How to Build Your Own Geriatric Team

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MARC AGRONIN: Recently, a woman in her 80s came to my office panic-stricken over a diagnosis of dementia.

Her doctor had done a cursory exam of her cognition, bestowed the damning diagnosis, and prescribed twice the recommended starting dose of a medication for her memory.

She then began suffering from severe appetite loss and nausea. Missing from her medical care was any detailed understanding of age-related cognitive changes and the proper dosing and side effects of the prescribed medications.

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How Technology Will Revolutionize Long-Term Care

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MARC AGRONIN: Henry went viral. Over 1.7 million viewers and counting have witnessed this wheelchair-bound nursing-home resident being provided with his favorite music piped into headphones from an iPod. This clip, from Alive Inside, a movie about the Memory and Music project that brings donated iPods to individuals in nursing homes, is one illustration of how technology is driving innovation in the long-term-care sector of health care.

The average long-term care resident, whether in a nursing home or assisted-living facility, is in his or her 80s or 90s and suffering from one or more serious physical or cognitive limitations. Aside from a few computer-savvy people, most of these individuals need help getting wired. In addition to the Music and Memory program, several other initiatives have begun using iPods, iPads and other tablets to bring sensory and cognitive stimulation to residents who are otherwise bored, restless or in search of some purpose in the moment. For example, a pilot study at the University of California, San Diego found that iPads were safe and effective in reducing agitation in patients with dementia. These same tablets are increasingly being used by family members to connect grandma or grandpa with distant family and friends via networks like Skype. Telemedicine and telepsychiatry make use of similar but more souped-up technology to bring specialists such as geriatric psychiatrists to the bedside of nursing-home residents in underserved areas.

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Why Is Aging Still a Joke?

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MARC AGRONIN: The news, it seems, is not good. Health-care costs will be overwhelmed, we are told, by the “silver tsunami” that is on the way. Even a gentler description of the coming “age wave” as opposed to a destructive flood still seems to portend trouble. World War G-for-geriatric is at hand and, lacking any true fountain of youth, we are all counseled by the media to train our brains to be like younger folk–supposedly stronger, smarter and less of a burden to the system.

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The Nursing Home of the Future Will Be in Our Homes

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MARC AGRONIN: In 2011, the first baby boomers turned 65. In 2031, these same baby boomers will begin turning 85, and a bubble of supposedly frail and cognitively impaired elders will begin swelling the nursing-home population.

Or will they?

While it’s true that by 2030 the U.S. Census Bureau estimates that 20% of the population will be 65 and above, nearly double the current statistic, it is not clear that these aging boomers will be in the same state of physical and cognitive decline as comparable elders today. Given current trends in medical research, health care and technology, it’s likely that the future long-term care facility will be less facility and more home. Let me explain my predictions for the future.

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Let’s Close the Alzheimer’s Diagnosis-Disclosure Gap

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MARC AGRONIN: “Frank, but not blunt” is how one textbook on medical ethics advises its doctor-readers to impart bad news to a patient. Most doctors today are generally good at this approach, girded by in-depth tests, scans and tissue samples that confirm the diagnosis. Gone is the doctor’s paternalism of days past when serious diagnoses like cancer were simply kept from the patient.

So why is there such a gap with disclosing a diagnosis of Alzheimer’s disease? According to a recent report by the Alzheimer’s Association, more than half of people with Alzheimer’s disease or their caregivers have not received the diagnosis from their doctors.

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A Humane Alternative to Physician-Assisted Suicide

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MARC AGRONIN: Since the inception of Oregon’s Death with Dignity Act in 1994, approximately 750 individuals having taken their own lives with the assistance of a physician, representing 60% to 70% of those who sought out and received a lethal but legal prescription. Routine data collected from these individuals indicate consistently that the most common reasons for seeking physician-assisted suicide in Oregon include loss of autonomy, decreased ability to participate in enjoyable activities, and loss of dignity. Concern about pain is less commonly reported, perhaps because up to 90% of individuals were enrolled in hospice.

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Why Older Job Seekers Must Have an Online Presence

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MARC AGRONIN: What one tip would I give to older Americans who are currently out of work, but who would like to find full-time employment?

Manage your digital footprint. I had a good laugh recently when I witnessed my 12-year-old son, Sam, fiddling with a VCR machine and trying to insert the tape upside down. This once-ubiquitous machine was a complete mystery to him, and with good reason. It is essentially obsolete, and I am not even certain why it still sits connected to our television set. He was even more bemused trying to figure out how an old rotary phone worked.

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Let’s All Stop Trying to Be Young Forever

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MARC AGRONIN: What is one element of growing older that has surprised me?

The new normal. A friend once related to me that when his mother moved into an assisted-living facility, her first complaint was having to spend so much time with all of the “old ladies” there. This was a surprising statement coming from a woman in her 90s, but it typified an element of growing older that many of us discover. With each age attained, we quickly accommodate to the change and feel that it is the new normal. In this mind-set, we often perceive “old age” as something that “other” people have.

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Why Your Grandmother Should Use Social Media

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MARC AGRONIN: Consider this a baptism by Facebook FB +1.31%.

Grandma goes onto the Internet and sets up a rudimentary Facebook profile, excited to begin perusing her grandchildren’s pages. A new world opens up—although perhaps not the one she expected—as she begins to take in all of the endless posts with photos full of risqué social activities and exuberant, silly rants and raves about their latest adventures.

Grandma then begins to add in her own commentary and photos, much to the (pick one) “delight,” “horror” or “outright astonishment” of her millennial brood. Several years ago it was speculated that the reaction was one of “uncoolness” and it was driving younger users from Facebook to Instagram, which is now—surprise!—owned by Facebook.

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How to Find Your Passion Later in Life

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MARC AGRONIN: Once upon a time the great American psychiatrist Gene Cohen made an interesting discovery while perusing the extraordinary works of 20 of the greatest African-American folk artists from 1930 to 1980 at an exhibition at the Corcoran Gallery of Art in Washington DC: 80% of the artists had either started their craft or reached a mature phase after the age of 65, and 30% of them did so after the age of 80.

Cohen’s observation teaches us a keen lesson about the potential for finding and developing one’s passion in life: Age is not a barrier but more often the trigger and sustaining fire for creative and meaningful passions in retirement.

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