Healing Dementia: Book Review

Published in 2017.

Approaches to dementia range from medical models to health care models. Every once and a while, I find people who respond primarily through the emotions.  This is the case for dementia advocate Kyrié Carpenter.

Live Longer, Live Better, Avoid the Risks: Book Review

Published July 12, 2017.

Healthy lifestyle choices serve as the foundation of sound health.

As people age, their habits have an enormous impact on their quality of life.

Authors William M. Manger, Ph.D. and Edward J. Roccella, MPH use their expertise in health care research to explain how to increase longevity and health by adopting healthy habits.

As a gerontologist, I have studied and taught classes on healthy aging. This book condenses a lot of literally vital information into one book.

The authors reference evidence-based scholarship in support of their advice for adopting healthy habits; however, the writing style isn't academic or stuffy.  It's clear and direct prose written for the lay reader.

The acknowledgement section lists about two dozen health and medical experts who were consulted to "improve the quality of this book" (p. 289).

The book's core chapters are as follows:

2017 Top 10 Posts

Adapted photo by June Marie.

Over the last year, this blog carried a modest number of posts, around two dozen.  Nevertheless, many received significant views.

Here are the Top 10 posts written / published on this blog in 2017 (in ascending order):

#10. Evansville Hosts Aging Avengers.

The Tristate (IL-IN-KY) enjoyed a visit by the Changing Aging Team led by Dr. Bill Thomas for a day of presentations on how to challenge stereotypes of aging and how to recognize the influential roles that older adults have in our communities.

#9. Lifespan Differs from Health Span

People in industrialized nations are living much longer than their grandparents. However, the last years of their life will more probably include living with chronic diseases and disability.

#8. Older Americans 2016 Federal Report on Aging

Every two or three years, several US government office work together to compile a report of key indicators of well being for older adults.  This post lists the 41 indicators and includes links to the full report and to a few executive summaries of the report.

Celebrating Grandmothers: Book Review

Published September 3, 2014. 

Have you ever wanted to go on a three-day retreat with a couple of dozen women who are introspective about the life stage of "grandmother"?

Ann Richardson gives you this experience without the cost and inconvenience of travel in her book Celebrating Grandmothers: Grandmothers Talk about Their Lives (2014).

Richardson transcribes interviews conducted with 27 women from the greater London area.

They come from a diverse background and have various viewpoints about grandmothering. And their experiences differ.

Some have the opportunity to do a lot of very hands-on grandparenting. Others have to innovate on how to do long-distant grandparenting.

The women interviewed have an array of relationships with their child, their child's spouse, and are part of a diversity of extended family structures.

The book is organized into the following sections:

Evansville Hosts the Aging Avengers

Photo of Aging Avengers L-R Nate, Jennifer, Kyrié, & Samite courtesy of
 University of Southern Indiana Photography & Multimedia. 

Evansville, Indiana enjoyed the opportunity of hosting Dr. Bill Thomas and other Aging Avengers on Monday, November 6, 2017.

The visit was organized by University of Southern Indiana's Center of Healthy Aging and Wellness, but adults of all ages from the broader tristate (IN, IL, KY) community attended. The venue was USI's beautiful, nearly 300 seat Performance Center.

This was a return trip for Dr. Bill Thomas, given that he was a keynote speaker at the 10th Annual Mid-America Institute on Aging and Wellness. Evansville and the tristate were thrilled to have him return with an intergenerational team of people who hold positive views about aging.

Dr. Ann White, dean of USI's
College of Nursing and Health Professions,
welcomes attendees.

The day consisted of three events:

* Disrupt Dementia in the afternoon
* Life's Most Dangerous Game in the evening
* Lobby Experience in between

All events encourage people to radically redefining aging. The benefits are not just for older adults.

By recognizing the life stage of elderhood, every generation benefits by working together to improve the greater society. 

Hag-Seed: Book Review

Published October 6, 2016. 

Reading Hag-Seed (2016) by Margaret Atwood is a 2-for-1 treat since her novel is a contemporary retelling of Shakespeare's The Tempest.

Her novel is part of the Hogarth Project, a series of novels retelling Shakespeare plays as part of the 400th anniversary of Shakespeare's works.

This novel's protagonist is Felix, a long-time director of a community theater in Canada.

Because Felix is in late midlife, the novel addresses themes such as working through relationships with younger professionals, confronting memories of past decades, and trying to shape one's own legacy.

Published the year Atwood turned 77, the novel contains a richness in depicting midlife and late life that novels with mature characters often lack.

The start of the novel begins with Felix foolishly handing over a lot of the control of financing and politicking to an assistant director, Tony, who uses that power to usurp Felix, who believed he could maintain power by focusing only on the creative aspects of theater.

During his "exile" from the theater, Felix must decide how to rebuild his career and decide how to address Tony's treachery.

The Lady in the Van: Film Review

Release date: December 4, 2015.

Maggie Smith--yet again--gives a stellar performance.

This time, Smith plays Mary Shepherd, the titular character in the 2015 film The Lady in the Van.

This film is based on real events experienced by author, playwright, screenwriter Alan Bennett. Readers are probably most familiar with his work as a screenwriter on The Madness of King George (1994), based on his play.

Bennett first knew Shepherd in the late 1960s as a vagrant who would park her broken down van on the streets of his neighborhood in Camden (outside of London).

Bennett's character is played by Alex Jennings, and the film is shot on the same street and the same house where the events took place.

In order to prevent her van from being towed, he let her park in his driveway.

She stayed for 15 years.

Over those many years, Bennett and Shepherd have an uneasy relationships. She is moody and irrational. She's not clean. She exhibits signs of paranoia. She's bossy and argumentative.  Nevertheless, Bennett ends up helping her in significant ways. However, he protests that he does so not out of kindness but because he's timid.

Dr. Bill Thomas: Is Evansville the One?

Rating culture change ideas on 3x5 cards.

If you live in Evansville, Newburgh, Henderson, Owensboro, you are in for a treat!

--> Dr. Thomas and many others are returning November 6, 2017. <--

On Friday, September 22, 2017, internationally renown geriatrician Dr. Bill Thomas asked two groups of people from the Evansville region, "Are you the one?"

He was asking if we have the desire to pioneer new housing, a new community that promotes wellness for older adults by better integrating them with other generations and by creating specialized housing that adopts cutting-edge technology.

Our region has the resources, he discerned during a visit in August this year. But do we have the drive?

Who Is Dr. Thomas? 

Describing Dr. Bill's Thomas' work proves challenging.

He's a geriatrician by training. However, watching him interact with others, he presents himself more as an artist and an advocate than a scientist (but he does know his science).

Dr. Thomas, catalyst for change.

For years, he has worked to create a culture change for how older adults relate to society at large. His ideals include the integration of all generations, so the scope of his work exceeds the boundaries of geriatrics.

See Changing Aging for more information about him and his team of aging innovators.

Dr. Thomas also takes an interdisciplinary view because he values the world views of the social sciences and the humanities in addition to the perspectives of allied health professions and sciences.

He also communicates his ideals through a variety of modes, ranging from scholarly articles to performance art. Consequently, his methods also exceeds the boundaries of his training in medicine.

He's iridescent.

I had the opportunity of participating in two events where he was the catalyst for the action.

Older Americans 2016 Federal Report

Image by Paul Weithorn.

In June of 2016, the Federal Interagency Forum on Age-Related statistics published a report entitled Older Americans 2016: Key Indicators of Well-Being.

The Forum refers to it as a "chartbook" because it contains a lot of data about older adults in the US, formatted into charts for ease of reading.

The full report is available here.

I spent a lot of time looking at the 2012 report, which I found valuable. Consequently, I am reviewing this more current report, too.

The 2016 report lists 41 indicators of well-being, which are divided into the following six groups:

• Population
• Economics
• Health Status
• Health Risks and Behaviors
• Health Care
• Environment

Here is the Forum's press release that includes highlights from the 179-page report.

This is the seventh report from the Forum.  The Foreword points out some of the additions, which reflect the dynamic nature of aging in the US:

"Among these additions are an indicator describing the changing demographics of Social Security beneficiaries and an indicator describing transportation access for older Americans. Indicators have also been added to describe dementia rates (including Alzheimer’s disease rates, among the non-nursing home population) as well as to examine the number of older Americans receiving long-term care by different types of providers. Finally, the Supplemental Poverty Measure (SPM) for Americans age 65 and over has been added." 

If you would like to read a summary of the full report, here are three options:

2017 Mid-America Institute on Aging and Wellness

MAIA 10th Anniversary Program & Swag Bag.

Every August, the University of Southern Indiana partners with the local Area Agency on Aging--SWIRCA--and others to present a two-day institute on aging and wellness.

As an employee of the university, I had the privilege of attending several sessions on Thursday, August 10th and Friday August 11th. I also received an invitation to attend the pre-conference workshop led by dementia educator Teepa Snow.  I discussed the events of Wednesday, August 9th in a previous post.

Below are highlights from a handful of sessions.

I'm loathe to admit that I could not attend every session.  There were 27 people leading concurrent sessions and four keynote speakers: Bill Thomas, MD, Faith Roberts, MSN, CRRN; Dean Hartley, PhD; and Neha Sangwan, MD.  There as also an exhibit hall featuring dozens of local business and agencies who support aging and wellness.

Such a wealth of experience and perspectives!

Many healthcare professionals attending earn CME credits (continuing medical education), but a good portion of those present are not healthcare professionals; they are community members who are pro-active about their physical, financial, social, and emotional health.

What follows are my notes that are woefully inadequate. I suggest that you attend next year so that you can follow the sessions that interest you the most.

Teepa Snow at MAIA 2017

Snow explaining unmet needs at MAIA 2017.

I spent the bulk of today attending a pre-conference workshop on dementia care.

For the past year, I have been teaching gerontology classes part time in the College of Nursing and Heath Professions at University of Southern Indiana in Evansville, Indiana.

Each August, the university hosts an aging conference sponsored by local agencies and businesses that support healthy aging.

Read more about the Mid-American Institute on Aging & Wellness (MAIA) here.

The two-day conference is packed with speakers covering an array of topics about healthy aging and elder care.

Age and Political Affiliation

Image by Hillary.

With discussions of politics dominating news outlets and water cooler conversation, sometimes people bring up this question:

Does a person's age influence political affiliation?

Let's take the Baby Boomers as an example (those born 1946 to 1964).

As a group, do they affiliate more with liberal, conservative, or even moderate political ideals?

In January of 2015, the Gallup company posted an article showing how conservative political affiliation increases in age in the polling of these four voting-eligible generations: Millennials (28%), Generation X (35%), Baby Boomers (44%), and Traditionalists (48%).

Why?

First of all, several factors can influence trends in the political affiliation of an age group. Demographers consider many influences, for example the age effect or the period effect.

But before we look at those demographers' theories, let's look at more poll / survey data:

Health Span Differs from Life Span

Photo by Quinn Dombroski.

Because I am a gerontologist, people often talk to me about their desire for longevity.

But is this wise?

I spent three years volunteering in a multi-level care center, observing the difference between lifespan (how long a person lives) and health span (how long a person lives without disability).

The all-too-human desire for longevity reminds me of the Greek myth of Tithonus.

He was a mortal who was the beloved of Eos, the Titan goddess of the dawn. She asked Zeus to bestow eternal life upon Tithonus. Zeus did so.

But Tithonus did not receive eternal youth. Instead, age transformed him into a grasshopper.

And that problem--immortality vs eternal youth--has been exaggerated in the 21st Century as people in industrialized nations are living several years longer than their great grandparents.

Big Fish: Film Review

Released: December 10, 2003.

Big Fish (2003) ranks as one of my all-time favorite films.

Yes, it contains themes related to aging.

However, many elements of the film are pertinent to people of all ages:

parent-child relationships (particularly father-son conflicts), courage, family legacies, truth vs illusion, coping with illness--and more.

The bottom line: WATCH THIS FILM!

I rewatched this film on Father's Day weekend with one of my teens.

What was my takeaway this time?

Big Fish illustrates this phenomenon: family members each hold their own version of reality.

My past viewings were informed by my decades of work in English departments.  In 2013, I earned a gerontology degree.  Between my new paid work and upcoming life changes, I'm looking less at the artistry and more at the family roles.

I'm now a midlife person who is launching a young adult son while offering (pitifully inadequate) long-distance support to aging parents.

(Young Edward from birth through childhood is played by more than one character, but the greater portion of the flashbacks are portrayed by Ewan McGregor; late-life Edward is played by Albert Finney. The adult son is portrayed by Billy Crudup.)

Modern Death: Book Review

Published February 7, 2017.

Modern medicine has increased the average life expectancy of people living in industrialized nations.

However, modern medicine has also decreased the health span.

In other words, people are living longer, but many are living in a state where their quality of life is very low while managing numerous chronic diseases and sometimes--for years--a terminal disease.

Particularly salient are Warraich's questions about how to balance extending life with quality of life during end-of-life care.

Haider Warraich, a fellow in cardiology at Duke University, provides a thoughtful exploration of issues surrounding end-of-life care in his book Modern Death: How Medicine Changed the End of Life. 

His book is one of more erudite on the topic. The academic register is a bit high.  And one of the earlier chapters discusses death at a cellular level, which I found very challenging. 

Nevertheless, Warraich includes a number of case studies to balance out the history, philosophy, statistics, and evidence-based research.  These stories help illustrate the complex and difficult situations that patience and their support team of family members and health care professionals face. 

The Luckiest Old Woman Around: An Elder Tale

Photo by Paul Downey.

Once long ago in Northumbria near the village of Hedley, there lived an old woman.

She earned a living by doing chores and errands for the local women.  They would pay her with some fire wood here, some tea, sugar, and flour there.

It wasn't much, but she made do.

This post is part of a series on elder tales. An elder tale features an older adult who relies on strength of character and wisdom to solve problems. This contrasts with tales about younger heroes who often rely on riches, magic or a mentor to help them solve problems.  

One afternoon she was headed home and spotted a black iron pot by the side of the road. She hadn't seen anyone else on the road for a while, so how would she find the owner?

She thought to herself, "Perhaps it has been cast aside on purpose. Maybe it has a hole in it?  Still, I could make some use of it as a flower pot."

Even though it was a smallish sort of pot, the old woman discovered it was quite heavy. She opened the lid and saw, to her great astonishment, that it was full of gold coins.

"Oh, I am the luckiest old woman around. But how will I carry this home?"

Creatinine Clearance: Biomarker of Health & Longevity

Photo of nephrons by eLife Journal.

What lab tests can signal signs of longevity?

The Dunedin longitudinal study showed that research participants with higher creatinine clearance levels had better health overall.

Nevertheless, kidney function does slow down a little as we age.

However, not every older adult is destined for kidney dialysis.

This post is part of a series on biomarkers of health and longevity.

Monitoring kidney function is important.

[Note: This post does not offer medical advice; its purpose is only to increase awareness. If you have any concerns about your kidney health, please see a licensed medical professional.]

Org Chart for Administration on Aging

Click on the image to enlarge.

This week, the President released his "Skinny Budget."

As a result, there's a lot of buzz about potential funding changes to a variety of federal programs.

Several programs affect older adults.

Meals on Wheels (MoW) is just one, and only a portion of their funding comes through the Administration on Aging under the U.S. Department of Health and Human Services.

Read MoW's press release about their funding sources. 

(Not all government programs benefiting older adults are affected by the President's proposed budget. For example, Social Security and Medicare are not part of the President's budget.)

It's difficult to monitor all programs available to older adults.

The enormity of the task discouraged me from looking at details. However, I feel as though it's time to start paying more attention to various programs that benefit our mature citizens.

So I'm getting my head out of the sand and looking at programs one at a time.

Where to start?

APA Using NCD not Dementia

Photo by Keoni Cabral.

If the Sapir-Whorft theory is to be believed, the language we use shapes our reality.

As a gerontologist, I am interested in the labels that people use to describe older adults, since language can filter how we see people and treat people. Sometimes these filters are ageist.

Over time, people have used an array of terms to describe neurological and cognitive problems as experienced by older adults.

Some might remember that the word "senile" was prevalent in the early 20th century.

In the last few decades, people have switched to using the word "dementia," but it's very broad. It's used to describe an array of neurological or cognitive problems.

In addition to being too broad of a term, the word "dementia" is related to the word "demented," which means "insane."  For these and other reasons, the American Psychological Association (APA) scrutinized the origins of "dementia"-- which original meaning is tied to "madness" -- and in 2013 introduced a new term in the newest edition of DSM-V, their diagnostic manual.

Neurocognitive Disorders (NCD)

Read APA's 2013 announcement of this new term and its relationship to dementia. 

On Living: Book Review

Published Oct. 25, 2016.

Kerry Egan draws on her experience as a hospice chaplain to share stories about how illness and dying highlight people's values.

Some might expect her to offer sermons about the place of religion in people's lives. She doesn't do that.  Instead, she demonstrates the healing power of narrative.

Egan observes that chaplains do the following work:

"We listen to the stories that people believe have shaped their lives. We listen to the stories people choose to tell, and the meaning they make of those stories."

Those who are sick and dying often find great insight in telling the story of their life. Egan focuses on maintaining an attitude of love and compassionate listening as people work to make meaning of their lives by sharing stories.

People talk about their childhoods, their life's work, their families, and most often their desire to love and be loved.

Motherhood: Lost and Found: Book Review

Published December 4, 2013.

Ann Campanella experienced a decade of tension about her mother's failing health and her difficulties carrying a baby full term, which she chronicles in her memoir, Motherhood: Lost and Found (2013).

As an award-winning poet, Campanella brings her creative abilities of insight and turn of phrase to her work.

She generously shares her tender feelings and insights about her mother and her pregnancies, which may serve as a great comfort to people facing one or both of these challenges.

At the start of her book, we watch as Campanella's mother grows increasingly distracted and emotional.

Her mother, Elizabeth (Betty) Williams, has trouble driving, keeping track of time, and remembering what city she's in. She even fails to recognize family members and grows more dependent on others to help her dress, eat, and use the bathroom.

But the changes to memory and bodily function are not the only symptoms of Alzheimer's Disease. Betty grows more emotional, alternating between being confused, angry, depressed, paranoid, and hurt.

In time, the doctor's describe Betty's symptoms as those consistent with Alzheimer's Disease.  While this does give the family some answers, a diagnosis of a disease with no cure doesn't remove the affiliated difficulties.

Tinkers: Book Review

Published January 1, 2009

Paul Harding won the Pulitzer Prize for Fiction in 2010 for his novel Tinkers, a story about three generations of men from New England.

We meet George Crosby, a clock repair man.  From the start, the novel focuses on time, memory, and perspective.  George is suffering from delirium as a mature man in his last six weeks of life.  This leads to some shifting perceptions between past and present, reality and fantasy.

This is a book that I read slowly, wanting to live in the moments that he creates on the page.

Readers are next introduced to George's father, a salesman. Every fall and spring, Howard stocked up a wagon full of goods and traveled through back roads with his mule, selling to impoverished country people and making very little profit.

Howard is a poet at heart, but between the demands of providing for his family and the difficulty of dealing with his epilepsy, he lives a far less elegant life.

White Blood Cell Count: Biomarker of Health

Photo by keepingtime_ca.

Most people know that having a high white blood cell count is most likely a sign that the body is fighting an infection.

Also, having a low white blood cell count can be a sign of a problem.

White blood cells play a central role in the body's immune system. These cells constitute about 1% of human blood. They are small, but they are mighty.

Until doing research for this post, I had no idea what values constituted a healthy range for white blood cell count (WBC).

Depending on the source, healthy ranges for WBC are listed somewhere between 4,000 to 5,000 per microlitre on the low end or normal and between 10,000 and 11,000 per microlitre on the high end of normal. 

This post is part of a series on biomarkers of health and longevity.

Happy 5th Blogoversary to TGAM

Image by Nick Lee.

Today marks the fifth anniversary of this blog on aging.

Initially, this was a place for me to record my observations as a graduate student in a gerontology master's program.

Since then, I have taught gerontology classes at Wichita State University before moving to Indiana, where I currently teach part time for University of Southern Indiana (USI).

One of my primary identities is "Life-long Learner."  The blog gives me a place to share book reviews, research notes, and film critiques.

Here are the 20 posts that have accrued the most views over the last five years. 

In ascending order...

20. Quotes about Aging (April 25, 2016)
19. New Home for an Emptying Nester (March 14, 2016)
18. Midlife Ennui (March 7, 2016)
17. The Lie of One-and-Done Caregiving (January 21, 2016)
16. Books about Alzheimer's (June 5, 2014)