause at lot of time the elderly are prey. And until we, as a society start to respect our elders, then only those who are well off will have a peaceful productive time, in their elder years.
Jltrescott

Hi Marc, I am so glad to hear us talking about this. I am a geriatric psychologist and RN who goes to many Independent Living Facilities and Assisted Livings very similar to the Miami Jewish Home. I am referred all those who are having problems coping, etc. And at any given time I only see about 5% of the population. What are the other 95% doing? those are the ones we don’t pay attention to. They are happy, thriving like Dr. Marc says. We tend to focus only on those 5%.

Another thought is that I used to say that I had never seen anyone 90 and above who didn’t have cognitive deficits. Now I eat my words. I have a patient 95 who just took up jewelry making and makes the most beautiful jewelry I have ever seen. I have 90+ year olds dating, dancing, talking to me about sex and how to manage their 70+ year old children’s attitudes about a “blended” family.

One final thought: I planned a trip to China this spring break with my 10 and 6yo children. My 90 yo dad heard about it and asked to go. I reluctantly said ok but it’s going to be a tough trip. He said he wanted to see the great wall before he died. my children were afraid he would die, but instead, we had a great time with him. He never complained, was positive and upbeat, always willing to try something new. My children’s favorite memory is when they were biking the ancient wall of Xian. my dad passed them in a rickshaw and said, “LOSERS,” as he put the L symbol to his face!!! That’s the new 90!
ptrafton

Dear Tom,
Thanks so much for On Point – relevant, stimulating, timely, and often brilliant (thanks to host, guests, and callers). I’m an evening listener on Rhode Island’s WRNI, forever grateful to Public Radio for opening my constricted saw-bones’ eyes, but thus unable to call in and contribute to your group discussion.
As I prepare a presentation about health care reform for my high school 50th reunion, I’m rather surprised that there was little mention of what the tea-party wing of the GOP (yes, that seems to be their vast majority) is recommending for elderly Americans. Except for the very wealthy (Kendall, etc., and above), the Republican proposals will consign older Americans, who have contributed so much to our country’s success, to the scrap heap.
I’m not talking about “death panels.” The issue is about preventing bankruptcy for our elderly due to health care costs, a certain result of Ryan’s so-called “Path to Prosperity” and Grover Norquist’s “Taxpayer Protection Pledge”.
I hope sincerely that a majority of voting Americans will understand the consequences of the misguided, theological ideas sold by those who have ensured that we have the best congress that money can buy.
Dr. May

WOW great show! thanks so much
Yip

I am 48 y/o female and have been very independent most of my life. Never married and for past 10 years, no long term relationships where I could really lean on or depend on someone. Have good friends but in NYC, they are naturally very busy…have their own lives….but I know they are there if I need them.

As such, I have learned to ‘entertain’ myself for the most part. Am confident, secure…no problem doing things on my own, though sometimes it WOULD be nice to have company when travelling for e.g. But I like my independence and time alone more than not. I also get alot of pleasure in nature….relishing it, bird feeding and watching, gardening, hiking. As such, I know that when I get older…even when those around me begin to die, one friend who’ll always be there is nature. And this is comforting to know. Being around nature always makes me happy. So I am not that worried about being ‘lonely’ when I get older.

As for giving up independence as I age, as an admitted independent person I recognize this may be hard for me. I have already started to try and let go, almost as a way to prepare myself. I already realize I can’t do everything like I used to…don’t have the same strenght and energy, and I’ve told myself that it’s ok to sometimes ask for help…that we all do or will need to do so at some point.

As for any fear of getting old, if anything I worry about growing old IN THE U.S. We have such a horrible, unhealthy attitude towards aging, the elderly and death. We want to look the other way…pretend it and they don’t exist. We don’t want to engage with the elderly. The elderly in the U.S., then sensing this apathy towards them, naturally feel isolated and depressed. And it shows. And which of us likes seeing depressed old people? So it becomes self-perpetuating. If we had a healthier outlook on aging, the elderly and death, as we ourselves aged, we would be more respected by society and treated better by young people. They would be more apt to want to engage with us.

But so long as our society shuns the elderly and is obsessed with youth culture, I don’t see the situation getting any better here. I often think about movign to another country when I get older…one where the elderly are more respected.
Billieboehm

I am 24 and I know my perspective on aging is limited however, I really love each year I get older. I don’t have a lot of jealousy for those who are my age or younger. My mother is 55 and I wish I was as grounded, experienced, and understanding as she. The people I meet that are over 50 have a lot of personality, they sit well with their flaws and the love themselves through and through. I am excited to have those qualities as I try and navigate the adult world….grey hair and all. FROM :Montana

Amy

I agree completely. I’m always amazed in interacting with the elderly how few hang ups they have , whereas. It’s so great, and I try to let it rub off on me!

Anonymous

While listening to your show, I was also reading the Miami Herald on the extreme abuse and neglect in many of the facilities caring for the elderly, disabled and mentally ill in Florida. I have observed the neglect in Rehab centers and nursing homes. Maybe the people that your guest treats get good care, but many , many people their older years are neglected and abused and their lives are hell. I hope to die before being put into any facillity, except a not for profit Hospice.

Sofia

Yes, there was just a case in the news of elders in nursing homes being photographed naked in their bathrooms by care attendants and the photos being shared around and laughed at. Shocking.

Sofia

Tom–
A terrifically important topic. Our elders are often craving simple face-to-face conversation and physical touch of any kind–a handshake, barbering, taking a pulse, a hug from a fellow congregant at a worship service. Without the means to purchase reliable transportation or companionship, they are too easily isolated with their own thoughts. The “neighborhood” idea is one taking hold in many so-called senior centers, which are being revamped in major ways by councils on ageing. No longer bingo parlors and places to sing along to a piano, agencies are including milder forms of exercise like tai chi and yoga, even Wii games (all easier on the joints), courses like financial management and creative writing, computer courses, and opportunities for seniors to volunteer, study, and travel together.

Here’s the new elderly: One woman I know started and ran a rape crisis center in her seventies, my own mother (in her mid-seventies) patrolled a neighborhood school area as an auxiliary policewoman (she’d been a secretary), and a third woman sold her big house and went to live in a yurt that she built. A man in his 90s has made it a point to see every first-run movie he can–he’s far more up on movies, recent best sellers, and even current events that I am (in my 50s).

Other cultures, particularly Eastern Asian (Japanese, Korean, Chinese) value the elderly for their collective wisdom and guidance. Americans have a long way to go to create elder-friendly neighborhoods in most of our larger cities and towns.
Sdonaldson57

Wow, thank you for this inspiring piece. Also really interesting reader comments as well. There is so much that needs to be done around age stigmatization. There is a documentary film saw recently that looks at this thru art therapy. Specifically how art helps people with Alzheimer’s to express themselves, and in the process helps to change the outlook of their families and caregivers. Really changes mindset. The film is called “I Remember Better When I Paint”, and we had read about it here http://www.secondact.com/2011/03/i/

Sharing as inspirational, and article/film gives good examples at looking at aging in a different way.
Sdonaldson57

Wow, thank you for this inspiring piece. Also really interesting reader comments as well. There is so much that needs to be done around age stigmatization. There is a documentary film saw recently that looks at this thru art therapy. Specifically how art helps people with Alzheimer’s to express themselves, and in the process helps to change the outlook of their families and caregivers. Really changes mindset. The film is called “I Remember Better When I Paint”, and we had read about it here http://www.secondact.com/2011/03/i/

Sharing as inspirational, and article/film gives good examples at looking at aging in a different way.
Amy

What a great piece. I worked for years as a speech-language pathologist in skilled nursing facilities. I still remember the day that I changed my mind about aging. I was treating a 90-year-old woman, and it turned out that we had so much in common, although I was a 28-year-old spring chicken. We had some similar musical tastes, had read many of the same books, and seen many of the same movies, although we were so far apart in years. It dawned on me that some things are just universal. If everyone realized the universality of wanting to experience life, have fun, and spend time with family and friends, this common bond between the old and young might help to dispel our society’s ageism.
Rosa Ergas

Dear Dr. Agronin:
This is one of the most sad and at the same time beautiful article I have ever read. It is an honor to have my father’s name mentioned in your book as a good person and your very good friend. Not because I am one of his two daughters, WITH PRIDE, MY SISTER AND I AGREE WITH YOU, HE WAS A GREAT MAN. MAY G D BLESS YOU, for the work you are doing, helping us older people to understand and accept what our last years might be like. This article has made me cry.

Thank-you

Rosa Ergas
sbh

Dr. Agronin correctly reports the statistic: 50% of 85 year olds are suffering from some degree of dementia. Immediately, he says: “We have risen to the challenge”.

How have we risen to the challenge? We have no medications that significantly alter the course or even symptoms of Alzheimer’s. (Read the most recent studies on current medications) And we are nowhere near a cure–although Dr. Agronin suggests that we will soon find one. Of course we can cherry pick and find elderly (85 plus) who are happy, satisfied, etc.. But the statistics (as well as the statistics on happiness in the 85+ population) tell a very different story.

Furthermore, where will the money come from to take care of the babyboomers who reach 85 and are in the unlucky half of the population? Medicare?

While I appreciate Dr. Agronin’s obvious care and kind heart, he is painting a grossly inaccurate picture of what it is like for most people who are over 85–as well as their families.

For those interested in a more realistic (and disturbing) view of growing old, read Susan Jacoby’s new book: Never Say Die : The Myth and Marketing of the New Old Age
http://www.senior-kaboodle.com Rob

I am a long-distance senior caregiver of my Mom and my in-laws who are in their 80′s and live 300-1500 miles away. All 3 are deteriorating slowly and it is difficult for me to watch it happen. I found this discussion so helpful and it gave me a better perspective on what I am living and what to expect. I tried to put my own experiences together at http://www.senior-kaboodle.com . I envy the people who are Dr Agronin’s patients.
windsor_julia

Bravo on this piece Tom. This is a topic that needs to be addressed. Dr Argronin is doing wonderful work. This is one of the most interesting threads have come across on aging. I checked out the title one of the comments mentioned, and came across this piece about actress Olivia de Havilland, who is still working – she is “a vibrant 94 years old” and recently narrated a film http://americanlibrariesmagazine.org/global-reach/film-legend-makes-memories-american-library-paris
Anne

I would be interested in continuing the discussion to talk about our extraordinary efforts to “keep people alive,” which I find interesting for two reasons.

First, if we project our fears on the elderly and subject people to toxic drugs (e.g. experimental cancer treatments) and multiple surgeries, are we really helping them? Dr. Agronin spoke of the elderly wanting dignity. How do we best accomplish this? I don’t know.

This conversation also touches on the policy debate in Washington. Much of the money spent on healthcare over a person’s lifetime is spent within the last days/weeks of life. Perhaps part of the solution is rationing care, providing more preventative care and then comfort at the end of one’s life. I sense, however, that “rationing” has a negative connotation for many in this country.

I would be interested to hear more on this subject in the future.
Aorourke

I find so much spirituality in working with older adults-I will add Dr. Agronins experience to mine. Recommend others read “My Mother, Your Mother” by Dr. Dennis McCullough as it has broad public policy ideas and can provide personal support to families, too.
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Sheep4wool

I enjoyed this show and re-listened on line. One side of all of this that was not discussed was the financial burden of aging. If we are living longer and longer, how are those of us without pensions going to afford this! We have done all the right things…have no debt..and what we thought was enough saved in stocks and bonds. But with this recession…I’m not so sure…it’s a worry. Thanks. Chris
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Alice

What a lovely post. I especially like this section:”…

my patients surround and guard the passageways around the nursing home, sharing an outward appearance of frailty but containing within lustrous seeds of history and wisdom that have been spread, year after year, throughout the lives of so many others.” It is so true that we have so much to learn from the elders in our lives, and we should appreciate them.

Sincerely,

Alice
http://www.drmarionu.com/dm_ltci/dm_ltci.htm
Sonias328

I found reading this article very touching, but I have always feared becoming old, and the frail which is why I have always avoided working with that population. The tought of loosing my freedom to old age, scares me. But from this article, my minds eye did not see rinkles, I invisioned just a man that once live then moved on. I saw a man with wisdom who was just like me once. With that thought meaby it will help me with dealing with the inevitability of life and death.