Friday, 22 May 2015
Are You an Elder Orphan?
I am. And it's not a comfortable thing to be.
In case the phrase is new to you:
An elder orphan is an old person who is single, lives alone, has no children or family member or friend who can act on his or her behalf in handling health, legal and financial issues.
An elder orphan has no one, or is uncertain of who, to list on that “next of kin” line in forms, no one deisgnated to carry out end-of-life wishes, and see to the funeral and burial.
Some of the media reported on this growing phenomenon following the presentation last weekend of findings on the situation at the meeting of the American Geriatrics Society:
”Dr. Maria Torroella Carney, who is chief of geriatric and palliative medicine at North Shore-LIJ Health System...estimates that nearly a quarter of all elderly Americans could be orphans...
“The outlook for the future is not any brighter,” continues the news story at CNN. “Based on 2012 U.S. Census data, about one third of Americans age 45 to 63 are single, and in a position to become orphans as they age.”
Further, a University of Michigan report referenced in U.S. News estimates that 22 percent of people 65 and older in the United States are elder orphans now or at risk of becoming so.
British Columbia's Seniors Advocate, Isobel Mackenzie, told news1130 that elders in that province of Canada depend on partners or children but like the U.S., that is changing.
“People who are single, people who don’t have children do need to think about how they are going to plan for their future and the aging process. It’s not going to be as clear who make decisions for them, who is their substitute decision maker, who gets their power of attorney who can be their representative.”
Dr. Carney began looking into the problem of elder orphans after she noticed that Super Storm Sandy left many old people who lived near the shore homeless, she told Bankrate, and she believes that single elders should not postpone making decisions:
”If you think you are going to be aging alone, Carney says now - while you still have the financial, mental and physical tools - is the time to figure out a plan. It could be a cooperative living situation, a shared household, a Golden-Girls' style commune or a formal assisted living facility...
"'It isn't a socioeconomic or intelligence issue. It isn't about race or ethnicity. It is the inability to reach out and make connections. That can happen to anybody at any time,' Carney says.”
She's right about that, and I think about it all the time. Hardly a day goes by that I don't.
I have no family. No husband. No children. I have friends I know I could trust but they all live 3,000 miles away. Not ideal but it might work; I just don't put my mind to it.
What else gets in my way (this is an excuse, not a reason) is that I think it's a good idea that advocate(s) be younger than I am – my most trusted friends are my age.
It embarrasses and pains me to admit all this publicly but perhaps it will impress on you (and me) the importance of designating a personal advocate because:
• If I get hit by a truck and am hospitalized, there is no one for the physicians to consult.
• If I have a stroke and can't communicate, there is no one who is authorized to speak for me.
• I do not have a health care proxy. I do not have a durable power of attorney.
• The only thing I have is a newly acquired emergency refrigerator card that lists my primary care physician but that “next of kin” or emergency contact line is empty.
So don't go by my lead. Listen instead to my New York friend, Wendl Kornfeld, who is married but has no children.
Wendl was on to this problem long before Dr. Carney's important advocacy. For the past year or so, Wendl has been conducting Group conversations for elders she calls “the unfamilied” - people like me.
As her notes state:
”The Group urges people without family to be their own strongest advocate and to support that by creating community as their family.”
Wendl, like Dr. Carney, says the time to do this is “RIGHT NOW” and, of course, they are both exactly right.
Stop worrying about which forms should be in place and just get them done – such forms as a will, durable power of attorney, health care proxy, a household handbook, medical history form, wallet card and that refrigerator card – filled in, for god's sake, not empty like mine.
Here's another terrific Wendl idea: “...the '2AM Team,' a couple of people you can call in the middle of the night if necessary. And offer to be on their 2AM team.”
This post doesn't begin to cover it all. For now this is meant to be an ALERT to get us started because, as I often say, if it's happening to me it's happening to millions of others.
Plus, with Dr. Carney's new report, many more - ageing professionals and people like you and me - will be paying attention and willing to help one another.
Let's not allow any of us to become or remain elder orphans.
Wednesday, 20 May 2015
Planning a Routine Doctor Visit
For me, the less medicine I am subjected to, the happier I am so in the arena of healthcare, I rely on two principles from the non-medical world:
- If it ain't broke, don't fix it.
- The hammer and nail rule (if you're a hammer, everything looks like a nail) applies equally to physicians: If your job is to heal people, everyone looks sick.
Now before we go one ssentence further today, let's be absolutely clear: the above is NOT a recommendation for anyone else. Period. Full stop. It's just a jumping off point to help explain how I came to write this blog post.
Okay? Moving along.
It's still two or three weeks until my “annual” wellness visit (“annual” in quotation marks because it's going on two years since the last one). It's a routine visit – I have no complaints - but I want my time with the doctor (which isn't much these days) to count. So I'm already preparing.
This is the kind of checklist I've used for many years and it has served me well particularly, I think, because with so little contact there is no reason the doctor should remember me. But it's a good idea even if you see a doctor more frequently, so you don't forget anything you want to know.
LIST OF MEDICATIONS
This time there are only two but one is a supplement the doctor said I need last time I saw him. So I want to be sure the test is ordered to check current levels.
Some people, particularly those who take a variety of prescription drugs, just drop all the bottles, into a bag to take to the appointment. Be sure to include over-the-counter supplements, pain killers, etc. and dosages.
MEDICAL CARE SINCE LAST VISIT
Another list, this one of health care the primary physician doesn't know about but should probably be in your main record. In my case, cataract surgery, the results of some short-term physical therapy, annual flu shot, pneumonia shot, and my ongoing dental work that includes bone grafts.
If care from other medical professionals is ongoing, include their names, locations and contact information.
MEDICAL/HEALTH QUESTIONS AND CONCERNS
Yes, another list. This one is of changes in how my body is working (it could be my mind, too, if/when I think that is in question) or symptoms that I want to ask about.
There are three or four items I'll ask about during this appointment. There is nothing that worries me but I want to confirm that and ask what's going on.
Such symptoms as dizziness, falling, hearing, incontinence problems, weight changes up or down, insomnia and chest pain among others become more common in old age. Don't ever be reticent about discussing anything of concern with your doctor.
If you have researched the web about any issues you have, bring printouts of what you think is applicable or about which you have questions but use your head. Don't give him/her a sheaf of pages – only what is minimally necessary.
UPDATED CONTACT INFORMATION
If any of your contacts have changed, that's another list to bring. Emergency contacts, health care surrogate, medical insurance changes if any, pharmacy name and telephone and, of course, copies of any DNR (do not resuscitate) and other emergency and end-of-life instructions.
As luck would have it, when I was mostly done with writing this, an email arrived from the National Institute on Aging titled Talking With Your Doctor: A Guide for Older People.
It covers most of what is listed above and one other thing I left out that is important: family and friends.
Many years ago, when she was in her 30s or so, a friend was diagnosed with breast cancer. She is a reporter and of course, went into research mode to see what treatment was recommended for her kind of cancer, what outcomes were expected and what were the variables, among other information.
But she realized, too, how rattled she was so she brought a close friend, another reporter, with her to every appointment and discussion with experts about her case so that she would be certain to have all the notes she would need to make her treatment decision.
I've always been impressed that she thought to do that, especially back when doctors were still perceived to sit on the left hand of god.
It's much more common today to be involved in our own treatment and you can bring a friend or family member with you, even on a routine visit if you need or want to.
The section about talking with your doctor at The National Institute on Aging is very good and there are prepared checklists for doctor visits that you can print out. You'll find it all here.
Monday, 18 May 2015
How to Celebrate Older Americans Month
May is Older Americans Month. It is also Jewish American Heritage Month, Asian Pacific American Heritage Month, Mental Health Awareness Month, National Physical Fitness and Sports Month, and National Foster Care Month but this is a blog about growing old.
In case you were wondering, Older Americans Month was proclaimed in 1963 by President John F. Kennedy and that led to the Older Americans Act (OOA) of 1965.
Through that Act, federal agencies, primarily the Administration on Aging, provide services and programs that help local communities promote the well-being of elders, particularly those that help elders live independently in their homes and communities.
So this time of year there are a lot of lunches and other activities to honor old people and I think we should take a day here at TGB to celebrate ourselves too.
We should do that for one day because during all the other 364, the universal doctrine that getting old is the the worst thing that can happen to anyone is what prevails.
If you spend any time at all with any kind of media (in the U.S., certainly), you are relentlessly blasted with anti-aging messages in so many forms that it takes entire books to explain them all. (I know; I own at least three of them.)
The perversion of language is among the worst. The word “young,” for example, is used as a synonym for healthy making the word “old” a synonym for sick. It happens hundreds of times a day in knee-jerk ways in movies, TV shows, books, magazines, newspapers, advertisements, conversation and more.
And it's not just a metaphor. To believe that the definition of old is sick is to cause real illness in yourself and lead to early death. Just accepting the negative stereotypes does that, as a growing body of evidence-based science is showing.
In January this year, CNN explained the results from one of the earliest of these research studies:
”In 2001, researchers from Yale and Harvard University looked at 660 participants between the ages of 50 and 80 who participated in a community-based survey, the Ohio Longitudinal Study of Aging and Retirement.
“They measured how self-perception of aging impacted survival over the course of 22.6 years. They found that participants who held a more positive attitude about their own aging - such as continuing to feel useful and happy - lived, on average, 7.5 years longer.
“In fact, they found that perception of aging influenced longevity even more than blood pressure, cholesterol, body mass index, or a person's tendency to exercise.
And a new study about old age and loneliness, published just last week in England, is the latest in a growing collection of similar results in various aspects of ageing:
”Brunel University London found that expectations and stereotypes of a lonely old age are predictors of actual loneliness. In a sample of 'not lonely' people over the age of 50 years old, a third expected to be lonely and a quarter agreed that old age is a time of loneliness.
“Those with negative stereotypes were twice as likely to report being lonely eight years later and those with low expectations were almost three times more likely to feel this way...
“This is especially significant given the willingness of younger people to accept the stereotype of old age as a time of insecurity, poor health and loneliness - a notion that has persisted in research findings since the 1950s.
“The new research could also shed light on the higher rates of loneliness in England compared with Europe where expectations and stereotypes about old age are quite different.”
Another study has shown that feelings of loneliness increase the risk of premature death by 14 percent.
Note that it is the old person's perception of old age that makes the difference. If you expect to be lonely, to be sick, to be unhappy, to die before your time you are more likely to experience that kind of old age – there is truth to self-fulfilling prophecy.
But you can change that. The way to celebrate Older Americans Month is to check your perspective. Are you harboring stereotypes and anti-aging beliefs about yourself or other old people?
Don't feel bad if you do – they've been brainwashing us about how awful old age is since the cradle. Just take some time to adjust remaining negative attitudes. You'll be healthier and happier for doing so.
Sunday, 17 May 2015
ELDER MUSIC: The Voice is the Thing
This Sunday Elder Music column was launched in December of 2008. By May of the following year, one commenter, Peter Tibbles, had added so much knowledge and value to my poor attempts at musical presentations that I asked him to take over the column. He's been here each week ever since delighting us with his astonishing grasp of just about everything musical, his humor and sense of fun. You can read Peter's bio here and find links to all his columns here.
In a column like this, JENNIFER WARNES is certain to be included and who better to start the ball rolling.
I think it was the song I Know a Heartache When I See One that first brought her to my consciousness back in the seventies. Since then I've sought out everything she's recorded with some measure of success.
Here's that song.
JESSYE NORMAN can sing in any style you can imagine and make it sound better than anyone else.
I really don't need to say anything besides that Jessye is one of the two best singers on the planet (Cecelia Bartoli is the other). Here she is in a rather unexpected style singing what sounds like an art song, Between Yesterday and Tomorrow.
I discovered TANITA TIKARAM's music a few years ago.
Tanita is multi-culturalism personified. She lives in Britain these days, having been born in Germany to an Indian-Fijian father and a Malaysian mother. She writes and sings really good songs. Here she is with This Story in Me.
AUDREY MORRIS calls herself a lounge singer, not a genre of music I usually listen to or like really.
I think Audrey has her tongue firmly in her cheek; she is a fine jazz singer and pianist (she was classically trained). She's still active, singing around the traps, particularly in Chicago, where I assume she lives.
She tackles the old standard, Guess Who I Saw Today.
JANIVA MAGNESS sings the blues. She sings with heart and soul because she's led the life in her songs.
I won't go into the details because it sounds like tabloid journalism but my goodness, can she sing. Today's song is I Won't Cry.
LINDA WRIGHT is a fine jazz singer from Louisiana.
She recently released an album of jazz standards and I'm afraid that is the sum total of my knowledge of her. From that album comes Satin Doll.
When she was a kid, MISSY ANDERSEN was inspired by the music of Gladys Knight, Aretha Franklin, James Brown, The Staples Singers and Teddy Pendergrass.
While still a teenager, she opened for Cissy Houston and was later a member of the Juke Joint Jezebelles who performed blues, gospel and soul music. These days, as a solo performer, she describes her musical approach as soul dipped in blues.
See what you think as she performs No Regrets, a different song from the more famous one Tom Rush wrote.
If BONNIE RAITT were a man she'd be held up as a rock god, guitar hero.
Instead she's quite respected and "my goodness, can't she play the guitar quite well. That's unexpected.”
Here she performs Randy Newman's song Guilty which (and I'm going to fall into my own trap here) Joe Cocker did so well.
SARAH JANE MORRIS sings in pretty much every style that's worth singing – jazz, rock, R&B, pop and art songs. She also writes songs.
Early in her career she was lead singer for an Afro-Caribbean-Latin band but they didn't receive much airplay due to their left-wing politics. She later joined a brass band that performed the works of Bertolt Brecht, Kurt Weill and similar composers. From that she went into theatrical performances of similar (or the same) composers.
For those with a literary bent, she is a cousin of the writer Armistead Maupin. Here's a bit of Afro-Caribbean music with Wild Flowers.
Finally, there's someone worthy to receive the baton passed on by Patsy Cline. TAMI NEILSON is not a household name in my household or many others, I suspect, outside of New Zealand whence she hails (by way of Canada).
When I stumbled on her album "Dynamite!" and played it, the proverbial (and probably the real) jaw dropped as I listened to her amazing voice. Do yourself a favor and seek it out if you like quality country singing.
From that album here is Cry Over You. Tami's definitely channelling Patsy.
When I played this song for Norma, The Assistant Musicologist, she said it sounded like an Ian Tyson song. I'm surprised I missed that as it was so obvious when she pointed it out.
I can't help myself. I was so impressed with Tami I decided to throw in an extra track of her singing a duet with BEN WOOLLEY called Whiskey and Kisses.
Think of Willie singing with Emmylou. The A.M. thought this one sounded as if Ian Tyson had written it too.
Saturday, 16 May 2015
INTERESTING STUFF – 16 May 2015
GRANDPA AND ME AND A HELICOPTER TO HEAVEN
Reader Tom Delmore sent this video of the touching relationship between an old man at the end of his life and his grandson. Simple and beautiful. (In Swedish with subtitles.)
OH, GOD, I WILL MISS JON STEWART SO MUCH
Last Monday, The Daily Show took on those Texas lunatics – including way too many elected officials – who believe a U.S military training exercise in their state this summer is a cover for instituting martial law.
Remember last week when the story about a crazy deer crossing lady was headlined, “They walk among us and they vote?” Just apply that to these people and enjoy Jon Stewart skewering them. Be sure to stick around for the last line.
DAVID LETTERMAN'S EXIT INTERVIEW
Jon Stewart is not the only legend leaving late night television soon. After 33 years, David Letterman is bowing out. The notoriously interview-shy Late Night host talked to Rolling Stone.
Here's something you probably didn't know:
”Three days a week, Letterman wakes up in his downtown Manhattan loft at 6 a.m., drives to his offices at 53rd and Broadway and immediately goes back to bed.
“He used to commute at a more normal hour, but at some point he decided he hated traffic so much that he'd rather sleep in segments than spend an extra 15 minutes in rush hour. Now he gets to his 12th-floor suite around 6:30, sleeps for three more hours, then gets up to start his day, 'refreshed and ready to go.'"
It's a long interview about the show, about quitting after 33 years, about his young son and what he'll do with himself now.
In reality, Letterman is a better interviewer than interviewee. But his retirement marks the passing of an era and should be noted - particularly, if like me, you've produced a zillion TV interviews in your life.
You can read the whole thing at Rolling Stone. Letterman's last show will be broadcast on this Wednesday 20 May. Stephen Colbert takes over that time slot on CBS-TV on Tuesday 8 September.
INSIDE THE COCKPIT WITH A BLUE ANGELS PILOT
I'm not too keen on the accompanying music within this video but it is fantastic to see how the Blue Angels work from the inside.
If you like that, there are more Blue Angels videos at YouTube – just search “blue angels”
THE CARE PACKAGE
That's the name of a new series on the PBS Newshour website from editorial cartoonist, Jack Ohman.
“When editorial cartoonist Jack Ohman sat down to illustrate his father’s final years,” writes someone unnamed at the website, “he did not want to sugar-coat his own experiences providing four years of long term care. Otherwise, the story would not have been worth telling, he explained...
“It was difficult, but he said he acted with a sense of duty.
“'He took care of me, and we had our issues, but I felt he was owed a dignified life, and I wanted to help him,' Ohman said.”
Here are two of the panels from Part 1.
You can see all of Part 1 here where you can also sign up to be notified as Parts 2-4 are published over the next several months. (Hat tip to Tom Delmore)
MICHELLE OBAMA'S TUSKEGEE COMMENCEMENT SPEECH
Last week, First Lady Michelle Obama gave a powerful, even soaring commencement speech at Tuskegee University in Alabama. I would wager no other first lady has been this outspoken and strong. Predictably, the right wing punditry was outraged.
Never mind about that. Just watch this amazing woman tell it like it is to the 2015 graduating class.
REPUBLICANS CUT AMTRAK FUNDNG AFTER DEADLY CRASH
Really. They did that. The Republican majority on the House Appropriations Committee.
In fewer than 24 hours after the terrible train derailment in Pennsylvania took eight lives this week, they snatched more than a quarter of a billion dollars from Amtrak. You can read about it here and here.
And you can check to see if your House representative was on that list here.
JOHN OLIVER ON PAID FAMILY LEAVE
John Oliver keeps telling people who ask that he is not a journalist, not an investigative reporter. Maybe he thinks so because he tells such funny jokes while exposing malfeasance, corruption, fraud, crime, exploitation, misrepresentation along with plain old stupidity.
And he does it thoroughly, competently and even when it's not headline news.
This week Oliver took on paid family leave and you will be shocked at the position the U.S. holds in the world on this subject.
POLAR BEAR MAMA AND HER CUBS
From Darlene Costner. I am charmed by polar bear video while simultaneously being frightened and sad for them as the polar ice continues to melt.
Interesting Stuff is a weekly listing of short takes and links to web items that have caught my attention; some related to aging and some not, some useful and others just for fun.
You are all encouraged to submit items for inclusion. Just click “Contact” in the upper left corner of any Time Goes By page to send them. I'm sorry that I won't have time to acknowledge receipt and there is no guarantee of publication. But when I do include them, you will be credited and I will link to your blog IF you include the name of the blog and its URL.
Friday, 15 May 2015
Things I Do Differently Now That I'm Old
Some people – well, many people – see old age as nothing more than decline and that's not entirely false. Our bodies slow down, we become more susceptible to the “diseases of age” and we soon learn we are invisible to younger generations.
What they don't know yet is that there are compensations. According to some research, old age is the happiest time our lives. We also stop worrying about wrinkes and sags, we don't care as much what other people think of us and due to certain changes in our brains, we actually become a bit more wise.
Even so, there are changes that come, usually by personal choice, that are directly related to growing old. Here are some of the things I now do differently at age 74:
• I don't drive on highways and I don't drive after sunset. The latter is lifelong – I couldn't see well at night even when I was a kid. But highways now make me tense so I take the long way around and usually it's a lot more interesting.
• I renew memberships and magazine subscriptions for only one year. Yes, it's a few dollars more expensive than two or three years but why spend the money when I might not live that long. If you subscribe to as many as I do, the savings is substantial and I can use it elsewhere.
• I haven't bought a dozen eggs in years. It's not about cholesterol and anyway, the “experts” are saying recently that we can eat eggs again. But I live alone, use them mostly hard-boiled in salads now and then and even with only half a box, some go bad before I get to them.
• I don't finish any book (or movie) that bores me. How is it that for most of my life I felt obligated to read to the bitter end just because I had begun? I'm over that now.
• It still breaks my heart but I don't wear high-heeled shoes anymore. There was a time when I couldn't stop buying them. I had more than a hundred pairs and worried that when I died, they'd compare me to Imelda Marcos.
Then one day they hurt my feet enough to make me cry and I couldn't recall if they had always hurt that much and I'd finally had enough, or if they just started hurting that day.
(Speaking of shoes, earlier this week Senior Planet included my shoe fetish in a story about Flaunting Age. I particularly like the idea of pimping out hearing aids.)
• I stopped eating red meat a decade ago because it began causing stomach aches and the upside is that it is much easier to keep my weight in check. Once or twice a year I crave a really good hamburger and I figure eating one that infrequently won't hurt me (or the environment) much.
• I no longer pay attention to dressing fashionably – only what fits well and is appropriate to the occasion. And no more cleavage, not that I ever had much.
• Unless it is extremely important and someone else is paying, I have decided to top using airplanes. They are expensive, unpleasant, uncomfortable and an overall miserable experience.
And finally, I have given up pursuing happiness. I don't even read the ubiquitous “research” studies about happiness anymore because no one – not the researchers nor the respondents – know what they mean by the word. I'm doing fine, enjoying my old age so far and that's good enough for me.
Now it's your turn. What do you do differently now that you attribute to growing older?
Wednesday, 13 May 2015
Growing Old with Unrealized Ambitions
It has been awhile since we've had a reader-suggested conversation which makes it high time, I think, to do so.
Today's comes from Anne Brew who tells me in an email that although she spent her career as a primary school teacher, she always liked loud engine noises and her undercover ambition was to
”...be on the deck of an aircraft carrier, guiding the jets in with what looks like two table tennis bats.
“Since Great Britain no longer has an aircraft carrier I suppose I would have to use an American one. And I suppose I would have to enlist to be trusted with that job.”
I get that. Similarly, though less exotic, I have spent years enjoying those lively dancing traffic directors in busy intersections when I see them. You know the ones – usually in European cities, sometimes standing on a box who make traffic control look like a fun to do.
I've always thought I would be good at that. And there is the obvious frisson of danger – not too much, just enough to keep you on your toes (so to speak) – that a driver might skim past just a little too close.
That possible career choice along with dozens of others have briefly engaged my mind as alternatives to where I spent my work life though none were anything I longed for or regret not doing.
One big unrealized ambition, actually a daydream, is not career- or job-related. It's about wealth.
There is plenty of good one can do for others with unlimited wealth and I like to think that I would do that. How many homes does anyone really need or cars or expensive gadgets and doodads.
That doesn't mean, however, that people of great means should not indulge personal whims; only that they should also share their good fortune. But that's for another time. Today, we're daydreaming.
If I had unlimited wealth, I would buy me my own large airplane, an Airbus 380, and outfit it as a splendid traveling hotel with living room, eight or 10 guest suites, entertainment areas, a world-class kitchen and chef.
For style, think updated, greatly enlarged private railroad car from the 19th century with luxurious fabrics on well-made furniture, fine wood trim and pretty little wall lamps.
There would also need to be an excellent gym because the reason for the big, roomy airliner with all possible comforts available in flight is to gather up certain friends, the ones who are adventurous about great good food, and travel the world eating the best there is in their places of origin in season accompanied by the finest wines or whatever local libations are the recommended accompaniments.
From Parisian haute cuisine to the biscuits and red-eye gravy in Nashvville. From a tajine in Marrakesh to lobster in Maine. Fresh gnocci in Rome, sushi in Tokyo and so on.
The gym, then, to keep our bodies from turning into Jabba the Hut.
You can probably tell that in odd moments, I've daydreamed this for decades, redecorating the plane as my tastes have changed, adding phones, movies, large screens and recently, wi-fi along with a mental list of restaurants as I read reviews from storied restaurants great and small from around the world.
I suspect that if this ever became reality, I would quickly tire of being always on the move but that does not detract from the enjoyment I get from thinking about it and that's all I really need from the idea – it's fun to imagine.
Anne Brew concluded her note to me with this:
“It suddenly occurred to me that as a 66-year-old woman living in the U.K. and not being a member of the armed forces, it's now certain I will never do this and it's come as a bit of a shock.
“Do you or your readers have secret ambitions that will now never be realised and how does that make them feel?”
Now it's your turn, readers. Following Anne's lead, what are your secret dreams – career or personal. Did any of you accomplish them? Was there disappointment when you realized you've reached an age when it won't happen? How have you, if necessary, dealt with letting go?