Thursday, December 27, 2012

Individuals Often Defy Patterns

Image by JoePhilipson
I like finding patterns in nature, in literature, in human behavior.  Patterns help me negotiate through the landscape of life. When I decided three years ago to pursue a degree in gerontology, I hoped to better perceive the patterns that emerge in the aging process.  Equipped with such knowledge, I might help the generation above me avoid some of the bumps in the road of advanced age. And by learning from them, I might better manage my own aging process.

Instead, I find that individuals often defy the norm and few are completely prepared for the challenges of aging.   

When I talk with clinicians, they are more aware than academics that individuals often defy the norm. A physical therapist can tell me what exercises can reduce risks of falls and recite statistics about the increase risk of falls with advanced age. But the same expert can produce several examples of people who walk briskly in their 90s and others who falter in their 50s.  People who have several chronic illnesses sometimes outlive their agemates who are mature athletes.  Aging is a crap shoot!  

Thursday, December 20, 2012

Penalty for Delaying Enrollment in Part D

Photo by NVinacco
When beneficiaries new to Medicare investigate Part D prescription drug coverage, some decide to go without that insurance.  Because the premiums for prescription drug coverage average $30 a month, I can see how declining coverage would tempt some beneficiaries.

Those who decline Part D insurance are most often not taking any prescription drugs or they are taking generics that only cost them around $10 a month--even with no insurance.  They say to me, “Why would I pay a premium that cost more than I spend in a month without any insurance?”


However, those beneficiaries who procrastinate enrolling in a prescription drug plan start accruing penalties that they must pay once they decide to sign up for Medicare Part D.  Depending on how long they procrastinate, these penalties can increase to (for example) an additional $4, $25, $60 for each month between eligibility and enrollment. 



Saturday, December 15, 2012

Adjusting to Bifocals: It Was All a Blur

Photo by Ms. Tina. 
By 2009, I had been wearing single lens glasses for forty years.  I never seriously imagined myself ever wearing bifocals.  But that was the year I turned 47.

This post discusses

* Warning Signs
* Denial
* Physical Challenges to Adjusting
* Timeline

I have since learned that when people reach their forties, they usually acquire presbyopia, age-related eye trouble that often requires the use of bifocals.

I started seeing warning signs, which I chose to misinterpret. If I read small print for too long, I was getting headaches. I was asking my children to read the small print on medicine bottles. And I was increasing the font size on the computer.

No matter how I adjusted the light and the distance, I couldn't read the text.  Finally, I went to the optometrist, thinking I would just get a minor adjustment to my standard glasses.

Nope. The optometrist informed me, “You need bifocals.”   I wasn't emotionally ready to make the switch.  However, my identity as an avid reader was stronger than my identity as a fashionable women—by a long shot—so I ordered new bifocal lenses.

The assault to my ego was mild compared to the assault to my senses. 

Oh, the vertigo!   Bifocals require you to move your gaze to either the top of the frames or the bottom of the frames, depending on the distance of the object you are viewing. Yes, I could read the small print of that reference book with ease; the book and I remain fairly still. However, walking, using the stairs and driving were incredibly challenging tasks. 

Saturday, December 8, 2012

Mild Cognitive Impairment (MCI)

Photo by Flood
As people get older, they experience age-related changes to their memory: i.e., they take longer to store and retrieve information, their attention is compromised when multitasking, and they take longer to retrieve the desired name, date, place or specialized word.

Sometimes older adults too readily fear that they are in an early stage of Alzheimer's disease (AD). Usually, these changes to memory are just normal signs of aging.

But what if the memory problems seem more serious?  Is it Alzheimer's disease?  Maybe, maybe not.

Yes, as people age, their risk for AD and other forms of dementia does increase. About 5% of those ages 65 to 74 have AD; the rate increases to about 50% for those 85 plus. Yes, symptoms of AD can often mask as normal changes to memory. Some disregard atypical memory changes, which postpones a diagnosis until people move beyond the early stage and into the mid-stage of the disease.

(For a fuller overview of various stages of memory performance,
see this list at alz.org.)

However, older adults with memory problems should first consider the possibility they have Mild Cognitive Impairment (MCI).

The Alz.org document 2012 Alzheimer's Disease Facts and Figures reports this prevalence: "Studies indicate that as many as 10 to 20 percent of people age 65 and older have MCI" (p. 9).  Furthermore, only a small percentage (15%) seek medical advice about MCI. Of those who do seek treatment, half will develop dementia in 3-4 years.

Clearly, older adults and their loved ones need a greater awareness of MCI as a distinct diagnosis.