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WHO's on 1st for Elders? WHO is
Some social groups get all the breaks. And the elderly are first and foremost in the "break department". That's what many people think when you mention the older population. Senior discounts. Senior tax breaks. Senior centers. Senior this and senior that.
Society's older people just take, take, take. Well, it just isn't so. Sure many elderly do receive help given by social agencies. But the bulk of the older population is actually a viable economic asset to the societies where they reside. As a case in point, Florida, known for it's great numbers of elderly, is often referred to as a "mailbox economy" because of all those pension checks arriving daily. Liability? Florida's kept a state income tax off the books just to continue attracting the older population because elders are good for the state's economy.
Blame the phenomenal increases in the worldwide aged population for society's preoccupation with the economic liabilities of the older population. I guess we just hear more horror than triumph stories about the aged. Let's face it. The active elder driving golf balls after he knocks off from his part-time job, just isn't news. An isolated elder surviving on dog food is. When it comes to elders, there doesn't seem to be good news and bad news. When it comes to the aged, bad news IS THE NEWS. Emphasis on the cost to society of providing pensions and health care for older people often obscures the continuing and significant economic contributions that older citizens make to society. It has given rise to the widely held myth that older persons are generally economically dependent and thus a burden on society.
Fortunately, the World Health Organization (WHO) is about to change all this one-sided negativism about aging. Sure a lot of organizations are trying to change the image of elders. But WHO is engaged in a worldwide effort. I guess, for that reason, it's fair to say that WHO's of first when it comes to advocating the efficacy of elders.
According to WHO, the depiction of the world's older population as an economic liability is not a true reflection of reality. Two important considerations, work and public pension protection, must be taken into account.
In regard to work, most older persons around the world continue to work, in both paid and unpaid jobs, making a significant contribution to the economic prosperity of their communities. There is no economic or biological basis for retirement at a fixed age. In fact, says WHO, in national economies which are dominated by agriculture, most older people, men and women, continue to work in farm production until they are physically unable to carry out their tasks, which is often very late in life. And in developed societies, there is a growing recognition that older people should be fully enabled to work as long as they desire. Age should in no way prevent or hinder a person from getting a job and indeed the benefits of age should be recognized and rewarded.
Many older persons are now covered by both public and private pension schemes which protect them from poverty, particularly in the more developed economies. The worldwide growth of such schemes is related to the industrialization of economies, to urbanization, and the loosening of traditional family bonds. These pension programs represent a collective approach to the sharing of resources between people of working age and those who have retired from the labor force. These efforts help preserve the network of social support provided by families. Strong families represent an important societal asset. On the one hand, the majority of elder care (as high as 80%) is provided by the family, not governmental social welfare programs. On the other hand, research has documented the substantial supports (financial, in-kind, social, emotional) provided by elders to their adult children and grandchildren in times of need.
WHO recommends efforts to preserve the viability of the older population by investing in this significant societal resource. Investing in the older population includes the following.
- life-long learning
educational programs to increase employment of elders.
- equal opportunity
eliminating age discrimination in the workplace.
- income security policies
providing adequate income protection via reliable pensions.
- adequate health care
early intervention to prevent poverty due to ill health.
- work and pension flexibility
adapting policies to provide maximum individual choice.
WHO's on first for elders? WHO, of course.
See related articles in the AgeVenture archives.
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AgeVenture News Service, www.demko.com
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A Prayer A Day Keeps the Doctor Away
Soldiers testify there are no atheists to be found in foxholes, and professors can't find'em on examination day either. So it should come as no surprise that you won't find many of'em in hospitals either. Increasing numbers of studies are demonstrating that one's religious belief may keep you out of the hospital. But if by chance the faithful are hospitalized, their length of stay appears to be a lot shorter than those of the faithless.
Older patients with some religious link sliced hospital stays more
than half, according to a study conducted at Duke University Medical Center. Patients age 60 or older with no religious affiliation spent an average of 25 days in the hospital compared to 11 days for patients with some religious denomination.
Additionally, researchers found that religious affiliation also lowered the probability of being hospitalized. Patients who attended religious services once a week or more were 56% less likely to have been hospitalized the previous year compared with those who attended less frequently. After controlling for factors
like age, physical functioning, and severity of illness, patients who attended religious services weekly or more were still 43% less likely to have been hospitalized in the last year.
Finding a factor like religious commitment that drastically cuts frequency and length of hospital stays among the elderly has potential huge cost saving benefits, the study indicated. Nationally, people 60 and over enter the hospital twice as often as younger adults. The elderly account for almost 50% of all short hospital stays, even a decade before the 76 million baby boomers start reaching 65. Already Medicare costs skyrocketed from $38 billion in 1980 to $170 billion in 1995, according to the American Hospital Association.
Why might a patient's religious link help slash stays? Religion may help people cope and thus hasten recovery, the researchers noted. One study showed that up to 40% of persons over age 60 point to religion as their primary way to cope with stress when hospitalized. Less depression among those with personal faith may also help cut stays.
See related articles in the AgeVenture archives.
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AgeVenture News Service, www.demko.com
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Need for Prostate Testing Questioned
Prostate cancer is cause for concern among mature men. It should be. Nearly 40,000 die each year from the disease. So quite naturally, if you are male and over 50, you would want to know if you have this dreaded disease. You'd probably want the diagnosis early. And you'd want that diagnosis to be accurate. And you'd insist on immediate and aggressive treatment if tests indicated you had prostate cancer. This progression from concern, to testing, to diagnosis, to treatment ... while logical ... is actually part of the problem surrounding prostate cancer controversy.
Here's the point. The search for better tests and treatment have distracted doctors and patients from the real issue. Does early diagnosis and aggressive treatment ... make any difference? Increasing numbers of professionals are saying that it doesn't. As a case in point, the PSA blood test for prostate cancer has come under question. Though many experts object to the PSA blood test that screens for prostate cancer because of its high error rate, it seems that a more accurate test would be of little consequence. According to Steven H. Woolf, M.D., Virginia Commonwealth University, a perfect prostate test would not solve the problem.
Speaking in an interview with News Choices magazine, Dr. Woolf says there is no clear evidence that early detection of prostate cancer improves a man's chances of survival. That appears to be the main reason why so many groups object to the PSA test. Besides, because prostate cancer is slow growing, early warnings aren't that meaningful. As a case in point, the majority of deaths (63%) occur in men 75 years of age and older.
"While 40,000 men die of prostate cancer annually, approximately nine million American men are currently walking around with the disease, and most of them might live their entire lives without ever knowing they had it," say Woolf. Although people have been led to believe that prostate cancer is often a fatal disease in 50-year-old men, this appears to be a misconception. Rather than dying of prostate cancer, these men succumb to heart disease or stroke.
Discovering cancer through PSA tests usually leads to treatment, reports the New Choices article, but sometimes the treatment is worse than the disease. In the U.S., doctors tend to treat even early-stage prostate cancer aggressively, surgically removing the prostate gland and then administering radiation treatments. But there is no conclusive evidence that it makes any difference in helping men live longer or better.
"Our European colleagues are convinced that American doctors have gone over the edge concerning prostate cancer treatment," notes Woolf. Interestingly, much of what we know about untreated prostate cancer comes from studies in Sweden, where doctors simply keep a check on men with localized cancer (one that hasn't spread), a practice called "observational therapy." At most, men receive hormone therapy, but no surgery or radiation. The survival rates of these men, 15 years after diagnosis, Woolf notes in New Choices, are essentially the same for American men who have undergone aggressive treatment. But it's hard to tell someone who has cancer that he doesn't need surgery, radiation, or drug therapy.
See related articles in the AgeVenture archives.
Highest Prostate Cancer Risk Is Black Male
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AgeVenture News Service, www.demko.com
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Neurobic Exercise Keeps Memory Fit
Do you lose car keys, umbrellas, eyeglasses? Ever drive right past your highway exit? Go blank on your best friend's name? Get up from your chair, then wonder why you're standing? Enter a room to retrieve something, then can't recall why? If you're like most people, you worry about your memory. And you know what that means. It means you're normal.
We get frustrated when the ol' brain slips into neutral every now and then. Then we get scared because we think it's a sign of old age, an inevitable loss of brain power. Well, you'll be glad to know that the adult brain is capable of new growth as it ages. That's right. I've got that on good authority. Dr. Lawrence C. Katz, Duke University Medical Professor of Neurobiology, and Manning Rubin have written one of the best new memory improvement books, "Keep Your Brain Alive".
The new book from Workman Publishing Company, New York (1999, $8.95) offers the reader 83 neurobic exercises to help prevent memory loss and increase mental fitness. The exercises represent a unique system of brain exercises based on the brain's power to produce its own nutrients that strengthen and preserve brain cells. Brain cells, says Dr. Katz, learn by making new connections called dendrites, which connect with neighboring cells through linkages called synapses. As the brain ages, these dendrite connections thin out. But the authors suggest that their mental exercises, called neurobics can enrich the connections between brain cells.
Neurobics are not about doing puzzles or brain-teasers. These exercises use the full range of physical senses and the emotional sense to help forge new connections among the different sensory structures of the brain. According to Dr. Katz, "People tend to use the same senses in modern life over and over again, so that they end up using lots of visual and auditory associations. But by bringing the other, under-used senses into play you actually increase the repertoire of brain pathways that are activated." In this way, neurobics act on the brain in much the same way that aerobic exercise enhances physical fitness.
And now, the best part. Neurobics doesn't require expensive equipment, or an inconvenient regimen. You can do it anywhere or anytime. Here are a few examples of how to incorporate these exercises right into your lifestyle routine.
- Use a different hand to brush your teeth.
- Take a new route for your work commute.
- Grocery shop without a list.
- Learn to read braille.
- Vacation at a cooking school.
- Try a new hobby.
- Master a new gadget like a computer.
By practicing the neurobic exercises, readers will become aware of the many ways to introduce new experiences to their lives and enrich their brains in the process. Dr. Katz suggests, "Experiencing life fully is good for the brain". For example, if you go on a trip to Europe, don't spend your time sitting on a tour bus, sleeping in an American hotel, and eating American food. "Instead, rent a car, figure out the roads and drive to a small town where you don't speak the language, and stay in a local bed-and-breakfast and sample the native foods." "That is brain exercise," says Katz. "That is a neurobic experience." By the way, if you get lost in some strange foreign hamlet in the middle of nowhere ... don't call me, call Katz, okay?
In this reviewer's opinion, "Keep Your Brain Alive" is the best value for your book-buying dollar. And, it's an investment in your brain power that will pay dividends for years to come. At $8.95, that's about eleven cents for each of the 83 neurobic exercises in the book. I figured that out all by myself. Hey, this neurobic stuff really works!
See related articles in the AgeVenture archives.
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Double Your Brain Power, plus the Brain Quiz
Brain Booster
AgeVenture News Service, www.demko.com
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Pneumonia Risk Linked to Elder Dysphagia
Current research on swallowing problems (dysphagia) suggests that hospital stroke management plans that include programs to diagnose and treat dysphagia may yield dramatic reductions in pneumonia rates, according to a new evidence report produced under contract to the Agency for Health Care Policy and Research (AHCPR). The report also found that use of comprehensive examinations conducted at the patient's bedside detected most serious swallowing problems, and could improve quality of care and may help reduce costs.
About 6.2 million Americans over age 60 have dysphagia, a condition that can result in "aspiration", when food or fluids enter a person's lungs, and lead to pneumonia. A full bedside
examination includes taking a detailed history, performing a physical examination of the mouth and throat, and observing the patient attempting to swallow various consistencies and sizes of foods and liquids.
Use of full bedside examinations in dysphagia management programs are capable of identifying up to 80% of cases of aspiration, which is often difficult to detect because about half of patients with dysphagia who aspirate do so silently, without a cough. There are, however, options for reducing the problem. For example, a study that compared a soft diet (some solids) to a traditional pureed diet (liquids only) found that a soft diet resulted in lower pneumonia rates among stroke patients with a history of aspiration pneumonia.
"The findings of this analysis will go a long way in helping those people on the front line of care to determine the most effective ways to treat dysphagia resulting from stroke and other neurologic diseases," said John M. Eisenberg, M.D., AHCPR Administrator. "In particular, use of information from the report could help to improve the quality of care for Medicare beneficiaries if the reductions in pneumonia rates the report describes can be achieved."
See related articles in the AgeVenture archives.
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AgeVenture News Service, www.demko.com
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Dr. David Demko, Editor
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