Every year the optimistic and energetic among us makes New Years resolutions. My experience with older adults is that most have goals and objectives for the coming year. I have a few suggestions. One of the obstacles that caregivers and other professional helpers run into is the task of trying to do what they think is the right thing, for someone who can’t make their wishes known. I had more than one conversation this week about what steps can be taken to direct someone’s estate after he passes, and about what decisions a person wants made for his ongoing care. It can all be written down. It should all be written down! If you don’t know what exactly needs to be done, and don’t have a lawyer, they periodically make themselves available at Jack Crippen Senior Center in El Monte. They’re the lawyers at Bet Tzedek. They are first rate, knowledgeable and have no vested interest in what you do with your stuff. They just want you to get a plan on paper. Bet Tzedek just published a guide for caregivers with all sorts of information on conservatorship, advance directives, benefits and so forth. Anyone who needs care, or knows someone who might, should have this book. They have other guides too. I have made use of Caring for a Relative’s Child and given out a few copies of the Nursing Home and Assisted Living Companions. They can be downloaded at www.bettzedek.org at the “publications” link. For anyone out there that doesn’t speak Hebrew, Bet Tzedek means “House of Justice.” They won’t do services like divorce and personal injury cases. They want to help low income LA County residents who need legal help. If your resolution is to get your affairs in order, this is a good place to start. Shalom and Happy New Year!

This week is the winter solstice. I feel better just knowing the days will start to grow longer. Many older adults feel the cold, which isn’t going away quite so soon, and the dark to a greater degree. Sometimes it’s because they have stopped the utilities to the house. It surprises folks how often older people don’t have power, gas, phone or even water. Sometimes the upkeep of plumbing or wiring has gotten too far behind. Other times paying the bill on time is too much.
Even those who have electric lights may have effects from the long nights of winter. Seasonal Affective Disorder is a type of depression that comes over a person who isn’t exposed to adequate natural light. The best treatment is full sunlight on the face within fifteen minutes of waking. If you wake up two hours before sunrise, you need a different therapy. The internal clock shifts backwards with age, the older one gets, the more likely he is to retire early and then rise early. Banks of special artificial light can do the trick for two thirds of SAD sufferers, others may require medication.
Falls are likely in the twilight. If you have holiday decorations up, I bet you have trip hazards of extension cords too. If the cold has numbed your feet, you might not notice slippery or uneven footing until it’s too late.
So this is the part where I have some wise recommendation to ease the problem. If you know an older adult with no power in their home, call Adult Protective Services. They may already be aware, but they might just have the right help. When the mail piles up, it’s hard to fill out the applications for lifeline services alone. But this may keep the lights on for an elder. If you are having trouble getting around on your own, start making changes that will keep you safe. Grab bars, throw out the throw rugs, get a shower seat, remember The Clapper! I don’t know how wise any of that is. I’ll do better when I get more daylight.

Be of good cheer! Or else! The pressure to have a good time during the holiday season can bring it’s own consequences. Stress to spend too much, to eat too much and drink too much has effects on mood and health. There is a national trend in the increase of heart attacks from Thanksgiving until after New Years. The reasons are many, including getting too busy to follow an exercise plan, unusual drinking habits and changes in diet. Even having one really big meal. Sudden high blood levels of fat can trigger arteries that are badly clogged. Unusual salt intake may retain enough fluid to stress a delicate circulatory system to trouble. High alcohol blood levels can irritate the heart directly and dangerously. The irregular beat can lead to stroke. Cold weather constricts the blood vessels on the outside of the body. Cold medicine can raise blood pressure.
Losing sleep, traveling, flu season and missing medications all contribute.
One of the biggest problems in identifying a heart attack is the difference in symptoms between men and women. Pain in the arm and chest is more likely for guys. Ladies may not hurt. They may have pressure, sweating and shortness of breath. One of the biggest contributors to fatal heart attacks is a delay in treatment. We can make it faster on my end with programs to get angioplasty started within 90 minutes of reaching the emergency room. The longest delays happen when a person denies the problem, takes an antacid and waits too long to go to the hospital. Another trend to improve survival is changes in how CPR is being taught. It’s easier than ever to learn and to do. And you can even take a class in using automated defibrillators! Clear!
Before that happens, keep your schedule intact. Sleep eight hours. Drink your water. Take your walks. Refill your prescriptions. And don’t ignore your symptoms. And be of good cheer.

There are two issues I think should be addressed this week. Both are related to the upcoming Thanksgiving Holiday. We hear about uncooked poultry and bacteria every year and it seems like everybody gets it, and then a new wave of food poisoning happens each holiday. A dear woman told me last week that her mother never taught her to cook a frozen turkey so she buys a fresh one every year. The woman is sixty-eight years old and I went to her mother’s funeral seven years ago. I think it’s time to learn on her own. The facts- you shouldn’t thaw a turkey (or other meat) on the counter. It takes about one day for every five pounds to thaw in the refrigerator. Then it can stay in the fridge for another two days. A fresh turkey should be bought the day before. No matter what the method of cooking (my wife like to brine, I like to deep fry) the center of the bird should be at 165 degrees F. Don’t get a pre-stuffed bird. Wash the bird, your work area and your hands every time! Those bleach infused towels do a good job of surface decontamination. Wash the pre-packed salads and spinach, even if the package says “washed.” The other topic is the point of the whole event. It is sometimes hard to stop and consider how much we all have. Many of us don’t count how many advantages we enjoy and just have an attitude of gratitude. Some families have a tradition of going around the table and saying “I’m grateful for…” on Thanksgiving. Some people don’t have a table to sit around. Some don’t have a family. Take a few minutes next week to think about whatever it is you are glad you have, to say thanks, to whatever your higher power might be, and to anyone around that day who might enjoy hearing it. And thank you dear reader, for your attention, time and effort each week.

Last week I recited some of my bona fides in respect to crime against older adults. The thing that surprises me time after time is the low return on crime.
Criminals that prey on older adults may get a quick claim deed now and then; sometimes they can arrange a loan against the senior’s home for a few hundred thousand. More often the proceeds of crime are just a few hundred or thousand dollars. Sometimes a lady can convince a well-heeled widower to buy her a car. Or a handyman persuades a woman to finance his daughter’s surgery- often back in the old country.
Younger adults become victims of crime because of greed. Older adults are more vulnerable because of sympathy and loneliness. The best protection they can receive is a full and satisfying social life. The best self-defense is to have a well-documented financial plan with a consultant on any large expenses or donations. Most importantly, in my opinion, is the willingness of a person to stand up and say, “I’ve been hoodwinked!” It can be embarrassing and frightening to realize and admit that someone you trust has taken advantage. Those feelings, and a well-meaning act of forgiveness can interfere with stopping the conman and protecting the future victims. And there will be other victims. If someone succeeds at this type of crime, they will try it again (and again). Knowing this may reduce the feeling of being special. Anger may lead to the courage to report. A professional criminal has professional level skills. It takes a professional to respond. The fraud detectives at the police and sheriff’s know how to find and nail these types. If someone is hurting you or someone you know, report the crime! If you don’t know how to ask a senior, try this: “Is someone hurting you?” A direct question is the best way to get a direct answer.

I haven’t ever explained the Elder Abuse Forensic Center. A grant allowed the adult protection team at county hospital to develop a team with the district attorney, city prosecutors, civil attorneys, geriatric doctors, police and sheriff’s detectives, advocates, adult protective services workers and my own mental health team. We meet every week to identify ways the team can act directly and indirectly to protect vulnerable older adults from criminal abuse. I also meet with the Coroner/ DA led elder death review team and I am the foreperson of a federal investigative grand jury. I tell you all this to prepare for this message. There is no federal law addressing elder abuse. There isn’t federal policy about the specific crimes committed against older adults. As the baby boom generation begins to age into seniority, I think it would behoove us to support long-needed policies on this type of crime. Why would that be needed?
I hear FBI agents, and ICE agents, and NCIS and Postal Inspectors and Forest Service and Internal Revenue testify and give evidence. I speak with City Police and County Sheriffs. They say that there is very specific training on child abuse but not elder abuse. Maybe the fraud investigators or homicide detectives have a smattering of experience that deals with specialty crimes against the older adult.
There needs to be policy on a national level. We need to make this an issue in next year’s elections. See www.ncea.aoa.gov for current legislation.
On an immediate level, I notice how many of the cases that reach prosecution begin with anonymous tips and reports. If you are afraid someone is being hurt, tell someone. If nothing is wrong, at least they were checked out. If something is wrong, you may have saved a life. If you are a mandated reporter, you may have saved your job. ELDER ABUSE HOT LINE (877) 4-R-SENIORS (877) 477-3646

Sleep hygiene: Not the practice of keeping clean but the behaviors we do to try to get to, and to stay, asleep. There is a belief that the older we get, the less sleep we need. The evidence is otherwise. The need for sleep remains about eight hours from young adulthood throughout life. It may be harder to get sleep the older we get because of health problems and other factors. The need for the full night’s sleep is evident in studies that show heart, mood and safety risks associated with less than adequate snooze time. Weight control and immune function have recently been linked to adequate sleep.
One truth is the “early bird” factor, the older we get, the more our circadian clock shifts backwards. Early to bed, early to rise was written by a guy who lived into his eighties at a time life expectancy was about 47 years. Teen-age brains don’t really turn on ‘til mid morning- getting up early to study didn’t help in high school.It is easiest to fall asleep when the body temperature is dropping. A hot shower or bath can keep you at fever temperature for hours. A tepid shower will help more with falling asleep. Remember that one of the ingredients in chocolate is caffeine. Even if there’s not a lot, a sensitive person will take a few hours to metabolize the stimulant. Avoid tea, coffee and soda after the sun goes down. Alcohol may make you feel drowsy but the chances of getting stimulated, restless and staying awake are just as good as going to sleep. Unless you drink enough to pass out in which case this column won’t help you one way or the other.
Darken the room, wear something or nothing, whichever is more comfortable. You might fall asleep in front of the TV but turn it off at bedtime. And have a bedtime! Consistency will help over time. Many people sleep better after sex. That would probably be with a long time partner, (no adventures if you want to rest).

I was at the flu shot event at Live Oak Park last Friday, seeing if my encouragement got anymore folks lined up for the jab. Since I last wrote about flu vaccine I saw a study in the New England Journal of Medicine citing a huge difference in death rates for older adults given flu shots. Up to 48% fewer hospitalizations! What I noticed in the long line in the morning, which quickly dropped to only about ten people waiting and a five minute visit over all, was this. Older people weren’t hurrying to get the shot and get out. They were hanging out with their friends, laughing and joking with the volunteers.
It reminded me of the value of laughter in health. It’s been long established that laughter will produce endorphins, circulate cerebro-spinal fluid and improve breathing. Most non-smokers never take a deep breath without a conscious decision to do so. Unless they’re laughing. The fluid around our brain and spinal cord has no pump, no heart to move it. Laughing does that.
“Words are worlds” and it’s no mistake that the opposite of gravity is levity. Laughter keeps you from the pull of the grave. So what if you have nothing to laugh about? What if you can’t remember the punch line of a joke? TV sure won’t do it. What causes a true belly laugh is the unexpected surprise in a conversation with someone else. Getting out with other people and taking an attitude of openness to the environment is the best thing you can do to find a laugh. You had to be there. Go to the movies or try a new restaurant. Find a group to join.
There is a new senior activity going on at Live Oak Park called Healthy Thursdays from 10 AM to Noon. It is free but they do ask for a reservation. The reason I bring it up is the November 29 topic- Laugh off That Turkey! That should levitate any of us. Call Mary @ 579-0461 to reserve.

One of those aging issues that is talked about is Parkinson’s Disease. PD happens to more men than women, more whites than African or Asian descended and increases with age. For those few unacquainted with the condition, a small part of the brain that regulates movement, called the substantia nigra, atrophies in a Parkinson patient’s brain. The usual symptoms are tremors or “pill rolling” sometimes starting on one side. Shuffling gait and stooped posture are a result of changes in balance. Eventually the person stops having control over starting and stopping motion. The face becomes mask like and the voice may soften or hush.
Recent studies link family members with dementia, especially Alzheimer’s type, to PD. They are very different diseases though. Memory changes with AD are different than the cognitive changes that may occur in late PD- attention rather than language tasks are measurably different. About 30% to 60% have memory changes after 70. Depression is also a concern. Swallowing can become an issue. It is easier to swallow something thick, like juice, than something thin, like water.
There is no cure for PD but there are a lot of treatment options. I read the other day that Parkinsonian rats get some relief from nicotine. There is a reduced incidence of PD with high cigarette and caffeine intake. The protection holds after stopping so there is no reason not to quit smoking, now! It is well established that some medications affect the ability to inhibit behavior; brain implants in PD patients have caused impulse disorders as well. This has led to compulsive gambling among other problems for some patients. Sinemet and other medications often give the person with Parkinson’s a cycle of time where their control is “on or “off.” At one hour they may be thrashing about quite a bit, later the control of movement is very good. In Belgium they have a rating scale to estimate driving safety for PD sufferers. There are a number of other conditions that can easily be confused with PD so be sure a qualified physician diagnoses and treats the symptoms. More info can be found at www.michealjfox.org.

I have tried to think of ways to begin talking about this topic without being too heavy handed or too flippant. The topic is suicide. I know that most of the people reading this will stop now and see what Bruce has to say about financial planning or Tamara about cars. Still, it is so essentially an older adult issue that I can’t let too much time pass without addressing it here.
An older adult completes suicide every 100 minutes in the US. Notice I don’t say he is successful. It is not a success. A completed suicide is a failure of the people and the environment around the person to hear and respond to the signals he’s given that he is at risk. A vast majority of older adults who die by their own hand have visited their doctor in the last month. Very few older adults will not tell someone, in some way, that they are thinking about killing themselves. Sometimes they start to give everything away, make arrangements for pets, and cancel services like meals on wheels or cable TV. Nearly all will admit this is their plan if asked directly.
Some groups are at more risk than others. African-American women seem to be protected by an unknown factor, White men, Asian women, and some other older ethnic/gender groups are more often at risk for suicidal behaviors.
There is basic information that everyone who knows older people should have.
If you ask someone about suicide, they won’t be more likely to do it. You can’t talk someone who is not suicidal into being at risk.
If someone talks about suicide they are at risk. It is a myth that people who talk about it never try it.
Alcohol is less often a factor for older adults and suicide than for younger folks.
Multiple changes, especially losses, will often be related to thoughts of suicide.
If someone you know tells you that they are thinking about suicide you or they can call 1(800) 273-8225 to get help. I’ll write something funny next week.

The Medicare Hotline established by the social security administration reports diminished satisfaction ratings with users who call for help with questions about benefits. I wonder how much of that dissatisfaction is from problems with the way you get information and how much is dissatisfaction with the news you get when you call.
I have seen a number of reports and cases from older adults who have reached the “donut” in Part D benefits- the new drug coverage has a surprise for many people who depend on their insurance to cover medication. When you get to a certain level of expense, they stop paying. The coverage resumes when you reach a new threshold. From about $2400 covered at 75% to $3000 you pay all the drug cost. For some users, accustomed to paying one quarter of the cost of their medication, they suddenly have to pay all of it. That part, the donut, lasts until the drug cost reaches $3051.25 then lowers again. So there is this time bomb of six hundred dollars you didn’t budget. The RAND Corporation reported last month that the real cost isn’t the six bills; it’s that about half of seniors don’t pay it. They miss the medication for as long as ninety days. For hypertension, cardiac and diabetes drugs, there is a higher cost at the point where those conditions cause functional impairment. That point is hastened by “drug holidays”. The difference between what the government expected and what was spent adds up to a rebate from the Part D insurers of … $4 billion! That’s a lot of pills folks didn’t get.
Help doesn’t seem to be available from the Medicare folks but there is a group called The Center for Health Care Rights that can coach you through some of this. If you are a Medicare enrollee living in Los Angeles County and have questions about Medicare or need help resolving Medicare or health insurance-related problems, you can call the Health Insurance Counseling and Advocacy Program at 1-800-824-0780. And the Medicare hotline isn’t just giving bad news. Of more than two hundred people trying to get through the automated answering system, only five got the information they needed. Please press 1 now to exit.

“I yam what I yam and that’s all that I yam, Right Olive?” It looks like the very first super-powered comic character in history may have been on the right track. Popeye got his strength from eating spinach. A recent study published in The Archives of Opthamology reports that spinach and other dark leafy vegetables prevent age related macular degeneration. Other eye problems are also reduced but AMD is the leading cause of blindness in folks between 60 and 80.
In an oddly related story, it seems that poor dentition and dementia have an unexplained relationship as well. A study in England noted that cognitive impairment and tooth loss have a high correlation. (They go together but cause and effect aren’t clear.) There could be inflammation or nutrition factors that create both conditions.
Last week I went on kind of a tirade about hand washing but never said this: Flu is probably carried to your upper respiratory tract by your hands, not from breathing in someone’s sneeze or cough. Advice: don’t touch your face unless you wash your hands first. That is tied for the best way to prevent flu with this: get a flu shot. If your Doctor isn’t giving flu shots, pay the pharmacy students at the corner drug store to give you one. It’s worth it.
So, let me review. Wash your hands. Eat your vegetables. Brush your teeth. Get your shots.
Now lest you mistake me for your mother, Eat chocolate, have a beer or glass of wine now and then and get plenty of physical intimacy. That’s advice every senior can put to use.

I enjoy writing about the lighter side of aging and anyone looking for chocolate after last weeks column should find a soccer player who is raising funds this week. However, my good friend Jeanine Yonashiro is a graduate student in gerontology at USC and reminded me recently that I am in a position to advocate against elder abuse in this space.
She reminds me of the recent news that caregivers for Alzheimer’s sufferers that receive counseling are healthier than those who are unsupported. Since the majority of abusers are family members and caregivers, keeping those people healthy is going to directly reduce the number of abuse cases that occur. Caregiver stress is a superhuman burden and I absolutely encourage those of you who care for a family member or client to seek out help, either from a mental health professional or a peer support group like Leeza’s Place in Sherman Oaks or from a church or religious group in your own community. The important factors are having someone to talk to who won’t try to tell you it’s like when their kids act up, but know what you are dealing with, and won’t be shocked when you tell them how very bad you feel sometimes toward the person who has multiple physical, cognitive and behavior problems.
Dr. Tony Kuo of the L.A.County Public Health tells me that the death rate for dementia is increasing and we don’t have the tools to track it and tell us why. A condition that is still poorly understood in many ways, often managed in isolation and silence, and now increasingly dangerous. How can a caregiver not approach burn-out?
My best advice is to use every resource offered. If the Alzheimer’s Association will pay for respite, take it. If the local hospital gives a support group, go! If your church starts an elder day care, use it. Make a selfish choice now and then. Now I think I need a piece of chocolate.

Once you get a cold, you will never get that cold again. If the virus changes to a new strain, it can then come back and infect you again.
The changes in strain, and the harbingers of where they will move are the factors used to predict what flu shots will be used in the coming year. It is a lot of science and a bit of guesswork that usually does a good job covering most people for a season. Older Adults are a priority population because of reduced tolerance of illness.
I teach a class called Field Safety with a Sheriff’s Sergeant for mental health workers seeing patients at home. My first question is always “what is the most important thing you can do to keep from being physically compromised and harmed working in the field?” Filling your gas tank, having a charged cell phone, parking safely are common guesses. The answer is, of course, “wash your hands.”
There is another factor involved, and one that is disturbing to medicine watchers. When the guys who do this kind of science call people at home and ask “do you wash your hands after visiting the toilet?” 92 percent says, “Yes!”
If you stand around public rest rooms and count the number of people that do wash their hands, you get a different number. 88 percent of women, only 66 per cent of men wash their hands after exiting the stall. Some places are worse than others. A baseball filed in Atlanta yielded the lowest rate for men (57%) but the highest for women (95%) Bless those Southern Ladies!
By the way, those gels they sell now to sanitize your hands are said to actually work better than soap and water to remove germs. But 20 seconds of soap, water and friction are still the greatest advancement in health in the history of mankind. Use it!

Sin ?

There are few topics more controversial than addictive behaviors and the defensiveness an addict or user might display when confronted with his or her behavior. There are many behaviors and substances that people get a habit for and I have written here about gambling, marijuana and some others. Now I think it is time to address a pervasive and misunderstood dependency we all run into in our daily lives. I mean Chocolate.
There are scholarly papers published on the psychoactive, mood altering effects and aphrodisiac properties of the cacao bean. Anandamide is a powerful chemical our brain produces to regulate mood and appetite. It occurs in chocolate. Caffeine is also present. So is tryptophan. The combination of stimulant and sedative effects may produce a unique mental state in a sensitive consumer.
The other effects are from flavonoids which seem to protect the heart and blood vessels. Chocolate, especially the dark variety is not particularly sticky. This means it doesn’t stick well to the surface of teeth. It is not a decay promoter. Phenylethelamine is the chemical that produces the feeling of love in the brain. This may be why the affection for chocolate is so passionate.
There have been a few centenarians who have been fond of chocolate but they seem to prefer the dark variety. The sugary milk chocolate popular in the US may contribute to weight and metabolic problems. Overall though, I would say a daily dose would do most people some good. It isn’t illegal and won’t make driving dangerous.
With Halloween only two months away, it may be time for some of you seniors to start stocking up on trick or treats and begin planning that costume! Don’t be shy, it’s for your health!

movin' on

As regular readers know, I scour the news for information on issues that relate to the seniors in the local community. Problems, solutions and situations to which they will relate. On the other hand… Last month there was a story on one of the news services about a 61 year-old man in Italy who was reportedly misbehaving to the point that his mother, with whom he still lives, cut off his allowance and took away his house keys. When the police were called on to intervene he complained about the food and his meager allowance. Mom complained about the “boy’s” late hours and poor attitude.

In parts of Europe it has become quite the fashion for men to stay in the parents home until they marry in their thirties. I don’t know of too many parallel circumstances in the local population. I know of a few cases where an unmarried son might live with an aging parent to share expenses and enjoy the familiar routine but this is an exception in the U.S.
It was more normal in past generations for the youngest daughter to stay at home to care for the parents in the later years of their lives, and that sacrifice of independence was part of the culture that focused on the family as an ongoing organism. The family was a priority. Mainstream American culture has been more and more concerned with the focus on individual freedoms. The person, not the family is now the central value of the culture. This grew from the framing of the government to serve the people, rather than the people serving the government or crown, as in the old country.

As we grow more diverse, and the assumptions of our culture evolve, we may see an increase in farsighted planning from Asian ancestor/descendant focus, or authority/ responsibility role definition from Middle Eastern influences. Wherever we go from here, one thing seems certain. That Italian guy should’ve moved out a long time ago.

There is a topic I feel it is necessary to discuss here, however because this is a family newspaper, I will do so without saying what I mean. I value openness and one of my missions is to “make the covert overt” but this topic is still a bit delicate. There seems to be some denial in society about where the baby boom came from. If you look at it straight on, it’s pretty obvious that the silent generation was being quiet so they wouldn’t get caught. Now that they are in their seventies and older, we somehow maintain the illusion that because we never saw them being intimate, they weren’t then and aren’t now. The AARP survey done on intimate behavior was done almost ten years ago. They found that older adults think about it quite often, and those who have an opportunity do it quite often. I’m sure that widowed women and men, and those who may have been out of circulation for a long time are as shy, awkward and unsure as any teenager or middle-aged divorcee trying to date without practice. But the one thing we know for sure about humans is that despite whatever obstacles they find, they find a way to get close.
If you are a family member or caregiver to an older adult, keep in mind they need privacy and atmosphere too, and remember my constant advice- take the oldest older adults to community events, how else are they going to hook up?
Now about the issue of concern. Just because you can’t … be with child…doesn’t make you immune to infection. There are some bad bugs out there! Virus that destroy your immune system, the classic STDs are still going around, and evolving into drug resistant strains. Use appropriate barriers to protect yourself and your partner. Get tested. Be safe. For gosh sakes! You’re a role model!

Suicide Statistics

v The Elderly make up 12.3% of the population, They account for almost 17 % of all suicides.

v Suicidology.org Elderly Suicide Fact Sheet

v The rate of suicide for older adults for 2002
was 15.6 per 100,000

v Suicidology.org Elderly Suicide Fact Sheet

v There was one older adult suicide every 95 minutes.
v There were about 15 older adult suicides each day,
v resulting in 5,548 suicides in 2002 among those 65 and older.

v Suicidology.org Elderly Suicide Fact Sheet

v Older white males were at the highest risk with a rate of approximately 35 per 100,000 each year.
v White men > 85 Years old were greatest risk of all age-gender-race groups with rate of 51.1 per 100,000.
v That is 4.6 times the current rate for all age groups 11.0 per 100,000.
v Suicidology.org Elderly Suicide Fact Sheet

v 85% of older adult suicides were male, the number of male suicides in late life was 5.5 times greater than for female suicides.
v Suicidology.org Elderly Suicide Fact Sheet

Suicide Intervention
v Ask the “S” word
v Listen for details…
– Is there a plan?
– Is there history?
– What are their resources?

First aid for suicidality…
v Make a plan for safety based on the details.
v Stay with the person at risk until there is a safe disposition.

It’s always being advised that older adults learn new skills and have ongoing goals to maintain both physical health and prevent mood and memory problems. There are always challenges we meant to pursue when we have the time to devote to a new hobby. They’re talking about a study that was provoked by a new age record for climbing Mount Everest. The new record is a 71 year-old Japanese man. The old record was a 70 year-old Japanese man.
The Professor who did the study was looking at what he called the Kareem Abdul-Jabbar effect. This refers to the phenomenon of a more experienced player using his smarts to compete at the same level as younger, stronger players. Getting smarter with experience gives an advantage! We all compensate for decline in physical prowess with better judgment, improved strategy and more accurate tactics. And there is constant evidence to refute the adage about old dogs and new tricks. It takes longer for an older learner to process words spoken to him than for a younger learner, but having decades of adapting to change makes it more likely an elder has rehearsed a change that a younger person might struggle with as a novice.
Unfortunately this doesn’t seem to apply on the mountain. The common wisdom is that an older climber is more cautious and can afford better equipment. The science shows that less than half as many climbers over 60 complete the climb and more than three times as many older climbers die on the mountain.
Now the reader may take this as a caution against mountain climbing over 60. I will paraphrase a park ranger I heard speak at the Grand Canyon awhile back. Would you rather your grandchild tells her friends “My Grandma died in that old folks home” or “My grandma died climbing the world’s highest mountain?”

Marijuana pt 2

On August 1 a study was published in England that shows an increase for Psychosis among older adults who have smoked marijuana at any age. And it seems that the more you smoked, the greater the risk. They were very careful to eliminate “confounding factors” that would otherwise explain the differences. It comes Well it’s very early in my column’s life span to start retracting my statements but I feel like this is worth mentioning. I was on the fence about the biology of marijuana use in my previous writing, more worried about the legal consequences. I have spent too many hours on the phone trying to find a rehab program for an eighty-year-old man who has court ordered treatment but won’t be able to handle the rigors of a program designed for thirty year olds.
down to this… if you smoke grass you are more vulnerable later in life to getting thought disorders, delusions and hallucinations. You might know someone who has a fixed belief in something that doesn’t fit in the culture and no one else can make sense of. Jealous ideas, people stealing unimportant items and returning them, being monitored by neighbors for unknown reasons or because one is secretly very special, these are delusions. If someone sees, hears or feels something that isn’t there, it’s an hallucination.
The treatments available for psychosis are still a little rough. The older medications will sometimes produce symptoms that look like Parkinson’s Disease, the newer ones often cause weight gain and metabolic syndrome leading to diabetes. These side effects are nearly always preferred to suffering with the symptoms, but they are still unpleasant. My opinion on medical marijuana is shifting. I think the science would suggest using marijuana for a serious, potentially life threatening condition like appetite disturbance and chemotherapy would be worth the risk. The chance it might prevent Alzheimer’s Disease is not worth the risk. Getting high to watch cartoons is definitely not worth the risk. The bottom line would still be the same as my previous writing. It’s a bad idea to drive to bingo with 200 pounds of smoke in the trunk of your car.

I read the other day about the benefits of weight training for older adults. The study suggested that doing resistance training can be good for you at any age, even after a heart attack or other health challenge. Meeting goals of being able to lift a grandchild or do the gardening are the reasons cited. High intensity walking is touted as a preventive for high blood pressure and to tone the thigh muscles. Another article talked about an 84 year old woman who made her first parachute jump.
Having a goal to work towards is important for any age. When the usual milestones of ambition have been passed, it might be hard to identify those goals. I saw George Burns when he was 99 years old. He had a goal of working in Vegas on his 100th birthday. He lived to 100 but wasn’t able to work, and passed shortly after. I met a man a few years ago who had quit smoking at 105 years old, I suppose not wanting to shorten his life. There are annual stories of yet another group of elderly ladies posing for a nude calendar to raise funds for charity. There are always new things to achieve, but if “survival” is the only goal, it is the one thing we all ultimately fail to do. A concrete, measurable, reasonable goal is most likely to keep you motivated and progressing.
In that theme, I will repeat two more headlines published on the same day. You decide if they are related. “JAVELINS KEPT AWAY FROM TRACK FOR SENIOR CITIZEN EVENT” & “ WHEN TO LET GO? MEDICINE’S TOP DILEMMA.”

I see a lot of information from my clipping service on keeping memory sharp by working puzzles and learning new things. The advice seems to be related to doing sudoku and other recreational activity. I would like to propose a different strategy for stimulating the minds of the older adults who read this. I often see a widow or widower who gets into some financial difficulty because their mate was the house bookkeeper. They may have gone thirty or forty years without using the checkbook. Now they have to try to rediscover the system at the worst possible time. It might be a good idea to switch jobs every few years so everyone in the house knows all the tasks.
I know how territorial people can be about these things. There’s the story of the accountant who retires then finds his wife has rounded off the checking account for thirty years and now that he has the time, he goes through the entire account history to rectify the account. After weeks of calculations he announces proudly that he has finished the job and discovered her balance was off by sixty-two cents!
Working the dishwasher and other appliances may have become (or always been) a mystery to your spouse, where is the air conditioner filter? What is that brush for next to the toilet? Who takes care of the tire rotation, oil changes and wiper blades? The risk you take by not knowing is the potential dependency on a paid money manager or family member to write your checks every month to keep the cable on.
Some folks just learn to golf, and that’s a fine way to keep yourself alert and oriented. It would also be a good idea to prepare for a time when you might have to do for yourself, because your wife is playing in the Master’s Tournament.

I’ve had two occasions this week to be reminded that for perhaps the first time in history, there are four generations occupying the workplace. An article in NurseWeek magazine and a workshop at the LA County Multicultural Conference in Pasadena.
The newest workers are often referred to as Millennials, or “Generation Y.” They were born after 1980 and before 2000. The Y would be to point out they follow Generation X. Gen X was born from 1965 to 1980. The generation we hear so much about these days is the Baby Boomers, born after 1945 up until 1964. The oldest workers are from “The Silent Generation” or “The Veterans.”
The commonality of the veterans and Millennials in family orientation catches my attention- both had challenges in their upbringing that brought them to marry carefully, avoid divorce and unplanned births. Both have higher difficulty in getting college education than those between. Availability of opportunity was the barrier for one; incredible expense is the barrier for the other.
The thing that in many ways defines the veteran generation is their experiences in the world wars. In being called on to do a hard thing that was clearly the right thing in the minds of nearly everyone, and being acknowledged for doing so. We baby boomers may have had significant war experiences but my peer's Vietnam was different from my fathers’ Korea. The honest, obedient, steadfast, durable stereotype holds true more often than not.
On Saturday, May 26, County Supervisor Antonovich will be hosting a Veterans Celebration at Arcadia Park. It gives us a chance to learn about the veterans who have survived, and to memorialize those that died in service to our country. I hope someone remembers my words from a few weeks ago and takes an elder to the park, to see the skydivers, to get a free haircut, to wave a flag the way many of us baby boomers might find a bit embarrassing.

I’ve had a few words on medical issues in the past weeks and thought I ought to be mindful of the most common and dangerous health challenge older adults may face. Heart attacks occur in about 1.1 million adults every year and 45 % of those are fatal. Most of the fatalities occur in the first hour, and before reaching treatment. It’s in everyone’s best interest if the person having a heart attack goes to the ER right away. The early symptoms are Chest Pain and discomfort, the pain or discomfort may spread to other areas like the arms, shoulder, back, jaw or stomach. Sweating, nausea and dizziness are frequent. One factor that confuses things is the difference in women’s symptoms. The pain may be different, there are more often the other signs with women. If these last more than just a few minutes, call the EMS (911). Your family will do much better if you get early intervention. Waiting may allow cardiac arrest to occur.
It’s a good idea to hang around people who know CPR and if you aren’t confident in the folks around you, know that any CPR is better than none. If you have a chance to learn how to use those new defibrillators (AED) it’s a good idea to do so. You know what to do to prevent a heart attack, first- choose the right parents. Next – don’t start smoking. If you didn’t already do these things, it’s never too late to improve you cardiovascular status. Especially if you still smoke, it costs too much, smells too bad and people like me nag you too much. Your cells start to recover on day one so every time you make an effort, it helps, and you get better at it each time so soon you’ll quit for good. I did it so I know you can too.

I wrote awhile back about a Leticia Garcia in Arizona and her bingo bust. She was running marijuana to finance her gambling and so she gets a recurrent role in my column for having so many issues (law, drug, betting.) I wrote about the legal and drug issues already. Let’s see what we know about the gambling problem.
There is an American Society on Aging training that includes the following facts:
An estimated 65% of the $3.7 billion profit by Atlantic City casinos in 1997 came from the pockets of people over 60 (New Jersey Helpline).
Older problem gambling has devastating results on lives, including loss of a lifetime of saved income, and suicide.
Americans gamble more each year than they spend on groceries ($600B+ annually) (US Bureau of the Census, 1997).
Older adults now form the largest group of annual visitors to Las Vegas (The Las Vegas Convention and Visitor's Authority).
Between 1999 & 2003, calls to California problem gambling hotlines from older adults increased 25% (California Council on Problem Gambling).
Between 1975 and 1998, the over 65 age group experienced the greatest increase in gambling, both for lifetime (from 35% to 80%) and for past-year (from 23% to 50%) (Gambling Impact and Behavior Study, 1999).

Older adults are healthier, wealthier and expect more entertainment than previous generations, maybe because they are less likely to live with family members, maybe because they have the same response to advertising pressure as anyone else with a TV. Availability is the biggest factor in gambling becoming a problem. If a casino opens nearby, if your state has lottery, racetrack or card rooms, all make it more likely the locals will spend their money on supporting “the house.” There is a reason the casinos in the desert send buses to pick up seniors in LA. It’s not because they want to show you a good time. They want all your money!
Lotteries and larceny is at the heart of a second huge problem for older adults. There are crooks out there calling, writing and emailing large numbers of older adults to find just a few who will send the supposed tax payment or some other deposit to receive a huge payoff on the Irish, Canadian, or some other non-existent prize. There are no international lotteries that you entered without knowing it. There are laws against selling them to you if they did exist. It’s a trick.
The challenge is to complete the quote I started earlier. Healthier, wealthier and…

A problem that concerns older adults more than the rest of the population is falls. Some of the reasons that falling is riskier for an older person are changes in both soft tissue like the organs, and hard tissue like bone. My Girl Scout troop is tired of me harping on the issue but I tell them frequently that they only have till age twenty-five to build their bone bank. After that they start to withdraw calcium and lose bone strength. For an earlier generation that may have avoided whole milk for weight control, had a cultural avoidance of high impact athletics for girls, and have other risk factors for osteoporosis, a fall can mean broken bones that require joint replacement or extended healing time. Another complication is the loss of water in soft tissue causes the organs, including the brain to lose volume. I don’t mean your intelligence shrinks, but the brain doesn’t fit as tightly in the skull anymore. If you bounce the skull, the brain has more room to bounce around in. There may be slow bleeding, sometimes related to medication to prevent strokes and heart attacks. I’ve known of older adults with a head injury to get symptoms weeks after a fall because it took that long for the bleeding to cause problems. Early medical treatment is the best way to prevent long term problems.
There are some steps you can take to avoid falls. The Academy of Family Physicians recommends removing hazards like cords and rugs and keeping things lit at night. Elder friendly design like low shelves and hand rails help too. An often-overlooked risk is new eyeglasses, especially bifocals that can confuse the depth perception on stairs and uneven surfaces.
If you know an older adult try to offer to change light bulbs, air conditioner filters and do other chores that require climbing and reaching to prevent this kind of problem. If you are an older adult and have been told to use a cane or other assistive device, it’s a good idea to follow the advice. And a nice walking stick can be a very dapper accessory.

I do a lot of research for my job and this column on the internet. One day in November this news popped up from Healthday, “Seniors Need Exercise.”
No kidding! The computer makes the obvious almost seem scientific!
The real science confirms it. A study at the University of Florida, Gainesville compared seniors who were taught about healthy lifestyles and seniors who had an exercise program. Folks who actually got out of their chairs and worked out had more independence a year later. It isn’t just better wind either. University of Wisconsin studied 4000 older adults for exercise and found those who did the equivalent of climbing six flights of stairs every day had a much lower incidence of macular degeneration- a major cause of vision loss in late life. Exercise is known to be both preventative and reparative for depression too.
Walking, even slowly, seems to be the best general exercise, especially for obese people according to a University of Colorado Boulder study. Even Johns Hopkins has published a study on older adults and walking. Dog owners who walk their dogs are more likely to get the recommended amount of exercise- 150 minutes per week according to the U.S. Surgeon General. It’s the walking, not the dog.
At the University of British Columbia they made another amazing discovery. Older adults prefer to exercise alone, with instruction, instead of in a group or class like younger adults. Who would believe people in their 60s and 70s don’t want to be surrounded by spandex wrapped 20 year-olds when they work out? A big difference is the body building culture. DHEA and testosterone, supplements and hormones are used to enhance athletic performance. But they don’t work on what the Mayo Clinic doctors called “elderly people.” They don’t improve strength, or physical performance on any measure for older athletes. There are other differences in sensation and tolerance as we age. The important things to remember are to get and stay hydrated. Older athletes don’t manage water balance as well as younger people. And if you hurt, if you feel faint or dizzy or short of breath… STOP. Rest. If you don’t recover quickly- call for help. But do find an activity that suits you, and just do it!

How are you? It’s a question we all ask but we usually don’t wait around to listen for the answer. If you are a vulnerable senior citizen and someone is abusing you, how can you get someone to listen? In the recent violence at Virginia Tech, discussion about prevention revealed that if teachers take a few minutes each day to chat with students, they hear about the problems that lead to violence and prevent these events by the dozens!

When we teach a class for first responders- firemen, paramedics and police- on how to recognize an older adult that needs help from non-emergency services, one question that needs asking is “Has anyone hurt you?” The answer might be non-verbal but you usually get a clear answer. Most reports to APS are for self-neglect but when someone is abusing an elder, it is most often a family member or caretaker. It may be hard to imagine but it should be easy to recognize if you ask the right question.

Health care workers and anyone whose job is to provide care or services to older people are mandated to report suspected abuse, but anyone can make a report. If the older adult lives in a skilled care facility or convalescent hospital, the Ombudsman should be called. If they live in the community, as most do, APS is the proper agency to get the report. Law enforcement agencies will cross report elder abuse as well.

We know that the problems of youth respond to this intervention, to asking, “How are you?” Kids are in school, older adults are everywhere. A civilized society cares for it’s elders and we can all spread civility by asking, and by listening to the answer to the question “ how are you?”

RESOURCES
Los Angeles County Department of Community and Senior Services
(877) 477-3646(877) -4 -R –SENIORS

Night out

This week is the 24th National Night Out, when across the country citizens make a point of showing criminals that we will not live in fear, will not surrender the streets to the bad guys. It is somewhat concerning that on the street where the event is to be held, there have been two violent crimes against African American youths in the past months. The protest is in the very heart of need here in Temple City. I meet with the District Attorney’s office a couple of times a month and the Deputy DAs I talk to work in the Elder Abuse Crimes Section. The older folks that seem to become victims of crime are not walking late at night and getting caught up in inter-racial violence, they are often sitting home when someone comes to offer repairs and ends up working a confidence scheme. I absolutely encourage the Older Adults in the community to attend on Tuesday night and take a stand against crime. I encourage younger folks to offer to take an elderly neighbor to the park for a hot dog and movie. Leave your porch lights on as a sign of solidarity. But keep in mind; the battle is in guarding against someone new wanting to do too much, asking for your checkbook, talking about power of attorney. Becoming like a son or daughter too quickly. A healthy older adult learns to shift attachment often because the longer you live, the more times you have to make new friends. A healthy older adult also knows that protecting your estate and property is a job for professionals, not the guy who mows the lawn.

t-con cerns

What is a conservator? Who can be placed in a conservatorship? These questions are on many senior’s minds but it may be hard to find the right person to ask.
A conservatorship is a legal relationship in which a Judge make a second person responsible for the Estate or the Person of another. There are a lot of different powers the Judge can grant the conservatorship in a probate court. The conservator may have the legal authority to sign medical consents or contact on behalf of the conservatee. If the conservator ship is granted in mental health court, there are some big differences. A LPS conservatorship must be renewed in court every year or it lapses. A Probate conservatorship is permanent unless revoked in court. The person has to be found to lack capacity to make decisions for himself. Sometimes because of an accident or illness, sometimes because of specific changes from a dementing illness. Someone has to request the court to grant the powers to another person and the person has a lawyer appointed for him called a PVP attorney. Both parties fees can be charges to the estate of the conservatee so it becomes a bit costly. If the person is vulnerable to undue influence or unable to keep their household running, it may be a life saving intervention. The conservator doesn’t get to do whatever he wants with the estate- hecan only use oit to take care of the person, with fees charged that are reviewed by the court. If “dementia powers” are granted, the conservator can give consent for psychiatric medication and may place the person in a higher level of care if needed.

Grandpa Sam

In Fresno I have a granddaughter who has another set of grandparents, Sam & Nina. Grandpa Sam is pushing 90. He is a retired cop and although generous and civil, he’s never been a really warm guy. Nina called me a few weeks ago to ask what she should do about Sam, as he seemed to be getting confused. They had made an appointment with a neurologist to have him evaluated. I saw Sam at a recent visit and noticed he was friendlier than in past years. He was warm. He asked a lot of questions about our drive, about the kids, about the drive, and about the drive. Nina said he had started to get lost just after that and he was having periods of disorientation and forgetting.
Since Sam had a quick decline in function rather than a long, step-wise change, I told Nina a Geriatrician might better diagnose him than a Neurologist. If it’s not a specialty you’re familiar with, think Pediatrician-Geriatrician, a Gerontologist studies in the field of sociology, not medicine. I told her to be sure they did a Chemistry Panel, Blood Count, B12 and Folate levels, Urinalysis and chest X-ray. Urinary tract infection or pneumonia are the most common causes of rapid change in mental status for older adults.
Nina called back after a few weeks to let me know after the work-up a little sub-lingual vitamin B12 had fixed Sam right up! He didn’t have Alzheimer’s, or a stroke or any of the things everyone was expecting. Absorption changes in the gut with age and injections of vitamins aren’t always the remedy. See your doctor if you think you may be having changes in mental ability and expect some silly requests like drawing a clock. Those are some of the most important screening tools used. If there is an immediate change in mental orientation in an older person you know, ask the older adult to repeat a simple sentence, smile and raise both hands. If they suddenly can’t do those things, call 911. The first hour of a brain attack is the most important for full recovery.
I hope Sam’s still warm when we go back next visit.

but baby it's hot outside!

As the weather gets warmer I thought it would be a good idea to review some heat related problems. As we all know at some level, when the body ages we store less water and more fat in our tissue. When we exert ourselves, the body sweats to cool itself. Since it’s June I should say that brides glow, they never sweat.
It takes a loss of only 2% of our body’s water to make us dehydrated and insatiably thirsty. Unfortunately for the older adult, that 2% loss is more likely to be reached than for a younger person, because of the water: fat ratio. Some strategies for managing bathroom visits whether at night or when traveling can increase the risk of dehydration as well. Medications for blood pressure can change our water balance and other medication can make it harder for the body to manage temperature changes. Ask your pharmacist if you aren’t sure about your meds.
Heat exhaustion and heat stroke can occur with exertion, heat and dehydration. The skin might get red, sweating may stop, nausea and vomiting can occur. Headaches, dizziness fainting are all signs of heat related illness. The victim can also become disoriented and confused. First aid is to cool off the body, rest and take fluids (/2 glass, no alcohol or caffeine,) if the body temperature is high, or the person isn’t responding to directions, activate the emergency medical system (911). Taking salt tablets is generally not a great way to avoid this condition, only do so with medical supervision. It is much better to dress for the heat- light colored clothes that increase evaporation, take frequent rest breaks and do heavy work in the coolest part of the day. And if you must go out for a mid-day stroll, wear a hat or use your parasol!

Relax

One of the more alarming things I run into with older adults who are aging in place and living alone is the prevalence of anti-anxiety medication in their medicine boxes. About 6% of older adults have a bona fide anxiety disorder, many more than that use these powerful medications to keep from crawling out of their skin from fear, nerves and worry.
Is there some way to be more comfortable without taking more medicine? Can I learn to lower my blood pressure with practice? It may not be covered by your HMO, but the answer is probably “yes!” Most of us have read about chemicals that occur in the brain called endorphins. We may know that they can reduce pain and relieve tension naturally. It may be difficult for some older people to engage in the activities that are often connected with these chemical events like aerobic exercise and meditation. You may believe that deep states of concentration are needed to trigger a relaxation response but it really isn’t that hard.

One thing we all learned to try to control our feelings was counting to ten. We usually counted the wrong direction. Instead of counting up to ten, try counting down to zero. If you close your eyes, try to visualize the numerals in your head and lower the tone of your voice as you count “10, 9, 8, 7, 6, 5, 4, 3, 2, 1, 0.” If you can see the numbers, next try to shift the color form red to orange, then to yellow, green blue, indigo and then violet and black. Let the energy of your tension and pain dissipate in the darkness of the zero. Then count upwards to come back to alertness without the discomfort. It may take a few tries to get comfortable with this, go slow, but do go!

Dr Herbert Benson at Harvard Medical School has taught many of his patients to use techniques like this to get control of their own bodies and reduce their dependence on medication. If you are in chronic, severe pain, special training and equipment might be necessary but for most of us with normal aches and nerves, it just takes a little trial and error to use your mind to help and heal your body. Dr. Benson has written a number of General Interest books on the topic, starting with The Relaxation Response.

Driving Safety

A few years ago 86-year-old George Weller drove through a crowd in Santa Monica killing ten people and injuring dozens more. It started a national debate on older drivers. This is an update of material I used in a presentation at the LA County Law Enforcement -Mental Health conference given in 2005. The information came from the AAA and AARP websites.One worrisome fact from the Institute on Highway Safety is that driver’s ages 65 and older have higher crash death rates per mile driven than all but teen drivers. But then a study of crashes involving older drivers in Wisconsin found that drivers ages 65 to 74 did not pose a greater risk of serious injury or death for others than did younger drivers. The danger from older drivers is only to the driver- not to others on the road. Frailty would seem to put an older person at greater risk in an accident than someone younger and heartier.Although older adults represent 14 percent of all licensed drivers, they are involved in only 8 percent of police-reported crashes and 11 percent of fatal crashes. This can be compared to drivers age 16 to 24, who are involved in 26 percent of police-reported crashes and 26 percent of fatal crashes, but represent only 14 percent of licensed drivers. So older drivers are kind of under represented in the more dangerous outcomes.Research shows that individuals who must stop driving experience "lower life satisfaction, poorer adjustment, loneliness, and lower activity levels...." so in looking at the issue of protecting the older driver- stopping him does more harm than good to the driver, and he isn’t that dangerous to the public.In California- At age 70, mail renewal is prohibited. This is one of the few age discrimination laws that we allow to stand. Formerly only a doctor could report to the DMV and his report would almost automatically cause the driver to lose his privileges. Now anyone can send in a form that will trigger the DMV to consider examining the driver for ability to drive. It isn’t automatic. It’s a mark of independence in Southern California to have a car, and drive it yourself. It may not be the highest good our culture promotes. In many other areas most adults use public transportation most of the time. It’s good for traffic, good for the environment and getting relatively cheaper as gas prices skyrocket. Dial-a-ride, Goldline, ride a bike! If you stop driving- buck the trend get out, get busy, have fun. If you are a younger adult, find out who the older folks are in your neighborhood and take them to events, ballgames, plays, and ceremonies. The oldest of the old should be included in every event in your community because that is the most basic gesture of respect we can give them

Marijuana

A few weeks ago I mentioned a lady in Arizona. A grandma who was convicted of drug running to support her Bingo habit. I will bring her up again when I write about problem gambling but today I think we should consider the other aspect of her story. The marijuana she had 214 pounds of in her car trunk.
Some recent studies suggest the active ingredient usually targeted in marijuana- THC – interferes with the breakdown of acetylcholine in the brain. That’s what drugs like Aricept do to treat Alzheimer’s type dementia. Heroin seems to cause the kind of tangled cell structures that are another characteristic of Alzheimer’s.
Marijuana advocates claim medicinal pot has beneficial effects on appetite, pain, nausea and other symptoms and side effects. Medical expert respond that there are approved medications that are more effective for those symptoms. There isn’t a good body of research to prove either point conclusively.
I’ve met and treated a few old pot smokers. They seem to have the same problems and strengths as other older adults. The issue that concerns me is the contact with the underground and sometimes criminal element that supplies the pot to them. Last winter Associated Press carried a story of a 92 year-old woman in Atlanta who had a search warrant served at her home. The police kicked down her door to try to find drugs they had good cause to believe were there. Kathryn Johnston shot three police officers before they returned fire and she was killed. She certainly didn’t die from pot smoking, but drugs were a factor- whether they found them or not. In On the Road, Jack Kerouac records the popularity of marijuana in the 1930s and 1940s. It’s not new. My caution to you Dear Reader, is this- as long as there is a war on drugs, stay as far away as you can from the war zone. If you know an older adult who is struggling with a drug problem, let them know they are not alone, they can get treatment and they can get their life back. If you or someone you know uses an herb, supplement or over-the-counter medicine, it’s important to let your doctor know. It makes a difference in what treatment they can safely give you. And don’t buy anything out of someone’s trunk at a bingo game.

First considerations

Although I’ve been working with older adults as a nurse and counselor for quite a few years, in starting to think about this column I decided to go through my files to see what folks in the 60 and over age group are up to these days.
Last October I found a story from Omaha about a 68 year-old man who fought off two teenage robbers, one of whom had a gun. As impressive as he was, a year before that I read about a 73 year old grandfather in Kenya who killed an attacking leopard – barehanded! They might have been a good match with R. E. Johnson, a 76 year-old retirement home resident in Davenport Iowa who was arrested for fighting in the smoking area of the home – with an 81 year old woman.
I wonder if Johnson might have been represented by Allen Stewart. Stewart graduated last fall from law school in Australia, after his 91st birthday. Mr. Stewart finished the 6 year program in only 4 ½ years stating “time is of the essence.” He might have seemed precocious to Nola Ochs in Kansa. She took a break from studying for her final exams to celebrate her 95th birthday n 2006.
The serious side of the legal issue came up in the summer of ’06 for Lena Driskol in Georgia. The 79 year-old defendant couldn’t get a jury of her peers while on trial for killing her boyfriend. The exemption age is 70 in her home state and the panel ended up with an average age of 30. Feeling comfortable with sitting in judgement on an elder was one of the barriers in selecting the jury.
The trial of Leticia Garcia in Arizona this January didn’t present that challenge. Mrs. Garcia was arrested on her way to Bingo in Tucson for having 214 pounds of marijuana in the trunk of her car. I will refer to Mrs. Garcia in a future column on gambling since that was her motivation for running drugs. Remind me to leave James Wilson out of that one- he won $254 million on Powerball this year. He’s 84 but his wife is only 79. I guess that’s a happy couple.
Speaking of married couples, there’s Nobel Prize winner Chen Ning Yang in China. He’s 82 but engaged to a student who might be reflection of himself- she’s 28! They don’t hold a candle to Muhammed Mesa in Malasia and his wife. He’s 33 and she’s only 104! You might suspect someones being taken advantage of though, it’s his first marriage but she’s had twenty husbands before Muhammed.
And we saw Elsie McLean on TV in April- at 102 the lady golfer hit her first hole-in-one. George Blevins in Richmond Indiana bowls rather than golfing. He’s been practicing… for 93 years. At 100 years old he has a 151 average. That might not impress Esther Meley in Centralia who rolled a 244 game at 94 years old, but then Esther is legally blind!
So I undertake the task of writing about my elders, without assuming they are elderly. With respect, affection and perhaps a drop of fear.