Some good news about aging societies

There’s an upside to aging societies that most of us haven’t much thought about. According to new information from The Gerontological Society of America published January 25 in ScienceDaily, as a society ages, it loses the taste--and the opportunity--for political violence. (World's Aging Population to Defuse War on Terrorism)

If you look at the Mideast, Iraq, Pakistan, and Saudi Arabia, you’ll see what happens with “youth bulges” in which there are proportionately more young people than usual. The youth bulge creates lots of people with “strong grievances against current political conditions and little stake in society.”

Population age cycles. In about 20 years, an aging, invested population creates political stability and economic development. Think about the US during—and 20 years after—the Vietnam war. You get the picture.

When the population continues to age and stops working, the period of economic development can slow or stop. Then a developed country will likely have to choose between accepting a high level of poverty among the old—or diverting money from military spending to avoid that poverty.

I will leave you to draw your own inferences. But I for one prefer the second option.

Author Mark Haas of Duquesne University says that the aging trend is starting to affect all the most powerful nations. By 2050, Russia’s working age population will shrink by 34%, and China’s median age will be almost 45. Will they choose impoverished old people or reduced military spending?

Apparently, the US will be less affected than China, Russia, Britain, France, Germany, and Japan. “In 2050, this country’s median age will be the lowest of any of the great powers,” ScienceDaily reports. At the same time, “the working age population in the US is expected to increase by 31%.”

While the article doesn’t mention it, I bet that the “youthing” of the US depends partly on immigration.

Makes you look at politics, the future, the economy, and aging a little differently.

Can we please talk about this?

If it’s sex or giving up driving, Mom doesn’t want the conversation.

Death, on the other hand, is okay to talk about, according to a recent Canadian study, The 40-70 Rule, by Home Instead Senior Care.

The title refers to the report’s suggestion that by the time you are 40 or your parents are 70 (whichever comes first), it’s time to start talking—and keep talking--about the hard subjects.

The 40-70 study found that the easiest topics to discuss were end-of-life wishes, living will, health concerns, and legacy. The hardest topics for Boomer children and their parents were independence (when Mom needs to move out of her home), personal hygiene, money, and when it’s time to quit – working, driving, and so forth.

Aside from parents refusing to talk, the main block to the conversation seems to be unprepared and fearful children.

Just how hard those conversations can be, and how little skilled most of us are in having them, is a message we keep hearing.

• At our January Member Meeting, Dialog with Discharge Planners, it became clear that no matter how good a job we do at discussing options at the end of life for advance directives, we haven’t really begun to talk about the shifts before the end. “Don’t resuscitate me” might be a much easier decision than what to do when Mom needs more help. We’ll pursue this topic further at our July 10 Consortium member meeting on Advance Directives. Check the calendar at our website.
  

• Yesterday (January 22), at WALA’s Aging In Place. . . Prepare for Evolution conference with Jim Moore, it was clear that senior housing operators also need to have clearer conversations with residents and family about changes in functioning that call for changes in housing or service.

David Solie’s blog entry, No Easy Way Out, has a wonderful discussion of the conversation problem. Solie is author of How To Say It to Seniors: Closing the Communication Gap with Our Elders.

As my mother approached 90 and despite increasing frailty and her super human responsibilities for my special needs brother, she simply refused any assistance. Every approach was rejected. The best we could do was build support scaffolding around both of them for when “the bottom fell out.”

This went on for years. Airline flights, phone conversations, involvement of other family members, protracted conversations with our family lawyer, meetings with my brother’s case worker, and endless strategy sessions with my wife all ended with the same outcome. It was my mother’s way or the highway.

So we shored up the situation the best we could. Despite my mother’s derogatory objections, we purchased long term care insurance when she was in her late seventies. We petitioned the court so she and I could have co-guardianship of my brother. We got her to sign a Medical Power of Attorney. Then we waited.

His recommendations?

1. Advance as far as you can go based on the personality and the nature of your relationship with the parent.

2. Retest the boundaries of that advance periodically even if they appear initally absolute. You never know when there is some give in the system.

3. Build the best scaffolding you can with what you have.

4. Keep asking yourself this question: What am I responsible for?

5. Draft a “When The Bottom Falls Out” list of the items that will require your management. Print it out and then start making weekly annotations. Your brain works better with a “starter” document. I think just “pre-thinking” about the house, the Medicare forms, the Power of Attorney steps, and so on will give you greater stability in the midst of the actual chaos.

6. Rethink what you know about the final mission of life. Most of what we are seeing in our aging parents is a need to maintain control in a world where all control is being taken away. Nothing is going to change that. It is not a rational need; it is simply a developmental task. We have all lived them in our own lives. The problem with the last one is how deeply it is connected to our family systems. However, knowing its true magnitude reduces the guilt over trying to craft a perfect ending or trying to control things that beyond our capabilities.

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We'd love to hear your comments, as always.

Make sure you can get there from here

A service and support program is only as good as the ability to access it. This concern was raised at the January 16 meeting of the Make It Work Milwaukee Coalition of health and human service providers. Cutting funding for intake and other staff—or not increase staff along with increasing caseloads—can put people in jeopardy. It also can waste the money poured into the program itself.

The Milwaukee County Department on Aging has built some economic support positions into its own budget to make sure that older adults get into and through “the system” without the delays and frustrations that others may encounter.

Milwaukee Journal Sentinel editorial cartoonist Stuart Carlson weighed in on the subject with this cartoon January 15. We’d love to hear from you about your solutions to intake and access problems you’ve encountered!

Beauty matters

With more than half of the “aging alerts” that come across my desk dealing with physical appearance, it doesn’t seem right to overlook the important topic of beauty and aging.

Nearly everyone agrees that Boomers are driving the exploding beauty business. We were the generation that would never grow old, that would just “fix” whatever we didn't like, including aging. By 2001, more than half of all beauty products claimed to have anti-aging properties. Plastic surgery and injections promising rejuvenation have become ubiquitous, and eating disorders in older women are growing.

Care in appearance is part of feeling good. I knew that my mother, who’s now in a nursing home for rehabilitation, was doing better when she asked my daughter to pluck her eyebrows and complained that I’d brought her the wrong lipstick.

But those who are battling against aging instead of exploring a new territory of a different kind of beauty are sure to encounter despair.

A new website, Beauty Paradox, promises some interesting guidance for women who are growing older. Its authors, Vivian Diller, PhD, and Jill Muir-Kukenick, PhD, are both psychotherapists—and former models. They’ve written a book by the same name in which they propose to offer a “psychological map through which a woman can explore the role beauty plays in her life as she ages.”

The goal is to redefine beauty on our own terms, not the media’s.

There’s not much on the site yet, but what’s there is promising. The first entry is a keeper. If you pass these thoughts along to others, please remember to credit the authors for them!

10 Beauty Thoughts to Hold onto as Aging Takes Hold of Your Beauty,
by Vivian Diller and Jill Muir-Kukenick.

1. Beauty is not just a physical experience, but a psychological one as well. Although we can't stop the physical changes of aging, we can effect change psychologically.
   
2. While aging is unconquerable, inevitable and irreversible, self-image is not. Self-image can be fluid and timeless.
3. Aging is not a battle of time, but with one’s image of oneself.
4. Chronological age does note have to define you. You can define yourself at your chronological age.
5. Put your beauty in your identity, not your identity in your beauty.
6. Take an honest look at who you are, not what you look like.
7. Rob beauty of its power over you. Take back that power and you will feel more beautiful.
8. Learn about the psychological forces of beauty you can’t see and those you can’t hide from.
9. Fear of aging interferes with aging attractively. Fear is unattractive. Aging confidently is not.
10. Beauty matters to all women, but to women who age beautifully, beauty matters not too much nor too little.

A place to live—and a little bit of grace

From Sarah Polley’s screenplay Away from Her:

Grant and Fiona are a comfortable, long-married couple who live in an old rambling house by a lake in Ontario. When Fiona’s memory begins to slip—“I seem to be disappearing bit by bit,” she says—they face a difficult decision.

(Fiona) picks up some forms from the dining room table.

Fiona What are these, Grant?

Grant They’re the. . . the forms to fill out. If you decide to go to Meadowlake

She looks frustrated.

Fiona But that is exactly what I have decided. You were to go and sign these forms. And leave them there.
. . .
Grant I don’t think I like the place.

Fiona I don’t think we should be looking for something we like here, Grant. I don’t think we’ll ever find that. I think all we can aspire to in this situation is a little bit of grace.

It seems like yesterday that I wrote about moving my mother into assisted living. But so much happened in the last week and a half. The Friday before the move, she became listless and delusional and was admitted to the hospital. A week later, after treating an infection and medication toxicity, straightening out her electrolytes, and getting the congestive heart failure under control, the hospitalist sent her off to a skilled nursing facility.

Like Grant, I don’t think I like the place. Not because there’s anything wrong with it: there isn’t. Because it doesn’t suit my image of how and where Mom should live.

But as Fiona said, in this situation, we’re aspiring to a little bit of grace. Here, she will be safer, and with grace, recover enough strength and independence to go to the original assisted living destination. If not, we’ll be grateful for the grace and care provided by a good skilled nursing facility.

Of course, we all want to be part of creating living and care situations people will like. I’m especially excited about a new event the Milwaukee Aging Consortium will present Friday, April 4, with the cooperation of LISC (Local Initiative Support Company) and hosted by Direct Supply. Linking Housing & Service Solutions for Bottom Line and Best Practice is a day-long seminar on bringing services to aging residents in Milwaukee area congregate living.

This seminar includes breakout sessions to stimulate working partnerships. Housing operators, developers and architects, home health and medical providers, and others won’t want to miss this! For more information and to learn about sponsorship opportunities, contact Tracy Straub, 414-289-0890.

More about this later!