George Francis died at 112 years, 204 days this week. The oldest man in America is now Walter Breuning of Montana at 112 years 98 days. The oldest woman is Gertrude Bains right here in La County at 114. Many people I talk to about longevity question why anyone would want to live so long. It sems like an odd question to me, it carries assumptions about aging that I need explained to me over and over. It reflects someone who may not be looking forward to whatever is coming next. George Francis had a reason to live this long. It was so he, as an african american, could vote for the first african american president in history. He seemed to value his vote, he used it for Franklin Roosevelt in the 1930s. He was in the world. He participated. If you think you may not want to live to 112 years, think about one thing that you do want to live for, to do, or see, or say. Then work on how to get there. It helps to write down a goal. It makes it more real in your mind, it keeps you from forgetting and gives you something to cross off when it's accomplished. I'm not asking for a new years resolution, just name a goal you already have. Write it down. Take a step.

Economic woes, Prop 8 fight goes on, Fires and Floods, Oh My!
I didn't do a Thanksgiving column this year , but I would like to take a moment to say thank you to my friends, and family and co-workers. If I didn't already know what George Bailey had to die to learn, it would not be a such wonderful life. And if things did not take time to unfold, then everything would happen at once.
I would often tell the story of Noah and the Ark to my daughter because I knew she would hear it from the disreputable kids at school. (I mean the Church goers) and I wanted her to know what it meant, not just a cute boat full of animals. The meaning I pointed out to her is that the rainbow was created by God to show that he would never destroy the world again. It was a message of safety and forgiveness. I try to weave this into the Christmas Story as well, that the reason people get so excited about Jesus was his promise that every person was forgiven and all could go to heaven. Period. She hears a lot of drivel about the conditions in small print, and I tell her those are lies. Everyone. Period. I think that makes a much better story than Homos can't go because it says something obscure in book so and so, but ignore the part about eating shrimp or pork because that doesn't count anymore.
If you're a christian, and trying to figure out what that means you're supposed to do, start with this. What if everyone was forgiven. If you didn't have to do anything? What would you choose to do? Consider the lillies of the field, go forth and sin no more. And have yourself a merry little Christmas.

I was interviewed for a public radio show this week about disaster relief with older adults. As is the deal with any reporter, they have a vision of what they are going to report in their story, then find voices to fill out the piece they are going to do. What the reality they find turns out to be has little effect on the final story.
I was challenged to convince the producer that older adults are not feeble victims of the elements, but experienced veterans of bad stuff. They have resilience and strength because of their age, because of the disasters and emergencies in the past.
I told her how middle aged people were devastated by losing everything they had. How they just couldn't imagine how they would go forward. And how older adults were more likely to be a resource and have the confidence that "we can get through this."
Not many depression era elders are overly impressed by the current economic crisis. When the economy failed in the 1930s there were few social programs, there was no safety net. Now a days, we have a lot of help. We won't starve, except for lack of asking. If you happen to be one of those folks who feel like all is lost, find a senior citizen to talk to. They just might set you straight.

So this guy turns 80 years old in Minnesota , not such a surprise. He gets a birthday card, still not such a shock. But wait…it was from his third grade teacher! Now I got your attention!

Hobart Anderson was in Colette Hartung’s classroom seventy years ago and when she saw a little item in the paper about his upcoming celebration she thought she would surprise him. I generally don’t recommend surprising octogenarians but I guess ninety –something year old school teachers can get away with anything.

For long time readers of this column/blog/rant, I heard some bad news today. I started writing by retelling news stories of exceptional older adults. One that has stood out for me as The Senior was Edna Parker of Indiana. Mrs. Parker died last Wednesday at 115 years old. She was preceded in death by her husband 69 years ago! She was not the type who gave advice on longevity like drink a beer everyday and don’t smoke. She encouraged education among her offspring which included 13 great-great-grandchildren. The odd parts of a story are the parts I enjoy. In August another noteworthy woman died at the same facility as Mrs. Parker. It was 7’7” Sandy Allen, Guinness’ record holder as the worlds tallest woman.

Two other bits of news are brought to mind by this story. One is the benefit that older cancer patients receive if they get home care focused on rehabilitation. Exercise and activity that younger patients may get from the need to return to work or other social pressure may leave older patients at risk of losing functional ability and increase the need for moving to a nursing home. The other story is a report in the United Kingdom of the difference in the wishes of older adults at the end of life to die at home, and the reality of the larger number whose end comes in a hospital bed. They are trying to sort out what factors create this disregard for the persons plan. Because of the system of public medicine in England, the factors we might expect in the US are less likely to control, such as hospitals billing higher technical support making money on terminally ill patients. The factors they have identified are age and medical condition. The part I’m interested in is that 56-75% of brits state they prefer to die at home. I will look for US figures to compare.

I was at the Oakridge Mobile Home Park in Sylmar this week doing disaster operations and relief work with the residents whose homes had burned in the wildfires last week. There were over 400 homes burned to the ground. These were not Earl and Joy’s trailer, these were huge, beautiful well maintained mobile homes. One couple had just finished redecorating with granite counter tops and new carpets, walls and fixtures. “It looked like Hawai’i inside” I was told. One woman in her eighties was just standing in front of the brick steps that had led to her front door. “I think this was it, that was my patio.” She said, looking at the drooping debris that had been a table and chair.
Another octogenarian who had survived the bombings in Europe in WWII said this is what the neighborhoods looked like then. “A war zone.” She and her daughter had both lost homes. They drove out the night of the firestorm with dogs and kids, slept in a supermarket parking lot so they could use the facilities and only made it to the shelter after about 28 hours. I talked with at least two dozen families that each had one phrase in common -”we lost everything.”
Some had a chance to take pictures, jewelry and papers with them. Some were back to comb the ashes for wedding rings and coin collections. All felt the same sense of being completely with out an anchor point. Nowhere is home to them right now.
The thing that impressed me most was the work being done by one particular group of helpers. Although the LA Fire Department, the Forestry service, State Police and CERT, Mental Health and Children’s Services, Red Cross and many, many others were looking for any way to ease the terrible shock for the residents, one group stood out. The Salvation Army volunteers set up a tent, drove around the grounds and asked each person there if the needed water, masks (the ash and dust were choking) chap sticks, gloves hats, food. They didn’t say they were from a church. They didn’t try to impose any process on the residents, helpers or other workers (like the cable and utility workers.) They just offered comfort of the most basic kind.
After the Prop 8 struggle with organized religion I am surprised to hear myself say this about a church. Any charity money you need to find a place for, think Salvation Army. I know that the California Senior Senate and other groups are certainly worthy and do great work. I just have my attention on those who find a way to give to people who have literally lost everything.

Deciding to place an elderly family member in a nursing home is often the hardest decision an adult child can make. Sandwich generation caregivers with children or grandchildren at home who are also taking care of an aging parent can reach the end of their rope, forced to choose who has to leave. I am sympathetic with the struggle yet feel I must contribute to the dilemma with information that can only make it harder. Two news items this week are factors. The Wall Street Journal reports that 15 states are cutting IHSS funding. This is the Medi-Cal (Medicaid) funding that pays for caregivers to come to the clients home to provide for the activities of daily living that they are unable to do for themselves. This includes cooking, cleaning, bathing, toileting and medication management. Folks with just a little need may only get a few hours per month, while someone totally disabled can get fulltime care. It lets those who choose to age in place get the help they need to do so. Family members are often the provider and so it can help extend the extended family living situation. It costs less than half as much to keep a person at home with this level of care than to go to a nursing home.
The other article was a study done in the city of New York on older adult suicides. Apparently the rate of suicide is dropping among community dwelling older adults.
The surprise was that the rate of suicide among nursing home residents did not decline from previous surveys. There is a difference in method among the two groups, community living elders are more likely to use guns, where as nursing home residents, who may have access barriers to firearms, die from ”long falls” most often. I had been under the impression that carbon monoxide was more frequent than jumping, but at least in New York it isn’t.
So it is becoming harder to keep a failing senior at home, and the risk of death is even greater in skilled care settings. These are reasons that I recommend a care giving family member make use of resources like Leeza’s Place and the Alzheimer’s Association. Feeling like you are all alone and desperate make it all the more likely that the choice to place will be made earlier than if a caregiver has a support system.
Los Angeles Caregiver Resource Center at USC: (800) 540-4442, www.losangelescrc.org
Alzheimer’s Association: 24 helpline (800) 272-3900
Leeza’s Place: ywyte@leezasplace.org

Sometimes I wonder if I’m the only one interested in stories like the one out of Chicago this week. It seems the brain scientists in Northwestern’s School of Medicine have determined that the brains of people who maintained sharp minds into their 80s have just as much beta amyloid plaque on the outside of their brain cells as people with Alzheimer’s disease. This was thought to be a mechanism of function lost in AD. The difference is in the neurofibulary tangles inside the cells. Little messes of protein that accumulate and eventually bust open the cells causing the atrophy that eventually shows to gross exam is what makes an AD brain different from a “super aging” brain.
One of the interventions that has shown poor response is using anti inflammatory drugs like Ibuprofen that will prevent the plaque forming from starting, but hasn’t had an appreciable effect on memory loss. This explains why- it wasn’t the plaques that were the problem.
Now what does one do about it? Well, memory reserve is the next big thing. What one needs to do to prevent memory problems in our 80s is go to college in our twenties. Education is the best prevention. When I signed up for geology and Japanese at PCC there were people who asked “what are you ever going to do with that?” I guess the answer is “act as your health care surrogate.” One of the exercises that seems to have the most late onset benefit is doing internet searches. Googling and yahooing can keep you young. Just remember to get up and stretch.

An Australian study that provides a direct link between positive mental health measures and falls in older adults was published and reviewed at www.medicalnewstoday.com. They found that the more often an elder responds negatively to questions about depression, morale and control over their lives, the more likely they are to have a fall in the next eight years. Falls are one of the leading causes of death and hospitalization for frail elders. They separated out factors like medical conditions and poor balance. Mood is a life preserver. So when an older persons doctor asks about trying an antidepressant medication, or going to counseling, it may make the difference in that patients quality and length of life. Since the weather is changing and wet, cold and wind are certainly fall factors, it’s time to review what we’ve said here before. Exercise is the biggest thing you can do to improve your chances of avoiding and surviving a fall. Walking, gardening, sex and using the Wii are great ways to get balance improving work outs. Bifocal glasses can put you at risk for falls, as can riding the escalator. Drink in moderation and avoid smoking, especially marijuana. I notice people getting knocked around a lot at the protest marches so I recommend older adults avoid those, but do send a representative. See you back here soon, remember to check out our advertisers!

Can I talk about anything else? Is there another issue in the world? Of course! Did you know the average income for gay men in Canada is 12% lower than for straight men? Even though they have higher education levels and are more likely to live in cities than straight men. Lesbians in Canada have a 15% higher income than their straight counterparts, living in the same urban locations and enjoying the same high education levels as gay men.

This study was done by the UC Irvine School of Business and is consistent with studies of US gays. And they can legally get married up there! Please remember to get out and vote on Tuesday, even if your candidate is winning by a landslide, the rest of the country isn’t voting on my proposition of preoccupation. Your vote is needed to put Prop 8 down for good.

If you have doubts about who is lying, I keep getting signs stolen off my lawn and Yes on 8 hacked into the No side's web site to block donations. Theives and cheaters. liars

I went to the local Baptist Preacher's blog and wrote something mean aabout the Yes on 8 crowd. I said they were idiots. I want to apologize. To idiots. I wasn't thinking. The issue that provoked it was the constant barrage of TV ads. Every kid in California has had more hours of gay wedding ed. from "their" commercials than they ever would in school. So, I'm sorry to all the idiots out there, I didn't mean to color you with hate like the Yes on 8 crowd.
Also- Lying with another man is an abomination in Leviticus, so is eating shell fish. In Deuteronomy it's sleeping with your ex-wife. Get over it, Jesus don't like you stoning that adulteress, or those gays.
And nothing in the old testament against Lesbians, is there?
If you look at the ads over there on the left, you might see ProtectMarriage.com.
Don't hesitate to click on the ad, they have to pay me if you do. If you can stomach going through the web site, find where to add your name to the list of supporters, then put Hannibal Lechter or Charlie Manson. It's fun and good for the environment!

I spent a few hours last night working the phone banks, calling voters to ask them to vote No on prop 8 in November. It was very nice to find more folks taking a stand for freedom and fairness than the few endorsing prop 8. The vast majority of course were "not home." I've been "not home" alot lately too. I think this issue is too important to duck out of the conversation though. The other side on this seems to be too wicked to let it go. From the tactics of stealing my NO on 8 lawn sign (on Sunday morning!) to the violence against children prop 8 leads to, it just needs to be stopped.
Some folks have a little trouble following the violence against children, and death of children trail. Proposition 8 will make gay and lesbian people less than straight people in the eyes of the Constitution of the State of California. They won't have as many rights as other people. Like pets. So when you can't kick a citizen, and you get pissed off, you kick a pet. or a gay.
School kids have a tendancy to bully. 9 out of 10 kids who identify as gay get bullied. That is the violence that is endorsed by prop 8. Unfortunately it doesn't stop there. Bullied kids act out. they may get a gun and take vengeance on their oppressors, but that's very rare. More often they get a gun and put it to their own head. That's the death of children part of a yes on 8 vote.
If for a moment you think that the Yes crowd cares about the children they are exploiting, I can assure you that more children have learned about gay marriage from their TV ads than ever will in school. They just don't care.
No on 8 = no on hate.

I’m taking a break from the campaign to go back to the roots of this blog. The news that caught my eye is the pair of grannies that were fighting crime and winning. A 68 year old retired nurse was sitting on a park bench when a trio of youths grabbed her purse and ran. She ran after them, and being a county champion in cross country in her youth, had the speed to catch up and grab one of the boys. He was so surprised he dropped the bag. I don’t recommend it, but it worked for her. The other is a 72 year old who got a phone call asking grandma not to tell but her grandson needed some bail money. She was almost victim to a scam where the bad guys call random numbers until they get a older adult, then they say Grandma I need help. Usually the sympathetic elder asks “Johnny, is that you?” giving the crook a clue to use in gaining her confidence and getting as much as five thousand dollars wired to him. Delpha Speak of Missouri called the jail where her grandson was supposed to be incarcerated and they told her it was a scam. Congratulations to these two crimefighters! And vote no on 8.

The proponents of proposition 8 have been citing Massachusetts as a case example of how things “go wrong” with same sex marriage. I heard a story this week of a couple, trying to get married in Boston and the obstacles they encountered. A couple, who were graduate students at Smith College in the schools of social work wanted to get married. They applied for a license, and since it was recently made clear that they could legally marry, they set out to find an officient. They called church after church, recruited friends to call too, and after explaining the situation, they were turned down time after time. No one would perform the ceremony. Finally a Unitarian Universalist agreed and performed the wedding. Now the story may not seem too remarkable, except to show that California ministers aren’t any more obliged to marry folks than they were before. Many ministers will only marry a couple who are members of the church, have gone through training in the church or agree to conditions like raising children within the faith. No requirement to marry anyone who comes in the door.
The difference is in the details. The story happened in 1965. The couple were a man and a woman, but he was African American and she was white. Sounds ridiculous now. In forty years, the whole furor over same sex marriage is going to seem just as stupid. We don’t force acceptance of, teach school children, deny tax exempt status or any of the other “Yes on Prop 8” fantasy claims around inter- racial marriage do we? It won’t happen with same sex marriage either.

A study was done to measure the relative effects of diet and exercise for weight loss in adults aged 60 to 75 years old. The physiologist doing the study had groups that dieted, exercised, did both and compared the results. Surprise! The exercise and diet group did the best. The important finding was the diet only group lost a lot of muscle mass, not just fat. That’s a worrisome fact for a group that is losing muscle mass already as the lean , water based tissue diminishes with normal aging.
Oddly a different study of sleep apnea, a known risk factor for cardiovascular disease and death has a benefit in some forms. Older adults with a mild case of sleep apnea seem to trigger some protective metabolic strategy that reduces their risk of death instead of increasing it. That doesn’t mean to go out and acquire sleep apnea, but if your spouse is a snorer, and they get checked out, it may be a little good news can be teased out of the diagnosis.
The last thing I want to highlight this week is a study of older adults who ask casinos to bar them from playing. The risk for suicide is much higher for the older players than for adults who try to quit betting. There are other differences, games played, onset of gambling to name a couple. The important thing to note is that on older adult who gets into trouble is less likely to ask for treatment, or to get sent, than a younger adult. Desperation leads to suicidal thoughts. Again, the lesson is treat older adults with treatments that work!

from www.letcaliforniaring.org:

By the Numbers
Key Facts about Gay and Lesbian Couples in the U.S.

Gay and lesbian couples live in 99.3 percent of all counties nationwide.
There are an estimated 3.1 million people living together in gay or lesbian relationships in the United States.
Fifteen percent of these couples live in rural settings.
Between 1 million and 9 million children are being raised by gay, lesbian and bisexual parents in the United States today.
The highest percentages of these couples raising children live in the South.
Nearly one in four gay and lesbian couples includes a partner 55 years old or older, and nearly one in five is composed of two people 55 or older.
More than one in 10 gay and lesbian couples include a partner 65 years old or older, and nearly one in 10 of these couples is composed of two people 65 or older. The states with the highest numbers of senior gay or lesbian couples are also the most popular for straight senior couples: California, New York and Florida.These facts are based on analyses of the 2000 Census conducted by the Urban Institute and the Human Rights Campaign. (See GAY AND LESBIAN FAMILIES IN THE UNITED STATES: SAME-SEX UNMARRIED PARTNER HOUSEHOLDS: A Preliminary Analysis of 2000 United States Census Data. August 22, 2001 by David M. Smith, Communications Director & Senior Strategist, Human Rights Campaign and Gary J. Gates, Ph.D., Population Studies Center, The Urban Institute; Report at www.hrc.org)

My focus on the Mormon opposition to Same Sex Marriage led me to the site: http://lds4gaymarriage.org They are a group of Mormons that have examined their scripture and their conscience and found that although there may be scripture that condemns homosexual behavior, the denial of the right to marry is none of their business. I have not studied the Book of Mormon and can’t quote on my own authority but they did post this on their home page:
Joseph Smith said, "If I esteem mankind to be in error, shall I bear them down? No. I will lift them up, and in their own way too, if I cannot persuade them my way is better; and I will not seek to compel any man to believe as I do, only by the force of reasoning, for truth will cut its own way."
(Joseph Smith, Teachings of the Prophet Joseph Smith, selected and arranged by Joseph Fielding Smith [Salt Lake City: Deseret Book Co., 1976], 313.)

more thoughts on Prop 8

One of the ideas that make the argument against same sex marriage seem logical is the myth of duality we enjoy. We like to think that things are either/or. It is appealing to our imagination that people come in two types, male and female. The medical facts are somewhat more complex. One variation is AIS. A condition of cell metabolism that makes it impossible for a boy to use the testosterone his body makes. He then converts that hormone to estrogen that works along with the naturally occurring estrogen in his body to grow a person that is to all appearances female. The only way to tell is by surgery, although the AIS adult is infertile. And as one patient states, “every time the box is on a form, I check Female.”
Another variation is the person with both sets of organs, called an hermaphrodite. The best selling book Middlesex told one intersex persons’ story of trying to fit into a world that didn’t recognize his gender. There are many other variations. My point is the fantasy that marriage can only be between a man and a woman has never been true. A transsexual, someone having their gender reassigned medically by hormone treatment and surgery is legally considered the gender they label themselves with. And the law requires they be addressed and treated as such in the work place.
There are about 7500 women in the US that are genetically men with AIS, there are thousands more that are women by assignment. They are able to marry without any legal restrictions. Why in the world would we make it illegal for two men, or two women who want to marry?

They are trying to decide, again, if treating older adults is good for their health. This time it's about flu shots. The information is that if you get a flu shot, you have 1/2 to 1/3 the chance of getting the flu compared to not getting the shot. If you get the flu, and you're frail medically, you may get pneumonia. Older folks die of pneumonia. But the new data suggests that despite 50% increase in getting the shot, deaths are not reduced.
So the conclusion is: gettting the shot reduces the risk of flu, and the severity of the flu if you get it. It may not make you live any longer. You might enjoy the time you have left more without the flu.
In Italy they have identified smoking as causing more damage to the hearts of women, at an earlier age than it does men. The rate of disease is different for women because in the past fewer women smoked than men. Now women are catching up because of the ad campaigns aimed at women in the seventies and eighties- and the smoking behavior of younger women. Quit now- it has immediate positive effects. And get your flu shot.

I have been called upon to defend my statements here that are interpreted to support same sex marriage. The most adamant critics are asking about the religious implications. One statement was: Marriage is an institution that has existed for 5000 years, and now they want to change it. Another: It is an offense to people of faith to have the same designation as homosexuals.
I am surprised that the leadership of the Anti Prop 8 movement seems to be from the Mormon community. I know that more recently than 5000 years they have had to struggle with the definition of marriage within their faith, and everyone didn’t agree to one man and one woman. I don’t want to start a quarrel with the Latter Day Saints, but that beam in your own eye hasn’t been out long enough to open an optometry shop.
As regards the argument about being lumped together with people who are different, I go back to the response about racial marriage laws. In 1948 California made it legal for blacks and whites to marry each other. A hundred years before that Abe Lincoln made it legal for African Americans to marry each other anywhere in the US. But it wasn’t until 1967 that US law allowed interracial marriage. I know that sexual orientation isn’t the same as race. The point of the argument is that as our society progresses, we keep deciding to treat people like people. If we really want all people treated equally, let’s go ahead. If we want some people treated as “less than” equal, please send me a list. Lastly, I would like to quote something I read on the internet site Religioustolerance.org,
"I guess I just don't understand how people can be so passionately hateful about something that won't affect their lives one bit."

Being in my early fifties, I think of being an older adult as over about 65. It’s always more than a decade away. But the Older Americans Act calls 60 and over “older.” AARP and the casinos on Fremont Street start at 50. Speaking of AARP they have a lawsuit in the news, an age discrimination claim. They are being accused of passing over a 61 year old employee for promotion based on her age. Now if you’re thinking that’s too old to take up a new job, the other sexagenarian in the news is another 61-year-old woman in Japan who is reportedly the oldest woman in the world to give birth!
So what is the connection? Sixty may be the new 40, but there are parts of our biology that don’t respond to fashion. We have elders work as long as they want to, even when they may lose efficiency, their experience should count for something. I was on a whitewater rafting trip this summer with my family. Our guide on the river was an older man by any definition. He was careful, read the river well, got us through the trip with a sense of adventure but no real damage. There were younger guides working with groups of young adults and teens. I was glad my kids (and me!) were in the hands of someone with decades more time on the water. Experience pays. But the ability of the body to support another life is pretty delicate. Hormone balance, nutrient absorption, blood distribution are all age related. I don’t know how the kid is doing, but I wouldn’t want all my eggs in that basket. The birth mother was a surrogate carrying her daughter’s child. I must say, someone younger may not have been as connected, but would certainly have been safer. This is one of the few safety versus freedom arguments where I will stand on the safety side. It’s not my safety, it is the child’s. And no matter how old we get, I think that is still our most important job.(If we can get it.)

I’ve made comments in the past about the Medicare web site, mostly negative. A new study finds that three out of four older adults couldn’t find the best Part D (prescription coverage) plan even when they were trained to use the site. It takes about ten pages of sorting to get there and most older adults couldn’t negotiate the technical language and multiple choices necessary. They also tried to have the test subjects, all of whom had college education and basic computer skills, enroll in home health. The same percentage failed that task as well. I guess that will keep the costs down. The other federal cost saving measures in the news have to do with restricting the use of PET scans to diagnose cancers. This is highlighted by the recent news that Christina Applegate was diagnosed with breast cancer only because of computerized scanning. She had several high risk factors that elevated her danger, so she had both the gene testing and scans done. This is a bit different than the concern about testing men for prostate cancer after 75 years of age. The life expectancy for newly diagnosed prostate cancer is 10- 20 years. For untreated breast cancer it is months. The AMA published a study done in Norway about B Vitamins having no preventive effect in heart disease. I want to be sure to underline that it is necessary for nerve function. Don’t stop taking your supplements because it proves ineffective for one illness without checking on other things that might benefit. For example there was a Cornell study that shows the mechanism of action for antioxidants in artichokes, blueberries and pecans to prevent blindness by protecting cells in the eye. I guess the broad advise would be, partner with your doctor, follow the age-old wisdom, and get help with the computer. The Center for Health Care Rights can help with the last. www.healthcarerights.org

It seems there are economic concerns about same sex marriage. One issue is business. The other state that recognizes same sex marriage, Massachusetts, does not allow non-resident same sex couples to marry there. California allows people to come from other states, get a license and wed here. Tourism is a huge part of the Southern California economy and people I know in the wedding business, event planners and such, are very interested in bringing that out of state money to our local economy.
Another slant on the economic issue is personal income, what does it do to help individuals? Married men tend to make more than men who have never been married. Researchers at the Federal Reserve of St. Louis found there may be a few reasons for this. For one thing, employers may have a bias in favor of married men because marital status might signify a man's stability or responsibility. Gay men have often been accused of being less stable so the ability to marry will dispel this stereotype. Another possibility is that marriage frees men up to focus on work, rather than on household tasks. If you’ve been in an apartment shared by a couple of single guys, you know they don’t keep house. It is somewhat of a myth that if you go to the home of a gay couple, you want to hire them to clean yours. The most likely reason is that the qualities that appeal to an employer are similar to those that appeal to a mate—characteristics such as background, education, and appearance.
A 2007 study from University of Northern Iowa looked at 2000 census data and found that cohabitating lesbians earn about 10 percent more annually than married women. They also earn more than cohabitating, unmarried, heterosexual women. Having someone support you in your work makes you work more effectively. A wife does that for her mate, male or female. I know that Prop 8 isn’t about the money, but in politics, money does talk. I wonder if who will listen.

I think the idea of gay marriage is so disturbing to some older adults that they don’t think out what exactly they are reacting to. It may seem at some level like they are voting on the private behavior of those individuals, not whether they should have rights. I know many clergy that have an attitude based on their reading of scripture that prohibits same sex marriage. They should never perform a wedding for a gay couple. Ever. No is going to ask them to perform such a wedding, it’s a day about love, why ask someone who hates?
But should they be able to stop people of other faiths from getting married? Should a Native American that isn’t Christian be barred from marrying? Should a Buddhist? Should a Catholic stop a Baptist? If marriage means only for procreation should women over 50 be barred from ever getting married? Does anyone propose fertility tests as a requirement for a marriage license?
On the web site www.letcaliforniaring.org, a story is posted from a guy who was with his partner for 50 years. When the partner died unexpectedly, he could not bury him, he could not get social security benefits, he lost his home. If the late partner had been married five times for ten years each in those 50 years, each of his ex-wives would get social security benefits.
There are many other stories there, many of them from seniors who have tried for decades and some never lived to have “the happiest day of their life.”
When you watch the commercial, the young bride who meets obstacle after obstacle, finally realizing she can’t marry the person she loves, do you think of someone you disapprove of? Or someone you love? California is the only state to approve same sex marriage through the legislative process, and we’ve done it twice. AB 849 and AB43 both would have made it legal but the Governor vetoed. The State Supreme Court ruled on the In re Marriage Cases and found it was legal. Prop 8 will try to reverse all this. All I suggest is that we think before we vote.

Labor Day is this coming. I have had this thought I want to write about since the conference in Napa last spring. Dr Torres-Gil warned the audience of mostly government employees about the inequity between their benefits and the publics average employment benefits. Los Angeles County is the largest employer in LA County and its employees are eligible for retirement through LACERA. I worked in the private sector for 25 years before going to the county and so I have paid into Social Security, a private retirement account and was vested in LACERA this year. It doesn’t mean I get to triple dip; you don’t get full benefits from SSI and LACERA if you paid both. We are represented at the county. Labor Unions act to negotiate and enforce agreements with the employer and employee. They tend to do a pretty good job at looking after the employee’s interest. So what Dr Torres- Gil was predicting was that the difference from most working people’s retirement benefits and medical – dental- insurance would become a point of contention. Although the reasons are not limited to the idea of government taking care of itself first, that is the inevitable perception. Since I have a foot in both worlds, I will be very interested in how this unfolds as the retirement age population begins to balloon.
I stopped by a big retirement facility on Duarte Road the other day to take my friend Harry a beer. He doesn’t go out much at 87 years old, but when he was living independently we often enjoyed a cold one together. He invested well enough to be able to live comfortably without worrying about what the SSI raise will be this year. As you enjoy the “day off for the working man” on Monday, consider these two things: what plans are you making to support yourself in retirement? Whose shoulders are we standing on that could use a friendly visit on the holiday?And if you do go out to visit, remember this is the last day to wear those white shoes until Easter!

Well good news at last! At least for those of us who need a calculator to get our BMI. There was a paper published in the Archives of Internal Medicine that called for a look at the difference in overweight and obese fit people and physically unfit normal weight people. They used a treadmill test and men who could keep up with an increasing grade for 8 minutes and women for 5 and a half minutes live longer than normal weight folks who can’t keep up. Even minimal fitness is a better predictor that weight.
The study suggests about one third of fat folk are metabolically healthy. They have good cholesterol, blood pressure, blood sugar levels. One in four skinny people have bad numbers in at least two risk factors. It’s better to be thinner and healthy than fat and unhealthy, but it’s still preferable to be healthy and fat than unhealthy and thin.
There were some foreshadowing studies last fall by the CDC and National Cancer Institute that showed heavier people have longer life expectancy than normal weight people. So the great obesity epidemic may not turn out to be all it was feared. And going to the doctor for those tests, and responding to the results, is maybe more important than getting on the scale every day. By the way, my writings last year about gastric surgery holds up in this light- the immediate effects on blood sugar, blood pressure and cholesterol save more lives than Lindora and Jenny put together. Exercise at least thirty minutes a day, not marathon training, gardening, walking, play the Wii. Have fun and loosen the belt, it’s OK!

There were a couple of manly stories in the medical field that are of interest to older guys. They are trying to decide if getting the blood test for prostate cancer is worthwhile after 75 years of age. It seems that the disease takes so long to kill you that the treatment is worse than the disease for the older men. The assumption is that the normal patient won’t live past about 85. I know a few much older men, and expect to know more as the baby boomers move up. The same discussion happens with lots of treatments and the conclusion is pretty consistent- yes treat old people if they have something medically wrong. The other story is in the same area, at least anatomically. Without prostate cancer, men don’t seem to have a whole lot more problems with bowel and bladder control as they age from 50 to 70 and 80. It is not “normal: to develop problems there. It is normal to have a little more trouble with what they call now ED. It’s certainly not universal but a Dutch study of 3800 men showed that many have a need for help, the kind Bob Dole was endorsing a few years ago. Oddly enough there was one other connected story, that doesn’t have quite the same focus. I read these so you don’t have to. It seems they were trying to deliver anti-cancer drugs to specific tissue in the brains of lab rats and found Viagra (Senator Dole’s little blue friend) and Levitra, another ED drug, were effective in getting the cancer drug to the tumor without affecting the rest of the brain. How’s that for improving potency?If you find a mistake in any of my columns, please remember that I do try to write something for everyone and some people just love looking for mistakes, so I try to add something for them.

I’ve been a guest speaker for several classes on aging at Cal State during the summer quarter. The students there are surprisingly focused on issues relating to older adults. One of the presentations I’ve given is a report on domestic violence with older adults. It is a very sensitive topic and there are factors that confound the students and me.
One of the most challenging ideas is the Faith Factor. Now I have often been a supporter of the partnership of health care and church in education, social and heath programs. Harvard researcher Dr Herbert Benson has documented the benefits of strongly held religious belief and physical healing. I always discuss the protective factor of religious practice in suicide prevention.
What provokes us in the domestic violence area is the perception by victims that a church (regardless of what kind) fosters domestic abuse and is not a resource for getting help. The difference in Theology and tradition may be the problem. Older women report feeling that if they go to a faith leader they won’t get any help. They feel pretty much the same about health care workers too. The only resource the women see as a possible protective factor is law enforcement. And they often believe it is only temporary relief. Since clergy members are mandated reporters of elder and child abuse, if they suspect abuse they must report it to APS and law enforcement. APS is staffed by social workers whose mission is to protect. No one deserves to be frightened, hurt or exploited. No one should have to bear the secret of having family treat them that way. There is help.Domestic Violence Safety Hotline is (800) 978-3600 with many language capabilities. APS phone number is 1(877) 477-3646. You can obtain assistance from Bet Tzedek Legal Services for an elder abuse restraining order (323) 939-0506. Other social services can be found in LA County by calling 211.

The Alzheimer’s Association has released another statement about the benefits of cardio vascular fitness for people with dementia. In addition to better blood flow to the brain and general health improving, the risk of falls is affected in a positive way. The focus of this announcement has to do with caregivers providing a fitness program at home. I wonder how many caregivers for someone with dementia have a chance to do this for his or her client or family member.
One of the areas of the brain that seems to deteriorate as much from lack of use as from the disease is used for spatial relations and balance. Physical exercise like walking can preserve this part of the brain and falls are prevented in the first months and on an ongoing curve.
Falls are what take people out of the home, Each year, about one in three Americans aged 65 and older suffers a fall, and 30 percent of those falls cause injuries that require medical treatment. In 2005, almost 16,000 older adults in the United States died from falls, 1.8 million were treated in emergency departments, and 433,000 were hospitalized
If you are a caregiver, or if you have a caregiver, it is probably beneficial for both of you to have a talk about adding exercise to your routine. Part of the talk should be about what kind of exercise you both enjoy. If you don’t like it, it’s harder to keep it on the daily schedule. One strategy for more impaired people is to begin walks in a specific route, so that if the person wanders, he will trace the rehearsed route home. Choosing a path that is low in hazards like aggressive dogs and broken sidewalks is wise. Stopping to chat with people on that route can provide a system of acquaintances for recognizing a wanderer and sometimes even returning him home. Exercise, increased safety and improved social contacts, stress reduction, improved sleep. And the caregiver gets the same benefits.
Remember to stay hydrated, check the feet for skin breaks and nail safety. Use sunscreen in the daytime. Now go enjoy a walk.

There was a big study published in England last week in which their government has been interviewing people born in 1952 every two years and crunching the numbers to see what happens. There were a few significant findings about risk of death for the group. The two risk factors or protective factors that stand out are issues close to our hearts. One is weight. Death due to disease for people who are obese, or who just have a large waist measurement and are not obese, but merely overweight, is a higher risk.
The other factor that seemed to protect people is wealth. Not only do poor people face a higher risk of death at any age, it goes higher as we get older. Quality of life is also related to wealth. It’s known that there is a limitation on the happiness/ money relationship. If your adjusted income is less than $50,000 a year more money may make you happy. Above that level, it doesn’t make any difference.
Another factor that wasn’t noted in that study is that women and men react differently to marriage. Men who are married live longer than men who are single throughout their lives. Women do not change in life expectancy because of marital status. I wonder what the new status of same sex marriage in our state will do to change the life expectancy for men who marry men, and women that marry women. It will affect the protective factor of wealth, because couples that are not married have a higher tax burden, and fewer benefits than single people, or people who have a registered domestic partnership. Even with state recognized same sex marriage a federal program like social security or Medicaid won’t allow the combined income reduction for calculating share-of-cost.
Since men traditionally gain the “freshman fifteen” pounds in the first year of marriage, I wonder if that will carry over. I guess it depends on which one cooks.
It looks like the November ballot will have a same sex marriage initiative. The state supreme court will not block the vote. I expect to have a lot to say about it here in the next few months and will consider any feedback you care to offer.

Last week it seems I might have been asking for new taxes. I don’t want more taxes, they don’t know what to do with what we pay now. What I do want is for the money we all contribute to charity to go to someone who will use it for the common good. We’ve all heard stories of the misuse of charity money for parties and vacation trips. The giving I am suggesting happens in a more controlled environment than a guy in front of Kmart with a bell and a bucket.
At the bottom of your state and federal income tax returns, you can check off contributions. Your tax deductible contribution is taken from your return and goes to the charity you select.
One of the important groups that gets this kind of money is the California Senior Legislature. The CSL is a volunteer group that researches, prepared proposals and supports the process of turning that into law. They are supported only through these donations. If you mark the CA FUND FOR SENIOR CITZENS box on your state return, they use the money to help you. For this year, the need for donations was only $250,000. But by April they had less than $100,000.
The legislation they work on includes assembly bills to address elder abuse mandated reporting, health facilities, infrastructure upgrades, and elder abuse offender registry- wouldn’t you like to know if your van driver or nurses aid had a record? Senate bills like Barbara Boxers’ “Caring for an Aging America Act of 2008” are analyzed and promoted by the CSL.
I don’t want to take money away from the Salvation Army- the guy in front of Kmart. I do want charity to be used for good works, not for trips to Vegas.
The CSL Mission is: To improve the Quality of Life for Aging Californians. They can be checked out at www.4cal.org

I hope that everyone had a great Independence Day. Mine was shadowed because I am very unhappy about some choices the federal government is making. Specifically, they announced this month that more than half of the wild mustangs that the bureau of land management is responsible for are likely to be put down. I know people who were born at a time when there were 2 million wild mustangs in America. Now there are 33,000 living in 10 western states, and another 30,000 in federal corrals. The problem is, of course, money. They don’t want to pay for care of the corralled horses. They want to euthanize them.
I don’t ride. I don’t really like horses up close. But I believe that horses, like dogs, are our partners in a very profound way. Man doesn’t build civilization without horses. People need a strong and willing companion in order to begin the process of trade, building and pioneering. The American wild mustang is a symbol of freedom that has a deeper and more inspiring effect than the other animals we use to evoke our country’s philosophy. The bald eagle, the wild turkey, each has a place in the nation’s lexicon. But the mustang is a part of our heritage that has much deeper meaning. It really is the horse we rode in on. And what excuse do the bureaucrats give to wipe them out? Because they don’t want them to over graze the range. Horses don’t over graze like sheep and goats. The only place there is overpopulation is in the federal corrals, where the horses were removed from their home turf. And sometimes neglected. How often are they released back to the wild?
One way to fund the necessary management of the herds is to make one of those optional tax return check marks, like they have for the election funds. I know I’d rather give a buck to the horses than give it to the part of ‘em that goes through the gate last.

Its summertime and the scammers are busy. I got two different emails this week from a poor orphan girl in the African nation of Ivory Coast. Seems that her father passed away and her trust fund of $20 Million can be accessed if I only send her a little personal information and agree to be her guardian here in the US. She would generously share a million bucks with me for my trouble! This is the first time I’ve had the sympathy element of the orphan in the African Email scam.
Another new twist on an oldie is free converter box ads. The true part of this scam is the fact that television signals will all go digital next February and if you don’t have a converter, your old TV won’t work. The box costs $60.00. The scam, a full page ad in newspapers all over the country announcing a free box that doesn’t even use the$40.00 government coupon to reduce the cost! The twist is their box won’t work without the $59.00 warrantee and the $40.00 shipping and handling to get it. Instead of $20.00 you pay about $100.00. This and other tricks are likely to have a boom until people get their TV signal sorted out next year.
The reason why older adults are more likely to fall victim is unclear. It is recognized that verbal information processing changes with normal ageing, so an older adult is less able to match funny captions with cartoons. It may seem like older people lose their sense of humor. There may be some related glitch that causes seniors to be more vulnerable to sending money for Irish, Canadian and other fake lotteries. If someone is telling you it’s not a good idea to send your money to some stranger, they really may be trying to protect you, not just your estate. If a deal seems too good to be true, it probably is. You can check out the changes to television signal at the DTV hotline at 888-DTV-2009 or visit: www.dtv2009.gov/FAQ.aspx.

Two things caught my eye in the news this week. One was a story sent to me by a reader that told the heartbreaking story of a couple of nursing home residents that were separated by the man’s family because they were caught by the gentleman’s son in an indelicate situation. The fellow’s son was apparently concerned that his inheritance was at risk, so he moved his father to another facility. The lady in question had been diagnosed with dementia. She had, for some months, been deteriorating under institutional care. When the romance began, she started to dress, groom and socialize like she was starting a new romance! Upon being separated from her suitor, she fell into a depression, lost weight and stopped bathing and changing her clothes again.
The supervising judge of the probate court here in LA County has told me “With good cause, I can take away all of someone’s rights except to marry and write a will.” Our right to choose an intimate partner is that basic a freedom. It is the last thing to go. But with rights comes responsibility.
The other story was a news release from a VA/ Stanford researcher who announced that it is cost effective to do routine HIV testing on sexually active older adults. Cost effective means it adds quality of life years to an infected person’s life if an early diagnosis is made, and treatment begun. Another way to state it is a $10 test can add six months of life. About 20% of new HIV cases are older than 50 and about half are undiagnosed. As much as younger people may want to pretend that older adults are no longer interested in sex, the evidence suggests that older adults can enjoy a healthy love life well into seniority.
My favorite quote was from the doctor treating the lady in the first story. "If you've made it to age 95, I'm sorry, but having sex is not going to kill you—it's going to prolong your life.”

“Cash is the sincerest form of flattery” said Lazarus Long, the world’s oldest (fictional) man. I suppose all of my readers are pretty well set financially but I’ve been meaning to talk about something that came up at the TCUSD Health Fair at Temple City Park a few months ago. I shared my booth with the representative from NAMI. Since there was someone there to pass out my material I wandered a bit. One table that caught my attention, because of the nicer-than-most give-aways, was California Mentors. Sara, the young woman made many attempts to describe her program to passers-by but didn’t get much focused attention after folks got a cow shaped kitchen timer off her table. I thought her message was important, so I had her give a presentation to my group one night. What Mentors does is something that I think many seniors may find interesting. They place developmentally disabled adults in private homes. And they pay a tax exempt stipend to the home. It takes some training to be a mentor because the host home has to meet standards for safety and quality. The regional center which is responsible for the client’s benefits oversees the program. But the clients, who may be developmentally delayed by mental retardation, seizures or another condition often are gone to a vocational or day program through the day. They need a bedroom and meals and sometimes help with medicine or problem solving. They are not severely impaired and are screened for ability to live in the community with this level of support. Many older adults struggle with an empty nest. Many others struggle with an empty checking account. If you think your home may be able to accept another member, and if the stipend opens your mind to the possibility, you can e-mail Sara at sara.pollaro@thementornetwork.com or call her at 626-859-9109.

Well, it was not very busy at the polls last week. I worked at a site that had three precincts voting and the turn out was pretty slim. As usual, the highest proportions were seniors. They read the material, they talk about the issues, and they turn out to vote. Even though there were some pretty big races; District Attorney, County Supervisor, the representation is small. Even though, I’m told, each LA County Supervisor directs more money than the President of the nation!
When I was at the Conference in Napa the keynote address was about multiculturalism. Dr. Torres-Gil talked a lot about the idea that as the baby-boomers age into seniority, and the percentage of ethnic minorities increases because of birthrate differences, the people who vote are not the people that are affected by that vote. It places a heavy responsibility on the voter. If older English speaking Caucasians are the decision makers, will they make choices that benefit younger people of color? Will lawmakers realize the population they need to target with their message? It certainly appeared so with the propositions on this ballot.
It’s still a little early to focus on the election in November. But it’s not too early to start listening to the candidates. It’s not too early to do a little planning for potential decisions, like gay marriage. Since I write to older adults, I may be preaching to the choir. One thing that made me proud was a blind voter who came in and used the audio booth. She said it was the first time in 35 years she had been able to cast her vote in privacy. It wasn’t easy to get there. It wasn’t easy to do. I hope in November it’s worth taking a few minutes and making your opinion count.

I went to a class on forgiveness last week. It was a training in providing mental health services to older adults at the statewide conference in Napa. A psychologist named Patrick was the presenter. He had come to learn about forgiveness in working with older adults on suicide prevention. In the course of that work, he had collected some powerful stories. The stories of terrible events people had suffered and the effort they made to come to a decision and forgive someone who had hurt them brought everyone in the room to tears. What became clear was that the victim made a selfish decision to forgive. Their hate and anger were harming themselves and the people who were close to them in the present. It was an act of survival to give the offender the gift of forgiveness.
Some older adults have carried resentment for many decades, often unable to recall what the original offense was. Sometimes the details are fresh and memory of the feelings is sharp and clear. It takes being ready to forgive. Someone who grew up with alcoholic or abusive parents may have nurtured their anger for 50, 60 years or longer! If you think you might be ready to consider forgiveness, write a letter (you don’t have to send it!), tell someone your story, but give it a new ending. Consider the choice, try out the words, see if you can unburden yourself. By the way, you don’t have to be a senior to do it.

At press time for this week’s paper I will be at the California Mental Health Directors Association 7th Annual Older Adult System of Care Conference up in Napa. The keynote speaker is going to tell us how public policy needs to change in the face of multiculturalism and the new aging. Wow, am I going to be smart when I come home! The new aging has to do with both the much longer life span we are experiencing, as well as the enormous baby boomer population starting to reach retirement age. How is the rest of the world supposed to cope with all these seniors?
Multiculturalism has to do with the diversity we have in California. How do you design services to include the largest population of Armenians, and of Hmong, and of Samoans, in the world? What kind of needs will they bring? If you get meals on wheels, or go to a senior center for congregate meals, is the food something you like? If you have a chaplain come to pray with you, will they be from your own faith? Will they have even heard of your faith? Having worked as a nurse for thirty years, I know how important using touch can be in helping and healing. But I also know that many traditions have a taboo against being touched by a person of the opposite sex. My well meaning pat on the hand could cause suffering if I’m not considerate of culture. In Napa there will be other sessions on care-giving, suicide prevention and forgiveness. I hope to share the findings with you over the next few weeks. I hear they also make a tasty beverage that is high in anti-oxidants, from the grapes up there. Maybe I’ll take a break and check that out too.

A number of news releases this week may be obscuring the understanding of prevention and risk factors for dementia. First came news that Ibuprofen use over time will reduce the risk of Alzheimer’s disease. Then came a different study that reports that other NSAID drugs do not have a protective effect for the same illness.
As is often the case, “the exact mechanism of action is not understood” is tagged onto each story. For the record, aspirin was used for about 100 years before its mechanism was understood, and it continues to be the most life saving drug in history. A Doctor I know often tells the story of saving four lives with one aspirin tablet when he was training in a third world country.
What seems to happen is the plaque on the brain cells that cause the neurofiber tangles in an Alzheimer’s victim’s brain is a response to inflammation. The inflammation may be from small bumps and bruises, which is why boxers tend to have a higher incidence of the disease. The inflammation may be from infectious illnesses or metabolic disorders. Ibuprofen seems to protect the brain from all this. Other drugs in the same class, like naproxen, don’t do so well. Ibuprofen seems to produce a difference if it’s used for five years or longer. Taking ibuprofen for that long has serious risks for stomach and kidney problems. There is always a risk / benefit balance to consider. The other factor published was the relation of limb length to risk for AD. Apparently long calves in women and long arms on men reduce the likelihood for developing dementia. There is also a correlation for long limbs and intelligence, another protective characteristic. Since I have four college degrees and a 37 inch sleeve, I am glad to hear about this. What troubles me of course, is the exact mechanism of action is not understood!

I was part of a focus group the other night, a cross section of people paid to sit through presentation and give an opinion. I like getting paid to give my opinion. You dear reader, get it for free each week. I didn’t expect to find a “Seniority Moment” there but as it turns out…
The topic was the upcoming June 3 election propositions 98 and 99. They are seemingly redundant proposals to reform the current state laws on eminent domain. You may recall the furor in Temple City about using eminent domain to acquire land for the K-Mart shopping center. Recently the US Supreme Court has ruled it legal for the government to take private land by eminent domain, then turn it over to private parties for development. Many states see the need to revise their laws to close this option. California is addressing it with these two propositions. What makes it an issue for seniors is the awareness by the groups flying the proposals that seniors are about the only folks that will bother to vote on this, and the subsequent use of older adult actors in the commercials. Old people being put out of their homes, churches closing for strip malls, oh the horror!
The idea that was the focus of our conversation turns out to have nothing to do with eminent domain. Prop 98 has a clause about phasing out rent control. It protects non-owner occupied housing, like apartment buildings and prevents the government form keeping the rent down. 99 on the other hand only protects owner occupied in the past year home including condos, from being taken for private business. AARP has issued support statements for Prop 99. A last word on politics, there is still time to write or call and defend the state budget for adult protective services. The proposed 10% cut would leave many older adults unprotected by this important department.

I enjoy visiting a site on the internet called religioustolerance.org because it has a very deep library of information about world religions. I once had to learn a lot about Druze, a small Islamic group; in a hurry and religioustolerance.org was the best resource I could locate. It has helped me to get a clearer idea about my own beliefs as well as those of others. What brings me to mention it now is the article I found buried in a link to Nudism (check out the pictures of bare chicks they have posted!) that mentions a survey of older Americans interested in visiting a nudist resort. The older Americans were the 45- 54 year olds! I haven’t got the slightest qualm about getting your grand slam breakfast for a discount when you turn 55, I don’t even mind getting my AARP membership invitation at 50. But 45? Back when there was a nudist club in LA County the membership seemed to be split about evenly under and over 50. The president and founder was 75 when I met him and he was by no means the oldest guy there. I have also been to some places in the Caribbean where the spring break crowd were the norm, but that is a totally different milieu. My only current contact in the nudist world is a 60+ woman who reports that it is still a family recreational lifestyle. Kids and grandparents and the safest place in the world to be. “The core group is elderly.” She tells me. (Elderly usually means 10 years older than whoever is talking.) I’m not trying to encourage anyone to do anything they might feel bad about later but maybe this should be a topic at the Healthy Thursday series.

There have been a lot of news stories lately about medical studies concerning older adults. Some good news, like aerobic fitness in middle age delays the aging process by as much as twelve years. Some bad news, sleep problems can magnify other medical problems in old age like diabetes and heart disease. More than half of older adults report problems with sleep, either restless leg syndrome or sleep apnea, or a type of insomnia. Oddly enough, exercise helps improve sleep. Keep those walking poles handy!
There are some new meds in the chute for Alzheimer’s Dementia. Caregivers, with aging parents at home are often called upon to make medical decisions for their elderly charges, either by court ordered conservatorship, or power of attorney for health care invoked after a dementia diagnosis is made. One of the frequent choices asked for is using antipsychotic medication to reduce aggressive behavior in a dementia patient. There is risk associated with these meds, recently a heightened incidence of pneumonia was identified and it has been long established that the life expectancy is reduced in patients getting these medications for agitation. They do improve the life expectancy for patients getting the medication for other mental health problems. Keeping the person busy, usually with familiar tasks like table setting, is one potential non-medical coping strategy.
There are some other medicine stories worth highlighting. In addition to the caution on escalators I gave a few weeks back, getting in and out of cars is a high risk activity for falls as well. One surprise is they are using Ritalin for prevention of falls with older adults. You may be familiar with Ritalin as a drug used to treat attention deficit disorders in children, adolescents and adults. The improvement in focus from the medication may prevent falls.
Apparently the complex mental process of walking requires better attention than we imagined. I do OK as long as I’m not chewing gum at the same time.

Last week 75 year old Pennsylvania Senator John Murtha said one of the presidential candidates is about his age and the job of President “is no old man’s job.” John McCain said “speak for yourself, I’m doing fine.” It is like most in-groups, I guess, where it’s ok to insult other members of the group, but other people can’t get away with it.
Living in LA County makes some people a little more aware of differences in culture. There are a million residents of African American ancestry here. In the US, LA County has the largest population of these groups: Urban Native Americans, Filipino, Roma, Mexican, Korean, Iranian, Samoan and Japanese.
There are long term relationships between many cultures that may be positive or may be historically negative. Wars, migrations and trade have melted many a pot before people came to the US. Many times at health fairs, like the one in Temple City Park this weekend, we see older adults who are of Japanese or Chinese ancestry but have lived in Latin America for so long they speak Spanish better than any other tongue. New neighbors cause us to acquire a different view of a culture, sometimes good, such as cooking smells of new spices and sometimes irritating, such as music our ears haven’t learned to appreciate.
Older adults of the generation that lived in the great depression may be more defensive and less open to strangeness than younger seniors. The influx of Asian culture following World War II and the expansion of international business has made later groups more accustomed to new characteristics.
But what about ageism and sexism? What experiences do we need to dismiss the qualifiers of candidates and attend to their qualities? We have an unique choice ahead, will we elect the first African American President? The first female President? The oldest President to enter office? Whatever happens, it will make history!

Older adults from the silent generation are often more resistive to mental health treatment than people of a previous or later generation. It once was a functional attitude. When the aerospace industry was a leading employer in the area a diagnosis of depression in a family member could spoil a worker’s security clearance. Medical treatment for other psychiatric diagnosis had side effects like involuntary movement disorders. Films would portray mentally ill people as maniacs and psychopaths. World War II veterans were among the first “normal” people to benefit from psychotherapy. Better treatments, both medical and psychological, have improved outcomes. Long term hospitalization and disability are no longer expected. But stigma continues. Shame, avoidance and denial are hard to release, but it can be done. NAMI is the National Alliance for the Mentally Ill. It is a support organization for consumers of mental health services and their families. The have a stigma busters arm that identifies movies, TV shows and other media that demean or ostracize people with a mental illness and call for letter writing campaigns to the organization. They also support and recognize media like the film “A Beautiful Mind” that portray mentally ill people in a realistic and respectful manner. Dolores, a past National Association President and I will have some material to share on this topic at the Temple City Health Fair on April 26 at Temple City Park. Stop by the table and say “Hi.”

I have been working on how to introduce a study about older adults having an increase in escalator injuries. The injuries aren’t usually very serious and mostly happen just standing on the moving steps. The cause of the slips, trips and falls seems to be about visual balance cues increasing with age. Looking down at the steps makes folks dizzy. I was researching ways for seniors to improve balance, strength and agility to compensate. A while back I told you I called the physical therapy conference hotline and they sent me some brochures about balance and falls. There were some exercises and advice about taking Tai Chi but they really want you to see a Physical Therapist.
Ultimately, I found a lady named Joey who teaches people to use walking poles. These lightweight sticks used in both hands like cross country ski poles increase the cardio-conditioning of a simple walk by 20%. They help you burn 48% more calories and reduce joint impact on the lower limbs by 26%. She let me and my wife try them out and gave us a few pointers on adjusting the length and foot pads on the poles. They were easy to use and I think a better safety choice than a single cane or stick. Walking is great exercise and enjoying it is the biggest factor in keeping on an exercise plan.Joey is 73 yeas old herself and besides working and being a caretaker she is promoting the walking poles because of her own recovery using them. She’ll be at the Temple City Health Fair on April 26 at Temple City Park teaching a clinic on walking poles. Or you can email her at walking4fitness@charter.net. In the meantime, use the elevator.

I have been working on how to introduce a study about older adults having an increase in escalator injuries. The injuries aren’t usually very serious and mostly happen just standing on the moving steps. The cause of the slips, trips and falls seems to be about visual balance cues increasing with age. Looking down at the steps makes folks dizzy. I was researching ways for seniors to improve balance, strength and agility to compensate. A while back I told you I called the physical therapy conference hotline and they sent me some brochures about balance and falls. There were some exercises and advice about taking Tai Chi but they really want you to see a Physical Therapist.
Ultimately, I found a lady named Joey who teaches people to use walking poles. These lightweight sticks used in both hands like cross country ski poles increase the cardio-conditioning of a simple walk by 20%. They help you burn 48% more calories and reduce joint impact on the lower limbs by 26%. She let me and my wife try them out and gave us a few pointers on adjusting the length and foot pads on the poles. They were easy to use and I think a better safety choice than a single cane or stick. Walking is great exercise and enjoying it is the biggest factor in keeping on an exercise plan.Joey is 73 yeas old herself and besides working and being a caretaker she is promoting the walking poles because of her own recovery using them. She’ll be at the Temple City Health Fair on April 26 at Temple City Park teaching a clinic on walking poles. Or you can email her at walking4fitness@charter.net. In the meantime, use the elevator.

If you’re one of those types who read to the bottom of the page, you’ve seen that I lead a mental health team for older adults. You might have noticed that I write often about issues related to dementia. I don’t always see the two as connected because the folks who pay for treatment have categorized dementia as a medical problem, not a mental problem. I could explain why, but it wouldn’t make any more sense than it does without a rationale. In the papers there was a story about how a big belly in your forties is related to cognitive decline in your seventies. I can’t tell you how much that news meant to me personally. The photo doesn’t show me in full figure for a reason, we have to leave room for the column. Since I’m out of my forties, I guess I can plan well for about twenty years to minimize the damage. I can buy long-term care insurance. I can develop my support network. I can simplify my life so the number of things I need to remember are few. And I can read the studies with an informed eye. The facts are that when the risk for dementia doubled with a large belly, 16 out of 100 subjects were affected. That means 84 out of 100 were not. That’s better odds than you can get in Vegas. I probably will not get dementia. Anyone who can read this probably will not get dementia because education level is a huge protective factor. It is surely better to make healthy choices. It is wise to take good care yourself. I should do those things I listed earlier to prepare anyway, because that is the smart thing to do. I plan to talk a little more about the kinds of mental illness that seniors do report in the next few weeks but right now I have to try to do some sit-ups.

The power of the vote is only one of the ways our voice is heard in the world of politics and government. When an elected official acts on the promises and expectations that got him or her into office, re-election is the reward. But we can make our wishes known to the lawmakers and executives before, during and after the elections as well. I have made some statements in this space about seniors as a voting block not working together. Even when it is in the best interest of the age group. Even when it is in the best interest of society at large.
The governor is trying to figure out where the budget can be cut. He will cut the parts that are least likely to effect re-election. That is how we give feedback after the fact. He has proposed cutting $11.4 million in state and federal funding to the adult protective services program. Not every older adult will need APS. Every older adult knows someone who will need APS. Reports of elder abuse have increased by a third in the past five years. The elderly population will double in the next twenty years as the baby boomers graduate into seniority. But the thinking in Sacramento is basically that the people who will miss out on needed help won’t make a difference at the polls. APS helps seniors to age in place. Without their services hospitalization and nursing home placements increase. The cost of those services is ultimately higher. Want to work together?
Jack Scott is on the senate budget committee. So is Bob Margett. Ed Hernandez is on the assembly budget committee. They send mail to your home asking you to vote for them. Why don’t you send them some mail telling them what to do for your vote? Search www.legislature.ca.gov by zip code to get your representative’s address. Buy a stamp. Tell ‘em “Hi” for me.

Awhile back I wrote about weight loss surgery in Australia being reported as a cure for diabetes. It was right before election day and the other poll workers read it and told me they had no intentions of going under the knife to lose a few pounds. For older adults it is notoriously difficult to diet off weight, especially if there has been a life long pattern of dieting. The metabolism is a genius at conserving weight to prepare for periods of famine. There is a study about the people who regain their weight after gastric reduction surgery at the Geisinger Clinic in Pennsylvania. They found that twenty percent of the subjects who had bariatric surgery had a genetic variation and had a poor response in weight loss. One in five would continue to have weight problems after the surgery. They don’t know enough yet to use this factor to select patients for the surgery, but it may help explain why some folks remain obese after the procedure. They may respond to genetic therapy yet to be developed rather than surgical treatment.
The people in the study had BMI (Body Mass Index, a reliable estimate of body fat) that was over 40. The limit for obese instead of merely overweight is a BMI of 30. If you don’t know your BMI there are several ways to get it. Weight Watchers has an easy to use chart and the National Institutes of Health has a wonderful calculator on their weight control web site: www.nhlbi.nih.gov, The NIH website also has a “portion distortion” link that is fascinating. It shows how the size of food portions has grown over the past twenty years and contributes to the obesity epidemic in the US.
On election day we soothed our nerves on the topic in a time tested and traditional manner- Girl Scout Cookies!

There were a couple of stories on the news services this week about the D word. The D word is Dementia. Apparently there is a study coming out in a neurology journal that rates the risk of developing dementia if both your parents got it. It seems that if two parents got the disease, it increases the likelihood their children will get it. But even after age 70, more than half of the kids are free of dementia symptoms. Still the rate for the general population is much lower. There is about a six percent lifetime prevalence in the US, so if both parents get dementia the rate becomes about seven times higher. There were other D word stories too. One had to do with the worries patients have when they are diagnosed with early Alzheimer’s disease. AD is only one form of dementia and does have several medications that are modestly helpful in slowing the progress of the disease. The worries patients have are about becoming dependant on others and burdensome to family. Doctors are often hesitant to tell a patient they have AD because of these fears. There is evidence from Washington University in St Louis that it relieves the patient to know and be able to make plans for long term care. The subjects in that study had no more depression or anxiety weeks after the diagnosis was announced than before they knew. Finally, the Alzheimer’s Association list of things to do if you have a diagnosis of early AD was published. They recommend hiring services like bill paying and transportation, writing notes to yourself about how to work appliances, and foremost- stay active physically and socially! If you know a person with dementia, you can help with the last suggestion- go for walks together, take them to church, invite them for a meal.

Last week I mentioned Granny D briefly. If you missed her story a few years back, here are the cliff notes: At the age of 89 Granny D, AKA Doris Haddock, decided that campaign fund raising was out of control. The millions of dollars donated to candidates for election and reelection and the potential for that money to influence the decisions made while in office drove her to demonstrate for reform. She chose a cross-country walk as her forum and starting in Los Angeles, walked 3200 miles ending in the District of Columbia. She was arrested while reading the declaration of independence. It took 14 months and four pairs of sneakers. In 2004 she ran for a senate office in New Hampshire and was defeated by the Republican incumbent as expected. She started her campaign only four months before the election but still got 37 % of the vote! Granny D is an older adult who brought a sense of fairness and honesty to the process of electing our leadership.
This year the decision seems to be centered on the conservatism of keeping the government out of private business, and a liberal use of the governments potential for good works, in social programs and controlling the behavior of industrial giants. We know that charity that is only from the good intentions of people doesn’t get spread around to all who need it. We know that a business will answer to it’s stockholders about cash flow before it answers to them about pollution and fair treatment of employees. Government can do those things. But we also know a government that is allowed to control it’s citizens will do so without considering those individual’s rights over the office and needs of the government. So what do we do? How does an older adult balance that caution with need? How will you decide to vote? Thank God I’m not running for office.

Following the presidential primary election at the beginning of the month, I’ve been thinking about politics. I work at the polls on Election Day. I have done so for a couple of years now and at several different polling places. I have had a chance to see and talk to voters for thirteen hours of voting. In this primary there were many young women who turned out with such a specific mission in mind that they couldn’t contain it. They came to vote for a woman president.
Older adults are the most noticeable age group at the polls that I once tried to get a survey on senior services passed out to them at election time because the volume of seniors is so high. But seniors don’t vote as a block. There isn’t coordination, even by special interest lobby groups like AARP. I see how advocates for children and youth turn out and speak up in implementation of prop 63 meetings while older adult advocates have trouble figuring out whom each other are. Children’s advocates get their tactics and strategy in place. Since the squeaky wheel gets the grease, you know where the money goes!
I know there is concern for the process. I was recently reminded of Granny D, the 90 year-old woman from New Hampshire that walked from Pasadena to Washington DC in 1999 to protest for campaign finance reform. She was so peeved about the near outright purchase of elected officials that she spent a year on the road to make her point heard. I have a hope that the talent, experience and skills that retired workers possess will be applied to shifting the platforms of the major parties to older adult issues. I hope that the budget crisis doesn’t decimate programs like adult protective services because no one worries about the older adult vote.

As of this writing, the weather prediction for the Camellia Parade weekend is showers. I’ve seen it rain so hard the parade was cancelled, but we usually have a day sunny enough that those of us who walk the mile from Sultana to Rowland with the kids every year can get a mild sunburn. It makes me wonder what the rest of the country is enjoying after the ground hog made his prediction.
The news in Durango is an 89 year-old woman went out on her patio to rearrange things that got wet and the door locked behind her. A six-foot snowdrift blocked her exit so she used an ax to bust into her own home. In Michigan a 71 year-old guy was complaining that he had to drive 150 miles to Lansing in the snow to collect his mega millions ticket winnings. He thought it was too much trouble for the $150 he calculated he had won. It turned out to be worth it when he was told he won a quarter million dollars.
My weather icon tracks the temperatures in Temple City and in Wauwatosa Wisconsin to see what conditions the in-laws are having. I enjoy seeing how many days the high temp there doesn’t reach the low temp here. It only met once so far this winter. They must’ve been dreaming of a white Presidents day this year. Despite the floods and droughts, earthquakes and smog, I think there is a distinct advantage to never worrying about frostbite when I walk the dog. Let’s keep our fingers crossed for a sunny parade and a memorable hometown celebration for the kids of Temple City. And if it is warm, take a senior out to see the scouts, bands, floats and schools. Bring a lawn chair and hat for them.

Last Friday was the American Physical Therapy Association convention in Tennessee. One of the activities they did was a toll free hotline with fall information. I called to discuss a few things with a charming young therapist named Ms. Davenport. Some of the suggestions she offers include an evaluation by a PT for balance and gait. There were a few exercises she described that show problems that are likely to lead to falls for seniors. Doing things that challenge your balance so that your nervous system has to keep fit to keep you upright is the key. When she found out I was calling from sunny southern California she brought up walking on the beach, sand making it harder to walk automatically.
I asked her specifically about a story from that day’s news on the Wii. If you remember a few weeks back I noted a commercial on TV with some seniors bowling together in virtual reality. Well, even though it’s not marketed for rehab, the Wii is enjoying huge success with occupational and other therapies for stroke, paralysis and other conditions. The physical therapy association isn’t endorsing it specifically but Ms. Davenport did encourage using any game that reduced the boredom of exercise, and increases strength, coordination and endurance.
I decided a trial of Wii Sports was in order. There are several games on this program; boxing, tennis, bowling and golf are each played with a few light handles in front of a TV screen that senses your hand motion. Not only can you work up a good sweat playing the games, they are entertaining enough to make you want to go back the next day. Since I’ve reached the bottom, here’s the bottom line: Do some exercise, it’s better if you enjoy doing it.

I asked the girl scouts what to write about this week and I was surprised at the insight. “Valentines Day of course!” In case there is a question of my connecting the girl scouts to senior concerns, I draw the connection from the social sciences. A study being published in England has described human happiness as following a U curve. The happiest times in the life span are at the beginning and at the end. Middle age is the most miserable. 44 years old is the peak of unhappiness in England, in the US it’s about 50. So there are common experiences for the most separate age groups. I pointed this out in considering foul language a few weeks ago. I guess all that cussing makes us in the middle less blissful.
Another concern I have regarding the upcoming romantic holiday is the high-risk sexual behavior that older adults may experience because they are no longer worried about unwanted pregnancies. HIV and other STDs are still increasing fastest among older adults compared to other age groups. It is preventable. It does require talking about it. I hope the conversation is nicely coded so no one breaks the mood, but you still have to decide who’s stopping at the store for protection. I haven’t been able to check out the resources for folks that are dependant on a caretaker for shopping. What does a resident in assisted living do? Call the city dial-a-ride for a trip to the 99 cent store? If they have a spouse, it isn’t an issue, although I am still trying to adjust my own thinking to the Sandra Day O’Connor story about her husband with Alzheimer’s finding a new sweetheart in his nursing home because he doesn’t remember being married. Justice O’Connor’s ability to understand and accept the situation called “mistaken attachment” must be the root of that upward trend in happiness that the Brit’s have found in their study. I only hope to live so long. Happy Valentine’s Day!

Health news this week is both good and bad. A study to be published on February 5 in Circulation, a journal for cardiologists, tells how a little exercise- two hours a week of walking for instance, can cut the risk in half for “premature death.” It doesn’t take Jack Lalane workouts to produce real results. Very high fitness levels reduce the risk further, but just getting off the sofa once or twice a day to take a brisk walk will have an effect. I see an ad for Wii, a television / computer game where a bunch of older guys are enjoying virtual bowling. It beats paying a couple bucks a game and does work up a sweat!
The other piece is about how women who have to pay as little as ten bucks, as co-pay will skip their mammogram. Medicare managed care plans usually ask for a small out of pocket to reduce the insurance companies cost. As it turns out, the costs increase because more women develop more serious cancer without this screening.
Lastly, and this has limited information behind it, they are starting to suggest that gastric surgery- banding was the case study, rather than bypass which is more frequent here in the US, is a diabetes cure. In Australia, they are suggesting that so many diabetics get off all meds after a surgery to reduce stomach size that it qualifies as a cure for diabetes. Many of the patients I’ve met report significant changes in their blood sugar controlling meds. If you are obese and diabetic, it’s worth looking into!
So again I end up sounding like a mother hen to people old enough to be my parents. Get some exercise. Go to the doctor for heath maintenance. Now a radical suggestion: diets work for very few obese people. Gastric surgery works for almost all of them. If you’ve been dieting for 50 years and are still too heavy, check out something that has proven to save lives.

As a follow-up to my recent advice to get some computer skills and get on the web, I thought it wise to let you all in on the following: I have won the lottery! Now you won’t see me on The Big Spin show or anything like that because I didn’t win the California lottery. It’s the Irish Lottery! And I didn’t only win once, I won twice! Oddly the same fellow, A Mr. Anthony Chagnot has notified me of both prizes without noting the other. If I email him my contact information, he can wire the money directly to my account! Funny, I don’t remember buying a ticket. And Ireland doesn’t have a lottery. I also get weekly offers to get me my inheritance from family I didn’t have. Also I could help a guy in a Nigerian bank get some money out of the country. One more scam is to send a real looking note to confirm your password, by a bank or other financial institution. This is called phishing. They get your email address somewhere. Mine is published in a newspaper every week. They send this nonsense to a thousand internet users and if just one or two bites, they have a phish on the line! With a few promises of wealth they get the number to an account and authorization to drain it every month when a pension check comes in by direct deposit. Sometimes I ask the phisher to send me proof of his good intentions. I want a photo in front of the bank where he works. Sometimes I ask him to wear a distinctive garment, so I know it’s him. A pink dress is my favorite. I like the idea of some fat guy in Bakersfield trying to figure out if he really should get a picture of the Bahrain Bank of UK with a guy in a pink dress out in front of the building. I never hear back from them. All in all, be careful, even in virtual reality, there are crooks everywhere.

I took the girl scouts to see Wiicked at the Pantages. The backstory to L. Frank Baum’s Wizard of Oz gives a new perspective to looking different, unreciprocated affection and altruistic sacrifice. At least that’s what the girl scouts thought. The older adults I’ve talked to don’t like the character changes. One told me that Glenda has always stood for purity and helpfulness. Her human frailty in the stage play was disappointing. A week later I sat behind some older adults in a matinee showing of Charlie Wilson’s War. I could see their physical reaction to some pretty provocative language in the film. Each bad word caused a stir of shocked disapproval and embarrassment. I heard one lady say it had ruined the movie for her. The codes of behavior that we learn in our youth tend to stick with us as we age. I know that in leading group therapy for older adults a rule about curse words is expected and followed. While younger adults seem to require a few expletives just to communicate at all. I know all those words existed 50 and 60 years ago. It just wasn’t acceptable to use them.
The girl scouts don’t like it either. But they do expect to call almost anyone, regardless of age, by their first name. Familiarity is not the issue it was when most seniors were in their youth. It would never have been ok for Eddie Haskell to tell Mrs. Cleaver “That’s a lovely housedress you have on today JUNE.”
Rules to remember when meeting older adults. 1) Use formal address like Mr. or Mrs. until invited to do otherwise. 2) Don’t cuss. 3) Agree that Glenda really was a good witch.

A couple of news stories caught my eye this week and got me thinking. One was about 84 year old Ester McCullogh in Texas. She tried to run down a neighbor in her car. She had a record of violence since she assaulted a policeman in 2005 with her cane. A Canadian man was ticketed and had his car impounded for “street racing” at 100 MPH when he passed a cop car. He’s 85 years old, so he beat the record previously held by two 75 year old men who were cited under the same law. What I got to thinking about is social pressure. How much of our tolerance for company, and need for support do we carry into our later years? Canada and rural Texas have a lot of space that is becoming more crowded. Since these two were born in about 1922, what are the population changes?
I like to take my dog to the dog park. I like the one in Sierra Madre best, but since I don’t pay taxes there, I generally go somewhere else. My dog doesn’t seem to have a preference since he tries to sit on my lap the whole time, regardless of where we go. It may sound cute, but he’s a big old Lab and thinks he’s a lap dog. He seems to have social anxiety but I don’t think starting him on Prozac is indicated.
I don’t expect the dog to “begin enjoying the support and company of his peer group.” I do sometimes expect older adults to start going to congregate meals and social functions after being solitary for years or even decades. The unexpected consequences of company may lead to bad driving behavior. And I won’t let the dog drive us home from the park.

I’ve had feedback about my contact information and the information I put here about various agencies that are often only accessible by computer. I know that many older adults didn’t use a computer at work. Some tried it for fun and it was too difficult to type all those instructions in code. I encourage those older adults who haven’t tried it for a while to get back on the web. It’s not like you never use a computer nowadays. The ATM at the bank is a computer. The gas pump at the filling station, your cell phone, and your satellite receiver are all computers. And the kind that sits on the table and uses a keyboard is now as easy to use as the others on the list. The reason why I want to promote computer literacy is simple. Everything in the world is designed to come to you this way now. I had to call Medicare this week to find out why someone was disenrolled from their Part D insurance. I had to wait for a long time and punch way too many numbers on the phone menu. The computer gets right through. I wanted to contact Paul Petersen, the actor turned advocate. I didn’t think I could figure out who his agent is, send a letter and get an answer. So I e-mailed him. And got a response!
I work with three people who are “old enough” to be on Medicare. All of them use the computer at work and at home every day. They print snapshots from the digital camera. They edit the Christmas letter. They find out if there are enough people left from the class of 1957 to hold a reunion! It is doable. Monrovia Adult School has Beginning Computer Classes for Seniors starting this month. “Patient, gentle instruction, no tests, no homework!”And lastly, you have to use a computer if you ever want to Google yourself.