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Aging

Palliative Care

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As a counterweight to the depressing topic discussed today, I chose some of the happiest older faces I met in my wanderings.

The article below is long, complex and I thought instructive. It is written by a Dutch doctor who helps with assisted suicide, legal in Holland, although only for Dutch citizens (unlike Switzerland which welcomes other people who seek that kind of fate.) He explains the concerns and hesitations and fears surrounding this act, but, more importantly, points to how improved palliative care could avert decisions of suicide. Palliative care has seen lots of changes in the last decades, as spelled out in the other two links, but for every step forward there seems to be some steps back – particularly when some insane nurse goes on a “mercy” killing spree in yet another hospital or nursing home.

I can think of many reasons that speak against assisted suicide beyond religious ones. The slippery slope to euthanasia has to be avoided; one of the largest fear of the dying is to be a burden on others – will that be a motivating psychological force? Does that justify the loss of a life? I can also think of many reasons that speak in favor, including the fact that there are certain types of unbearable pain that cannot be relieved by current pharmaceuticals. In the end it has to be a personal decision, with a safeguard structure provided from the outside, as it is in Oregon’s laws.
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http://www.threepennyreview.com/samples/keizer_f16.html

http://www.nytimes.com/2016/02/16/health/in-palliative-care-comfort-is-the-top-priority.html?_r=1

https://www.1843magazine.com/features/how-to-have-a-good-death

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Alive inside

20150322_4616If you have 2 minutes today do yourself favor and watch this trailer for a fabulous documentary on how music helps the aging heart and soul.

http://www.aliveinside.us/#trailer

I cannot wait to make time for watching the entire film.

There is generally now a lot of evidence to confirm what we all probably believed to be true: art helps us to live happier lives, now and in every year of aging. A thorough summary of the findings can be found here:

http://well.blogs.nytimes.com/2016/03/07/using-the-arts-to-promote-healthy-aging/?_r=1

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Consuming art, as in listening to music, but also making art. Singing, dancing, painting, conducting, drawing, writing, working with sculpture materials – you name it. My favorite artist, when it comes to aging, is Rembrandt. He was interested in the process, documented in his endless self portraits, with curiosity, not fear or cruelty.

https://www.theguardian.com/artanddesign/jonathanjonesblog/2012/mar/29/rembrandt-old-age

 

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Aging in Place

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The average person over 65 manages a walking speed of 3km/hour. At 80 that goes down to 2km/hour, compared with the average for a working age person of 4.8km/hour. (35 years in the US and I still can’t compute miles….) Crossing the street at a signal with the time allotted for younger persons might be quite difficult for us baby boomers in 10 years or so.

This is one of the many, many urban design features that need to be thought through to adjust our cities (or in building new ones) for an aging baby boomer generation. Safety issues are a concern, but even more so is the need to combat the tendency towards isolation when moving around becomes hard. Architects and city planners increasingly take into account transportation issues, both in terms of green links devoid of traffic, and bus or other transportation modes routed to connect the elderly to places where they can gather.

In terms of housing there are now entire courses offered in architecture programs that deal with the needs of the elderly – in particular creating buildings that are flexible in design, so they can be adjusted easily to life stage changes and that contain more age friendly features than you would see in designs aimed at first time users only.

The three links below all tackle some aspects of these issues, seen and described from different perspectives.

https://www.theguardian.com/cities/2016/apr/25/improving-with-age-how-city-design-is-adapting-to-older-populations

 

http://www.archdaily.com/604158/how-should-cities-prepare-for-an-aging-boomer-population

Portland is mentioned favorably!

http://www.citylab.com/design/2013/01/how-build-eldertopia/4514/

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Going South

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These days Central America is referred to as the new Sun Belt, because so many American retirees are moving there.

If you are suffering economic hardship in the States, retiring in Ecuador, Belize, Costa Rica, Mexico and above all Panama is a seemingly good move. Cost of living, medical care, taxes are all a fraction of what you would have to spend here. The weather is kind to aging bones, and the sense of adventure in trying something so completely new can give a second wind. Many of those nations have special incentives to lure Americans there, providing financial relief and bonuses for the offshoring expats. 

As always, there are costs attached. Patients with limited mobility or complex medical conditions will not find the care they might need. U.S. wills and estate plans do not necessarily translate into the law of the host country and so need re-configeration. And unfamiliarity with the new language, culture and customs can lead to difficulties at an age where adapting is harder than it used to be.

Another aspect that gets rarely discussed is the cost to the host country. As the terrific article below spells out in more detail, the influx of – comparatively – well-off retirees increases prices for the South American populations to a point where it makes it impossible for them to keep up, not just in rent, or entertainment or some such, but in the most basic necessity like food prices. “Offshoring elders are leaving one kind of inequality in the United States to be the beneficiary of another kind globally.” No easy solutions, no matter where we turn.

https://www.thenation.com/article/inequality-has-gotten-so-bad-were-offshoring-our-grandparents/

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On being mortal

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The trucker wearing this t-shirt actually came quite close to dying – almost being murdered by your’s truly after she spent a night in a non-air conditioned Texas motel room next to his idling truck, which he probably used as a nicely cooled B&B….the noise made it impossible to sleep.

Downshifting to the real issue in today’s blog brings us to a Mother Jones interview with the author of Being Mortal. Some days I think I am the only person on the planet who has not yet read the book, despite many recommendations by people who’s assessment I trust. The interview certainly solidified the impression that it will be a worthwhile read. So why am I hesitating? It’s not that I am unfamiliar with the topic of and the issues surrounding death and dying, after volunteering for a local hospice and sitting through several deaths. Maybe it’s more the sense of wanting to delay thinking about aging, and what needs to be done to improve the process. So consider this week an attempt to tackle that!

http://www.motherjones.com/media/2014/10/atul-gawande-being-mortal-interview-assisted-living

 

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On Aging

My dissertation advisor Jerry Bruner died this summer at age 100. He played tennis still at the age of 93, although he admitted he now needed an “occasional nap.” Even more impressive, he joined the NYU faculty around age 75 to build a new program there, teaching the Colloquium on the Theory of Legal Practice at the law school for more than two decades. This after having shifted numerous times onto a totally different topic of research during a long and distinguished career.

There are many examples of successful aging around us, and many explorations of how one could make it the norm, at least for those of us who have the luck of being reasonably healthy. Since I come from a background where relatives on one side died around or before the age of sixty, and the other side in their late seventies, with the occasional exception, I never thought I would need to inform myself about what works and what doesn’t during aging. But I might as well, in case I should live longer than expected – and anyways, it is actually an interesting topic.

So, for this week I’ll be digging up some smart materials that teach us what should and what shouldn’t be done to promote a productive, healthy and hopefully content old age. We start with some thoughts on the relationships between the generations, and a shift in one’s own perspective with increasing years. The link provides an interesting discussion of finding the balance between independence, not wanting to be controlled by your children, and the need to listen to their advice, should we be lucky enough that they care.

http://www.theatlantic.com/health/archive/2016/03/when-youre-the-aging-parent/472290/

Photographs are with few exceptions all street photography. Note, of course, since they were all met in public, they still had the ability to move – something that is unfortunately not true for so many shut-ins due to mobility issues. So the sample might be skewed.

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