Broken Bone Broken Hearts

Reader Kristin Stevens writes…

What should we do for a 86 year old with mid stage ALZ with a femur neck fracture without option for repair because of critical aortic stensis, who is who unable to get out of bed, unable to toilet out of bed, who is very frustrated and confused and anxious and angry about not being able to get up, who tries over and over and over again to get up who can’t remember that he has a fracture. Efforts to redirect, to just stay present, to be with what is happening fail. Drugs loom as the “solution”…loving, skillful care partner is at bedside 24/hr. How would REAL CARE address this dilemma?

First of all we can all pause, for a moment, and feel compassion for a daughter and her father as they struggle together through difficult and unfamiliar terrain. The situation is painful and seems to offer no good answers.

Second, we can take refuge in the principles of person-centered care. The answer to “What should we do for a-” depends entirely on the individual in question.
Read the full story here.

Fear of the Unknown

Simple things can work surprisingly well. This is the new frontier of health care. It’s not about the molecules anymore. The new frontier is all about ideas and insights into what constitutes real care and then organizing resources in a way that makes real care happen— every time. Consider this insight from Atul Gawande for example.

Power-Up Friday: Real Problems, Real Solutions

The University of Iowa’s Geriatric Education Center recently sent out a summary of studies year-to-date regarding “Management of Behavioral and Psychological Symptoms of Dementia”. Here’s a brief summary of the nine studies quoted:
(1) One study could not prove that stroke incidence was increased with antipsychotics, while another said it likely was increased.
(2) Antipsychotic use has increased in recent years in nursing homes without evidence of any coherent thought process, and out-of-proportion to any increase in dependency or behavioral symptoms over the years.
(3) Several studies were so “brave” as to say that “caution” should be exercised before using antipsychotic drugs in dementia, even though their data suggest that this wording is too mild.
Here’s a challenge: The REAL problem is not that these drugs are largely ineffective and dangerous when used for behavioral distress. The REAL problem is not even that we over-medicate people with dementia.
The REAL problem is that the very notion that this distress requires any pill is a flawed paradigm.
The REAL solution is not to find better pills. The REAL solution is Real Care.

Race, Eldercare and iPhone Apps

Yes, there is an App for everything these days — including the new free “Geriatrics Cultural Navigator” iPhone App for eldercare workers:

Are you a clinician caring for older adults from different ethnicities? Do you want to better understand the role of culture and ethnicity in health care in order to make better decisions about these patients? Then the Geriatrics Cultural Navigator is just the tool for you.

Read more here.

ChanginAging Hits Top 50

Hey ChangingAging readers, your nominations put us in the top 50 Boomer Blogs. What I love is that when we started ChangingAging.org there wasn’t even such a thing as Boomer Blogs, and now we’re in the top 50!

What to Call the Boomers

The Boomers have not been babies for a very long time.
In order to understand them at this point in their lives I think it makes the most sense to refer to them as members of the “Post War Generation.” I’ll be writing much more about this in the months to come.

Forced Retirement

It’s more common than I thought and the Great Recession is worsening the trend:

According to a new study by Sun Life Financial, more than 20% of American workers are forced into early retirement by layoffs, cutbacks, and shutdowns. In an age where pensions have gone by the wayside and the future of social security is in doubt, the report finds they often find themselves with half of the expected savings and investments they anticipated for their golden years.

Watch a conversation about forced retirement here:

Ageism and Sexism are Cousins

A woman challenges the Thai Buddhist hierarchy for the right to be a monk. The objection here is derived from the same rotten core that we find at the heart of ageism. Rather than being judged as an individual this female monk is being judged as a member of a class. The same kind of thinking drives mandatory retirement schemes.

Anderson Cooper

Posted with out comment:

Anderson Cooper Offered $1 MILLION To Ditch Gray Hair
Anderson Cooper has reportedly been offered $1 million to get rid of his gray hair for the next five years, the Sun-Sentinel reports.

The War Between the Generations

Elders and the very young have long been allies. In fact, there is an old joke that goes, “Why do grandparent and grandkids get along so well? They share a common enemy.” Life in a modern, post industrial, economy frays these ancient bonds.
Let’s look at a blogospheric exchange in reaction to last week’s New York Times Magazine Cover Story “What Is It About 20-Somethings?”
Click here.

Getting the Job

In the comments, Pat Blanchard offers some good advice that deserves broader attention. I’ve gone ahead and added hyperlinks to her original comment. If you have a minute, click on some of the the links and note how the related material further illuminates what Pat has to say. Even though social media can seem new and new fangled, it allows people to extend and develop elements of an ongoing conversation and, in that sense, it’s as old as humanity:

One reason it’s harder for older job seekers to find jobs today is that job search techniques and strategies have changed drastically over the past 20 years ago. A long, detailed work history listed in chronological order can be a deal killer, whether it’s written on a resume or verbalized in an interview.

Read more here.

Denial: It’s not just a river in Egypt

We are going to run a series on anti-aging quackery.
Here’s our first entry. By the way, I could not make it all the way through the video. I feel sorry for this nice lady and wish she could feel more comfortable with her true self:

Immortality?

This is a recollection written by James Boswell which records his death bed visit with the great philosopher David Hume.
Hume was well known as a “free thinker” which meant that he did not accept any religious dogma and doubted the existence of an afterlife.
Boswell wondered if the approach of death may have changed the great man’s mind.
What do you think he found?

Institutional Home Care

It is easy to point at nursing homes and criticize the way that they institutionalize care. Home care, we often assume, must be warm and friendly and– person-centered. Unfortunately, home care can drift into institutional patterns despite the care team’s best efforts. How does this happen?
Click here to find out.

Power-Up Friday: The Medicalizaton of Dementia

In their 2008 book, The Myth of Alzheimer’s: What You Aren’t Being Told about Today’s Most Dreaded Diagnosis, Drs. Peter Whitehouse and Daniel George entertain a radical possibility–that Alzheimer’s disease may be less of a distinct disease than part of the spectrum of brain aging. They discuss the ways in which the lives of people who live with dementia have become medicalized, and the industry that has grown around this process.
Now, a study from UC San Francisco lends some interesting support to this argument.