Navigating Family Dynamics When Caring for Aging Parents: An Interview with Francine Russo

Posted on: June 11th, 2014 by Anhtuan Hong

Francine-Russo_BookFrancine Russo has an impressive history of expertise around relationships and family dynamics. An acclaimed journalist, she has authored pieces in The Atlantic, The New York Times Magazine and The Village Voice, among other publications. As Time magazine’s Boomer Expert, Francine answered questions about aging loved ones and other subjects from adults around the world in her “Ask Francine” column. 

Her writing on the impacts that increasing care needs can have on a family unit and her countless interview hours with experts in fields such as gerontology, social work and elder care law culminated in the highly acclaimed book, They’re Your Parents, Too! How Siblings Can Survive Their Parents’ Aging Without Driving Each Other Crazy (Random House, 2010). She describes:

I was not alone in needing help. Even the family experts I interviewed told me that this family transition was so difficult that even they, who managed relationships for a living, had trouble with it. In my years of research to learn more about all the different pieces of this transition, I interviewed Geriatric Care Managers, leading family therapists, gerontologists, elder law attorneys and many other professionals in the worlds of aging and family. I talked to researchers on caring for aging parents, sibling and parent relationships, end-of-life decisions, dementia, death, mourning, and more.

Hailed as “an indispensable book for anyone whose parents are aging,” the book addresses common questions such as:

  • Who will make major medical decisions, manage finances, and enforce end-of-life choices if your parents cannot? And how will this be decided and carried out?
  • How will you negotiate caregiving issues and deal with unequal contributions or power struggles?
  • How can caring for your parents be an enriching experience rather than a thankless chore?
  • How can you ensure the best care for your parents while lessening conflict, guilt, anger, and angst?

We had the great pleasure of speaking with Francine about her life and work and are thrilled to share her words with you:

Q. How did you make the transition from writing about relationships and family dynamics in a more broad sense to becoming the de facto baby boomer expert at Time magazine?

I am one of the oldest boomers, so I have a jump on trends. I get a sense of what my peers are dealing with or will be dealing with because I’m one of the first to whom it happens. I had left my family—when I say left, I got out of town and kept some distance – call on Sundays and visit once in a while. The dynamics of my family were pretty uncomfortable and I wasn’t eager to get more involved. My sister and I had a difficult relationship always. Since our mother wasn’t very loving I was looking for friends and teachers and people who would mother me and be my big sister and I didn’t really have it in me to be the kind of big sister she wanted. In addition, she’s convinced, and maybe she’s right, that I was my mother’s favorite and she was very, very angry about that and was tremendously resentful. Also the fact that I left town and she stayed meant she was there and I wasn’t, and this became especially pronounced when my mother started aging and it was my sister helping my dad through it. I want to stress, I think it’s really important, that nobody asked me to do anything. Instead the message I got was “You’re not around, you’re a bad person.” It was like guilt, guilt, guilt and anger and my response to guilt and anger was to keep my distance. When my mother died and I was at the funeral I saw my father and my sister holding each other up and sobbing and I got a sense for the first time of the horrible ordeal they’d been through without support from me and I felt terrible. I learned much later to forgive myself because as I studied other families, and I began to do that, I saw that what happened in my family was not at all unusual – that often family dynamics prevent the person who’s the caregiver from getting the help they say they want. There are many variations on this but as the boomer expert in Time magazine I began to see so many other siblings in trouble because nobody had really dealt with the fact that siblings get together – or don’t get together – but deal with each other over their aging parents in a very intense way and sometimes this interaction is the first in probably 30 or 40 years. I saw it in my own family, I saw it in every family I interviewed, and I interviewed many families, [that] everybody goes back to being who they were when they lived together so that if the older sister had the role of taking charge and being bossy, the older sister will take charge, or try to, even though other people in the family may be better qualified or emotionally more the right person. Those dynamics fascinated me and that’s what I wanted to find out about. 

Q. What ultimately spurred you to write They’re Your Parents, Too! How Siblings Can Survive Their Parents’ Aging Without Driving Each Other Crazy (Random House, 2010)?

It was a much bigger subject than just an article. Until my generation most people didn’t live to be old and needing care. But now, that’s just not the case. It was completely new and families just didn’t have a model for how to do it – they still don’t have a model. It all falls to the family and they kind of scramble around and they try to do it and all of the old history comes back to infect the process. There are things that people can do to make this better but they need insight. When the siblings get back together again over their aging parents, they’re dealing with mortality – their parents’ mortality and their own mortality – and it awakens some pretty scary feelings. So, people tend to react at a very profound emotional level and whatever feelings they had for each other when they were growing up come out in spades now as if the intervening 30 or 40 years didn’t matter. People need to be aware that this is coming from a childhood feeling that is not totally rational at the moment. One of the reasons I wrote the book was to give people insight into this emotional process. Then, people can deal with the actual decisions they have to make and not just be driven by emotion.

Q. What has the response been, both from readers and your family? Have any of the responses surprised you?

In general people are incredibly appreciative and they have also told me they found the book surprisingly easy to read—it’s incredibly readable. They fear that it will be a heavy book, but I remember one person who wrote to me said, “I just got the book and my husband made me put it away at midnight—I couldn’t stop reading it.” People’s responses are, “Oh my God, this is about my family.” I tell the stories of many, many families in the book but the basic story of coming back together with your siblings when you see time with your parent(s) running out and all that arouses—that’s kind of universal. 

Q. Did your sister react to the book at all?

Not very much. I did end up apologizing to my sister because I wasn’t there for her when my mom died and then I was much more there for my dad in his last years, but she remained very, very angry with me. After my dad died I did make her an apology, a heartfelt apology that I hadn’t been there for her the first time around and she accepted the apology. One of the things when I talk to audiences, which I do now – I go around the country giving talks, is that I stress that every sibling reaction is an interaction between two people at least and if one person in the interaction changes their attitude, what they do, what they say, even a little bit, that can change the whole tenor of the interaction. One of the most insidious forces in families at this time is guilt. Guilt is uncomfortable and people defend themselves from it. Siblings often go into what I call the “anger-guilt gridlock” where I try to make you feel guilty, you respond by not doing what I want and perhaps getting angry, I try to make you feel more guilty, you get even angrier, it goes round and round and round until one of the people realizes they can get out of the dynamic and does something different. One of the things everybody needs to recognize is each person has a role in what happens. I’m sure there are absolutely rotten sisters and brothers somewhere but most people are very complicated and they’ve had complicated relationships with their parents and it’s important to remember that each person has a completely different relationship with the parents and that will affect what they’re willing to do and how much they’re willing to do and everything about this.

Q. You often bring your own, rich history as a wife, widow, mother, sibling and friend into your writing. Is it difficult to do this, and what impact do you think this has on your readers?

It’s actually the easiest thing to do, although I have to be careful because I’m writing about other people who are close to me. I think it enables me to talk to other people and be able to share their experiences because I’m coming out of similar experiences of my own. 

Q. What was the hardest thing about writing They’re Your Parents, Too!? What was the most rewarding?

One of the most rewarding things about the book was the many, many conversations I had with siblings about their deepest feelings – about their parents, about their sisters and brothers. Also the most fascinating thing was that in many families, I was able to talk to more than one sibling and sometimes as many as five and you know, I heard five different stories. Those conversations were very rich, very intimate and I learned a tremendous amount. Those people were incredibly generous to share those things with me. I would say the hardest thing was writing about something that had not been written about in this way before and finding a way to organize it and deal with all the issues without repeating myself. Plus, I had never written a book before. It was a very difficult process.

Q. In your research, what have you found to be the best predictors of how well a family will handle transitions into parental or spousal care needs?

Well, I would say having a reasonable family history where there hasn’t been a lot of anger and guilt, where the family gets along relatively well, is the first. The second thing is if the siblings who are not doing the primary caregiving give emotional support at the very least to the person doing it – I would say that is the most critical factor because caregivers can feel very alone. I will say that there are some caregivers who make it very difficult. Also, caregivers often don’t know what they need – nobody will help me but then it turns out they really want to control it themselves and they really don’t so much want help – what they really want is appreciation and emotional support. It’s really helpful if the caregivers can figure out what they really want and if they expect help of some kind, even long distance, many things can be done using technology. They just need to be able to delegate and work cooperatively.

Q. You talked to experts in myriad aging-related fields – if you could assemble a “dream team” to help a family facing the care transition, who would be on it?

If they have the money and it’s not that expensive I recommend [families] hire a Geriatric Care Manager. This is a field that’s grown exponentially in the last 20 years and people belong to a professional organization. They tend to be either social workers or nurses and they check in on the parents, they are masters of every resource they might need whether it’s a certain kind of doctor or health care aides or assisted living, they also give reports on health – when they see the parents, they examine them and they can talk about mental condition and physical condition and make suggestions to the family. The other thing they can do, which is invaluable, is to hold family meetings. Having a professional person at this meeting short-circuits all the family dynamics that get in the way. I would also say, if you don’t have a Geriatric Care Manager or even if you do, it might be helpful to have a family therapist or a psychiatric social worker to deal with the family and have these family meetings. I would also say of course you need a physician who is trained in the diseases of older people. And I would say an elder law attorney. A lot of things will have to be legally put in place – power of attorney for health, power of attorney for finances, arrangements, will, end-of-life instructions – and many of these elder law attorneys have worked with many families and have also helped to make the peace. 

Q. What are the themes that most intrigue and inspire your writing today in the realm of aging (e.g., family relationships, brain health, retirement)?

I am interested in older people and retirement, family relationships always but really nowadays it’s often the people who are my readers being the oldest in their families and dealing with the younger generation – that interests me very much. The other thing is I’m very interested in romance and marriage after 60 because 45% of people over 65 are single – either divorced, widowed or single – and people are dating like never before and I’m especially interested in the new relationships they form – both the way they deal with them on a practical level and the emotional texture of these relationships and how they are the same or different from marriage and relationships at other periods in their lives and how they are different from people who are married, say 40 or 50 years. This is something I’m just starting to research. I hope to do a book on it. I actually believe that in some ways forming a relationship after 60 could be one of the best times in life to do it – there are fewer distractions and challenges like raising a family, struggling over money, being young and unformed and trying to figure out who you are and create your identity and deal with your partner as you each go through inevitable changes. Also older people not only have a huge amount of experience, but emotionally they tend to live more in the moment; they focus on the good things in life and they don’t sweat the small stuff. They know what they want, they know who they are. It’s about being together and enjoying life, it’s not about anything else.

Q. If you could offer one piece of advice to the baby boomer generation what would it be?

Do what you can to be healthy—exercise and enjoy life.

For more information on Francine or her book, visit www.yourparentstoo.com.

Hearty, Healthy Minestrone Soup

Posted on: May 6th, 2014 by Anhtuan Hong

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I’m totally in a soup mood these days.

It must be the impending fall weather, the fact that Halloween is two weeks away, and that the evenings are cooler now.

When we were in Italy this summer, we had the most delicious minestrone soup. The kind that just sticks to your bones and warms you from the inside out. So I was excited to see if I could recreate the recipe at home, in a way that would be more of a one-pot meal for me and the husband.

I was inspired by this recipe from FoodNetwork.com, but I made a bunch of modifications to make it veggie-friendly and much healthier.

It turned out to be absolutely delicious!

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The chunky vegetables and beans gave it a stew-like consistency, and the parmesan cheese (and rind) added a power-punch of flavor.

It was super filling and pretty easy to make too! It had that “slow-cooked-all-day” taste, but it took under an hour to make. Now that’s my kind of dinner :)

The Ingredients

  • 1 tsp olive oil
  • 1 red onion, chopped
  • 2 carrots, peeled, chopped
  • 2 celery stalks, chopped
  • 2-3 garlic cloves, minced
  • 1 pound Swiss chard, stems trimmed, leaves coarsely chopped
  • 1 russet potato, peeled, cubed
  • 1 (14 1/2-ounce) can diced tomatoes
  • 1 fresh rosemary sprig
  • 1 (15-ounce) can cannellini beans, drained, rinsed
  • 28 oz low-sodium vegetable broth
  • 1 ounce piece Parmesan cheese rind
  • 1/2 tsp salt
  • 1/4 tsp pepper
  • Optional – 1/8 tsp crushed red pepper
  • Shredded parmesan cheese (for topping – 1 Tbsp per bowl)

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The Directions

Step 1: Heat the oil in a heavy large pot over medium heat. Add the onion, carrots, celery, and garlic. Saute until the onion is translucent, about 10 minutes.

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Step 2: Add the Swiss chard and potato; saute for 2 minutes. Add the tomatoes and rosemary sprig. Simmer until the chard is wilted and the tomatoes break down, about 10 minutes.

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Step 3: Meanwhile, blend 1/2 cup of the beans with 1/2 cup broth in a processor (or mash together with a potato masher) until almost smooth. Add the pureed bean mixture, remaining broth, salt / pepper / spices, and Parmesan cheese rind to the vegetable mixture. Simmer until the potato pieces are tender, stirring occasionally, about 15-20 minutes. Stir in the whole beans and simmer until the beans are heated through and the soup is thick.

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Step 4: Discard Parmesan rind and rosemary sprig (the leaves will have fallen off of the stem) before serving. Top with 1 Tbsp shredded parmesan cheese.

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The husband absolutely loved this recipe. And both he and I went back for seconds! We couldn’t help ourselves. I loved how packed with veggies and protein it was – it felt like an easy way to sneak more veggies into our diets (with minimal effort!)

The husband said this soup reminded him of Italy, which was all the validation I needed. I hope you enjoy this as much as we did!

Exercise

Posted on: April 18th, 2014 by Anhtuan Hong
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A woman on the phone to her friend: “I feel like my body has gotten totally out of shape, so I got my doctor’s permission to join a fitness club and start exercising. I decided to take an aerobics class for seniors. I bent, twisted, gyrated, jumped up and down, and perspired for an hour.

But, by the time I got my leotards on, the class was over!”

Love

Posted on: April 18th, 2014 by Anhtuan Hong
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A story of true love: While working the lunch shift at a local restaurant, a waitress watched an older couple sitting together. It seemed as if the man was the only one eating- first his appetizer, then his main and finally his dessert. All the while, his wife just looked on, not even touching her food. Confused, the waitress approached the woman and asked if there was anything else she could get for her. “No thank you,” came her answer, “it’s his turn for the teeth.”

The Benefits of Self-Compassion: Embracing Positivity

Posted on: April 15th, 2014 by Anhtuan Hong


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We live in a success-driven culture. Being a “go-getter,” “Type A” or a “Super Perfectionist” are descriptors that many of us use to describe ourselves with pride. But even for the most driven among us, aging can make us slow down and call into question whether we need to tone down our strongest critic: ourselves. Recent years have seen both a resurgence of and backlash against an oft-misunderstood field of study, positive psychology. Far from being an overly idealistic, somewhat delusional “be happy at all costs” theory, positive psychology is simply the name given to a subfield of psychology that seeks “to make normal life more fulfilling.” Positive psychology promotes an exploration of our values, strengths, talents and virtues and encourages us to challenge the negative styles of thinking that may be impacting our mood and wellbeing.

Dr. Emma Seppala, Associate Director of the Center for Compassion and Altruism Research at Stanford University, has built a successful career around promoting the virtues of happiness, social connection and compassion. We have shared her infographic for the Benefits of Self-Compassion to the left. This is a useful guide to beginning the journey to develop greater empathy and compassion for ourselves. Dr. Seppala writes, “Self-compassion involves treating oneself as one would a friend, being more mindful, and understanding our situation in the context of a larger human experience. When we can be more understanding and gentler with ourselves, identify less with the emotions that surround our mistakes, and understand that failure is a normal part of the larger human experience, we become stronger and more successful in the long run.”

Called a “self-defeating tendency,” self-criticism is the polar opposite to self-compassion. It is a tendency to put oneself down and engage in critical self-talk that is often full of statements that start with “I should have…,” or “If only I had been more/less…,” or “Things would just be so much better if…” But our thoughts can become our reality; there is nothing to be gained by repeating negative self-talk. The good news is that self-compassion can be learned. It is a daily mental exercise that over time can become a more natural way of thinking and living. And, it’s never too late to start.

Indeed, when asked what is one thing that they wish they could have told their younger selves, many of the inspirational elders who we interview at Changing the Way the World Ages are quick to reply “I’d have been kinder to myself” or “I wouldn’t have sweat the small stuff as much…I’d have enjoyed myself more.” Self-compassion is a common characteristic in those who remain active and fulfilled into their 90s and beyond. We’ve distilled many of the self-compassion self practices common among the inspirational seniors with whom we engage into the five tips below:

  • Cultivate a resilient approach to setbacks; use perceived failures as lessons learned and then move on.
  • When you feel your mind wandering or find yourself ruminating on stressors or concerns (especially those that are out of your control), do what works for you to bring yourself back into a good mental state—for some people this is exercise, for others it is meditation and still for others it’s simply reading a good book.
  • Remind yourself each day why you’re proud of yourself. Try to focus on your strengths and make a lifelong commitment to personal growth and development of your passions.
  • Develop a culture of gratitude for what you have rather than focusing on what you lack. The happiest older adults describing focusing on their abilities rather than their disabilities.
  • Give yourself the same courtesy you give others: we tend to be much harder on ourselves than we are on others. Be gentle with yourself, and be aware of the self-critical words that you use.

Caring for the Caregiver: Using Lessons Learned from Caring for Others to Take Better Care of You

Posted on: April 7th, 2014 by Anhtuan Hong

Old-and-Young-hands_quote“There are only four kinds of people in the world – those who have been caregivers, those who are currently caregivers, those who will be caregivers and those who will need caregivers.”—Rosalyn Carter

There are currently over 75 million family caregivers who provide home care for a loved one. By the year 2050, there will be over one million centenarians – individuals over the age of 100 – living in the North America alone, rendering Rosalyn Carter’s words, quoted above, all the more powerful. Family caregivers fill a vital role in the health and quality of life of their loved ones. They are often the most familiar with the care recipients’ medicine regimen; they typically are extremely knowledgeable about the treatment regimens; and they usually intimately understand the recommended dietary and exercise plans. However, family caregivers also have extremely high burnout rates, with stress-related physical and emotional impacts. In fact, around 55% of family caregivers exhibit depressive symptoms. So, what is the approaching-burnout-caregiver to do?

My good friend, Emily, who is caring for her 82-year-old mother with Alzheimer’s, has enlisted the help of a local in-home care agency for the first time in her three-year journey as a family caregiver. She described at first feeling a sense of guilt for “bringing in an outsider,” but such doubts soon dissipated and were instead replaced with a profound gratitude for the freedom that eliciting additional help provided. Though my friend read copious pages of Alzheimer’s disease caregiving how-to books, tirelessly scoured the internet for up-to-date resources and was curious and informed when meeting with physicians (all while wearing her other hats of mother, wife, friend and business woman, I might add!), she reached a point around the holidays where, as she described:

“I realized I felt…more like a firewoman than a daughter, caregiver, wife, mother, entrepreneur—I was constantly putting out ‘fires’ caused by spreading myself too thin…rescheduling missed appointments, playing a never-ending game of catch-up at work, not being engaged in one task I was doing at any given time…”

Emily started by bringing on a caregiver just four hours a week; at the urging of the care manger at the in-home care agency that provides her mother’s care, Home Care Assistance, Emily took this time to be her “me” time—time to leave the home and do the errands, activities, social meet-ups that she had described feeling too overwhelmed and guilty to justify doing prior to bringing on additional care. She slowly increased the hours of professional care to where she felt comfortable in resuming many of the activities so important to her own quality of life (e.g., exercising, book club) that she had forsaken over the past three years. Not only did she notice a difference in how she felt, but she noticed a difference in her mother as well.

“I felt like I was a daughter again, and I think on some level Mom feels that now too. When I would be around her frazzled and stressed [before bringing in professional help], in retrospect, I think she sensed that. She would get more agitated, more sad.”

Emily described a common phenomenon that family caregivers describe: when she was more positive and happy, her dynamic with her mother was better too. She was more patient and compassionate and this translated to more smooth and enjoyable interactions. But it was what happened next that Emily found the most surprising. She started taking some of the very principles that she saw the caregivers working with her mother utilizing—promoting exercise, planning a diet rich in “superfoods” and nutrients, cultivating a sense of purpose and calm—and incorporating them in her own life. Further, whenever she would read something about providing good, loving care to an ailing family member or learn about tips to help improve her mother’s functioning and quality of life (e.g., sleep hygiene skills, music therapy) she would find ways to ensure that she was taking the same high caliber care of herself. Emily’s story is not unique. Sometimes simply taking the time to do for you the very things that you do for your loved one can make a world of difference.

It is a paradox too common in family caregivers that though they are aware that they are fatigued, burned out, unmotivated and overwhelmed, they feel guilty in taking the time to ensure that their own needs are being met. I once heard a woman at a family caregiver support group describe that she was on plane about to take off, listening to the same safety instructions that she had heard hundreds of times prior, but for some reason something stuck with her: “Place the oxygen mask on your own face first before helping others.” This resonated with her because it was a metaphor for her own relationship with her chronically ill husband for whom she was providing care—she needed to make sure that she was healthy and taken care of first in order to ensure that she could take the very best care of her loved one.

Are you or do you know a family caregiver who has learned important lessons on his or her care journey? Share your experiences and thoughts about what has helped you thrive in your role.

Sleeping Beauty: 10 Tips for Better Sleep

Posted on: March 31st, 2014 by Anhtuan Hong

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It seems that the medical community is latching onto the classic adage, “The bed is only for sleep and sex.” In a recent presentation, Dr. M. Safwan Badr, President of the American Academy of Sleep Medicine, elicited both laughter and applause when he announced, “I say the bed is for two things that begin with the letter S, and struggling and suffering are not among them.” As more and more research emerges on the important role of sleep in overall health, many clinicians and health advocates are making awareness around sleep hygiene a priority.

Sleep hygiene refers to the habits and practices that make sleeping well on a regular basis more likely (e.g., not eating dinner in bed). As we get older, our sleep patterns change as part of the normal aging process, though our need for quality sleep does not. Chronic sleep disturbance can result in a number of physical and mental health consequences. While achieving a restful night of sleep may seem like a fantasy for those of us who experience occasional or chronic sleep problems, evidence suggests that there are a number of non-pharmacological, lifestyle behaviors that can promote better sleep.

Below we have compiled 10 of the top tips for achieving a more satisfying night of sleep:

  1. Ban unnecessary bedroom light. Even the tiny flicker of light that a cell phone or digital clock may emit can disrupt sleep. Experts recommend turning off TVs, computers and any other devices at least one hour before it’s time to sleep. If you have a device that you can’t fully turn off, try covering it with a blanket so the light is hidden.
  2. Break the napping habit. Taking a nap, especially within a five-hour window of your ideal bedtime, can exacerbate problems with achieving a restful night’s sleep. If you do need some extra shuteye during the day, keep it to a brief 15-20 minute nap at least five hours before your bedtime.
  3. Train your body’s natural clock. Sleep experts recommend going to sleep and rising at the same times every day (yes, that includes weekends!) to set a sleep-wake rhythm.
  4. Bask in some morning light. If you feel groggy in the mornings or have a difficult time waking up when you would like to, try getting out in bright, natural light for 5-20 minutes almost immediately after you rise. This is one of the single most impactful sleep hygiene changes for many adults.
  5. Skip the afternoon macchiato. For most adults, some morning caffeine in the form of tea or coffee will not significantly disrupt their sleep-wake cycle. However, having caffeine (even in the form of chocolate, some pain relievers, or sodas) later in the day can wreak havoc on sleep patterns.
  6. Exercise during the day and relax your mind/body at night. Consistent exercise during the day, ideally at least four hours before your bedtime, coupled with a gentle relaxation exercise such as meditation or progressive muscle relaxation at night, can be a great formula for a good night of sleep.
  7. Cut back on nighttime liquids. If you find yourself waking up in the middle of the night to use the restroom, try to make it a habit to avoid liquids within a two-hour window of your ideal bedtime. If you do have to use the restroom at night, keep a nightlight on in the bathroom to avoid having to turn on too many bright lights.
  8. Prep your surroundings when it’s nearing bedtime. If falling asleep is a challenge, try prepping your body a few hours before you’d like to sleep by dimming lights and limiting exposure to stressful topics that may be on the news or online.
  9. Invest in some white noise. If you live in an area where noise is an issue (e.g., a loud neighborhood dog), consider investing in a white noise generator or even a fan to drown out the distractors. Ear plugs can also be helpful.
  10. Don’t worry about not sleeping! This may be easier said than done, but ruminating about not sleeping can actually disturb sleep patterns, which then feeds the worry, creating a vicious cycle of not sleeping and worrying about not sleeping. If you find yourself tossing and turning, consider getting out of bed, having a relaxing cup of chamomile tea in some dim light, and then getting back into bed when you’re feeling more relaxed.

Do you have any tips for getting a better night of sleep? Share them with us in the Comments section or on our Facebook page!

Wearable Fitness Trackers: The Ultimate Accountability Tool for Seniors?

Posted on: March 21st, 2014 by Anhtuan Hong

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Clinical psychologists have noted the importance of self-monitoring in maintaining overall health for decades. Want to motivate someone to stop smoking? Simply asking him or her to write down how many cigarettes he or she smokes each day, with no other instructions or information about health risks, will lead to a significant reduction in cigarettes smoked. Being mindful of our behaviors and feelings is what enables Cognitive Behavioral Therapy (CBT), a type of psychotherapy, to be so successful. Now, with the trend in wearable fitness trackers, the ability to monitor and keep oneself accountable to fitness goals has been revolutionized. While the makers of these products initially envisioned their target demographic to be hardcore athletes, they have found that these devices hold mass allure.

The common theme across experiences with the trackers seems to be both a sense of satisfaction with activity gleaned from daily activities (e.g. not realizing that the leisurely morning walk with a neighbor was virtually equivalent to a rigorous, two mile walk each day), and surprise at the extent of activity “dead-zones” (e.g., learning that it’s typical to spend most of your Sunday afternoons completely sedentary). As one blogger summarized in his review:

“At first, as I’d expected, I liked tracking myself. It lent a pleasing empiricism to my existence. I learned that on an average day—strolling to the subway, the office, and the lunch spot—I might tally 8,000 steps… On the flip side, I’d never realized quite how sedentary I become on winter weekends. Over the course of one snowy, couch-bound Saturday, I barely eked out 1,000 steps. I was like an obese panda lazing in a zoo habitat.”

These devices are truly powerful ways of increasing the level of knowledge each of us has about how we’re spending our days. They keep us accountable—there is no arguing with a step count.

And, seniors are not being left out of this revolution. In fact, the Columbus, Ohio Home Care Assistance office launched an innovative campaign called “Walk to Okinawa” where seniors are given wearable fitness trackers to record progress as they “walk” the 7,500 miles from Columbus, Ohio to Okinawa, Japan (the city renowned for being home to one of the longest living, healthiest populations in the world). Those who register receive a free pedometer and are asked to report their total steps to the office each week. The use of fitness devices to promote physical activity in seniors is an exciting area that we look forward to seeing develop further!

Have you used any of the wearable fitness trackers on the market? What was/is your experience?

Busting Aging Myths

Posted on: February 3rd, 2014 by Anhtuan Hong
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In Western societies, aging is often viewed as a progressive process of loss—of loved ones, senses, memory, flexibility, etc. In Okinawa, Japan, on the other hand, aging is viewed as a rich and meaningful part of life and elders are highly respected. We often take for granted that growing older is indeed a privilege. Here we take a look at some misconceptions about aging with the hope of promoting a more positive, celebratory view:

  • Myth: Older people are unhappy.
    Fact: Older adults tend to report higher levels of happiness and satisfaction. As we age, we generally exhibit a positivity bias and become more skilled at regulating our emotional health. In addition, as time becomes more finite, we begin to focus on what is most important and meaningful, tailoring our experiences to increase wellbeing, a phenomenon Stanford psychologist Laura Carstensen termed “socioemotional selectivity theory”. As we stop “sweating the small stuff” and start cherishing simple pleasures, the frequency and duration of negative emotions decrease. A longitudinal study conducted by Carstensen followed participants aged 18-94 for ten years and found that those in their 70s and early 80s were happiest. Additional studies have replicated these findings.
  • Myth: Older people are lonely.
    Fact: While social isolation can be an issue for homebound seniors, older adults usually have close contact with family and friends. Many seniors remain active and engaged members of their communities, often with greater social adeptness than their younger counterparts.
  • Myth: Aging means that you will have difficulty learning new skills.
    Fact: In actuality, older adults tend to have high levels of mental flexibility. The idea of neuroplasticity, or the brain’s ability to change structure and function in response to experience, is becoming a more widely accepted concept in the science field. Aging extraordinaire Phyllis Sues became a musician and learned Italian and French in her 70s, took tango and trapeze at 80 and started doing yoga at 85.
  • Myth: Aging reduces libido.
    Fact: Research has found that sexual activity and enjoyment do not decrease with age. Indeed, a New England Journal of Medicine study surveyed 3,005 men and women about their sex lives. 73 percent of adults between the ages of 57 and 64 said they continue to have sex, as did 53% of adults ages 65 to 74 and 26% of adults ages 75 to 85.
  • Myth: Mental and physical deterioration are inevitable.
    Fact: According to the New England Centenarian Study, the vast majority of centenarians surveyed were able to live independently well into their 90’s and about 15% have no age-related diseases. While it is true that an individual’s physical and mental faculties can decline with age, implementing healthy lifestyle habits can slow down the process. Lack of exercise, not old age, is often what results in reduced flexibility, muscle mass and bone strength, and achy joints. In addition, dementia and other cognitive conditions are not characteristic of “normal” aging. Just as regular exercise can keep you physically fit (and there are some older adults who are more fit than most young people!), regular mental stimulation can keep you cognitively fit. For example, taking classes on an interesting topic, learning a foreign language or doing activities such as crossword puzzles and Sudoku are great ways to keep your mind sharp.
  • Myth: Older adults are less productive and creative than younger people.
    Fact: Many older people remain active and productive throughout their lives. Retirement often offers the freedom to develop creative abilities and volunteer in the community. Hal Lasko, now age 98, started using Microsoft Paint at age 82 to create amazingly detailed “portraits,” which he sells to the public.

Were you surprised by any of these facts? Comment below or on our Facebook page!

Preparing for a Disaster

Posted on: January 22nd, 2014 by Anhtuan Hong 1 Comment

imagesNo matter where you live, disasters – whether natural or man-made – often strike quickly and unexpectedly; local officials and relief workers may not be able to reach you or your loved ones right away. Thus, knowing what to do before, during and after an emergency is incredibly important, especially for older adults. While individual needs and abilities may vary, every person can and should take basic steps to prepare for various disasters.

Make an Emergency Supply Kit
Plan to make it on your own for at least three days. Identify the resources you use on a daily basis and think about what you might do if they were limited or unavailable. Store the supplies in one or more easy-to-carry containers, such as a backpack or duffel bag, in an easily accessible location. Depending on your needs, your “Go Kit” may include:

  • Water (1 gallon/3.8 liters per person per day)
  • Non-perishable food (if you have canned food, include a can opener)
  • Battery-powered or hand crank radio (extra batteries)
  • Flashlight (extra batteries)
  • First aid kit
  • Blankets
  • One change of clothes and sturdy shoes
  • Whistle to signal for help
  • Dust mask to help filter potentially contaminated air
  • Plastic sheeting and duct tape to create a shelter-in-place
  • Moist towelettes, garbage bags and plastic ties for personal sanitation
  • Cash or traveler’s checks to purchase supplies
  • Any medications you take regularly (talk to your pharmacist or doctor)
  • Extra eyeglasses, contacts or hearing aids
  • Extra batteries and chargers for hearing aids, motorized wheelchairs or other battery-powered medical or assistive technology devices
  • Local maps
  • Food, water and other essentials for your pets, if applicable
  • Names and numbers of your medical providers and everyone in your personal support network
  • Copies of important documents such as prescriptions, medical equipment model and serial numbers, medical insurance, birth certificates, wills, passports, power of attorney documents, deeds, social security/social insurance/other benefits numbers, credit cards, bank information and tax records. It is best to keep these documents in a waterproof/fireproof container

Maintaining your kit is important. Review the contents at least every six months or as needs change. Replace food, water, batteries, medications and other perishable items based on expiration dates.

Make a Plan
Plan to evacuate or shelter-in-place
Depending on the nature of the disaster, you may either have to find shelter-in-place or evacuate. Know the safe places in your home in case you need to shelter-in-place as well as the best and quickest escape routes from your home and neighborhood. Choose several destinations in various areas so you have options. Note that emergency public shelters only allow service animals so plan in advance for alternatives that will work for both you and your pets, if applicable (e.g., family, friends, local veterinarian).

Create a personal support network
Make a list of family, friends and other contacts that can help you in an emergency— for example, people who may be willing to host you. Share your concerns and limitations and discuss an action plan (e.g., transportation needs, evacuation routes). Also, let them know where your emergency supplies are located. Arrange for someone to check on you in the event of an emergency and make sure he or she has a key or other means to access your home. Practice the emergency plan to make sure potential needs are adequately addressed and review the plan every six months.

Develop a family communications plan
Consider a system where each family member calls the same loved one in the event of an emergency. Note that it is often easier to make long-distance calls during a disaster so out-of-state contacts may be better able to get in touch with separated loved ones.

Talk to your service providers
If you undergo routine treatments administered by a clinic or hospital, or if you receive regular services such as home health care or home care, talk to your service providers about their emergency plans. Work with them to identify back-up providers within your area and the areas to which you might evacuate. If you use medical equipment in your home that requires electricity to operate, talk to your health care provider about what you can do to prepare for its use during a power outage. Ask your utility company about emergency procedures and know how and when to turn off water, gas and electricity. Keep any tools you may need nearby.

Ensure access to funds
A disaster can disrupt mail service for days or even weeks. If you receive any benefits or checks through the mail, you may not have access to your account during an emergency. Consider setting up a direct deposit system through your bank to ensure immediate access to your funds.

Stay Informed
Evaluate risks in your community
Think about the risk for both natural (e.g., hurricanes, flooding, winter storms and earthquakes) and man-made (e.g., hazardous material spills and transportation accidents) disasters. Research various emergency preparedness programs in your local community for further, location-relevant tips and resources – how will you be warned of a disaster and how will authorities communicate with you during and after a disaster? Some local emergency management offices maintain registers of seniors so they can be located and assisted quickly in an emergency.

Weather Radio/All-Hazard Alert Radio
Weather service-sponsored radios often provide the earliest warnings of weather-related and other emergencies, and can be programmed to alert you to disasters in your specific neighborhood.

We hope that you found our emergency preparedness tips helpful! Have additional suggestions? Let us know in the comments below or on our Facebook page!