Aging, changing American demographics: even on the political radar?

Forget McCain's age for a moment. An aging America is nowhere to be seen in either presidential candidate's radar, says Newsweek and syndicated columnist Robert Samuelson (July 6, 2008).

John McCain and Barack Obama are against poverty and fiscal irresponsibility. . . (They) favor “reform.” But beyond these platitudes, they’re mostly mute.

That global aging is “a demographic shift with no parallel in human history” is not exactly a secret or even a disputed issue. So its absence from the discussion table seems curious. Then again, according to Samuelson,

It is one of our fondest political myths that elections allow us collectively to settle the "big issues." The truth is that there's often a bipartisan consensus to avoid the big issues, because they involve unpopular choices and conflicts. Elections become exercises in mass evasion; that certainly applies so far to the 2008 campaign. A case in point is America's population transformation. Few issues matter more for the country's future — and yet, it's mostly ignored.

Samuelson has visited the issue before, specifically focusing on developing bi-partisan think tanks to come up with data and policy solutions to the problems related to government spending on older Americans and immigration issues.

But that’s not enough, according to Encore, an organization devoted to revitalizing later life careers.

. . .Samuelson’s challenge is all to the good, but the framing is too narrow, too Beltway. Rather than merely craft a policy that averts the fiasco, we need a vision that fosters a renewal, both social and individual. Aging boomers are more than liabilities, after all, they are also assets. Changing the starting point of the discussion also changes the end result. Rather than muddle through, why not break through?

Certainly, longer working lives are likely to be a feature of boomers’ encores, but that reality will be much more appealing if work itself is reimagined: encore careers at the intersection of personal meaning, continued income and social impact.

How do we in the community of professionals and “experts” on aging find ways to bring constructive solutions to a table that’s not even set? It seems having faith that whichever candidate we prefer will “do the right thing” is a bit misplaced.

What’s your organization doing locally or nationally to “not muddle through, but break through”? Share your ideas and experiences with us!

Is age an issue in the presidential election?

Last weekend, the New York Times suggested that age was the new "combustible" topic enflaming people's biases and prejudices in the presidential election. The others are race and gender, as we've seen.

Said author Adam Nagourney, the issue is not just candidate John McCain's age but the voters' age as well.

"Many boomers, as we all know, cherish and chase youth, and many of them, not surprisingly, could be found at Mr. Obama’s rallies this fall, the political equivalent of a 50-year-old man wearing a baseball cap backward. Yet, at a time when many Americans live into their 80s and beyond, those who are beginning to contemplate their first Social Security check can simultaneously embrace the belief that they will remain active members of society for years, even decades, to come. For these voters, Mr. McCain may seem as much a barrier-breaker as either Mr. Obama or Mrs. Clinton."

The same day, an article by geriatrician Greg Sachs, MD, professor and scientist for the University of Indiana Center for Aging Research, welcomed the controversy.

"I see this as an opportunity to help encourage greater education of the public about aging, health, and memory issues in particular." And those issues, he pointed out, don't just arise every four years but are with us always.

It's easy to merely dismiss concerns about age affecting performance as "ageist." But Dr. Sachs reminds us that, contrary to the beliefs of a youth-worshipping society, age brings with it greater diversity. It's not all old people who tend to be alike: young people are more similar in health and ability. With older people, you just can't generalize about anything. Especially not health.

Aging carries real concerns. Cancer, heart disease, stroke, diabetes, and kidney disease are found increasingly as people grow older. And so are alterations in brain and cognitive function. The latter is not an easy problem to address, as routine screening for cognitive impairment has yet to be found cost-effective.

Still, Dr. Sachs suggested, "perhaps older people who hold important positions affecting the lives of many others ought to have a more comprehensive evaluation on a regular basis."

Seems like a reasonable suggestion. For all of us, the ability to do the job should be the measure of suitablity, not age, race, gender or other factors.

What do you think about age and ability? Share your thoughts on this or other aging-related topics with us.

Doctor, care manager, gerontologist?

Aging is an interesting field in which to work. But messages about training for professions in the field can be confusing.

An aging population assures a growing “market” for the services of knowledgeable providers of just about anything aging people need. In April the Institute of Medicine predicted an impending crisis and verified what many have already observed: a shortage of geriatricians (medical doctors specializing in aging patients), nurses, and frontline aides skilled in the concerns of aging patients. Meanwhile, the New York Times is touting geriatric care management as “one of the most important professional roles in the whole health services delivery system” over the next 10 years.

At the same time, the March-April 2008 issue of Aging Today raises thoughtful questions in two articles about whether gerontology can continue as an academic discipline. The problem, according to authors Anabel Pelham and Robert Binstock, has to do with lack of formal accreditation programs.

Perhaps the problem also has to do with lack of clarity. Neither article bothers to define gerontology. Wikipedia says it has to do with everything about aging except diseases, which are claimed by the field of geriatrics.

I guess if you’re in the field, you know gerontology “belongs” to the human services side. But it would be a mistake to assume that others share that understanding. Pelham says that “gerontology can synthesize the field’s many realms of knowledge;” it would help the rest of us to know toward what end.

No fewer than four different programs certify geriatric care managers, who don’t have to be social workers, and case managers, who do. And no one has any trouble figuring out what it is that those worthy professionals do: the name is self-explanatory.

Gerontologists, help us clear up some of the mystery that surrounds you. We’d love for you to tell us what you do and what is happening in your field in Milwaukee and beyond!

A jug of red wine and 90 becomes the new 50

Eartha Kitt at 80 sets a tough standard. Image from Wikipedia

Is red wine the fountain of youth? I'm not suggesting that the divine Ms. Kitt relies on that elixer for her youthful appearance. But a handful of articles came across my desk today touting the potential of a resveratrol, a substance found in red wine, to keep people's hearts and bodies young.

All were based on two studies that found resveratrol kept aging mice healthy, middle aged, and slim in much the same way severe calorie restriction, a much less attractive way to maintain youthful vigor, does.

One of those studies came from Madison's LifeGen Technologies and the University of Wisconsin. (Barger JL, Kayo T, Vann JM, Arias EB, Wang J, et al. (2008) A Low Dose of Dietary Resveratrol Partially Mimics Caloric Restriction and Retards Aging Parameters in Mice.)

You'd have to drink a lot of wine to stay as young as the mice--the equivalent of 1,000 bottles a day. I'm thinking that after the first one, you might stop caring much.

The New York Times takes a balanced view, pointing out that the findings are interesting but there never is a panacea; that it's way too soon to understand what the research means for people; and that one reason for the interest is the enormous potential for a pharmaceutical company to clean up on this "longevity elixer."

The Reuters article focuses on potential protection to heart health.

The Atlanta Journal Constitution version homes in on the vanity angle, asking "is 90 the new 50?" and providing photos of well-aged celebrities such as Sean Connery, Kitt, and Sophia Loren. David Sinclair of Harvard Medical School, author of the second lab research report, admits to supplementing his diet with resveratrol. But he reminds readers that the most effective way to improve longevity is exercise.

I wonder what the desire for a magic fountain-of-youth pill that keeps us slim, healthy, and young without really trying does to the way we spend our healthcare dollars. And continuing to raise the bar for expectations of sustained youthfulness seems to serve product manufacturers more than it does the rest of us.

I don't know about you, but I'm having enough trouble keeping up with 50-something being the new 40-something!

Getting ready: continuing the conversation

"Butting heads" by isadoreberg, flickr

A recent blog entry introduced the topic of talking to loved ones about difficult issues in aging. But it's a conversation that needs revisiting often.

One of the most thoughtful writers about Boomer children and their aging parents is David Solie, author of How To Say It to Seniors: Closing the Communication Gap with Our Elders. His most recent blog entry, How do we get them to move? answers bluntly the question so many of us have: we don’t.

“Older adults see where they live as the Alamo and will make their last stand defending it. We advance with logic, manipulations, and threats and they use any means at their disposal to repel us.”

The problem, he says, is that the children see themselves as managers of a situation, while their parents see themselves as preservers. We (the children) want to manage to avoid the inevitable disaster. They (our parents) want to preserve what they know far better than we do will soon enough be lost. Home, health, loved ones, mobility: “Having any of these another day is invaluable victory in the final phase of life.”

So we are left in a holding pattern. What do we do during that time? Put aside persuasion in favor of listening. Celebrate each good day as a gift. And help them—and ourselves—get ready to move when the time comes.

As mentioned in the earlier blog, My way: A workbook for planning and living life your way is an outstanding resource to aid in getting ready and shifting from conflict to partnership. It’s available from the Aging Resource Center of Milwaukee County and was presented at the May member meeting of the Milwaukee Aging Consortium. Another great resource is the 40/70 Rule Guide to Conversations brochure from Home Instead Senior Care.

Tell us your experiences with talking, listening, planning, and getting through the changes that come!

Something good about aging

Blissed out in Natalie's Chicken Blog

Things change with aging, and even, sometimes, for the good.

University of Texas sociologists Catherine Ross and John Mirowsky found that around age 60, people begin to report "more feelings of ease and contentment than their younger counterparts." Their study "Age and the balance of emotions" appeared in Social Science and Medicine in May 2008. More about it here.

The researchers also found a shift from "active" emotions such as excitement to "passive ones" like serenity. Talking about that might be a little tricky, since it seems to require some adjusting of a cultural bias that active is good, passive is bad, and excitement trumps all. Adding to the complexity is the need to consider that positive and negative things can happen at the same time. Pub Med's abstract writer puts it this way: "In order to accurately portray the shifts in emotional tone, age may best be considered as simultaneously indicating maturity and decline."

It's not scientific, but I've found that getting older makes it a lot easier not to sweat the small stuff--and to know that most of it is indeed small stuff.

And serenity is definitely something to look forward to.

"We do our best and lean on each other"

The popular press coverage of aging falls mainly into two camps: 1) fight it/beat it and 2) what to do when you can't anymore.

At the May 8 Milwaukee Aging Consortium member meeting, a panel of experts entered the important middle space between resistance and resignation. Critical conversations: helping families and elders get ready for transitions went beyond advance directives for the very end of life to address planning for a longer period of change. Panelists and audience considered the questions:

• How do we think about the time of many transitions during the last developmental stages of life?

• How do we talk to our older clients and relatives about making practical decisions that honor their desire for control?

On the same day as the meeting, Kathleen Merryman told a story in the Tacoma News Tribune that illustrates the problems of unanticipated change. The account of a recent shift in her family's universe begins, "Two months ago, in a Maverick gas station in Bridger, Montana, my dad backed into a post and shattered his sanity."

Merryman's 79-year-old father, who planned to live forever, was returning from a doctor's appointment with the news that he had not only an infection but an aortic aneurysm. The collision with a post marked what Merryman's mother described as "all the bonds of reason in his brain shred(ding) at once."

The collision was not caused by the aneurysm rupturing. The impact caused no physical damage to Merryman's father or mother who was also in the car. The cause of the sudden change was and remains a mystery.

But at least metaphorically, in losing his image of himself, he became someone else mentally and emotionally, someone living in a hell populated by delusions. His wife and children (one lawyer, two nurses, and others) were able to move swiftly through the maze of care options and changing housing and financial needs.

Even with the best of family support, the call for strength in the face of interpersonal friction and fatigue stunned the family. They now know "With aging, we do our best and lean on each other."

No matter how much planning has gone on, a sudden change for the worse is devastating. Unlike this story, the sudden changes in aging often follow a longer period of unrecognized decline. But having deep and honest conversations about what really matters and how to support basic values and desires can go a long way toward easing the pain.

It's probably a good idea to decide that "don't put me in a nursing home, ever" isn't the end of the conversation. It's just the beginning.

Some resources from the meeting to help in starting and sustaining the conversations include My Way, an in-depth planning tool from the Milwaukee County Department on Aging, and two documents developed by Home Instead Senior Care: 40-70 Rule 7 Tips (for conversations between Boomers and their parents), and the 40-70 Rule Guide booklet.