Tuesday, 23 September 2014
The Quarterstaff Revolution Redux
On yesterday's post about falling, Bruce Cooper noted that there are elders who could prevent falls by using a cane but are too vain or embarrassed to do so.
I believe Bruce is on to something and that reminded me of Dr. Bill Thomas, the well-known geriatrician who, a few years ago, wrote a regular column for this blog. (Nowadays, he has his own blog: ChangingAging.)
In 2008, in these pages, Bill called for a “quarterstaff revolution,” writing a compelling story about why such a device might be better for elders than a traditional cane.
In addition, maybe a quarterstaff is a “cooler” choice for some of us and if that keeps us upright, I'm all for it. See what you think.
In 1992, The New York Times took a look at the research AARP was doing on walking canes:
”Many people who use canes injure themselves because they don't do the necessary research before buying one. That is an early conclusion of a continuing study on canes sponsored by the American Association of Retired Persons.
“According to Dr. Margaret Wylde, vice president of the Institute for Technology Development in Oxford, Miss., which is conducting the study, the conclusion is based on a review of recent medical and rehabilitation literature and on more than 1,000 letters solicited from A.A.R.P. members who are regular cane users.
“Some of the most serious damage, Dr. Wylde said, can result from the cane's grip. Carpal tunnel syndrome, a painful ailment, can result from any repetitive motion like typing or using a cane.”
There are two reasons people use walking canes.
- To improve balance by providing a third contact point with the ground
- To redistribute weight away from an injured or arthritic lower limb
As a physician, I have never really liked walking canes. Here is one patient's experience:
”I noticed several problems within the first five minutes. My triceps were quickly fatigued as they worked to hold my weight up.
“As a result, my scapula elevated to relieve the triceps, putting strain on my rotator cuff. This "shrugging" effect could be somewhat offset by lowering the height of the handle below my waist, which served to extend the arm and reduce the amount of elevation in the shoulder.
“The handle of the cane was designed in such a way that the grip increased in broadness from the neck of the handle to the end, providing a wider, flatter surface where the palm would rest.
“Unfortunately, the result was not a more comfortable feel, but rather a terrible dorsiflexion combined with ulnar deviation in the wrist and a bruised hamate bone where the weight was concentrated. I felt tweaks of pain all day long in my wrist and shoulder which continued into the night, long after I had ended my experiment.
“Aside from design problems, there were several functional problems as well. For instance, each step was accompanied by a jarring vibration which was transferred up the entire length of the arm every time the rubber cane tip struck the concrete. The swing of the cane often had to be initiated by a flick of the wrist, resulting in a constant repetitive oscillation between ulnar and radial deviations.
“Furthermore, adjusting the cane to the correct height was difficult due to a simultaneous push of a button and pull of the shaft requiring relatively dexterous fingers; arthritic hands would be pitifully ineffective.”
PREDICTION! Elders of today and tomorrow are going to give up on the cane, abandoning it in favor of the quarterstaff.
"Gandalf the Grey carried about with him a spike brown staff which served partly as an agency of his power, as can be seen when he faced the Balrog in Moria. Besides functioning as a useful walking stick, it was also thought to symbolize what he was and his position in the Istari."
There are three reasons I think elders can and will retire the old-time walking cane and embrace the quarterstaff:
- The cane places the greatest strain on the smallest muscles and joints (the wrist and forearm). Repetitive use can easily lead to wrist and forearm injury.
- The quarterstaff transfers the weight into the shoulder girdle itself. The shoulder joint and its surrounding muscles are much better prepared to handle the load than are the wrist and forearm.
- Imagine a scene: an older woman using a bent-top walking cane crosses a building lobby, trying to reach the elevator before the doors roll closed. Now imagine the same scene with the older woman striding across the lobby with the aid of a seven-foot, oak quarterstaff. People hold the door open not because of chivalry, not out of a desire to help little old ladies, but rather because she just looks so damned cool.
I'll close my appeal with a quote from one of America's greatest walkers.
"Although the vast majority of walkers never even think of using a walking staff, I unhesitatingly include it among the foundations of the house that travels on my back. I still take my staff along almost as automatically as I take my pack. It is a third leg to me - and much more besides.
“On smooth surfaces, the staff helps maintain an easy rhythm to my walking and gives me something to lean on when I stop to stand and stare. Over rough going of any kind, from tussocky grass to pockety rock, and also in a high wind, it converts me when I am heavily laded from an insecure biped to a confident triped…
“It may well be, too, that the staff also gives me a false but subconsciously comforting feeling that I am not after all completely defenseless against attack by such enemies as snakes, bears and men."
- - Colin Fletcher, The Complete Walker III, 1984 (page 78)
[AFTERWORD from Ronni: For about the last six or seven years of her life, until she died in 1978, Margaret Mead and I lived across the street from one another in Greenwich Village. I didn't get to spend as much time with her as I would have liked, but we sometimes walked several blocks together on our errands around the neighborhood.
She always used a quarterstaff, although I didn't know it was called that. She looked magnificent and powerful striding down the block, especially in the colder months when she wore a full-length cape.
I've known since then that when the time comes, I will use a staff and not a cane. Now, with Dr. Thomas's permission for us to do so even if we don't require one yet and the Colin Fletcher quote, I may start sooner.]
At The Elder Storytelling Place today, Clifford Rothband: Joy Unto Others
Monday, 22 September 2014
Preventing Falls on the First Day of Fall
Depending on who's talking, today is the first day of fall or tomorrow is the first day of fall. The day has to do with the tilt of the earth, northern and southern hemispheres, daylight savings time and
Oh, never mind. Here in the United States, all of September is designated National Falls Prevention Month By The National Council on Aging (NCOA) and tomorrow, Tuesday, is Falls Prevention Awareness Day in 47 states and the District of Columbia.
I like that someone, a few years ago, connected falls and Fall making it a handy reminder for an annual prevention checkup.
Now don't go yawning. I write this post every year because unlike many old age afflictions, falls are something over which we have a lot of personal control. All we need is some vigilance.
Falling is serious business for old people:
FALLS ARE THE LEADING CAUSE OF INJURY-RELATED DEATHS, EMERGENCY ROOM VISITS AND HOSPITALIZATIONS FOR PEOPLE 65 AND OLDER.
Did you see those words “leading cause”? That means, the NCOA tells us, someone in our age group dies from a fall every 29 minutes.
Every year, one-third of Americans 65 and older – 12 million of us – fall. Even if someone doesn't die from it, a broken bone can severely restrict the rest of an old person's life.
The good news is that falls are highly preventable. In past years, I have given you a long list of causes and remedies – the 2013 edition is here.
This year, I discovered an excellent, easy-to-read falls and fractures section at the National Institutes of Health (NIH) website that lists the variety of causes with links to the best information for prevention.This NCOA page clears up some myths about falls.
And remember, too, what your mother repeatedly warned you: “Watch where you're going.”
Here's a little video clip I used on last year's falls prevention post. I still like it – from the old TV show, Hill Street Blues.
At The Elder Storytelling Place today, Marc Leavitt: E Pluribus Unum
Sunday, 21 September 2014
ELDER MUSIC: States – New Mexico to South Carolina
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.
Continuing our musical sojourn through the States, we're just finishing off the "new" states and venturing on, north and south.
For that state's song I turn to HANK WILLIAMS JNR.
It seems from the song that Hank got lucky in Clovis, New Mexico.
Now, to select one of those. I've chosen, not quite at random, JENNIFER WARNES.
The song, Big Noise, New York, was written by Marcelle Clements and Donald Fagen and it certainly sounds like a Steely Dan tune. That sort of thing is okay in small doses.
"THE BLIND CORN LIQUOR PICKERS, like the moonlight-brewed intoxicant for which they are named, play a variety of bluegrass whose origins are difficult to ascertain.
“As corn liquor flows through an old car radiator, old-time traditions mix with modern methods in ways that can be unsettling, inspiring, euphoric or blindness-inducing.
“It's bluegrass that burns going down, warms your gut, and then hits your head like a thunderbolt of white lightning."
The song they perform is called North Carolina. This was the only tune in my collection with that state's name in the title, so it got the nod.
Fortunately for me he writes and sings about other places as well. Indeed, his was the only song I found that mentions North Dakota. That also is the name of the song.
We don't have an old singer though – well, not one from that period but she is nearly one of us. Here is KIM RICHEY.
This is taken from an album called "The Beautiful Old Turn-of-the-Century Songs" where current artists interpret songs from back then. It really is a nice album.
Kim's song is Beautiful Ohio.
Tom is noted for his topical songs but he wrote in many different genres. I don't know how you'd categorise this one, My Oklahoma Lullaby. Probably just an observational song.
That's probably not unusual for successful performers (and a bunch of unsuccessful ones as well).
He continued this while at college but his plans were interrupted by a stint in the military (as they paid for his tuition). After that he returned to music and has released a bunch of albums.
From his biggest selling album, “Soul's Core,” we have Twin Rocks, Oregon. It may be the only song ever to mention the writer Richard Brautigan.
It's one from my childhood and was a favorite of my sister at the time and she went around singing (an approximation of) it all the time one year. The performer (besides her) is GUY MITCHELL.
As we're up to Pennsylvania, most of us know I'm talking about Pittsburgh, Pennsylvania.
The song really is about a chook but the state is mentioned in the title so that's good enough for me. That song is Sweet Rhode Island Red.
Okay, the song is just about Carolina – there are no songs that specifically mention South Carolina. However, the official song of the state is just called Carolina, so if it's good enough for them it's good enough for me.
There are many songs that reference Carolina but Kate's was really mellow and I think that's what was needed after Tina. Her song is Carolina Pines.
More states in two weeks' time.
Saturday, 20 September 2014
INTERESTING STUFF – 20 September 2014
WHO SHOULD HAVE KNEE REPLACEMENT SURGERY
Too often in government health videos for elders I've seen, the speaker sounds like he or she is talking to toddlers. This one, however, is a straight-forward explanation of how decisions for knee replacement surgery are made.
Because joint wear and tear is a common issue with elders, this is good to know.
And, if you or someone you know is a candidate for knee replacement surgery, here is a video from the same surgeon about what it involves.
SCOTTISH INDEPENDENCE FOR NON-BRITS
After a week-long hullabaloo about possible Scottish independence from the United Kingdom, the vote is in. There will be no is dissolution. You can read about it here.
Before referendum day, I discovered this video which could easily be named Scottish Independence for Dummies (that would be me) and it's fascinating to consider the ramifications if the vote had gone the other way. Take a look.
Click here to see how the numbers from the vote stacked up.
A FRICKIN' ELEPHANT
It is rare that I post a joke here because I think they don't work well in print a lot of the time. But this one from Darlene Costner is a really funny "out-of-the-mouths-of-babes" moment.
From the diary of a pre-school teacher:
My five-year old students are learning to read. Yesterday one of them pointed at a picture in a zoo book and said, "Look at this! It's a frickin' elephant!"
I took a deep breath, then asked, "What did you call it?"
"It's a frickin' elephant! It says so on the picture!"
And so it does.
THIN, FLEXIBLE SOLAR STICKERS THAT GO ANYWHERE
This is cutting edge solar science but not pie in the sky. It is being developed now and, as Xaolin Zheng explains, it can power the world while providing a sustainable energy future.
The video is 13 minutes long and gets into the scientific weeds a bit but it's worth sticking with (to coin a pun). It's an amazing new technology.
DOG EATS 43.5 SOCKS
I know, it sounds impossible or, at least, that the Dalmation should be dead. Not so. Take a look.
RECORD NET NEUTRALITY COMMENTARY
You will recall that not long ago I asked you to send your comments on Net Neutrality to the Federal Communications Commission – the idea being to persuade the commissioners to not allow “fast lanes” for big companies while slowing down web site delivery for sites that don't pay up.
The public commentary period closed this week and it set a record for the number of submissions, more than doubling the previous record of 1.4 million set with Janet Jackson's “wardrobe malfunction” that briefly exposed her breast during the 2004 Super Bowl.
Now we await the FCC's decision. You can read about that at The Guardian.
CBS TV SUED OVER A FARTING HIPPO
If you are a regular viewer of NCIS, you are probably familiar with Bert the farting hippopotamus, a running joke on the TV series that is so popular, CBS-TV has been selling the stuffed animal on its website.
Now, however, puppet maker Folkmanis Inc. is suing the network for $733,000 for copyright infringement. CBS issued this public response, according to Mediaite:
“We believe this to be a flatulent abuse of the legal system, and we intend to clear the air on this matter immediately.”
For those of you who are unfamiliar with the farting hippo, here is a scene from NCIS starring said toy:
THE WORST NEWS OF THE WEEK
In the category of scaring the pants off you, it's hard top Ebola and beheadings. Even so, this news joined them and global warming on my personal fright list:
”According to the new analysis by researchers at the United Nations and several academic institutions, there is an 80 percent chance that the world’s population, now 7.2 billion, won’t stop at nine billion in 2050 [as had been predicted], but will instead be between 9.6 billion and 12.3 billion by 2100.”
There are forces that could reduce that number, most particularly climate change that could
”...put major stresses on agriculture and water supplies, and these stresses were not considered as potential checks on population growth.
“Nor does the study take into account that population growth could trigger deadly calamities like food shortages, war, and disease even without climate change...”
It doesn't look good whatever happens. You can read more details at MIT Technology Review.
For boomers, PBS will premier a new documentary on Tuesday next week, 23 September, titled The Boomer List.
It seems to consist of interviews with one famous person born in each year of the baby boomer generation – 19 in all. Here's the trailer:
You can read more here and as always with PBS programming, check your local listings – shows are broadcast on different times and days throughout the country.
THE CAT PRINCE
Yeah, it's a commercial but anyone who has ever rescued a cat (or dog) will like the story.
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 probably 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, 19 September 2014
Trying to Find Some Amusement in Being Sick While Old
So commonly does disease, decline and debility catch up with people in old age that for a majority of those who are younger, they are the only definition of being old.
That belief is so prevalent in the general population that after the half dozen years of research into aging I conducted that led me to create this blog a decade ago, it became my goal to refute it – we oldies are more than our aches and pains. Much more.
That doesn't mean I am in denial. After five or six decades of steady use, our bodies wear down. Stuff happens. Things go wrong. And there is an impressively large variety of ailments that can afflict us – from the deadly serious to just annoying.
Today I am concerned with the latter category.
Generally, I am remarkably healthy. (I say that in a whisper while knocking on wood.) Now, however, for the better part of a month, I have been off my feed, as it were, and for some periods of time in a lot of pain.
The first was abdominal cramps, the kind that cause screaming into a pillow, deep misery and pleas for a quick death.
After two days it began to subside, though my innards felt sore for a few more days, like they had been bruised, but I was grateful in the end that the gods had ignored my death requests.
The doctor has no explanation (a not uncommon diagnosis for me over the years) and it took another week before full energy returned.
No sooner was I almost mended than the entire length of gum on one side of my mouth swelled to a gargantuan size. The dentist supplied two kinds of antibiotics for the infection and after a week, it is nearly cleared up.
Nearly is the operative word. The pain, even with medication, makes it impossible (still) to wear my denture. This led to a few issues that I should have anticipated but did not.
One: It is amazingly difficult to talk without teeth. TH, F and V sounds don't work right at all. S and soft C take a lot of effort to sound as they should – or as close as possible – so talking for more than a few minutes is more tiring than I would have believed until it happened.
Also, attempting S's and soft C's too forcefully causes spitting if you're not careful and that's in addition to the ongoing drool. (These two side effects have almost – I said ALMOST – given me a newfound appreciation for unkind old age jokes some comedians tell.)
There were several misunderstandings in a phone conversation and I giggle now when I see that guy in the fraud/frog protection TV commercial.
I'm pretty sure, too, this explains why babies wait so long before they speak real words; no teeth yet.
Two: As I mentioned a couple of days ago, no way will I allow anyone – anyone at all – to see me without my denture but staying home for more than a week is not possible so I developed a few ruses that, if they didn't work, people were kind enough not to tell me.
For grocery shopping, I wrote the list on a larger piece of paper than usual and used it to tap my upper lip as though I were deep in thought. When I needed to speak to anyone directly, I covered my mouth with my hand and just made a joke of it: “Sorry, my denture's out for repairs and you don't get to see me without it.”
They usually laughed – with me (I think). In one case, to be sure the person understood I was kidding about something, I said, “I'm smiling behind my hand” and that seemed to work.
It's hard to shop with only one hand free so now I have obtained some face masks and I'll just let people wonder whether I'm contagious or I'm afraid of their germs.
Three: Last but hardly least, have you ever tried to eat with no teeth? For a week I've been subsisting on mashed potatoes, apple sauce and soup and I'm damned tired of it.
A few days ago, thinking that I was probably lacking enough green stuff and protein, I checked out the baby food aisle at the market. I'm here to report that Gerber's mashed peas are remarkably fresh tasting and their mixture of carrots, zucchini and broccoli is delicious too.
But look out for the chicken and noodles. Now I know why babies spit out so much food.
None of this stuff is a big deal. If these are the worst health issues I ever have, I win and I will be grateful. Meanwhile, I've managed some small amount of fun figuring out how to work around the no teeth problem.
At The Elder Storytelling Place today, Dani Ferguson Phillips: A Change in Perception or Just What the Doctor Ordered
Thursday, 18 September 2014
Elder Services in Your Town - Follow Up
Our experiment two days ago in holding a TGB open forum or what might be called a reader-to-reader feedback day on a specific issue appears to be a rousing success. The question of the day, from SusanG, was
”...what senior services are offered by your town, do you use them, or are their other services you would like to see offered?”
Commenters did an excellent job of letting us know what does and doesn't work in their communities and what could be improved. Many of you named the town or area where you live and that was particularly interesting to me.
Today's post is a short summary of your responses.
A number of readers are pleased with their local transportation – in such places as Fresno, Sacramento, Seattle, Ann Arbor, Cape Cod. Those communities use a variety of solutions: free or reduced-fare public transportation; scheduled buses to senior centers or shopping; inexpensive taxis for medication transportation, etc.
Lack of transportation is a big issue for a larger group of readers in such places as Yonkers, a Texas town, western Michigan, Montreal as it is in almost all rural and suburban areas in the U.S. and, I'm guessing, Canada too.
One person suggested the new, app-controlled taxi-like services Uber and Lyft.
They are mostly available only in large cities and they are controversial, so much so that Germany has banned them and some cities in the U.S. are looking into serious issues of insurance, liability, etc. that are required for licensed taxis but not these new services.
Just yesterday, a German judge lifted the ban but appeals are going forward. You can read more here and with that in mind, of course it's up to you to decide to use the services or not.
A few of readers reported mostly good elder services in their areas: Yonkers, Spain, Canada (transportation in Montreal notwithstanding) and an area of suburban New Jersey where SusanG, who submitted the question, lives.
As has been revealed in many surveys and studies of elder needs and desires for community services, more opportunities for social engagements are high on every old person's list.
Jean wrote poignantly of a common dilemma many of us share as friends die or move away:
”I don't have family near-by and no close friends. (I didn't get out much when I was a full-time caregiver to my husband for 12 years and a part-time caregiver to my dad in the 5 years before that.)
“Since my husband died 2 1/2 years ago I've been working my tail off trying to be active in various groups to help build friendships but but so far I have many friendly acquaintances but no close friend to exchange favors with.”
That's a big one for many of us old folks.
As several readers mentioned, almost as important as personal relationships is the small stuff – that can easily build up into big stuff. Suz put it this way:
”I would appreciate someone to clean and put away the outdoor furniture next week; someone to come by once or twice a year to explain the new (and old!) tech information for computer and cell phones.
“Someone who could assist going through boxes of memorable or useless items that now number in the dozens; help with eliminating unwanted clothing and household items & then donating them to my favorite homeless shelter.
“And I'd love for someone who could put together a list of all the small, pesky things (like screen repairs, paint touch-ups, ceramic gluing, etc.) and have it all done.”
These regularly needed and one-time household chores are precisely the kind of things that Villages volunteers can do so well. Jean left a note asking for links about how Villages work and how to start one.
Instead of many links, I'll give you one that that has an excellent library information from which you can pick and choose as is useful to you.
It is the website of Villages NW, my local Villages “hub” working hard to help build the (so far) eight Villages being developed in the Portland, Oregon area. Use the dropdown menus under the headers, Learn About Villages and Resource Library, where there are dozens of informative papers.
EXPLOITING THE ELDER MARKET
Cathy Johnson of Rockford, Illinois, left a comment about her visit to “Senior Expo” where, she says, only about 10 percent of the exhibitors had information of real value to elders:
”The majority were selling insurance, high-priced in-home care, bathtubs for those who cannot use a standard one, food supplements (the only vendor of these that I spoke to could not tell me the contents, only that it 'helped him avoid a recommended knee replacement a couple of years ago')...”
Yeah, right. You can read Cathy's entire comment here.
FUTURE TGB FORUMS AND YOU
So Tuesday's forum experiment confirmed some beliefs I have on elder needs and supplied a lot of new information, as I hope it did for you. As usual, all the comments were thoughtful, informative and useful.
This idea came from SusanG and just when I needed it, too. For a variety of reasons over the next several weeks I will not have as much time as usual to give to this blog.
The best reason is that Peter Tibbles, the “musicologist” who writes the Sunday Elder Music column on this blog and Norma, the assistant musicologist, arrive next week from Melbourne for a good, long visit I've been eagerly awaiting.
If Tuesday is any indication, the TGB Forum is a great way to reduce my time obligation and still keep the blog fresh every day. Here's how you can help:
In the comments today, leave your suggestions for future TGB Forum topics. It might be best to state them in the form of a question but that's not a requirement and don't let it confine you. They can be serious, informational or just fun/funny. As always at TGB, they must relate in some manner to aging.
You will be credited if I use your suggestion so if you have a personal blog, be sure to include the URL in the comment form so I have the link.
At The Elder Storytelling Place today, Mickey Rogers: A Long Lost (with good reason) Lone Ranger Show
Wednesday, 17 September 2014
DEA Allows Return of Unused Prescription Drugs
Once or twice a year in my town there is a day when residents can turn in leftover prescription drugs that are then disposed of properly rather than flushing them down the toilet to enter streams and rivers or be found in medicine cabinets by children or grandchildren.
The problem has now been addressed by the federal Drug Enforcement Administration (DEA). Beginning next month, the agency will
”...permit consumers to return [certain] unused prescription medications...to pharmacies,” reports The New York Times and others...
“The new regulation, which will go into effect in a month, covers drugs designated as controlled substances. Those include opioid painkillers like OxyContin, stimulants like Adderall and depressants like Ativan.
“Until now, these drugs could not legally be returned to pharmacies. The Controlled Substances Act allowed patients only to dispose of the drugs themselves or to surrender them to law enforcement.”
What I didn't understand until reading about this new regulation is that the “take back” days are a national event organized by the DEA. The next one is on Saturday 27 September.
”In the past four years, these events have removed from circulation 4.1 million pounds of prescription medications,” reports The Times.
But that's only a drop in the bucket compared to how many drugs are in circulation:
“'The [take back days] only removed an infinitesimal fraction of the reservoir of unused drugs that are out there,' said Dr. Nathaniel Katz, an assistant professor of anesthesia at Tufts University School of Medicine in Boston who studies opioid abuse. 'It’s like trying to eliminate malaria in Africa by killing a dozen mosquitoes.'
“Dr. Katz is optimistic that the D.E.A.’s decision could have a powerful impact. Putting drop-off receptacles for controlled substances in pharmacies will mean consumers have year-round access to disposal services.”
The new regulation is voluntary and does not require pharmacies to have drop off receptacles so it is unknown at this point how many will participate.
It seems such an obviously important service – especially for elders who use more prescription drugs than younger people - that it is amazing it's never been thought of before. You can read the entire story here.
At The Elder Storytelling Place today, Joanne Zimmermann: Worldwide Music Man