Anti-Anti-Aging: Alternative Perspectives on Getting Older

In my last post, I explored the world of "brain training" and offered my opinion on some of the lofty claims of the burgeoning brain fitness industry. Although there are several such programs available on the market offering a variety of games and activities, each strives to accomplish a common end result: delay, if not reverse, the cognitive declines associated with aging. Much of their success comes from the fact that this promise is appealing to many people who view aging with trepidation and perhaps even disgust. Especially in the United States, to a society that prizes youth and beauty above all else, the stereotypical characteristics we associate with getting older are decidedly unpleasant. Although the millions of dollars generated by industries capitalizing on this public fear (anti-aging cosmetic products, plastic surgery, etc.) speaks volumes about the majority's view of aging, alternate views have emerged in recent years and are also enjoying increasing support within the aging communities.

Whether concerned with the physical or intellectual tolls of "normal" aging, much of the research emanating from laboratories today ultimately ends up being put to use to make a product available to the public for sale. The anti-aging industry is, after all, a business. New studies, however, have implications that go beyond the superficial aspects of aging and the preventative measures (such as diet and exercise and the prophylactic use of vitamins and supplements). In his post, "How a story reversed the aging process," Improved Lives blogger Stu describes the recent research showing that merely imagining yourself younger can often bring the health benefits of actually being younger. The post goes on to suggest the beneficial consequences of this "mind over matter" approach, illustrating one perspective that deviates away from the money-based solutions that dominate the current market. Money too is at the heart of the approach taken by guest essayist Dr. Daniel Callahan in a recent post featured on the New York Times New Old Age blog. "How old is too old for lifesaving surgery?" is distinct from other views on the aging process in that he asserts that risky and costly procedures are too often performed on elderly patients that in the past would have been turned down simply due to their age. It is Callahan's belief that our already cash-strapped Medicare system would benefit hugely from an "age-based rationing" of care, denying expensive surgeries to patients who most likely will only go on to develop another fatal complication of old age. Almost 20 years after he first published his proposal in his book (pictured below), Callahan updates and defends his controversial position, citing a Medicare system that has only gotten worse in the years since. Although the content of the posts themselves are distinct, both refuse to view aging as a disease to be avoided at all costs. In addition to posting them on their respective blog sites, I have included my comments to each below.

"How a story reversed the aging process"

Comment:

I would like to first thank you for your interesting and thought-provoking review of the recent experiments that have demonstrated aging to be as much of a state-of-mind as it is a physical process. Although it may simply be the implication that we have a considerable amount of control over the nature of getting older that is so appealing, these studies have the potential to dramatically change the approaches to aging we take. On one hand, it seems as though so much of the admittedly admirable work that comes out of the science and research communities focuses on the abnormal aspects of aging, while on the other, the booming cosmetic and plastic surgery industries bombard us with the notion that vigor and vitality are things we have to buy in a bottle. For so many left somewhere in between the two extremes, it is refreshing to learn that psychological as well as physiological benefits can be had using the power of thought. While the three "suggestions" you set forth might seem like common sense in achieving these ends, I believe they speak to a larger acceptance of aging as a journey within itself, rather than an obstacle to be overcome or an ending to be dreaded.

"How old is too old for lifesaving surgery?"

Comment:

While I may not agree entirely with your proposal to ration care to the elderly, I thank you for sharing a fascinating and provocative perspective I was previously unfamiliar with. As someone who is passionate about both the scientific and societal aspects of aging, I had yet to recognize the conflict created by advances of the former and inflicted upon the latter as an explanation for our floundering Medicare system. Although I am undeniably supportive of research efforts to diminish or altogether do away with the unpleasant physical declines of aging through use of surgery and other medical procedures, I am also of the opinion that aging overall ought not to be viewed as a disease to be eradicated completely. Instead of being grateful for the added years science and improved technology has brought us, we are all too quick to assume that human longevity can, and should, be infinitely drawn out. The argument that costly procedures are, for lack of a better word, wasted on individuals who have little chance of survival, and will likely face additional diseases even if they do, is a persuasive one, especially amid the staggering Medicare figures you cite. Although I would prefer an alternative path to fixing our health care system that does not include cutting off benefits to patients based solely on age, the fact remains that something has to change. That you first proposed this policy change almost 20 years ago only emphasizes the magnitude of the country's dilemma.

Aging Well: Is "Brain Training" the New Fountain of Youth?

A recent AARP.org article offers to seniors five keys to living longer, but it might be more accurate to call them five keys to living better. The advice, which includes encouragement to seek work and volunteer opportunities, spiritual fulfillment and self-awareness, seems to credit longevity to living with purpose. After centuries of working to increase human lifespan primarily by way of improved medicine, food production, and access to care, researchers and aging individuals alike are now focusing on adding worth to the years we've gained beyond the numerical values. Simply put, to those devoted to the science of aging, quality is as important now as quantity.

When it comes to living well, although we have seen some innovation, much of the "new" information we are inundated with lately appears to many to be common sense, or at the very least a rehashing of what has already been discovered and divulged. A separate AARP.org article entitled "50 Ways to Boost Your Noodle" is one such example of this. The article is yet another recitation of the recycled mantra commanding aging persons to "sleep" and "get support for stressors," as if this information is somehow new or different to most semi-intelligent individuals. Although it may be true that there is a disconnect between what the American public knows is good to do and what it actually does, pieces of advice similar to those offered here usually fail to deliver the dramatic opportunity for a lifestyle revolution so often promised. In addition to merely annoying the readership with their repetition, some of the information shared can be confusing and even contradictory. The perfect example of this of course is the oft-heard question of exactly how many glasses of red wine one is supposed to drink per day, in order to achieve the optimal health benefits. One? Two? 1,000 (perhaps some claims are more obviously flawed than others)? Along with the constant directives to eat right and exercise for better health in our aging years, of particular interest and focus has been the ways in which older individuals can "train" their brains, or improve their cognitive functioning abilities by way of simple daily tasks and games. While these programs can be entertaining, the health benefits they bring are far from revolutionary, and most likely do not exceed those achieved by performing any other minorly engaging cognitive task that is already present in everyday life (such as reading a paper).

One field that has benefited tremendously from the growing public awareness of brain health maintenance in old age has been the brain "training" websites and programs. The games produced by these research teams and companies are full of brightly animated colors and addicting tasks, and test memory, attention, processing speed, and other executive functions of the brain that have been found to decrease in efficiency as we age (a sample game can be found here, a screen shot of which is shown to the left). Web-based Lumosity.com is one such enterprise that has garnered both media attention and user adoration in the years since its conception. The research organization behind the games is Lumos Lab, whose Scientific Advisory Board includes neuroscientists from Stanford University and UCSF. Links from the site to ongoing research reveal that the program is just part of a larger study, and even allows users to volunteer to participate in testing the newest brain training tools. The home page boasts a sample of the prestigious publications and outlets that have featuring the site, such as the New York Times, Women's Health magazine, and the Martha Stewart show ("I've been having so much fun," Martha claims). Multiple graphs, such as the one shown below, accompany the site's study-based claims of proven memory and attention improvement in individuals that play the games. The site itself is clean, attractive, and user friendly, and older audiences were clearly in mind when the navigation and layouts were designed. The website additionally sponsors a blog that highlights recently published research on brain health, such as a recent post about the effects of smoking on the brain written by a cognitive neuroscience research at SFSU and UCSF. In a demonstration of the organization's efforts to stay current, the myBrain Facebook application was launched in September 2008, allowing users to access many similar features from the popular social networking site.

A New York Times article that reviews Lumosity.com also points out that the website is not the only brain training game in town. Similar products have enjoyed their success as well, including Nintendo's Brain Age 2, which has sold 14 million copies worldwide since its release in 2005, and Happy-Neuron.com, which has partnered with AARP and can be accessed by visitors to that site. In fact, the so-called "brain fitness software" industry is a booming one, and expected by one company head to "reach $2 billion by 2015." Despite the popularity of these programs, fellow researchers, however, are more skeptical of the claims they make. For one thing, the notion that humans can exercise their brains much in the same way we exercise our muscles to gain stamina and performance is not exactly a novel idea. According to a New Scientist article, commercial brain training has been around for a decade, but has only recently begun to achieve mainstream attention. Moreover, there remains no clear answers to several questions, one of which being whether the games enhance brain functioning or merely slow the decline. The answer to the most significant question, does it work? "It depends." Writer Graham Lawton goes on to cite problems in the research designs of Lumos Labs' studies, including a small number of participants and the lack of findings being published in a peer-reviewed journal. Overall, the article likens brain enhancing programs like Lumosity.com to anti-aging creams, an analogy I find to be applicable for nearly all of the advice and information on living better as we live longer. While there is no one study that can be conclusively pointed to as proof that these tools and tricks work, alternatively there is no study to prove that they do not. Games promising to train one's brain are perhaps no help, but are definitely no harm, so why not?

Working Through Retirement: Avoiding Red in the Golden Years

In my last post here, I focused on what I see as the need for Americans to postpone retirement until at least age 70, due to the substantial increases seen in longevity alone since the establishment of the federal assistance program for aging folk during the Great Depression. While I admit that the reality of turning this directive into policy will most likely take considerable time as Social Security is all too bogged down by bureaucratic hurdles and partisan conflict, individuals in the meantime must take personal responsibility for their financial futures and emotionally reconcile with the necessity of working longer. This need has been made all the more pressing in recent months as the economy has taken sharp downturns that have hit workers hard across the age spectrum. Current issues for older employees (loss of pensions, decreasing values of investment funds) therefore present two options: staying longer than intended at their current jobs, or, if that is not an option, finding another job, referred to by some as a "second career." Many have been forced into the latter route even after years of retirement. In an effort to gauge how others feel about this development, I surveyed the blogosphere and found a number of thought-provoking entries. In a post from the Forrester Blog for Information & Knowledge Management Professionals, blogger Connie Moore examines the challenges older workers face, both on the job and in deliberating retirement. A second post from the Job Searching Blog explores the alternatives offered to those unable to stay at their current jobs. My posted comments to both appear below.

"Retirement??? You've Got To Be Kidding!"

Comment:

Thank you for your insightful post regarding the various and often complex considerations that go into modern retirement. It seems so often that we hear about older workers having difficulties or being the target of layoffs because of their inability to keep up with job responsibilities and the demands of an ever-changing workplace, frequently without satisfactory explanation as to why this is so. Your detailing of some of the specific physical changes that underlie such instances is fascinating and appreciated. Regardless of the troubles some aging employees face, they are a valuable asset to countless offices and companies across the United States, and their presence and contributions to the workforce ought not to be discounted. The simple fact that we will all be in their position one day further mandates that we afford them the satisfactory treatment they deserve. Given the current economy, many of us face an even greater amount of financial insecurity upon reaching senior status. According to a recent survey conducted for TD Ameritrade, 63% of people have stopped contributing to their retirement accounts. Now more than ever, when investment funds once depended upon to support older individuals in retirement are subject to the volatile market swings, we need to reexamine their role in the labor force and make it easier for them to at least continue to work in some capacity years later than they may have originally planned for. This includes both the increase of resources to be made available to those older individuals looking for so-called "second careers" as well as on-the-job training for those able to stay where they are currently (an example of which is pictured above). Because many companies may resist the implementation of an expensive training program, I advocate an "official" delay of retirement at the federal level, from the existing 65 (although the average retirement age is in fact 63) to perhaps age 70. While many people have already come to terms with this postponement, and you speak of those who even desire it, it is time we incorporate it on the policy level so as to motivate the working masses and make on-the-job training for older workers the norm, rather than the exception. I do recognize that retirement for many is an emotional as well as a financial decision to those who have eagerly anticipated a few years of well-deserved rest and relaxation after decades of service, and I similarly concede that even the contemplation of when to retire is a taxing one. Nonetheless, my preference to delay Social Security benefits a few years would not only help to alleviate the fiscal implications of deciding when to retire, but would also force people to reevaluate contemporary retirement by removing the element of choice (obviously, exceptions would apply). Aging workers can get the help they need, if we adopt change at both the policy and personal level.

"Rewire, Don't Retire"

Comment:

Your interesting and judicious post is a timely one, as the economic downturn is often felt twice as hard by seniors as retirement funds are lost and layoffs are disproportionately doled out to older workers. I especially appreciated your use of statistics tracking the aging workforce. The numbers cited are both ominous, as to whether or not a prolongation of this bleak economy will be able to support such a growth in 65+ workers, as well as encouraging, in that an increasing number of persons expect to work in retirement. While older employees might fear being laid off in favor of young and perhaps more "trainable" workers, your post makes the valid point that aged individuals who do not require training are considerably more financially efficient in certain fields. A number of other traits traditionally recognized to be held more so by older workers inspires additional confidence. Nonetheless, for those who may have to seek further work, the prospect of entering the current job market is daunting, especially for older individuals unprepared for the competition and even more so for those who are having to come out of retirement after several years of respite. Resources directing these people to senior-friendly companies (such as Wal-Mart) and available training programs are invaluable to this demographic, and will hopefully lend assistance where it is increasingly needed. While I am heartened to read that several of the individuals you cite, as well as many of those polled by AARP, are resigned to working years past they originally planned, it is my opinion that the "official" retirement age (defined here by the age at which Social Security benefits kick in in full) be extended. Although I admit this to potentially carry an emotion cost comparable even to the financial benefit of working longer, it is my opinion that continuing to work, especially in a "second career" type of situation, can not only be fiscally smart but psychologically rewarding for many aging individuals as well. Of course, this potential fulfillment will only come when seniors are able to find work relatively easily and in varying areas of interest, further emphasizing the need for resources akin to the ones you cite here.

Rethinking Retirement: The Consequences of Increased Longevity and Financial Uncertainty

For many people in this country, the promise of a relaxing and carefree retirement is as much a part of the American dream as the decades spent working for paychecks and climbing career ladders. Unfortunately, this dream is turning into more of a fantasy for many who planned to walk out of the office door and never look back upon reaching age 65. The reality of previously held unrealistic expectations regarding retirement, compounded with the increasingly dismal economic crisis, have forced American workers across the pay scale to acknowledge that retirement may have to wait. Even if the economy was good, which it clearly is not, a retirement age of 65 is simply not practical. While some may feel it unfair to be told to put a few extra years in, the retirement age should be extended, if not at the policy level then at least at the personal level for now. This decision is now all but required for the present and future financial security for aging individuals.

Although some companies offer employees pension plans in one form or another, a major source of income for many retired Americans is government-operated Social Security. Frantic projections that Social Security funds are to run out any second and explicit reform plans from Congress members and interest groups aside, one thing is certain: while demographics have undergone immense changes in the proportions of older individuals to the rest of the American population in the years since Social Security was first conceived, evolution of the program itself has failed to keep pace with the society in which it operates. The Social Security Act was passed by President Roosevelt in 1935 in response to the unemployment rates brought on by the Great Depression. The Act allowed retired workers aged 65 and older to collect annual wages from the federal government. At the time, life expectancy at birth in the United States was 61.7 years, a full 3.3 years less than the retirement age! This means that more than half of the people born in 1935 were not even expected to reach retirement age, let alone be eligible to collect Social Security. In 2004, as shown by the graph at the right (along with projections through 2050), U.S. life expectancy at birth was 77.9. The retirement age, however? Still 65. In fact, workers are now able to begin receiving Social Security benefits at age 62, albeit at a reduced rate. Additionally, the life expectancy at age 65 (the number of additional years an individual can expect to live upon reaching the age of 65) has increased as well, so qualifying retirees can expect to collect benefits for longer than they did when the Act was originally conceived. In other words, there are not only more individuals collecting benefits (there were a total of 35.9 million adults age 65 or over in 2000, up from 7.8 million in 1935), but also collecting for longer. A simple look at the numbers and it is easy to see why Social Security has become such a problem for this nation.

Unfortunately, the current economic climate not only increases the necessity of delaying retirement but also makes the directive of merely telling working adults to stay behind the desk for a couple of extra years a little more complicated as well. A recent New York Times article details the declines in millions of 401(k) plans as a result of the plunging stock market, as well as the increasing amount of individuals who are not currently able to contribute to such retirement funds in the wake of rising mortgages and energy prices. Among boomers, "20 percent said they had stopped contributing to retirement plans, 34 percent said they were thinking of delaying retirement and 27 percent acknowledged problems paying rent and mortgages." Article author Steven Greenhouse also features several individuals who are now preparing to retire as many as ten years later than they had originally planned. Nicolette Toussaint, age 57 and an associate vice president for communications at Alliant International University in San Francisco, is one of those reconsidering her future. "'I sort of assumed that I would probably retire around 68," Toussaint is quoted as saying. "But with what's happened recently, I'm thinking I might work until 75 or 77, so long as I'm healthy." An AARP feature additionally mirrors the growing concern about the economy's impact on individual retirement plans, providing the answers to the top financial questions from seniors. Many of these queries concern investment funds previously depended upon to support them in their retirement, now seriously jeopardized by market drops. Furthermore, the economic quandary delivers a double blow to seniors in the fact that hard-hit employers are having to resort to layoffs, a development that disproportionately affects older individuals as companies aim to push out the most expensive employees (who tend to be the oldest). Aged workers are also often viewed as having more difficulty adapting to new technology and changes in responsibilities. As a result, even those older adults who want to delay retirement are sometimes forced into it.

So what can older members of the workforce do? First and foremost, if possible, they should keep working. If doing so at their current job is not an option, there are still a number of alternatives to full retirement. Other New York Times articles highlight the growing number of aged individuals who go back to school for alternate and advanced degrees (the number of graduate students older than 50 "grew by 38 percent between 2001 and 2005, according to the National Center for Education Statistics"), as well as some who leave more competitive fields for second careers involving personally meaningful work. Those wishing to embark on their "second act" have a number of resources to turn to, including job search websites aimed at older job seekers such as SeniorJobBank.org and RetiredBrains.com. RetirementJobs.com (pictured at left), for example, lists a number of their "certified age friendly companies," from Macy's to Safeway to Wells Fargo. Although it is clear that the provisions of Social Security will have to be reformed in a major way by the federal government, it is imperative that individuals incorporate change into their retirement plans now. This is especially necessary given the present economy. While this may be an emotional as well as a financial adjustment for some, a fiscally secure retirement is well worth it.

Aging Online: A World Wide Web of Aging Information and Resources

For my post this week, I took to the web to explore the websites and blogs I find to be interesting and useful regarding the developments in aging. These sites represent a wide variety of style, content, and intended audience, but all are united in their desire to provide information on the important and rapidly-changing world of aging research and policy. Using the guidelines established by the Webby Awards and the IMSA, I evaluated my favorite sites along a number of criteria, including content, structure and navigation, visual design, functionality, interactivity, and overall experience. Additionally, I assessed the selected blogs on measures such as blogger identity, authority, citation, and sophistication. As well as adding these sites to my linkroll, I have included the links within my brief synopses here.

The first subset of sites I find to be useful are those that disseminate the basic background and information concerning the health issues that are commonly associated with aging, Alzheimer's disease in particular. WebMD, a popular and user-friendly health information database, has an Alzheimer's Disease Health Center that is well-organized and information-rich on the many facets of the disease. Visitors familiar with the main site can trust the comprehensive disease guide to be accurate and easy to understand. Message boards increase the site's personalization and interactivity. OurAlzheimers.com presents a similar collection of disease facts, treatments, and resources. The reputable site affiliates and featured content from leading health publications bolster the credibility of the site. Health Talk is another news and information database for Alzheimer's patients and their families. The site is easy to navigate and does not overwhelm the visitor with links. A search function allowing visitors to type in their city and state provides a helpful tool for those looking for a specific type of doctor in their area. Health and Age presents an attractive and organized home page offering a variety of Alzheimer's news, articles, and tools. One sticking point is the ambiguity of the graphics along the left side of the site, as it is unclear whether they are links or advertisements. As an international health database, Health Republic offers much of the same information found on the previous sites, as well as a collection of health news that draws from a global rather than national database. Although not all of the stories concern aging health issues, the volume of articles, as well as the pleasing visuals, makes the site a unique informational resource.

The next subset of my preferred sites is made up of nonprofit organizations and lobbying and special interest groups. Probably the most well-known senior interest group, AARP's website (the logo of which is pictured below) is exactly what a visitor would expect: authoritative, organized, and wide-ranging in terms of information. In addition to the usual news and research presented on many sites aimed at seniors, AARP offers fun and entertaining features, such as recipes and travel tips, that contribute to the sense of a well-rounded community. Another prolific organization is the Alzheimer's Association. Their site offers a similar collection of information and community tools, although the lackluster aesthetics leave a little to be desired. AgingCare.com is a comparable forum with a more appealing layout. However, a lack of clear affiliation and identity (be it partisan or nonprofit, et cetera) lends doubt to its authority. The Alliance for Aging Research's page is far less interactive that previous sites, and instead focuses on the concise detailing of recent publications concerning research conducted in the field of aging. Despite its lack of bells and whistles, the site serves its purpose as a compilation of more obscure sources. Likewise, the International Longevity Center's site favors function over form. Unlike other organizations, the focus here is not dementia or Alzheimer's but "normal" aging, setting it apart in a unique and interesting way. In addition to these non-governmental organizations and groups, the federal government offers its own assortment of sites aimed at the aging community, a couple of which are of particular use and interest. Clearly, these sites, although they tend to be a bit on the boring side, carry a huge amount of authority. The first site is the Administration on Aging (AoA), a collection of government-sanctioned resources for the press, professionals, and elders and their families. As part of the larger Medicare site, Ask Medicare is the new government feature aimed directly at caregivers (as well as the topic of my analysis in an earlier post).

The final subset of websites I feel are particularly helpful are blogs, many of which are created and maintained by individuals, professionals and laymen alike. The first several blogs I explore, however, are sponsored by major news outlets. The New York Times' The New Old Age is devoted to exploring not only the effects of aging on seniors, but other adults majorly implicated by the changes (such as the boomer generation) as well. The blog obviously brings a strong authority, and blogger Jane Gross effectively and knowledgeably details a wide range of aging topics. A supplement of links and resources adds to the well-roundedness of the blog. Similarly, the Wall Street Journal lends its weighty reputation to their Health Blog, which emphasizes the business aspect of the health community. The content-rich site adds fresh perspective to the overall implications of what an aging society means for America. The first of the individual blogs, Ageing Research focuses more on the scientific, rather than societal, developments in aging. Posts are well-written and engaging, and the author clearly brings an extensive education and background to the discussion table. Another blog, Ouroboros, also focuses on the biology of aging. Although some of the posts are a little inaccessible in their terminology and technicality, a unique perspective and a clean layout make for a fascinating, if somewhat tangential, read. As part of a much larger network of caregivers' blogs, Minding Our Elders is aimed at the family and friends of aging individuals. Although it features a scattered design and hodgepodge of subject matter, the blog hosts a definitive voice and obvious passion. Another blog centered on caregiving is Aging Parents Insights. Author David Solie addresses a number of significant issues within the realm of aging, and offers visitors to pose questions to him directly through the website. The Health Care Blog (pictured right), vetted by respected news organizations for its insight and information, almost overwhelms with the amount of links and resources it offers, in addition to its diverse reporting on the site itself. Content is topical and sophisticated, with a discriminating use of graphics and advertising that could distract from all the site has to offer. Finally, Senior World Chronicle is the blog answer to Health Republic, in terms of its international accent. While most posts seem to be a republishing of articles from around the world, extensive archives and labels tie a number of topics concerning aging to a centralized site. While not without some drawbacks, each of these sites offer a number of positive aspects and unique perspectives. I encourage you to visit them and explore the many resources and viewpoints that exist within the aging news and research community.

Caring for Caregivers: Dealing with Medicare's Long-Term Coverage

In my last post I explored the potential impact of the federal government's recent resolution to hold Medicare Part B premiums stable for 2009. While the decision will be beneficial to many Medicare recipients requiring doctor visits and other outpatient services, most of the patients and their families dealing with the costs of long-term care will see no such respite. Long-term care has for a while been the "Achilles heel" of health care reform advocates, as it is often overlooked in favor of the far more prominent aspects of health care such as prescription drug costs and doctors' fees. Many credit this to the prevalent assumption among middle-class Americans that Medicare (and more specifically Medicaid, which oversees most of the long-term care coverage that is funded by the government) will provide for them in their later years, and therefore fail to seek out other options that might save them money in the long haul, such as long-term care insurance. This plea for greater consumer awareness is heard from across the political spectrum. In a blog post titled "USA: Long-term care often left out of talks on health care reform," Emily P. Walker quotes senior fellows at both libertarian and conservative think tanks acknowledging the increased responsibility Americans must assume over their long-term care needs.

This week I surveyed the blogosphere to get a feel for how others viewed the public's perception of long-term health care, and the amount of reliance placed on a government program that explicitly lacks the provisions of adequate coverage for all but the poorest Americans. The first blog post I looked at was on AgingCare.com, a popular and informative resource aimed at caregivers. A survey of caregivers they had conducted reveals an overwhelming lack of predictability and planning concerning how caregivers were going to pay for their parents' care needs in the years ahead, as well as statistics regarding the current impact of care financing in the day-to-day lives of caregivers. The second blog post I looked at was part of "The New Old Age" blog hosted by the New York Times. Author Jane Gross explores a new government-sponsored website offered through Medicare aimed at caregivers, specifically with the intention of directing those who do not qualify for aid to other resources that might help to fill in the gaps. In addition to posting my comments directly in these blogs, I have excerpted them below:

"Cost of Caring for Aging Parents Could be Next Financial Crisis"
Comment:

As someone who is very curious to see just how we as a country are going to deal with the increasing number of elderly Americans who need long-term care in the coming years, I would like to thank you for highlighting such an important issue that is so often overlooked by policy-makers and the public. Your survey emphasizes the vast numbers of caregivers in this country who are struggling to finance the costs of caring for their parents while maintaining happy and healthy families of their own. I was especially shocked to read the overwhelming percentage of caregivers who had to make substantial sacrifices in their own careers as a result of caregiving responsibilities. This phenomenon, combined with the increasing costs of personal caregiving and the lack of government support leaves little wonder as to why so many have minimal foresight into maintaining that care in the future. The emotional toll this compilation of stresses takes on caregivers is ominous for the mental and physical health of our country, perhaps soon leading to a health crisis of its own, in addition to that already faced by the millions of aging individuals who require such devoted care. As articles such as this one circulate beyond the all-too-aware caregivers who are personally familiar with such grim statistics, we can be hopeful that the government and health care reform advocates who work to improve its programs recognize the need for long-term care improvement within the framework of a larger health care overhaul. Until then, increased awareness from the American public regarding the burdens they too may one day face can only be a positive thing.

"Medicare Reaches Out to Caregivers"

Comment:

While it would be nice if the American public needed to look no further than Medicare/Medicaid to receive the assistance it requires when paying for the long-term care costs incurred by so many aging individuals and their families, the new website directing inquiring consumers to other resources should hopefully be a useful compromise while we wait for an extensive overhaul of the health care system. Caregivers and their advocates have long been familiar with the gaping holes left by the long-term health care coverage provided by the federal government, but have often remained uncertain of where exactly to turn for help. This website is a positive force, both for those who currently struggle to obtain the care information they need, as well as a possible signal of recognition of the burdens long-term care stands to place on the average American from Medicare officials. Perhaps in the near future administrators who are aware of the overwhelming financial strains incurred by long-term care--such as Kerry Weems--will be given the necessary platform to initiate legislative reform. Until then, the website will have to suffice. As for the specific content of the new website, I appreciate the inclusion of non-government sources such as AARP and the Alzheimer's Association, which have long been vital mainstays of support to caregivers. Until Medicare evolves to include a larger portion of American taxpayers, it is crucial that these embattled individuals receive all the assistance they can get, and a centralized hub of resources available will certainly help to do so.

The Axis of Alzheimer's: Global prevalence is on the rise, while domestic Medicare policy changes fail to ease the financial burden of long-term care

This past Thursday, the world's oldest man celebrated his 113th birthday. It is fitting that Tomoji Tanabe, who wants to live "another five years or so," lives in the world's oldest country, Japan. Over a quarter of Japan's 127 million plus population is over the age of 60, and that number is expected to grow to 44% by the year 2050. Although Tanabe has been fortunate enough to enjoy relative good health in his late years, millions of others have not been so lucky.

Today, September 21, is World Alzheimer's Day. While enormous strides have been made in the understanding and treating of this harrowing disease, doctors, patients, and caregivers the world over champion for greater awareness and action. They continue to stress the need for increased research and care funding, as the United States and other countries struggle to assist those afflicted, a demographic bound only to increase as the world's population of elderly individuals grows. As the world observes this day of awareness, a reflection on a recent change to Medicare and the diminishing role of health care in the upcoming election indicates a need for increased focus on the financial aspect of long-term care for those suffering from Alzheimer's here in the U.S.

The most common form of dementia, Alzheimer's currently affects some five million Americans, and 26 million people worldwide. With the cause uncertain and no known cure (at best, current treatments have proven only to slow the loss of function associated with the disease), Alzheimer's is the sixth leading cause of death in the U.S. Alzheimer's is a degenerative disease of the brain, resulting in the loss of memory and cognition, and ultimately, the loss of bodily functions. Although the prognosis and duration can differ from person to person, Alzheimer's ultimately leads to death.

Despite the fact that Alzheimer's is commonly known as a disease of old age, a mounting number of cases are being diagnosed in patients in their 30s and 40s. That, combined with the growing proportion of Americans living longer makes for an estimate of 16 million that will be afflicted with the disease by the year 2050.

The crisis of how to handle elderly health care is an international one. As Japan struggles to finance health care insurance for their large population of senior citizens, France, Britain, and Germany are experiencing similar demographic shifts skewed toward the older populations that will mirror Japan's in the years to come. The charts on the right depict Japan's population based on age and sex. The one on the far right, projecting Japan's population in 2050, is in the shape of an inverted pyramid, demonstrative of a nation facing an increasing proportion of the elderly relative to younger and middle-aged adults. Here in the U.S., the state of Florida already has an elderly population proportional to Japan's, with Colorado expected to follow in 2020. As expected, greater numbers of aged individuals translate to greater numbers of Alzheimer's patients. Asia hosts half of the world's Alzheimer's cases with 12.6 million suffering from the disease, a number projected to jump to 62.8 million in 2050. Even developing countries, where prevalence rates of Alzheimer's were once incidental due to low life expectancies, are faced with how to deal with the epidemic as newfound prosperity increases longevity.

On Friday, the federal government stated that, for the first time since 2000 and only the sixth time in the history of Medicare, outpatient premiums will not increase in 2009. The premiums staying constant at $96.40 fall under Medicare Part B, which covers doctors' visits and other outpatient services. Although many Medicare recipients may see this as a positive step toward easing the cost of health care on the individual, it is doubtful this plan will assist those suffering from and caring for patients of Alzheimer's. Out-of-pocket nursing home care deductibles, an expense more commonly associated with caring for patients with Alzheimer's, will rise $44 to $1068 in 2009. Additionally, as it stands now, Medicare covers only skilled nursing facility or home health care deemed medically necessary, denying coverage for most long-term care. The pie chart on the left represents the national health expenditures for 2006. Most long-term care needs (those most commonly associated with Alzheimer's and other chronic illnesses) fall under the categories of home health care (3%) and nursing health care (6%). An offshoot of Medicare, Medicaid currently provides long-term coverage for low-income individuals and families, a program currently under reform with hopes of increasing choice in care options available to patients and families, improving the quality of long-term care offered, and reducing costs and supporting government tax law changes to provide for the private funding for long-term care needs.

For the millions afflicted with Alzheimer's here in the U.S., and the millions more in charge of their care, something in the way our government provides health care has to change. As the presidential election approaches amid crises in the stock market and mortgage industry (both of which make affordable health care that much more important as food and gas prices rise, often disproportionately affecting the elderly), health care reform advocates struggle to remain at the forefront of issues. While long-term care, particularly related to caring for those with Alzheimer's, isn't specifically the focus of the health-care debate, increased attention and insistent action from the American people can only stand to benefit the progress being made fighting the disease and caring for those who suffer from it here in the United States.