Must See: Ken Dychtwald's Keynote Address at the 2010 ASA/NCOA Conference

Ken Dychtwald covers so much important territory in this keynote address at the June, 2010 American Society on Aging / National Council on Aging joint conference. If you're interested in being alive over the next century, regardless of how you feel about aging, older adults or anything else, you have a vested interest in this speech. Dychtwald is an engaging speaker and this 15 minutes flies by.

Dr. Butler's Death in the News

I'm following the reports of Dr. Butler's passing in the news. It's early still, but there are some very nice missives being released about him. I like this one by Richard Peck, a former editor of Geriatrics magazine. Peck is apt in his description of Dr. Butler as "smooth" and "gentlemanly," and the word "bemused" certainly captures some of his character. The piece also captures some of the broader elements I sense about Dr. Butler's work - that it is now and always has been ahead of its time and will only truly be appreciated down the road. Here are two wonderful nuggets from the piece:

What impressed me a great deal was the "drop everything and do it" attitude these distinguished people displayed when the smooth, gentlemanly Butler requested their participation in Geriatrics projects and panel discussions. He was clearly held in universal high regard within the worldwide geriatrics community.

and 

For the past several years Dr. Butler headed up the International Center on Longevity and continued to explore new territories of aging-related issues that will someday be commonplace to all of us.
It will be another decade or two, I'm sure, before his achievements register upon us in full.

Here are some of the other pieces that have shown up on the Internet so far:

The statement "On the Passing of Dr. Robert N. Butler," by the Director of the New York State Office for the Aging speaks to some of Dr. Butler's accomplishments, as does the third version of the AP article.

More News Coverage: 
Here are some more articles that appeared shortly after Dr. Butler's death.

http://www.nytimes.com/2010/07/07/health/research/07butler.html

http://www.washingtonpost.com/wp-dyn/content/article/2010/07/06/AR2010070605125.html

http://www.latimes.com/news/obituaries/la-me-robert-butler-20100707,0,6726206.story

http://money.usnews.com/money/blogs/the-best-life/2010/07/07/seniors-owe-robert-butler-many-thanks.html

http://www.time.com/time/health/article/0,8599,2002134,00.html?xid=rss-health

http://www.themoneytimes.com/featured/20100708/gerontology-pioneer-robert-n-butler-expires-83-id-10119849.html


http://www.cjr.org/campaign_desk/the_passing_of_dr_robert_butler.php

On the Death of Dr. Robert N. Butler

We have all lost an ally this week, all of us who are aging that is, whether we be five or one hundred and five. 

I was stunned and saddened today to learn that Dr. Robert N. Butler died on July 4th. Just writing that seems implausible to me.

Two weeks ago I was in New York City interviewing Dr. Butler for a video biography project. We reviewed much of his life and work and touched on many topics, including death and illness. I don't know if he knew then how sick he was, but he didn't let on about it. He was gracious and warm, funny and poised. He was exactly as I would have expected such a great and prominent man to be - almost noble in his demeanor. I was initially drawn to the idea of doing a video biography with Dr. Butler because of the incalculable impression he has made upon the landscape of gerontology and geriatrics. It was wonderful to discover that, beyond his career achievements, he was also a genuine gentleman with a gracious perspective on the world. He was a tremendous humanitarian whose life's work fought against the pernicious impact of ageism, and he still had his sights set on so much more to do. He was in the midst of two significant new projects which I hope will be continued in honor of his work.

My thoughts and prayers go to Dr. Butler's family, friends and colleagues.

Nifty Stats from the Page that Counts at Yes Magazine

Average annual health care costs of an elderly person with income under $10,000/year: $14,692

Average annual health care costs of an elderly person with income over $30,000/year: $8,855(4)

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Number of American medical schools, out of 126 surveyed, that required students to take a course on death and dying before graduation: 4(13)

The Page that Counts

"Public Option" Option Not Yet Dead in the Water

This speaks to the power of the press and perception. The Huffington Post published two articles yesterday that covered the same issue - where the Public Option option stands in Congress.
Robert Creamer's interpretation is upbeat, as he figures that the 'near miss' of a passage connotes a "Growing Momentum for Public Option." On the same day, the aptly named Ryan Grim reported that the "Public Option Amendments Fail in Senate Finance Committee." I suppose it's all in how you look at it.

Thoughts?

TR Reid Commonwealth Club

In our class discussion yesterday, someone mentioned TR Reid's September 14, 2009 speech at the California Commonwealth Club, entitled "Can We Really Fix US Health Care?"

I haven't listened to it yet - I like to download podcasts and listen to them on my commute in to class! Here's the direct link, if you prefer to copy and paste.

http://castroller.com/podcasts/CommonwealthClubRadio/1232943

The Effectiveness of Smoking Bans

I saw this article about how effective smoking bans have been. I wanted to put it here because it relates to a pet interest of mine - High Fructose Corn Syrup (HFCS), or, more specifically, how it's in everything.

Clearly, the success of the smoking ban is largely due to reductions in second-hand smoke deaths, and there isn't a correlative "innocent bystander" in eating, but the study does demonstrate that banning substances can have a big impact on public health.

Mother Kills Daughter / Self at Nursing Home

I wanted to update this post with a link to the letter Diana Harden sent to the local news channel. You can find it here, at the California Advocates for Nursing Home Reform (CANHR): http://canhr.org/newsroom/newdev_archive/2009/Noyes-nursing-home-letter.pdf

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This is a tragic situation - last week a 64 year old mother entered the nursing home where her 43 year old, disabled and brain damaged daughter lived, and killed her daughter and then herself. The whole event is a tragedy - not just the two women's deaths, but also what seems to have led up to the act.

I read the initial report of this crime the day it happened, and thought that it related to Gerontology studies for three reasons:

1. The mother was aging and it appeared that she was largely motivated to commit this crime because of ailing health, which would have ultimately limited her ability to advocate for her daughter. Aging and not being able to care for dependent loved ones is a Gerontology issue.
   
2. The daughter was in a nursing home and vulnerable. Though she's not of the "aged" cohort, she is within the same system of care that so many of our aging population fall into. Therefore, the issues of quality of care that were implied in the crime relate to Gerontology.
3. Even in the initial crime report, it seemed that this crime was motivated by some version of quality-of-life-motivated suicide that's often the fodder for assisted suicide and euthanasia arguments that we will only be seeing more of in the years to come.
   

This most recent article, which alludes to details that were given in the mother's letter to a local news channel, confirms a lot of my suspicions. Again, this tragedy is rife with all the things that can go wrong in caring for people in fragile economic and health states, and the numerous ways that government oversight can let things fall through the cracks. Perhaps the daughter would have been unhappy no matter where she stayed - it seems part of her brain damaged condition led her to be a pretty difficult patient. However, the fact that so many complaints have been registered against this home and so little official censuring (lots of confirmation, but little punishment) occurred will always leave a shadow (or pall) of doubt as to whether the outcome and quality of life could have been different had the checks and balances worked correctly here.

What are your thoughts about this in relation to Gerontology?

NYT Article on People Leaving Nursing Homes

A great deal of the reading we're doing in the Social Policy class talks about how the present structure of public policy tends to force elders into institutions and poverty (if they weren't already impoverished to begin with). Recently, some states have been working on ways to redistribute Medicaid money so that more people can stay at home rather than nursing homes.

This article from the New York Times (linked here in the mobile version, which has less banner ads, etc), does a pretty decent job of going over some of the high-level pros and cons of these "Money Follows the Person" programs.

Some main points:

• PRO: people are thrilled, thrilled, thrilled to escape having their final days in a nursing home
• PRO: it looks like people moving out of nursing homes costs less money
• CON: the "less money" part is most likely due to family members doing labor that is paid for in nursing homes. The article implies that this is a problem, or at least potential hardship for family members, but doesn't delineate that most of the burden of care falls on... you guessed it... women.
  

The article is very good also because it touches on how devastating things can be in older age - a slip and fall can rapidly lead to being shuttled into a nursing home and never getting to go home, much less wrap up your possessions. Life is so very fragile.

Finally, the article mentions:

A recent study by researchers at the University of California, San Francisco, found that home care costs taxpayers $44,000 a year less than a nursing home stay - though this number cannot be used to estimate total savings, because often home-based services replace family care, not nursing home care.

I'd bet that Carroll Estes is somehow related to that study!

(the article noted in this post is "Helping Elderly Leave Nursing Homes for a Home" by John Leland)

Follow up on Mid Life Crisis Study

Here's an abstract on the Universal Mid-life Crisis study I posted about:

Recent research has argued that psychological well-being is U-shaped through the life cycle. The difficulty with such a claim is that there are likely to be omitted cohort effects (earlier generations may have been born in, say, particularly good or bad times). Hence the apparent U may be an artifact. Using data on approximately 500,000 Americans and Europeans, this paper designs a test that makes it possible to allow for different birth-cohorts. A robust U-shape of happiness in age is found. Ceteris paribus, well-being reaches a minimum, on both sides of the Atlantic, in people's mid to late 40s. The paper also shows that in the United States the well-being of successive birth-cohorts has gradually fallen through time. In Europe, newer birth-cohorts are happier.

NBER Bulletin on Aging and Health

Mid-Life Crisis is Universal?

This article in The Financial Times discusses a recent study that claims mid-life crisis is universal.

I found this article to be interesting on a number of levels. First, it's interesting that women appear to have the crisis earlier in life. I wonder if there's a correlation between dwindling biological reproductive prospects and the depression of mid-life crisis.

Second, why are economics professors doing a study on mid-life crisis?

Third, both of the readings from the classes I'm taking referenced how perspectives on aging have shifted since gerontology began. The initial belief was that as we age, we disengage from society and life. Two newer perspectives are that we either have successful aging, wherein we are active and get more involved in life after retirement, or that we simply experience an extension of ourselves throughout the life spectrum. The quote below from the article seems to reference this last perspective as having been a point now refuted by the study:

"...the findings contrasted with many previous studies and with applied psychology textbooks – suggesting that, on average, our mood stays relatively consistent as we age."

The article also gives a few descriptions of the aging process that are very interesting, again, considering that the observations are coming from economists:

The most likely explanation, the researchers speculate, is that people “learn to adapt to their strengths and weaknesses, and in mid-life quell their infeasible aspirations”. Minor contributing factors might include a “selection effect”, with people living longer if they are cheerful than miserable, and – towards the end of life – a “comparison process” in which people count their blessings as they see their old friends dying off.

“For the average person in the modern world, the dip in mental health and happiness comes on slowly,” said Prof Oswald. “Only in their 50s do most people emerge from the low period. But, encouragingly, by the time you are 70, if you are still physically fit then on average you are as happy and mentally healthy as a 20-year-old. Perhaps realising that such feelings are completely normal in mid-life might even help individuals survive this phase better.”

WSJ Article on Shopping with "Senior Eyes"

The Wall Street Journal had an interesting article today about special training programs for people who do merchandising for health-related stores, such as drug stores. The program is run by the Kimberley-Clark Corp. Sadly, the WSJ doesn't allow full access to articles older than a day, unless you have a paid subscription.

Here's the link anyway:
http://online.wsj.com/article/SB125288402995807243.html