#AGS21 - American Geriatrics Society 2021 Virtual Annual Meeting

From the American Geriatrics Society Web site:

"Founded in 1942, the American Geriatrics Society (AGS) is a nationwide, not-for-profit society of geriatrics healthcare professionals dedicated to improving the health, independence, and quality of life of older people. Our nearly 6,000 members include geriatricians, advanced practice nurses, social workers, family practitioners, physician assistants, pharmacists, and internists." 

It's important to note that they are active in the growth and improvement of healthcare delivery for older people with their "programs in patient care, research, professional and public education, and public policy." Beneficial change needs to embrace various sector including economic, political, professional, societal, etc. The Covid-19 pandemic made deficiencies in American healthcare more visible, especially with the geriatric population.

The annual meeting started yesterday with pre-conference sessions. Today, we have the educational sessions. Here are the links for the full program and the abstract book.

The first session caught my interest: "Decision Making for Older Adults with Multiple Chronic Decisions."

This presentation "Caring for People with Multiple Chronic Conditions: Optimizing Medications" by Cynthia M. Boyd, MD, MPH used this graphic (click to enlarge) to show the complexity of patient management.

(more to follow)

Anthony Hopkins' Filmography about Aging

The Oscars are here again, but chances are it will not have a strong viewership, partly because of the effects of the pandemic. However, I made it a point of seeing "The Father" at a local cinema, on a discount Tuesday no less.

You can now rent it for $19.99 on Amazon Prime video. It has six Academy Awards nominations: Best Picture, Best Actor (Anthony Hopkins), and Best Supporting Actress (Olivia Colman), Best Adapted Screenplay, Best Film Editing, and Best Production Design.  It has a Certified Fresh score of 98% on Rotten Tomatoes.

This is the synopsis from Cinemaholic: "The Father’ is a drama film that tells a heart-touching tale of a man battling with dementia and slowly losing his grasp on reality as his daughter helplessly watches on. Anthony Hopkins delivers a spellbinding performance in the film directed and co-written by Florian Zeller. It is based on the French play ‘Le Père,’ also written by Zeller, and is a compelling, thought-provoking, and emotionally moving film that gracefully deals with the subjects of aging and mortality. The film has been lauded by critics for its performances and depiction of dementia..."

The impact of this film comes from you as the viewer seeing what happens in the eyes of the main character, Anthony. You encounter a confusing jumble of changing faces, locations, and time frames that burdens Anthony as his mental state worsens as a result of his dementia. You'd think that the ending would be depressing, but the humanity seen among his caretakers shines above the occasional cruelty, and you leave (at least I did) with the impression that you benefited from this truthful exposition.

Anthony Hopkins has another film related to aging: "The World's Fastest Indian" from 2005 where he portrays a version of the real-life story of speed motorcycle racer Burt Munro. The 68-year-old Munro works to optimize his 1920 Indian Scout motorcycle at his home in New Zealand, but needs to transport it and himself to the Bonneville Salt Flats in Utah to make an official time trial. As a 60-year-old facing multiple health challenges including angina worries those who know him but he cheerful engages everyone he encounters in this seemingly impossible quest. He reflects on mortality, for instance a brother who died from a tree falling on him, and emphasizes the need for purpose in life that others find infectious, even the local Kiwi motorcycle gang who raise money for him to make his trip to America to see his dream to fruition.

"Oh, the reason and not the need...." This 2018 adaptation of Shakespeare' King Lear is available free on Amazon Prime Video.

Hopkins as Lear portrays a character who feels confident he can regress into a comfortable existence ceding all his possessions and power to daughters he thinks will care for him, unconditionally, except for one. It doesn't work out this way: "How sharper than a serpent's tooth it is

To have a thankless child!"

Reviews reflected a fine performance (Wikipedia): "Sam Wollaston of The Guardian commended Hopkins' performance as Lear, deeming him 'shouty, vulnerable and absolutely mesmerising' and wrote that 'Shakespeare on television – a box it wasn't designed for and doesn't necessarily fit – isn't always successful. It only works if it's not just a play on the telly, but something in its own right, too, with its own identity. This one achieves that, with pace and modernity.' The Wall Street Journal's John Anderson also commended Hopkins' performance, writing that he enjoyed watching him 'gnash his teeth, wail and go gloriously mad opposite one of the best supporting casts imaginable.'"

"Keep Sharp" by Dr. Sanjay Gupta: first impressions

 

Purchased and downloaded "Keep Sharp" by Dr. Sanjay Gupta this morning.

"Brain training" is a worthwhile pursuit for all ages, but especially motivating is the thought that brain plasticity (brain's ability to change and adapt as a result of experience) can persist even in the elder years.

After the introductory chapter, Gupta follows with a list of 24 questions you can ask yourself to see is you might be at risk for "brain decline." They include questions about family history, medical history, but mostly about personal behaviors such as alcohol use, exercise, diet, etc.

It will be interesting to see what he reports on the latest research and thinking about brain health and functioning, especially as it pertains to aging.

Elder Caregiving Webinar with Richard Lui

 I was prompted to do this post about caregivers and their role in helping the elderly either at home or in a care facility by today's webinar sponsored by Nebraska AARP, and hosted by journalist and news anchor for MSNBC and NBC News Richard Lui.

After the webinar, I'll do a summary, plus add some important resources as well. Stay tuned.

UPDATE: I was able to watch the first half of this webinar, which I thought was a very good presentation on the current state of caregiving for elders.

The moderator (I'm sorry I didn't catch her name) began by sharing some statistics. It is estimated that there are 53 million caregivers in the US, about 21.3% of the population. This is compared to 43.5 million in 2105. In Nebraska, there are 240,000 unpaid caregivers whose labor is estimated at a worth of $2.9 billion.

You can get download the 2020 report "Caregiving in the U.S." prepared by AARP and the National Alliance for Caregiving.

Richard Lui was introduced and started by saying "little things are big things." The decisions, the hugs, the touches, finding out what's good for the person you're taking care of. He said his 84-year-old father is now 8 years into his Alzheimer journey. He found that just be touching him on his forehead, it allowed his father to recognize him. This little thing had become a grand gesture.

Lui went on to say there's "a lot of joy in the difficulty" of caregiving. In most cases you don't sign up for it, and while helping others it helps you become more human. "Everybody is their own expert," he said, emphasizing that each person brings a unique perspective to this type of work. It can be stressful work, but he said, "I still try to enjoy the laughter of life."

He said that caregiving is not fully appreciated in our culture. One would think it is mostly female, but males also contribute making up 4 out of 10 caregivers. He says that he is part of the sandwich generation, Gen Y & Z, who play a significant role. He cited that students make up over 5 million caregivers, as well as children, those under the age of 18.

Coming to terms to his commitment to his father and to his employer, MSNBC, seemed daunting at first. He works at a job where's he's on call, and not in a position to refuse appearing in a broadcast. He was faced with coming up with a plan that would allow him to become a long-distance caregiver. AARP helped him with the idea of an Employee Resource Group (ERG) in approaching his employer, which had a successful outcome.

ERGs and BRGs (Business Resource Group) serve the function of "voluntary, employee-led groups that foster a diverse, inclusive workplace aligned with organizational mission, values, goals, business practices, and objectives. Other benefits include the development of future leaders, increased employee engagement, and expanded marketplace reach," as stated on the Catalyst.org website.

In regard to Covid-19, Richard said that we already have been facing a "Care Pandemic." The moderator stated that Federal and State programs realize a savings when the elderly can age in place, and this should be factored in when funding is considered.

Lui stated that 4 years ago he began work on a documentary film, Sky Blossom, which features families working through caregiving including Richard and his parents, Stephen and Rose Lui. His father grew up in a large family with 13 siblings, one of whom contacted Richard when Stephen starting not recognizing them. Stephen initially worked as a Pastor, a youth minister, and later became involved with social work for the next 25 years.

 At present, Lui says, "he's an 84-year-old child," requiring constant care, but now that he's in an assisted living facility, he sees his father once every 3 weeks, or twice every 4 to 5 weeks. Initially he was flying back to San Francisco from his job in NYC on a weekly basis.

I'll keeping adding resource links to this blog post, as I hope this becomes a hub for significant information about the challenges of caregiving and the elderly.

"3rd Act Journey" YouTube Channel

 

"A society grows great when ELDERS plants trees whose shade they will never enjoy."

This is my modification of an ancient Greek saying that serves as a slogan for my new YouTube channel: "3rd Act Journey." I think the tree motif works well with connotating wisdom achieved through a long life.

Nebraska’s state nickname before the “Cornhusker State” was the “Tree Planter’s State.” Settlers coming to the prairie were ambitious in planting trees because they had a vision for a better life. It is for this reason that this state is the home of Arbor Day.

The seniors in our society have the responsibility to use their wisdom and perspective to begin initiating changes for which future generations will benefit, something very similar to tree planting.

For this reason, my organization Elder Lives and its YouTube channel 3rd Act Journey use images of trees to represent the needed long-term solutions.

The next step in my journey is to develop my online media and engage in speaking opportunities, as well as write a book to share my vision, engaging and inspiring others to have a purpose of creating a better future.

"The Good Ancestor: A Radical Prescription for Long-Term Thinking" by Roman Krznaric

 I received an alert from the "Talks at Google" YouTube account concerning a new video about Roman Krznaric and his recently released book:  "The Good Ancestor: A Radical Prescription for Long-Term Thinking."

After a quick investigation, I realized that this was the perfect read for developing the direction of my Elder Lives blog and organization.

“A society grows great when ELDERS plant trees whose shade they will never enjoy,” is my version of an supposedly ancient Greek aphorism, and conveys my feeling about my current mission.

Nebraska’s state nickname before the “Cornhusker State” was the “Tree Planter’s State.” Settlers coming to the prairie were ambitious in planting trees because they had a vision for a better life. It is for this reason that this state is the home of Arbor Day.

The seniors in our society have the responsibility to use their wisdom and perspective to begin initiating changes for which future generations will benefit, something very similar to tree planting.

For this reason, my organization Elder Lives and its YouTube channel 3rd Act Journey use images of trees to represent the needed long-term solutions.

The next step in my journey is to develop my online media and engage in speaking opportunities to share my vision, engaging and inspiring others to have a purpose of creating a better future.

Here's the blurb from YouTube: "Philosopher Roman Krznaric discusses his most recent book "The Good Ancestor: A Radical Prescription for Long-Term Thinking". Krznaric explores six ways we can expand our time horizons to confront the long-term challenges of our age— from the threats of climate change to the lack of planning for a global pandemic. Do we have what it takes to become the good ancestors that future generations deserve?"

I'll be doing a full review of this book for another blog post, but I'm glad this serendipity happened today, and it will be the best read for this Thanksgiving Day week. Gratitude is important, but it's just as important to have an eye towards the future, and how to make it better for our descendants, if we want to be good ancestors.

"How Covid-19 Will Change Aging and Retirement" WSJ Report

 

"How Covid-19 Will Change Aging and Retirement: Among other things, expect more aging in place and a wave of innovation," is the title of the supplement in the November 16th edition of the WSJ.

Aging in Place: Growing Older at Home

More will age at home, or so this report predicts. Here's a good guide from the NIH National Institute on Aging.

Ai-jen Poo is part of the organization National Domestic Workers Alliance. In this report, she's quoted: "40% of Covid-related deaths in the U.S. [are] occurring in long-term-care facilities.,"

Ai-jen Poo

Technology will play a key role for the elderly

"The most dramatic change under way is the growth in tele-medicine, facilitated in part by Medicare's decision since March to expand reimbursement to doctors for virtual visits."

Healthier lifestyles will help support biological age

While age is the considered the primary risk for mortality from Covid-19 , it's better to look at biological age to assess this risk. It will be up to clinicians to help determine this for each patient, and ways to alter behavior.

Elders begin to focus on purpose and better use of their time

This is the main focus of this blog, to help elders lead a flourishing life in the true spirit of the ancient Greek concept of eudaimonia. By having a purpose, whether it be a hobby or a loftier goal of serving others, you can develop the will to overcome the problems the aging, and not distracted by them.

Planning for end-of-life care becomes important

The Conversation Project website talk about the April 16th National Healthcare Decisions Day. They have a special page dedicated to Covid-19 and advance care planning, which includes links to resources in 40 US states.

More savings are needed for retirement

According to some financial advisors, retirees in the past relied on the 4% rule, "which says you can withdraw 4% from your savings in the first year of retirement, and then give yourself an annual raise to account for inflation, without running a big risk of running our of money."

Now, the safe-spending recommendation is between 3 to 3.5%, meaning those who want to retire safely need to save $1.2 million over the previous recommendation of $1 million.

The 401(k) no longer have to highest priority for saving, because in perilous times, it can be hard to withdraw funds before retirement. Instead, employers are now offering a flexible savings account "that lets workers funnel salary deferrals to more than one goal, including emergencies and retirement."

One prediction is that the government will eventually apply the current tax advantage for retirement savings to them.

Lifespans will shorten

For the elderly that succumb to the negative effects of isolation will face a greater risk of "death, cognitive decline, depression and heart disease."

The elderly will work longer

Laura Carstensen, Director of Stanford University's Center on Longevity, is quoted: "There's so much uncertainty about the future... most people are going to continue to work as long as they can."

The WSJ adds, "...the percentage of people 55 and older in the labor force has risen steadily, to 40% in 2019 from 29% in1993, according to the U.S. Bureau of Labor Statistics."

Ageist stereotypes will be challenged

One of the benefits of the stressful times of Covid-19, optimistically speaking, is that ageist stereotypes will be challenged. It's time to dispel the notion that elders are frail and need to be isolated, as the only strategy for the pandemic. As the vaccines emerge from Phase III trials, we will see a more hopeful view for elders.

While elders are often characterized as being more psychologically resilient compared to those younger, it can't be assume that they can face challenges on their own. It may be beneficial for the younger set to embrace the perspective of their older acquaintances to help achieve the wisdom and perspective a long life brings.

Much thanks to WSJ's Anne Tergesen for contributing to this report.

I'll follow up each of these topics in-depth with future blog posts.