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