Do We Simply Not Care About Old People?
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The covid-19 pandemic would be a wake-up call for America, advocates for the elderly predicted: incontrovertible proof that the nation wasn’t doing enough to care for vulnerable older adults.
The death toll was shocking, as were reports of chaos in nursing homes and seniors suffering from isolation, depression, untreated illness, and neglect. Around 900,000 older adults have died of covid-19 to date, accounting for 3 of every 4 Americans who have perished in the pandemic.
But decisive actions that advocates had hoped for haven’t materialized. Today, most people — and government officials — appear to accept covid as a part of ordinary life. Many seniors at high risk aren’t getting antiviral therapies for covid, and most older adults in nursing homes aren’t getting updated vaccines. Efforts to strengthen care quality in nursing homes and assisted living centers have stalled amid debate over costs and the availability of staff. And only a small percentage of people are masking or taking other precautions in public despite a new wave of covid, flu, and respiratory syncytial virus infections hospitalizing and killing seniors.
In the last week of 2023 and the first two weeks of 2024 alone, 4,810 people 65 and older lost their lives to covid — a group that would fill more than 10 large airliners — according to data provided by the CDC. But the alarm that would attend plane crashes is notably absent. (During the same period, the flu killed an additional 1,201 seniors, and RSV killed 126.)
“It boggles my mind that there isn’t more outrage,” said Alice Bonner, 66, senior adviser for aging at the Institute for Healthcare Improvement. “I’m at the point where I want to say, ‘What the heck? Why aren’t people responding and doing more for older adults?’”
It’s a good question. Do we simply not care?
I put this big-picture question, which rarely gets asked amid debates over budgets and policies, to health care professionals, researchers, and policymakers who are older themselves and have spent many years working in the aging field. Here are some of their responses.
The pandemic made things worse. Prejudice against older adults is nothing new, but “it feels more intense, more hostile” now than previously, said Karl Pillemer, 69, a professor of psychology and gerontology at Cornell University.
“I think the pandemic helped reinforce images of older people as sick, frail, and isolated — as people who aren’t like the rest of us,” he said. “And human nature being what it is, we tend to like people who are similar to us and be less well disposed to ‘the others.’”
“A lot of us felt isolated and threatened during the pandemic. It made us sit there and think, ‘What I really care about is protecting myself, my wife, my brother, my kids, and screw everybody else,’” said W. Andrew Achenbaum, 76, the author of nine books on aging and a professor emeritus at Texas Medical Center in Houston.
In an environment of “us against them,” where everybody wants to blame somebody, Achenbaum continued, “who’s expendable? Older people who aren’t seen as productive, who consume resources believed to be in short supply. It’s really hard to give old people their due when you’re terrified about your own existence.”
Although covid continues to circulate, disproportionately affecting older adults, “people now think the crisis is over, and we have a deep desire to return to normal,” said Edwin Walker, 67, who leads the Administration on Aging at the Department of Health and Human Services. He spoke as an individual, not a government representative.
The upshot is “we didn’t learn the lessons we should have,” and the ageism that surfaced during the pandemic hasn’t abated, he observed.
Ageism is pervasive. “Everyone loves their own parents. But as a society, we don’t value older adults or the people who care for them,” said Robert Kramer, 74, co-founder and strategic adviser at the National Investment Center for Seniors Housing & Care.
Kramer thinks boomers are reaping what they have sown. “We have chased youth and glorified youth. When you spend billions of dollars trying to stay young, look young, act young, you build in an automatic fear and prejudice of the opposite.”
Combine the fear of diminishment, decline, and death that can accompany growing older with the trauma and fear that arose during the pandemic, and “I think covid has pushed us back in whatever progress we were making in addressing the needs of our rapidly aging society. It has further stigmatized aging,” said John Rowe, 79, professor of health policy and aging at Columbia University’s Mailman School of Public Health.
“The message to older adults is: ‘Your time has passed, give up your seat at the table, stop consuming resources, fall in line,’” said Anne Montgomery, 65, a health policy expert at the National Committee to Preserve Social Security and Medicare. She believes, however, that baby boomers can “rewrite and flip that script if we want to and if we work to change systems that embody the values of a deeply ageist society.”
Integration, not separation, is needed. The best way to overcome stigma is “to get to know the people you are stigmatizing,” said G. Allen Power, 70, a geriatrician and the chair in aging and dementia innovation at the Schlegel-University of Waterloo Research Institute for Aging in Canada. “But we separate ourselves from older people so we don’t have to think about our own aging and our own mortality.”
The solution: “We have to find ways to better integrate older adults in the community as opposed to moving them to campuses where they are apart from the rest of us,” Power said. “We need to stop seeing older people only through the lens of what services they might need and think instead of all they have to offer society.”
That point is a core precept of the National Academy of Medicine’s 2022 report Global Roadmap for Healthy Longevity. Older people are a “natural resource” who “make substantial contributions to their families and communities,” the report’s authors write in introducing their findings.
Those contributions include financial support to families, caregiving assistance, volunteering, and ongoing participation in the workforce, among other things.
“When older people thrive, all people thrive,” the report concludes.
Future generations will get their turn. That’s a message Kramer conveys in classes he teaches at the University of Southern California, Cornell, and other institutions. “You have far more at stake in changing the way we approach aging than I do,” he tells his students. “You are far more likely, statistically, to live past 100 than I am. If you don’t change society’s attitudes about aging, you will be condemned to lead the last third of your life in social, economic, and cultural irrelevance.”
As for himself and the baby boom generation, Kramer thinks it’s “too late” to effect the meaningful changes he hopes the future will bring.
“I suspect things for people in my generation could get a lot worse in the years ahead,” Pillemer said. “People are greatly underestimating what the cost of caring for the older population is going to be over the next 10 to 20 years, and I think that’s going to cause increased conflict.”
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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Mindsight – by Dr. Daniel Siegel
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A lot of books these days bear the subtitle “The New Science Of…”, but usually it’s not new, and often it’s not even science. So how does this one measure up?
- Is it new? The core ideas are mostly very old, but some of the interventions are new in presentation—and backed by relatively recent research—so we can give him this one on a technicality at least
- It is science? Yes! The author is a clinician (a psychatric clinician, specifically) and there’s nothing here that doesn’t have its foundations in robust science.
So, what’s this “mindsight”, then? Dr. Siegel wants to express to us a concept “for which no word currently exists”, so he had to make one up, to convey the idea of having a conscious awareness of what is going on in our brain, on an experiential basis. In other words: “mindfulness”. There was totally already a word for this, which he goes on to lampshade not very far into the book.
Nevertheless, we’ll forgive him a little copywriting swizzle with the title, because the content here is genuinely top-tier.
In the book, many ideas from many other pop-psychology books are covered, in useful, practical, no-nonsense fashion, laying out tools and interventions to strengthen various parts of our brain and our relationship with same.
Bottom line: this is the most comprehensive, science-centric, book on mindfulness that this reviewer has read.
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The Sleep Solution – by Dr. Chris Winter
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This book’s blurb contains a bold claim:
❝If you want to fix your sleep problems, Internet tips and tricks aren’t going to do it for you. You need to really understand what’s going on with your sleep—both what your problems are and how to solve them.❞
So, how well does it deliver, on the strength of being a whole book rather than an Internet article?
Well, for sure we wouldn’t have the room to include all the information that Dr. Winter does, in one of our main feature articles here (we’d need to spread it out over several weeks, at least).
He examines very thoroughly what is going on with sleep, sleep disturbance, and sleep deprivation. What’s going on with the different phases of sleep (far more than your phone’s sleep app will), and how imbalances in these can cause problems.
While the usual sleep hygiene tips do get a mention, he broadly assumes we know that part already. Instead, he focuses on aligning as many components as possible of our rich and interesting circadian rhythm. Yes, even if that means clawing our way out of insomnia and/or a bad sleep schedule (or lack of coherent sleep schedule) first. He gives plenty of practical advice on how to do that.
Bottom line: if you’d like to more deeply understand sleep, what is or isn’t wrong with yours, and how you can fix it, this book is a great resource.
Click here to check out The Sleep Solution, and enjoy the benefits of better rest!
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Make Your Negativity Work For You
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What’s The Right Balance?
We’ve written before about positivity the pitfalls and perils of toxic positivity:
How To Get Your Brain On A More Positive Track (Without Toxic Positivity)
…as well as the benefits that can be found from selectively opting out of complaining:
A Bone To Pick… Up And Then Put Back Where We Found It
So… What place, if any, does negativity usefully have in our lives?
Carrot and Stick
We tend to think of “carrot and stick” motivation being extrinsic, i.e. there is some authority figure offering is reward and/or punishment, in response to our reactions.
In those cases when it really is extrinsic, the “stick” can still work for most people, by the way! At least in the short term.
Because in the long term, people are more likely to rebel against a “stick” that they consider unjust, and/or enter a state of learned helplessness, per “I’ll never be good enough to satisfy this person” and give up trying to please them.
But what about when you have your own carrot and stick? What about when it comes to, for example, your own management of your own healthy practices?
Here it becomes a little different—and more effective. We’ll get to that, but first, bear with us for a touch more about extrinsic motivation, because here be science:
We will generally be swayed more easily by negative feelings than positive ones.
For example, a study was conducted as part of a blood donation drive, and:
- Group A was told that their donation could save a life
- Group B was told that their donation could prevent a death
The negative wording given to group B boosted donations severalfold:
Read the paper: Life or Death Decisions: Framing the Call for Help
We have, by the way, noticed a similar trend—when it comes to subject lines in our newsletters. We continually change things up to see if trends change (and also to avoid becoming boring), but as a rule, the response we get from subscribers is typically greater when a subject line is phrased negatively, e.g. “how to avoid this bad thing” rather than “how to have this good thing”.
How we can all apply this as individuals?
When we want to make a health change (or keep up a healthy practice we already have)…
- it’s good to note the benefits of that change/practice!
- it’s even better to note the negative consequences of not doing it
For example, if you want to overcome an addiction, you will do better for your self-reminders to be about the bad consequences of using, more than the good consequences of abstinence.
See also: How To Reduce Or Quit Alcohol
This goes even just for things like diet and exercise! Things like diet and exercise can seem much more low-stakes than substance abuse, but at the end of the day, they can add healthy years onto our lives, or take them off.
Because of this, it’s good to take time to remember, when you don’t feel like exercising or do feel like ordering that triple cheeseburger with fries, the bad outcomes that you are planning to avoid with good diet and exercise.
Imagine yourself going in for that quadruple bypass surgery, asking yourself whether the unhealthy lifestyle was worth it. Double down on the emotions; imagine your loved ones grieving your premature death.
Oof, that was hard-hitting
It was, but it’s effective—if you choose to do it. We’re not the boss of you! Either way, we’ll continue to send the same good health advice and tips and research and whatnot every day, with the same (usually!) cheery tone.
One last thing…
While it’s good to note the negative, in order to avoid the things that lead to it, it’s not so good to dwell on the negative.
So if you get caught in negative thought spirals or the like, it’s still good to get yourself out of those.
If you need a little help with that sometimes, check out these:
Take care!
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What happens to your vagina as you age?
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The vagina is an internal organ with a complex ecosystem, influenced by circulating hormone levels which change during the menstrual cycle, pregnancy, breastfeeding and menopause.
Around and after menopause, there are normal changes in the growth and function of vaginal cells, as well as the vagina’s microbiome (groups of bacteria living in the vagina). Many women won’t notice these changes. They don’t usually cause symptoms or concern, but if they do, symptoms can usually be managed.
Here’s what happens to your vagina as you age, whether you notice or not.
Let’s clear up the terminology
We’re focusing on the vagina, the muscular tube that goes from the external genitalia (the vulva), past the cervix, to the womb (uterus). Sometimes the word “vagina” is used to include the external genitalia. However, these are different organs and play different roles in women’s health.
What happens to the vagina as you age?
Like many other organs in the body, the vagina is sensitive to female sex steroid hormones (hormones) that change around puberty, pregnancy and menopause.
Menopause is associated with a drop in circulating oestrogen concentrations and the hormone progesterone is no longer produced. The changes in hormones affect the vagina and its ecosystem. Effects may include:
- less vaginal secretions, potentially leading to dryness
- less growth of vagina surface cells resulting in a thinned lining
- alteration to the support structure (connective tissue) around the vagina leading to less elasticity and more narrowing
- fewer blood vessels around the vagina, which may explain less blood flow after menopause
- a shift in the type and balance of bacteria, which can change vaginal acidity, from more acidic to more alkaline.
What symptoms can I expect?
Many women do not notice any bothersome vaginal changes as they age. There’s also little evidence many of these changes cause vaginal symptoms. For example, there is no direct evidence these changes cause vaginal infection or bleeding in menopausal women.
Some women notice vaginal dryness after menopause, which may be linked to less vaginal secretions. This may lead to pain and discomfort during sex. But it’s not clear how much of this dryness is due to menopause, as younger women also commonly report it. In one study, 47% of sexually active postmenopausal women reported vaginal dryness, as did around 20% of premenopausal women.
Other organs close to the vagina, such as the bladder and urethra, are also affected by the change in hormone levels after menopause. Some women experience recurrent urinary tract infections, which may cause pain (including pain to the side of the body) and irritation. So their symptoms are in fact not coming from the vagina itself but relate to changes in the urinary tract.
Not everyone has the same experience
Women vary in whether they notice vaginal changes and whether they are bothered by these to the same extent. For example, women with vaginal dryness who are not sexually active may not notice the change in vaginal secretions after menopause. However, some women notice severe dryness that affects their daily function and activities.
In fact, researchers globally are taking more notice of women’s experiences of menopause to inform future research. This includes prioritising symptoms that matter to women the most, such as vaginal dryness, discomfort, irritation and pain during sex.
If symptoms bother you
Symptoms such as dryness, irritation, or pain during sex can usually be effectively managed. Lubricants may reduce pain during sex. Vaginal moisturisers may reduce dryness. Both are available over-the-counter at your local pharmacy.
While there are many small clinical trials of individual products, these studies lack the power to demonstrate if they are really effective in improving vaginal symptoms.
In contrast, there is robust evidence that vaginal oestrogen is effective in treating vaginal dryness and reducing pain during sex. It also reduces your chance of recurrent urinary tract infections. You can talk to your doctor about a prescription.
Vaginal oestrogen is usually inserted using an applicator, two to three times a week. Very little is absorbed into the blood stream, it is generally safe but longer-term trials are required to confirm safety in long-term use beyond a year.
Women with a history of breast cancer should see their oncologist to discuss using oestrogen as it may not be suitable for them.
Are there other treatments?
New treatments for vaginal dryness are under investigation. One avenue relates to our growing understanding of how the vaginal microbiome adapts and modifies around changes in circulating and local concentrations of hormones.
For example, a small number of reports show that combining vaginal probiotics with low-dose vaginal oestrogen can improve vaginal symptoms. But more evidence is needed before this is recommended.
Where to from here?
The normal ageing process, as well as menopause, both affect the vagina as we age.
Most women do not have troublesome vaginal symptoms during and after menopause, but for some, these may cause discomfort or distress.
While hormonal treatments such as vaginal oestrogen are available, there is a pressing need for more non-hormonal treatments.
Dr Sianan Healy, from Women’s Health Victoria, contributed to this article.
Louie Ye, Clinical Fellow, Department of Obstetrics and Gynecology, The University of Melbourne and Martha Hickey, Professor of Obstetrics and Gynaecology, The University of Melbourne
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Prevention Is Better Than Cure
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Preventative healthcare is the theme this week:
New year, new risks
The start of a new year is a great time to update adult vaccinations, including the flu shot, any COVID-19 boosters, and vaccines for pneumonia, shingles, and tetanus—when was your last booster, after all? Vaccination recommendations vary by age and health conditions, so do check what’s appropriate in your case. Key vaccines include the pneumonia vaccine for those 65 and older, the shingles vaccine for adults over 50, and the Tdap vaccine every 10 years to protect against tetanus, diphtheria, and pertussis (whooping cough), especially for new parents and grandparents, to protect infants:
Read in full: Why it’s important to update adult vaccinations for a new year
Related: The Truth About Vaccines
The heart-healthiest swap you can do
Based on a large (n=202,863, of which 160,123 women and 42,740 men) dataset, a higher plant-to-animal protein ratio is associated with significantly lower risks of cardiovascular disease (CVD) and coronary artery disease (CAD), with diets lower in meat (especially if lower in red meat) and instead rich in plant-based proteins like legumes, nuts, and whole grains reducing CVD risk by 19% and coronary artery disease risk by 27%. Which is quite considerable.
Substituting even small amounts of animal protein (especially if it’s red meat) with plant protein further enhances heart health:
Read in full: Higher plant-to-animal protein ratio linked to lower risk for CVD, CAD among U.S. adults
Related: Plant vs Animal Protein: Head to Head
Let’s keep pan-resistant superbugs at bay
Researchers want to warn us about the threat of pan-resistant bacteria, which could render all known antibiotics ineffective, leading to a sharp rise in global infection-related deaths.
To be clear, we don’t have anything pan-resistant yet, but antibiotic-resistant superbugs are getting close, and in the long term, are likely to win the evolutionary arms race if we don’t change things to diverge considerably from our current path. Modeling a hypothetical pan-resistant E. coli strain, researchers predicted U.S. sepsis deaths could increase 18- to 46-fold within five years of its emergence.
The study calls for urgent action, including stricter antibiotic stewardship, new drug development, and monitoring technologies, emphasizing that without intervention, the global impact could be catastrophic:
Read in full: A public health emergency is waiting at the bottom of the antibiotic resistance cliff
Related: Stop Sabotaging Your Immune System ← see also (linked therein), 4 ways antibiotics can kill you
Take care!
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How Your Diet May Be Causing Chronic Tightness (& How To Fix It)
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There is often more to hamstring flexibility than just stretching:
Three steps
The method focuses on three areas: diet, mindset, and movement.
Why diet? Poor gut health and inflammation, often caused by processed and fast foods, contribute to chronic hamstring tightness. The video suggests nutrient-dense meals like Greek yogurt with poached eggs. As for collagen, that is found most abundantly in the bones and skin of fish and other animals, but if you are vegan/vegetarian, fear not, you can just make sure to eat plenty of its constituent parts instead, and synthesize it yourself like any other animal. See also: The Best Foods For Collagen Production
Why mindset? Addressing pain and other somatic (bodily) concerns involves understanding the body as a single interconnected system. So, it’s necessary to also take care of any emotional stress or other underlying conditions, as well as ensuring your hormones are all in order.
Why movement? Machine-based training, which isolates muscles, can cause imbalances. Instead, consider functional movements like hanging and compound exercises such as Pilates or other calisthenics systems. These improve core strength, enhance flexibility, and prevent stiffness, ensuring better overall function.
Some example exercises:
- Bent knee hamstring stretch: hold for 2 seconds; do 10–12 reps (2 sets per leg).
- Straight leg active isolation: focus on quad engagement with assistance from a band; 10–12 reps (2 sets per leg).
- Active hip abductors: target IT band and glute medius; 1 set of 12 reps per leg.
- Active lunge stretch: incorporate a band to intensify the stretch; 2 seconds at the top range.
For more on all of this plus visual demonstrations of the exercises, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like:
Fix Tight Hamstrings In Just 3 Steps
Take care!
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