Aging–Macular Degeneration: A Determined 100-year-old’s Efforts to Maintain Quality of Life

R's 100th Birthday

                                                               R’s 100th Birthday

Sr. Advisor R has been called “amazing” for years by so many 40-60-year-olds, who also call her “terrific” and “timeless.” Past posts have underscored their respect for her wisdom and admiration for her ways of handling things. She’s both an advisor to this bog, and my m-i-l. And currently she is facing another challenge: a big round spot blocking vision in one eye–macular degeneration.

During 100 years of living she has overcome much–the last big hurdle: her impressive recovery from a broken hip (femur) at 97. That was three years ago. Her mind remains excellent for her age and she was aware her sight was suffering “a little” degeneration, but was getting no professional treatment and hadn’t noticed that her sight was changing until it suddenly began over several days.

Coincidently she had an opthalmologist appointment scheduled a few days later. While she began immediate treatment, the prognosis from two ophthalmologists is that results will be slow and no doubt limited. With her vision impacted and depth perception a real problem she is making adjustments.

“We take eyesight for granted–don’t realize how important it is–it’s your connection to the world,” says R, who adds “I’ll do the best I can with it.” With one “weak but useable” eye, she is using two magnifying glasses of different magnifications to finish doing her income taxes (making itemized lists) for the accountant next week. Everything takes much more time now, and planning how long something will take is “ify,” especially getting ready to go some place.

R acknowledges that when facing serious challenges in the past, she had to let go of some things and prioritize others in order to redirect her energy towards maintaining independence. This is the last year she will do her taxes. Which brings us to yesterday.

R continues with her life, albeit at a slower pace because vision problems affect simple things like putting on make-up and doing her hair. Yesterday she needed to go to the bank.  My husband or I could have done that errand for her but she didn’t want to give in to that.

She requested I pick her up more than an hour later than the usual time. The young woman who usually helps at the bank, J, was away when we arrived. She later heard R was there and appeared as R was finishing her business. “I haven’t seen you in months and I was worried,” was J’s greeting. Then ensued a conversation about R’s eye situation and being 100 and how much she admires R.

J then told what I believe to be a true story about a friend’s grandfather. We seem to like to talk about amazing older people who still make the effort.  At age 103, he still works out at the gym 4 days a week. Evidently one of the trainers told him that perhaps he should cut down the number of workouts–or at least shorten them. To which the grandfather asked: “How old are you?” Response: “30 something.” “I’m 103,” said the grandfather.

Whereupon a thought entered my mind: When older people are doing great and still have a good mind, why do younger people feel a need to give them advice? I know R doesn’t believe in what she calls “unsolicited advice.”

We hear more and more about people living into old, old age. No doubt all have some aging problems. The ones who “soldier through,” who make the effort, are the amazing ones. They have been called “The Greatest Generation.” I wonder if we will do as well.

R has often said “I’m a realist.” Yet I’ve never heard her say anything like “Growing old is not for sissies.” Instead she will be the first to tell you getting old “isn’t easy,” explaining “it takes willpower, energy, and common sense–more every year.” She has been widowed half of her life, thinks deeply and shares knowledge of a lifetime when appropriate. Her younger friends say she has taught them so much about living. It has cemented a special bond.

“They care about me and I care about them too,” she says.

If that doesn’t provide the bedrock for quality of life and a reason for making the effort, I don’t know what does.

Related:
In sidebar– 12/11/13 Mayo Clinic’s Age-Related Vision Problems and How the Eye Perceives Them

3/26/14 Help! Aging Parents has been nominated for 2014 “Best Blogs by Individuals” recognition and we would appreciate your vote by 4/28 if you’re on Facebook. We were honored to be judged part of a 3-way tie for first runner-up last year thanks to your votes which took us to the judging round. Click top badge at right to view a universe of helpful aging blogs and resources, even if you can’t vote on Facebook.

Changing often: “Of Current Interest” (right sidebar). Timely links to research and information from top universities, plus some fun stuff to help parents age well.

 

Aging Parents and Us: Must Age, Health Decline, and Dependency go Hand in Hand?

 Growing Older Doesn’t Necessarily Mean Growing Old

We may question this assumption if we’re in the midst of caring for aging parents with health issues. On the other hand, the results of research, published last month in the Journals of Gerontology, may be heartening for us if our parents are still relatively healthy and independent–and also heartening as we think about our years ahead. It’s written by Dana Goldman, a most distinguished professor at USC, who is an adjunct professor at UCLA as well.

In short: after analyzing extensive survey data of Americans aged 51+, researchers  from U. of Illinois at Chicago, Stanford, and the University of Southern California, “found that a substantial group of individuals at all ages experienced not just exceptional health, but their mental and physical functioning was at a level exhibited by people decades younger.” (The MacArthur Foundation, a longtime a leader in aging research  and the  National Institute on Aging funded the study.)   Isn’t that good news!

Dr. Goldman’s article is an easy, quick read (less than 2 minutes) with interesting details. Sometimes, when we feel burdened, hearing something positive, based on  facts, is just “what the doctor ordered.”

And if you need/want more of “what the doctor ordered,” watch/listen to the interview link below, courtesy of the 12/2/13 Huffington Post, for a futuristic way of delivering medical information and services.

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If we’re currently dealing with parents’ health issues, and frustrated with the communication problems that often arise, this interview from the 12/2/13   Huffington Post, with Dr./billionaire Patrick-Soon-Shiong is a must-watch. I believe cancer was an initial motivating factor in his work, but everyone who has health issues will benefit.

Using the cloud, genome data, a specially designed super-computer, and more, he has created an infrastructure for a new medical delivery system that includes a “fluid medical information highway.” This could soon bode well for everyone’s health care, regardless of age. (FYI– Pancreatic cancer patients have been free of the disease for 5 years using these futuristic technologies.)

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The Thanksgiving holiday provided me time to catch up on some reading and  learn a bit about telomeres and aging from my husband’s cousin (a highly respected researcher at one of the two top institutes of technology in the US). It also caused me to post this a day late.  (Returned to NY last night.) A post about telomeres will appear once I’ve had it vetted for accuracy.

Research clearly provides us with interesting, exciting and hopefully personally helpful information, as we continue to meet the challenges of helping parents age well.

Changing weekly: “Of Current Interest”(right sidebar). Links to timely information and research from top universities, plus some free and some fun stuff–to help parents age well.

 

VELCRO–Part 2: Shoes for Aging Parents

Velcro ClosuresNot all shoe styles with Velcro are suitable for old people!

…Yet some styles fulfill a need. Think: one foot wider than the other; arthritic or old fingers that make using buckles difficult.

Sr. Advisor R, like other older and old people, has a fear of falling (especially after breaking her hip two years ago). She’s concerned about maintaining good balance when walking. Yet she has never purchased those unfashionable-looking shoes that so many elders wear for balance.

Instead she has invested time and energy to find sandals that give her feet support, are comfortable and look good, and provide what she calls “a solid platform” that’s “weighty enough” to give her confidence when walking.

As people age, feet can widen and/or develop bunions, hammer toes or other problems that cause one foot to be wider than the other. This is where Velcro comes to the rescue. Proper fitting sandals, with velcro closures that accommodate a wider foot near the base of the toe, have been the answer for R. Rather than buying shoes in two sizes, Velcro lets her adjust for each foot’s width. The sandals look contemporary when one lives year-round in a warm climate. Currently R is wearing Naturalizer’s Valero style.

Researching for this post, made me aware of older people’s shoes as I was riding the bus to visit a friend in NYC. We’ve been having warm weather so sandals are still seen everywhere. Many have Velcro-type closures.

Click to enlarge

Click to enlarge

Dr. Jonathan Moore’s article, Our Vital Role in Fall Prevention (pp. 13-15) in “Podiatry Management–the most influential publication for the podiatry profession” mentions Velcro with this caution: “Velcro laces are ideal, but Velcro latching is often neglected, thus creating a situation where the shoe can become loose.  Shoes with lace are fine, so long as they are tied snug to create a good fit.” (While Dr. Moore’s brace invention comes under criticism in other articles, his shoe information re: Velcro makes sense.)

Being able to walk is important exercise with many health benefits in addition to the freedom it gives a person. We know this. And properly caring for–especially–old feet should be part of one’s regimen. When aging parents have foot problems, a podiatrist, preferably a DPM, should be consulted and no doubt shoes should be part of the discussion.

Can sandals with Velcro closures–fastened snug enough to create a good fit–offer a contemporary shoe alternative for your aging parent’s feet needing different width shoes? His or her podiatrist can answer that question.

VELCRO– for Aging Fashionistas and Those with Old Fingers

Pure Jill easy zip-front poncho
Soft, hooded style, side snap closures, two-way front zipper

Sr. Advisor R, during the week between her 100th birthday and her party the next weekend, couldn’t help giving me more advice when she proclaimed: “VELCRO” in much the same way as I remember “PLASTICS” in the 1960’s classic movie, “The Graduate.”

R said I had to write about the virtue of Velcro for old people.     OK!

Wearing apparel–from head to toe with buttons and hooks and eyes and buckles–is a challenge for many older people’s fingers, especially if arthritis is an issue. And shoe size–or perhaps better stated “comfortable, decent-looking shoes”– is another challenge for older feet of fashion-conscious elders.
R took one look at a catalog of easy-to-put-on clothing for older people about 5 years ago, and said it “depressed” her. I’ve written about the fact that for years R has carefully selected and purchased clothes through regular catalogues (her favorites have been posted often around holiday time) and she always looks well put-together.
Never-the-less, before I realized how good R was at catalog shopping, I’d thought about introducing the idea of using Velcro in place of buttons on some of her clothing as follows: (this was before the Velcro Button Conversion Kit and the “coins,” which I’ve not tried.)
1. –cut off button
2.–attach button to a piece of material whose color matches the clothing (or to the wrong side of velcro if the color is right). Piece should be larger than button hole.
3. –button button through its original button hole
4. –then sew that piece of matching material (or velcro) to the underside of the garment to keep button (looking buttoned) in place.
Now for the Velcro–if matching material was used initially
1.  Sew one piece where the original button was.
2.  Sew the other (corresponding) piece where the material w/ button is.
3. Repeat for each button–probably 5 total for sweaters or jackets
Check out Velcro’s iron-on Fabric Fusion Tape. Haven’t tried it, but sounds good.
Let’s not forget men’s shirts, jackets–and I came across a picture of a Velcro fly on a pair of men’s slacks.
It’s important to stitch well, using strong or doubled thread, remembering there will be pressure from pulling the Velcro apart when putting on and taking off. A dressmaker or tailor could easily do this and if it brings new life to favorite clothes that haven’t been worn because of aging fingers, it would no doubt be worth the cost.
For old fashionistas, it can make purchasing new clothing with difficult fasteners an option. (Or keep them and us on the lookout for smart clothing with zippers.) LOOK GOOD, FEEL BETTER helps everyone.
 Next Saturday’s post: Aging feet, shoes, and Velcro
Related: http://www.jjill.com/jjillonline/index.aspx–one of Sr. Advisor R’s more pricey, preferred catalogues– (for above zippered poncho, jacket and more).

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Check out “Newsworthy” (right sidebar). Links to timely information and research from top universities and respected professionals, plus practical information–to help parents age well.****

 

 

Hospitalization Tips That Make a Difference: For Aging Parents, Grandparents, Our Children, and Us

     I recently learned that a friend who worked in the health professions needed surgery.  He recently turned 65, is medicare eligible, but elected to remain with his managed care plan. The hospital he selected was one he knew and liked, was near his home, and was approved by his plan.
     Surgery was successful, but was followed by an infection, then other complications. His family insisted he be moved to a larger, more comprehensive hospital for additional treatment. This took a lot of doing–was not easily accomplished.
     After well over a month and several weeks in the larger hospital, he is in rehab for physical therapy, but health issues remain and he’s very weak. There’s conversation about his returning to the comprehensive hospital.

This sobering chain of events calls attention to:

1. a slogan
2. advice, gained from Dr.Susan Love’s (surgeon and prominent breast cancer prevention advocate) hospital experience about the importance of family.
3. information from Jon La Pook, MD (NewYork-Presbyterian/Columbia U. Medical Center and Chief Medical Correspondent for CBS News) about how to get optimal hospital care.

1. WHERE YOU’RE TREATED FIRST MAKES ALL THE DIFFERENCE. Memorial Sloan-Kettering Cancer Center’s slogan (goes back to the 1990s if not earlier).

2. The IMPORTANCE OF FAMILY MEMBERS WHILE HOSPITALIZED.  NY Times 2/19/13 Science Section interview, Susan Love’s Illness Gives New Focus to Her Cause. Dr. Love discusses the 4-week ordeal following her bone marrow transplant and the fact that family members “offered round the clock support,” advocated for her during that time “when she wasn’t very articulate,” and the fact that one family member “slept in the hospital every night.”

While the article initially focuses on Dr. Love’s reasons for devoting her efforts to the cause of disease rather than the medicines to treat it, we learn about the importance of family, which translates into good advice for all of us.

Likewise, Marti Weston shares a personal experience as she blogs about the importance of family in her 2/9/13 post  Elder in Hospital. Does a Family Member Need to be There, Too? The bottom line is “yes.”  Marti gives specifics about why and about certain things/actions family members can do/take (which includes sleeping at the hospital) to avert problems.

3. OPTIMAL HOSPITAL CARE. Dr. Jon La Pook’s TV interview on CBS (following  NY-Presbyterian/Columbia U Medical Center’s earning #7 Best Hospital honors in the latest US News Best Hospital’s edition) gives the excellent advice about how to get optimal hospital care these days.

For example, Dr. La Pook stresses the importance of communication between the patient’s regular doctor and the hospital’s doctor or the hospitalist, emphasizing it needs to be “a good hand-off” and likening it to the passing of the baton in a relay. You don’t want the baton dropped.

He opens our eyes to to basic, but critical, things like hand-washing “it could save your life;” tells you what to be on the lookout for; and introduces new terms ie. “electronic healthcare buddy.” Link to this enlightening interview: http://www.cbsnews.com/8301-204_162-57594022/u.s-news-and-world-report-releases-2013-best-hospitals-list/.

This information can benefit all generations, as we try to help parents age well.

Note-New: Check out “Of Current Interest”(right sidebar). Links to timely information and research from top universities about cancer, dementia, Parkinson’s, plus some fun stuff–to help parents age well.

Senior Games: Fun and Mental Stimulation for Older Parents and Grandparents in Assisted Living

DON’T FUN AND GAMES HELP PARENTS AGE WELL?

I remember my grandmother played Canasta with a group of ladies. They cleaned their apartments, polished the silver, made the glassware sparkle, and served lovingly-prepared food and of course, deserts. They shared camaraderie, if not their special, secret recipes.

A modern-day version is going on with one group of 70-year-olds. Seems like a good idea. They just have fun–playing tile games (eg. rummy cube) once a month. They contribute pot-luck for the luncheon. No stress. No competition. “Not like bridge,” said one player. “We talk and play. The games take more luck than strategy.”

Many contemporaries play bridge–either because they love it or they believe it will help memory. This sparked my thinking about last Saturday’s post: Senior games and Cognitive Gains. My playing-for-fun friend is also a bridge player, who plays bridge with her friend’s 90+-year-old, vision-impaired mother at least once a month.

Thoughts turn to my 88-year-old cousin in assisted living 3,000 miles away. She’s alone a lot; doesn’t avail herself of many of the facility’s activities. Her choice. Her reasons. For example, she plays Bingo on scheduled days, but doesn’t attend movies (she enjoys movies) because she says the chairs are uncomfortable for her.

A conversation with a staff member informs me the “Bingo chairs” are near the “movie chairs” and she could just move one over. Of course, her mobility problems won’t allow that kind of “just moving.” She’s evidently reluctant to ask for help (and evidently no staff person offers).

It may not make sense to us, but it does to her–and that needs to be our mindset. Some people thrive in assisted living. Others don’t. Could the boredom problem that be partially solved by fun games that we could bring over?

Vintage Selright Selchow & Righter 1948 Scrabble GameWhen we visit care facilities why can’t we take a board game or cards with us, perhaps play while there, then leave the game?  I’m thinking there are often old Scrabble games in homes. My cousin does crossword puzzles by herself. Would she enjoy Scrabble? or Anagrams? So what if her short-term memory isn’t so good. Anagrams is mnemonic. Memory might improve.

I’ll phone her most devoted daughter (I live far away), and gently suggest–if she doesn’t have a Scrabble set–that she take some cards and perhaps play gin rummy with her mother. It’s a 2-player card game that they both once played. There must be loads of other games out there. I’ll also mention the movie attendance issue.

Assisted Living Helpful Gestures

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P.S. Several years ago I asked this cousin what gifts people in assisted living would like. (I was thinking ahead about the holidays.) She made a short list that I included on a post that year.

She was new to assisted living then. Friends would pick her up weekly to play cards, go to the movies, have lunch etc. I saved the list. I notice “play games” is on line 3.

At the time I wasn’t thinking that at least one item on her list would be useful to know about—-now.

Check out “Newsworthy” (right sidebar). Links to timely information and research from top universities and respected professionals, plus practical information–to help parents age well.

Senior Games Offer Cognitive Gains

 On July 8th I wrote about a new game, Road Tour, that researchers find restores cognitive processing speed and improves field of vision. Peripheral vision evidently shrinks as people age and affects safe driving. Here are details, plus a video, from the UK’s Daily Mail on-line: http://www.dailymail.co.uk/sciencetech/article-2317955/New-game-make-brain-years-younger-hours-effects-lasting-year.
Game on: Playing the Road Tour game could prove to be beneficial

Three months later (9/4/13) several publications inform us that the scientific magazine, Nature, is publishing findings that cognitive scientists say: “are a significant development in understanding how to strengthen old brains.” (NY Times 9/4/13) plus a snippet: “Cognitive scientists have found that a simple game that forced players to juggle two different tasks, helped players improve the short-term memory and long-term focus of older adults. Researchers said those as old as  80 began to show neurological patterns of people in their 20s.” (NY Times 9/9/13.) Read the complete 9/4/13 NY Times article:  http://www.nytimes.com/2013/09/05/technology/a-multitasking-video-game-makes-old-brains-act-younger.html?_r=0  

Doesn’t it sound like the above games hold significant promise for older people? Older people, of course, need access to a computer.

Googling or Yahooing “brain games” and “games for seniors” brings forth a proliferation of games from which to choose.  Many enterprising people are jumping on the “Senior Games” band wagon.

Soon perhaps, a reputable company or organization will find it financially advantageous to rate the games, to help us know which claims of aging brain improvement are valid. For now we must do our own homework and stay current with news from reputable sources–as we strive to help parents age well.

The progressively challenging video game NeuroRacer requires players to navigate a winding mountain road.  Performance improved in those who played more often.

Gazzaley lab U of San Francisco

Top Photo: UK Daily Mail on-line
Botton Photo: Boston Globe