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Wednesday, May 25, 2016

Death and Dying in America

Death and dying in America
May 25, 2016--Why is Alzheimer’s disease causing relatively more deaths in Washington state?  State and local health officials increasingly plumb such disparities for clues that may help them develop preventive programs and save lives.

For instance, Kentucky and New Hampshire have high rates of death by accidental poisoning, which includes drug overdose. In response, Kentucky has begun a program to monitor the prescribing of addictive painkillers. It has also expanded the availability of treatment for substance abuse.

New Hampshire Gov. Maggie Hassan, a Democrat, signed a bill in January calling for stiffer penalties for drug dealers and more tracking of prescription drugs, calling the epidemic of heroin and prescription painkillers “the most pressing public health and public safety issue facing our state.”

Sometimes states can only do so much about higher incidents of mortality. Take suicide, for example. Guns often are more available in some Western states, said Catherine Barber, who directs the Means Matter Campaign at Harvard University. Their prevalence can drive up suicide rates, she said, not because gun owners are more likely to be suicidal — but because guns are more lethal if a person decides to commit suicide.

Data Drives Action

After noticing a stubbornly high rate of liver disease, intoxicated-driving and other causes of alcohol-related deaths, New Mexico’s Health Department this year began an alcohol-awareness programthat focuses on areas of the state where the problem is most acute.

“The rate was not improving over time,” said Rosa Isabel Lopez, health data dissemination coordinator for the state health agency. “The decision was made to create more data points for community audiences and get this information into the hands of our neighborhoods.”

The state also launched a public website last year that displays data on health issues in small areas of the state, which communities can use to understand problems and target them.

Local detail, plenty of data, and plain language for policymakers are important aspects of successful state efforts to prevent deaths, said Ross Brownson, an epidemiologist at Washington University in St. Louis who wrote a 2010 guide on the subject.

“We like to say, ‘What gets measured gets solved,’ ” Brownson said. Until recently, he said, communities often didn’t have enough details about health problems to make policy decisions.

In the last few years, he said, there’s been improvement nationally in collecting and distributing health data. The University of Wisconsin’s Population Health Institute, for instance, introduced county health rankings for Wisconsin in 2003, and then expanded them nationwide in 2010.

The rankings noted drug overdose deaths “reaching epidemic proportions” in some areas such as northern Appalachia, and rising 79 percent nationwide since 2002. The Stateline analysis also found high rates of accidental poisoning, which includes drug overdoses, in Massachusetts and New Hampshire.

Deadly Puzzle

In Wisconsin and nearby Iowa and Minnesota, there are disproportionate instances of accidental falls that are fatal. It’s a phenomenon that has puzzled researchers for years, said Patrick Remington, an associate dean at the School of Medicine and Public Health at the University of Wisconsin.

“We’ve supposed that it’s due to cloudy weather, no sun and so no vitamin D [which promotes bone health], but there’s not been a good answer yet,” Remington said. Wisconsin’s Health Department has a fall prevention program, which points out that the elderly are particularly susceptible to falling.

Elizabeth Stein, a preventive medicine resident at the University of Wisconsin medical school, said low vitamin D levels can lead to both fatal falls and dementia in older people, though studies have yet to confirm a link between those causes of death and the area’s cloudy weather.

Washington state prepared a plan to address Alzheimer’s disease last year after data indicated it was the state’s third leading cause of death, killing people at a rate two-thirds higher than the national average. Worse, Alzheimer’s was on the rise while other top killers like cancer and heart disease were in decline.

But the apparent rise could be attributed to better data. Washington has a more rigorous method of collecting and verifying death data than some other states. States’ totals for all deaths from dementia, which includes Alzheimer’s, suggests that many might not be reporting the disease as carefully as Washington.

Differences between the states in recognizing and coding the cause of death can muddy the picture, said Francis Boscoe, a research scientist at the New York State Cancer Registry who used differing death rates by state as a “conversation starter” about state-specific mortality issues.

“It seems entirely plausible that physicians or coroners in Washington could be coding as Alzheimer’s what other states might call pneumonia or something else,” Boscoe said. “There are explicit rules for all this, but that does not mean they are all being followed the same way.”

After Boscoe wrote last year about peculiar death patterns in states, he said he heard plenty of feedback about data-collection issues that can make for misleading numbers.

Flawed Death Certificates

As Stateline has reported, how the cause of death is recorded on death certificates, from which officials draw data, can vary widely even within a state.

In Kansas, for instance, what appeared to be the most distinctive cause of death — hardening of the arteries, or atherosclerosis, killing people there at seven times the national rate — was actually more of a data-recording problem than a medical one.

“This is a classification issue,” said Cassie Sparks, of the Kansas Department of Health and Environment. She said the state plans to emphasize better reporting and classification in training materials for medical examiners and others who sign death certificates.

But even if some data is flawed, cities and states can get life-saving or life-extending results by taking action on the evidence of health problems that do emerge. Brownson of Washington University in St. Louis points to New York City as an example.

The life expectancy in the city grew faster than the national average, paced by drops in heart disease, cancer and HIV from 2001 to 2010, a study published in the current Journal of Public Health Management & Practice found.

New York has focused in recent years on using health trends to guide new, albeit sometimes controversial, public policy — from restrictions on trans fats and tobacco to unsuccessful bans on oversized portions of sweetened drinks.

“The city health department is really a prime example of evidence-based policy, of making the policy dependent on the data,” Brownson said.

How Does Memory Work?

At the cellular level, it's a lot like faster networking

Newswise, May 25, 2016 — We tend to think our memory works like a filing cabinet. We experience an event, generate a memory and then file it away for later use. 
 However, according to medical research, the basic mechanisms behind memory are much more dynamic.
In fact, making memories is similar to plugging your laptop into an Ethernet cable—the strength of the network determines how the event is translated within your brain.

 Neurons (nerve cells in the brain) communicate through synaptic connections (structures that pass a signal from neuron-to-neuron) that “talk” to each other when certain neurotransmitters (chemicals that allow the transmission of these signals) are present. 

Think of a neurotransmitter as an email. If you’re busy and you receive one or two emails, you might ignore them.  

But, if you are bombarded with hundreds of emails from the same person, saying basically the same thing, all at the same time, you will likely begin to pay attention and start a conversation with the sender: Why on earth are you sending me all these emails?

 Similarly, neurons only open a line of communication with each other when they receive stimulation from several of the same neurotransmitters at once: Oh, my neighbor keeps hitting me with the same signal? I better talk to them! So, how exactly does this relate to memory? It’s the strength of these connections between neurons that determines how a memory is formed.

 “The persistent strengthening of these activated synapses (connections) between neurons is called long-term potentiation (LTP),” said William Griffith, Ph.D., a cellular neuroscientist and chair of the Department of Neuroscience and Experimental Therapeutics at the Texas A&M Health Science Center College of Medicine. “LTP is the most recognized cellular mechanism to explain memory because it can alter the strength between brain cell connections. If this strength is maintained, a memory can be formed.” 

LTP happens when nerve cells “fire” or talk to one another at an elevated rate without further increased stimulation from neurotransmitters. In a sense, it’s like building a relationship with the email sender.  

Once you’ve started a dialogue with the sender you’re in a better position to communicate more easily and maintain a strong rapport. Just like you might add the sender to your contact list, your brain has created a ‘strengthened synaptic contact.’ But, if you’re not talking, the relationship wanes. 

Likewise, your ability to recall and remember certain memories depends on maintaining the strength of this long-term connection between synaptic contacts. LTP acts as an Ethernet cable of sorts—allowing your brain to upload, download and process at a higher rate—which may explain why some memories are more vivid than others: the pathway on which you contact them performs at a faster pace. 

“The brain is a plastic organ,” Griffith explained. “This means it can easily reconfigure or modify itself. However, it’s also a muscle. You use it or you lose it. As the synapses and pathways between neurons are used, they gain the ability to become strengthened or permanently enhanced. This is the building block of how memory works.”

 In the same vein, losing this strong LTP— or heightened synaptic connections between neurons—could be the reason behind cognitive loss and impairment.

 “Because the brain is an organ, it will show wear and tear,” Griffith continued.

 “Many people believe this decrease in neurons ‘talking’ to one another is responsible for cognitive loss—because the pathways are not being used or strengthened. Just as muscles in the body atrophy when you don’t use them, the brain will deteriorate when it’s not stimulated.”

 Griffith said the argument about how memory is consolidated and retrieved is vast, and there are many aspects that still need to be studied about the phenomenon.

 “When you look at or smell something, it contributes to your memory of an event,” he said.

 “This can be mapped in many parts of the brain. Memory may also be involved in certain behaviors like addiction. Why does this happen? Is it because the pathways for addiction are strengthened, or because they’re repressed? We don’t know yet.”

 The science behind memory is a complex one, and will likely be studied for decades to come.

 “Many different pathways in the brain interact to set up complex circuits for different types of memories,” Griffith said. “There’s much debate and more research that needs to be done to fully comprehend how our brain generates, consolidates and retrieves memories.”

 About Texas A&M Health Science Center

Texas A&M Health Science Center is Transforming Health through innovative research, education and service in dentistry, medicine, nursing, pharmacy, public health and medical sciences. As an independent state agency and academic unit of Texas A&M University, the health science center serves the state through campuses in Bryan-College Station, Dallas, Temple, Houston, Round Rock, Kingsville, Corpus Christi and McAllen. Learn more at or follow @TAMHSC on Twitter.

Tuesday, May 17, 2016

Redefining Health and Well-Being in America’s Aging Population

New approach looks at factors in addition to disease

Newswise, May 17, 2016 — Chronological age itself plays almost no role in accounting for differences in older people’s health and well-being, according to a new, large-scale study by a multidisciplinary team of researchers at the University of Chicago.

The work, part of the National Social Life, Health, and Aging Project (NSHAP), supported by the National Institute on Aging of the National Institutes of Health, is a major longitudinal survey of a representative sample of 3,000 people aged 57 to 85 done by the independent research organization NORC at the University of Chicago.

The study yielded comprehensive new data about the experience of aging in America that formed the underpinning of the research and its conclusions.

The research presents a sharp departure from the traditional biomedical model’s reliance on a checklist of infirmities centered on heart disease, cancer, diabetes, high blood pressure, and cholesterol levels.

Using what they call a “comprehensive model” of health and aging, the team has shown how other factors such psychological well-being, sensory function, mobility and health behaviors are essential parts of an overall health profile that better predicts mortality.

“The new comprehensive model of health identifies constellations of health completely hidden by the medical model and reclassifies about half of the people seen as healthy as having significant vulnerabilities that affect the chances that they may die or become incapacitated within five years,” said UChicago biopsychologist Martha McClintock, lead author of “An Empirical Redefinition of Comprehensive Health and Well-being in the Older Adults of the U.S.,” in the current issue of the Proceedings of the National Academy of Sciences.

“At the same time, some people with chronic disease are revealed as having many strengths that lead to their reclassification as quite healthy, with low risks of death and incapacity,” co-author and demographer Linda Waite added.

The paper is based on the results of a major longitudinal study of aging Americans, funded by the National Institute on Aging, that is the first of its kind to collect this sort of information from a scientifically selected group of people.

The comprehensive model reflects a definition of health long advanced, but little studied, by the World Health Organization that considers health to include psychological, social, and physical factors in addition to the diseases that are the basis for the current medical model of health.

McClintock is the David Lee Shillinglaw Distinguished Service Professor in Psychology. Waite is the Lucy Flower Professor in Sociology. Other members of the team are geriatrician William Dale, associate professor of medicine, and chief, Section of Geriatrics & Palliative Medicine at UChicago Medicine; and sociologist Edward Laumann, the George Herbert Mead Distinguished Service Professor in Sociology.

In addition to finding that chronological age itself plays little or no role in determining differences in health, the research also found that:

• Cancer by itself is not related to other conditions that undermine health.
• Poor mental health, which afflicts one in eight older adults, undermines health in ways not previously recognized.
• Obesity seems to pose little risk to older adults with excellent physical and mental health.
• Sensory function and social participation play critical roles in sustaining or undermining health.
• Having broken a bone since age 45 is a major marker for future health issues in people’s lives.
• Older men and women have different patterns of health and well-being during aging.
• Mobility is one of the best markers of well-being.

Six new ways of looking at aging

The comprehensive model’s healthiest category represented 22 percent of older Americans. This group was typified by higher obesity and blood pressure, but had fewer organ system diseases, better mobility, sensory function, and psychological health. They had the lowest prevalence of dying or becoming incapacitated (six percent) five years into the study
A second category had normal weight, low prevalence of cardiovascular disease and diabetes, but had one minor disease such as thyroid disease, peptic ulcers, or anemia and were twice as likely to have died or become incapacitated within five years.

Two emerging vulnerable classes of health traits, completely overlooked by the medical model, included 28 percent of the older population.

One group included people who had broken a bone after age 45. A second new class had mental health problems, in addition to poor sleep patterns, engaged in heavy drinking, had a poor sense of smell and walked slowly, all of which correlate with depression.

The most vulnerable older people were in two classes, one characterized by immobility and uncontrolled diabetes and hypertension. A majority of people in each of these categories were women, who tend to outlive men.

“From a health system perspective, a shift of attention is needed from disease-focused management, such as medications for hypertension or high cholesterol, to overall well-being across many areas,” said Dale.

“Instead of policies focused on reducing obesity as a much lamented health condition, greater support for reducing loneliness among isolated older adults or restoring sensory functions would be more effective in enhancing health and well-being in the older population,” said Laumann.

Thursday, May 12, 2016

Families Paid $1,200+ More in 2015 for Senior Housing and Care than in 2014, But Rate of Growth Well Below General Housing Market Increases

 Regional data demonstrate Southern and Western states face the fastest acceleration in cost growth compared to other U.S. regions

SEATTLE, May 12, 2016 -- A Place for Mom® (, the nation's largest senior living referral service, has released findings from its National Senior Living Cost Index demonstrating a 2.7 percent increase in annual costs in the United States (U.S.) across three primary senior living categories: Independent Living, Assisted Living and Memory Care.

Seniors at median are paying $99 more per month towards senior living expenses compared to 2014, with people living in Southern states ($125/month) and Western states ($90/month) facing the greatest increase in growth (4 percent and 2.7 percent, respectively).

Although the median cost of senior living is on the rise (2.7 percent), it is still well below the median growth rate of the national housing market from 2014 to 2015 (7 percent according to Redfin, a national real estate brokerage company).

A Place for Mom also reports that seniors are waiting longer to move into senior living and people aged 84 or older making the transition increased by 3 percent between 2013 and 2015. This fact creates higher acuity needs once seniors make the move, resulting in a higher general spend by the consumer.

"With 40 million people aged over 65 living in the U.S., representing nearly 15 percent of the population, A Place for Mom is releasing this information to help families and seniors plan for the future," said Charlie Severn, vice president of brand marketing at

"Each year, A Place for Mom's local Advisor network refers more than 200,000 families to senior living communities across the country. Most of the families we work with do not understand the true cost of senior living or the types of care available, and providing this information allows them to plan for the future and can lead to better outcomes for seniors needing living solutions down the road."

New Planning Tool
A Place for Mom today also unveiled a new, interactive planning tool hosted on its website that allows families to access the information within the National Senior Living Cost Index to help plan for future senior living costs.

Using state-of-the-art statistical methods and A Place for Mom's massive database of senior housing referrals, the new tool allows families to map and rank senior living costs by county, state and region, as well as to see year-over-year and multi-year trends in senior living costs.

Developed in partnership with Dr. Matthew Harris, assistant professor of economics at the University of Tennessee, the National Senior Living Cost Index tracks transactional data collected by A Place for Mom between consumers and senior living communities across the U.S. from 2012-2015, organizing it across four primary regions of the nation as defined by the U.S. Census Bureau. A Place for Mom is the only organization within the industry tracking what consumers actually pay for rent and care costs, and the transactional data included within the index is the first of its kind available to the public.

The National Senior Living Cost Index is a representative sample of A Place for Mom's overall referrals for families, focusing on monthly rent and care data collected for more than 10,000 senior living communities over the five-year tracking period.

National Senior Living Cost Index Findings
Cost data collected for the three primary senior living categories – Independent Living, Assisted Living, and Memory Care – includes a number of different expenses. Independent Living only includes rent, meals and other recurring monthly charges (as Independent Living does not include any care costs or assistance for the residence), whereas Assisted Living and Memory Care costs include the resident's assessed care charges in addition to rent, meals and other recurring monthly charges.

Chart 1 depicts the national and regional median of senior living costs for 2015 in the three primary senior living categories.
Chart 2 is an overview of the annual year-over-year percentage of cost changes in senior living, nationally and regionally, from January 2012 – December 2015 for the three primary senior living categories.

Explaining the Tends
As with most of the major industries in the U.S., the recent recession affected senior living and costs dipped as the country's economy shrunk, property values fell, and consumers had less disposable income. Senior living costs are now growing and rising fast as the economy continues to recover and expand.

Following are insights into the specific trends found in the new year-over-year data:
  • The increase of senior living expenses from 2014 to 2015 is outpacing inflation across all regions of the country (1.5x faster than core inflation).
  • Costs are rising fastest in the Southern region (4 percent) and Western region (2.7 percent) of the U.S. from 2014-2015, where the recession hit hardest and the biggest downturn in property values occurred.
  • Many people sell a home prior to moving into a senior living community. Home prices are rising faster (7 percent) than senior housing costs (2.3 percent) from 2014-2015, meaning now may be a good time to sell a property.
Cost trends for each type of the primary senior living categories A Place for Mom tracks vary. Following are insights into the specific trends, per senior living community type since 2014:

  • The recession hit Independent Living communities the hardest, which A Place for Mom speculates is because seniors delayed selling homes to prevent an investment loss on properties.  As the economy improved, property values started to bounce back, correlating with the rise of Independent Living costs (3 percent).  
  • Memory Care was most resilient to the recession, due to the urgent demand and inability to delay the need for this type of housing. These costs have grown steadily for a long time, but there is less evidence that the pace of growth is accelerating (.8 percent increase year-over-year since 2012).
  • Assisted Living cost trends are less clear. A Place for Mom hypothesizes that the greater urgency of assisted-living demand made it more resilient to the recession; however, costs in this category are rising faster now than in 2012 or 2013.
Metropolitan Areas and Cities

The Senior Living Cost Index includes median charges for metropolitan areas and cities. These small-area estimates are based on an econometric model that combines move-in charges with data on income and people aged 55+ from the U.S. Census. By combining move-in charges with demographic data, A Place for Mom is able to glean both the median and range of costs even in areas where there is little data.

Washington, Boston and New York are the top three most expensive metros for senior living. Senior living costs vary in predictable ways within metros, as well. For example, median monthly Assisted Living costs in Manhattan ($5.5Kin 2014 and 2015) are 9 percent higher than the metro median, while the Bronx ($4.2K) is 15 percent lower in comparison.

Chart 3 is an overview of the most and least expensive cities for senior living in the 15 top designated market areas in the U.S.  This data along with the city and metro level data allows consumers to research and plan for geographies that may be more affordable.

"A Place for Mom has produced an instructive analysis of the changing costs of senior living from 2011-2015," said Dr. Matthew Harris, assistant professor of economics at the University of Tennessee. 

"Whereas other, also valuable, cost of care estimates rely on list prices, A Place for Mom's analysis uses actual rents paid and care charges.  As with all data sources, there are certain caveats and limitations. However, the information from the National Senior Living Cost Index provides useful insight into emerging trends within the senior living industry."

Median Monthly Senior Living Costs by Region and Care Type in 2015 

About A Place for Mom
A Place for Mom, Inc. is North America's largest 
senior living referral service with more than 400 senior living Advisors providing resources and personalized assistance in finding senior living options. A Place for Mom works with a nationwide network of over 17,000 providers to help families find options based on a loved one's stated needs, preferences and budget.

This may include independent senior housing, home care, residential care homes,assisted living communities and specialized Alzheimer's memory care. The service is offered at no charge to families as providers pay a fee to Place for Mom. For more information, visit, call 1-877-311-6099 or visit one of Place for Mom 's social networks at TwitterFacebookGoogle +Senior Living Blog and Pinterest.

About the Data
The Senior Living Cost Index is based on actual rent and care charges collected from a sample of A Place for Mom move-ins (nearly 100,000 move-ins were used in the analysis) from 2012 - 2015. National and regional median costs and growth estimates are based on communities with at least one move-in for a given care type two years in a row. The index reports the median cost and year-over-year changes across communities based on their annual median move-in charges for each care type.

City, metro and state estimates are based on an econometric model of inflation-adjusted move-in charges (in 2015 dollars) during 2014 and 2015. Estimates in zip codes with few move-ins borrow information about costs from other zip codes with either similar median household income or geographic proximity.

Cost estimates in each location are a weighted average of zip code-level estimates. Zip code weights are based on 2014 American Community Survey population counts of persons over age 55.

Texas and Oklahoma estimates are unavailable, as APFM does not collect monthly care and rent charges due to state regulations.

The Coming "Age Wave" That Presidential Candidates Need To Address…But Aren't

Issues Facing An Aging American in 2016 Elections
May 12, 2016 -- An age wave is coming that could either make or break America. Yet the issue has received little attention in the current presidential campaign.

When our Constitution was crafted, the average life expectancy in the U.S. was barely 36 years, and the median age was a mere 16. In this regard, we are living in truly uncharted territory and longevity is humanity's new frontier.

As the baby boomers turn 70 at the rate of 10,000 a day, America is becoming a "gerontocracy." Already, 42% of the entire federal budget is spent on Medicare and Social Security.

And according to the Congressional Budget Office, this will exceed 50% by 2030. In the 2012 election, older adults out-powered all other age groups with 72% of men and women 65+ voting, while only 45% of those 18-29 did.

This demographic transformation will create new social contribution and marketplace opportunities, as well as potentially devastating medical, fiscal, and intergenerational crises.

Are we prepared? No. Are the candidates addressing this age wave and offering innovative solutions? No. WHY NOT?

These are the questions being asked by Ken Dychtwald, PhD, author of 16 books on aging related issues and CEO of Age Wave. Based on his 40 years of research, dialogue, and analysis, Dr. Dychtwald believes there are five essential transpartisan issues that must be addressed if our newfound longevity is to be a triumph rather than a tragedy.

Issue #1: What is the new age of "old?"
Our economy is hinged to 19th century notions of longevity and old age. When Otto Von Bismarck picked 65 to be the marker of old age in the 1880s, the average life expectancy in his country was only 45. Similarly, when Social Security began, the average American could expect to live only 62 years, and there were 42 workers paying for each "aged" recipient. Today life expectancy is approaching 79, and due to decades of declining fertility, there are fewer than three workers to pay for each recipient. And we have to ask, is 65—or even 67—the right marker of old age in the 21st century? As our demography continues to tilt older, the economic impact of these numbers on working Americans will be massive. This is not a Democrat or Republican issue. This is not an issue that only impacts "seniors." The designated age of "old" in the 21st century is a demographic/social/economic issue that will affect us all. Left unchanged, it will have a particularly brutal impact on the millennial generation.

Issue #2: The diseases of aging could be the financial and emotional sinkhole into which the 21st century falls.

As a result of modern medical advances and public health infrastructure, we've managed to prolong the lifespan, but we have done far too little to extend the healthspan—with pandemics of heart disease, cancer, stroke, Alzheimer's, and diabetes. In addition to being quite costly, our healthcare system is incompetent at preventing and treating the complex conditions of later life. For example, Alzheimer's (and related dementias) now afflicts one in two people over 85, and it has become the nation's scariest disease. Unless there is a breakthrough, its sufferers are anticipated to grow from 5+ million today to 15+ million, with its cumulative costs soaring to $20 trillion by 2050. But our scientific priorities are out of synch: for every dollar currently spent on Alzheimer's care, less than half a cent is being spent on innovative scientific research. Our doctors are also not aging-ready. We have more than 50,000 pediatricians, but fewer than 5,000 geriatricians. Only eight of the country's 145 academic medical centers have full geriatrics departments, and 97% of U.S. medical students don't take a single course in geriatrics.

Issue #3: Averting a new era of mass elder poverty
According to the Government Accounting Office, roughly half (52%) of all households near retirement (headed by someone age 55+) have NO retirement savings and about half (51%) of our population have no pensions beyond Social Security. We could be heading to a future in which tens of millions of impoverished aging boomers will place crushing burdens on the U.S. economy and on the generations forced to support them. On top of this, we are not fostering financial literacy or responsibility among the young. For example, 37 states require providing sex education to high school students by law, while only 17 states require financial education.

Issue #4: Ending ageism
In Colonial times, elders were respected and honored for their wisdom and experience. During the industrial era, all of that turned upside down. Now, in our youth-focused society, many people of all ages are gerontophobic—uncomfortable both with older adults and their own aging process. And many institutions—from urban planning, to technology, to employment hiring practices, to housing, to popular media (where advertisers will pay networks far more for a 30-year-old viewer than one who is 60) are both youth-centric and ageist. For example, our homes were not built for aging bodies: less than 2% of our housing stock is built to be safe and accessible for elders (and 1/3 of the elderly fall each year).

Issue #5: The new purpose of maturity
Today's retirees feel they are in the best time in their lives to give back. And they do: contributing both more dollars and volunteer time than any other age group—doing everything from teaching schoolchildren to read, to helping their peers recover from loss, to building homes for Habitat for Humanity. Going forward, medical science will increasingly prolong life. But political, religious, and community leaders have yet to create a compelling vision for the purpose of those additional years. For example, our 68 million retirees currently spend an average of 49 hours a week watching television. Ultimately, the problem may not be our growing legions of older adults, it may be our absence of imagination, creativity, and leadership regarding what to do with all of this maturity, experience, and longevity.

A letter is being sent to each major candidate asking them to articulate their views on these five critical issues.

A written copy of Dr. Dychtwald's views and a recording of his April 21 press briefing, including the specific questions on these issues that he believes the candidates must address – with fact sheets and related data and sources, can be accessed at

About Age Wave

Founded in 1986, Age Wave is a pioneer in the exploration of the impact of the longevity revolution. Under the leadership of Founder/CEO Ken Dychtwald, PhD, Age Wave advises businesses and non-profits worldwide on the opportunities and challenges of an aging population.

Psychology Has Important Role in Helping Older Americans as They Age

Psychology important role helping Older Americans as they Age Special issue of APA journal reviews psychology’s role in promoting health cognition, confronting ageism, ensuring retirement security

Newswise, May 12, 2016 -- With more than 13 percent of Americans currently over age 65, and that proportion expected to grow in the coming decades, psychology has played and will continue to play an important part in helping seniors maintain their health, adjust to retirement and prevent cognitive decline, according to the flagship journal of the American Psychological Association.

In a special issue of American Psychologist® entitled “Aging in America: Perspectives from Psychological Science,” researchers review the current and potential contributions of psychological science to the well-being of older Americans, including promoting healthy cognition, preventing dementia, confronting ageism, recognizing the role of family members in long-term care and ensuring retirement security, both financial and emotional.

“Aging is often viewed in negative terms, with a focus on inevitable physical and cognitive decline, dependence, vulnerability and older adults being a drain on society,” noted Deborah A. DiGilio, MPH, director of APA’s Office on Aging and one of the scholarly leads on the issue.

“The articles in this issue highlight actions that older adults, professionals and systems can take to promote aging well and to engage older adults as valuable members and contributors to society.” said Karen Roberto, PhD, of Virginia Polytechnic Institute and State University, the issue’s other scholarly lead.

The idea for the special issue originated from the 2015 White House Conference on Aging, during which APA presented a series of white papers outlining how psychology could help improve the lives of older Americans in the four areas identified as themes by the White House.

After the conference, authors of the white papers were invited to expand those papers into full journal articles that comprise the special issue.

“Psychological research on the processes of aging informs how we address critical aging issues that have far-reaching societal impact for years beyond the 2015 White House Conference on Aging,” Roberto said.

“To further our understanding of the varied and competing issues facing an aging society, the articles in this special issue address individual, societal and technological shifts that influence aging well, including mind, body, wealth and relationships.”

Among the nine articles in the special issue:
“Psychology’s Contribution to the Well-Being of Older Americans,” by Margaret Gatz, PhD, University of Southern California; Michael Smyer, PhD, Bucknell University; and Deborah DiGilio, MPH, American Psychological Association.

In an overview of the special issue, the authors outline some of the areas where psychological research can contribute to the well-being of older Americans, including promoting healthy cognitive aging, planning for retirement security (both financially and emotionally), reducing vulnerability to financial exploitation and abuse, enhancing good health behaviors, incorporating families into the long-term health paradigm, and reducing the incidence and impact of age discrimination.

Contact: Margaret Gatz

Financial Exploitation, Financial Capacity, and Alzheimer’s Disease,” by Peter Lichtenberg, PhD, Institute of Gerontology, Detroit, and Wayne State University.

Financial exploitation of older adults is increasing. Psychologists are skilled in assessing financial decision-making as part of cognitive capacities but have just begun to address this form of elder abuse. This article outlines a new model for evaluating the factors involved in financial exploitation that may lead to more comprehensive assessment and research on these interrelated vulnerabilities. It also calls for financial professionals to be given the tools and training to identify and curb financial exploitation in older Americans. 

“Retirement Security: It’s Not Just About the Money,” by Jacquelyn Boone James, PhD, and Christina Matz-Costa, PhD, Boston College; and Michael Smyer, PhD, Bucknell University.

While there are many guidelines for financial security, there are few for crafting a rewarding life after retirement. Retirement security is often equated with financial status, but security also extends to psychological concerns, such as the need to belong and continue to contribute to society. Ageist attitudes and outdated social structures can impede older adults’ engagement in work and volunteer activities. This article summarizes what is known about the current context of retirement, identifies barriers to psychological security later in life and suggests how psychologists can help remove these barriers and support retirees’ meaningful engagement.

“Caregiving Families within the Long-Term Services and Support System for Older Adults,” by Sara Honn Qualls, PhD, University of Colorado, Colorado Springs.

Families provide most of the long-term care of. Because family caregiving emerges from a historical relationship and is so common, the needs of families are often unnoticed. Serious illness brings major role shifts, and psychologists can assess family needs and provide key support services when needed. This article outlines the role of family members as caregivers for older adults while identifying policy and practice barriers to integrating them into care structures and systems.

Contact: Sara Honn Qualls

Other authors contributing to the special issue are Kevin E. Cahill, PhD, Boston College; Sara Jane Czaja PhD, University of Miami; Todd D. Nelson, California State University – Stanislaus; Joseph F. Quinn, PhD, Boston College; Karen A. Roberto, PhD, Virginia Polytechnic Institute and State University; and Glenn E. Smith, PhD, University of Florida

End-of-Life Decisions: POLST Provides Peace of Mind

End of Life Directives from PhysiciansNewswise, May 12, 2016 — Medical blogger Leon Kraybill, MD, CMD, is a geriatrician at Lancaster General Health and a Pennsylvania Medical Society member. In this blog, he writes about end-of-life care and his father’s ‘Physician Orders for Life-Sustaining Treatment.’

My father lay unresponsive on the emergency room cart. His normally smiling 94-year-old face was blank. There was no response to my voice or touch. His pulse and blood pressure were worrisome.

My physician brain instinctively realized that he was probably dying. As a son, my heart cried out against the end of life for this vibrant and compassionate man.

Earlier, he and my mother had navigated to services at their long-term care facility. He appeared to fall asleep, did not wake up, and was transported to the emergency room.

It is the phone call no child wishes to receive. I arrived to find my mother at his bedside. Her face told me that she also recognized the seriousness of the situation.

As a geriatrician, I work every day with individuals with changing health. Discussions of disease, functional change, clinical decline and end-of-life care are very common.

I routinely encourage people to consider health options, make treatment choices, and share these through discussion and advance care planning documents. It is easy to give these recommendations to others.
But now it was my father in front of me.…

To read the entire blog, 

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