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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Life After Death? (Your Life; A Loved One’s Death)
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The Show Must Go On
We’ve previously written about the topics of death and dying. It’s not cheery, but it is important to tackle.
Sooner is better than later, in the case of:
Preparations For Managing Your Own Mortality
And for those who are left behind, of course it is hardest of all:
What Grief Does To Your Body (And How To Manage It)
But what about what comes next? For those who are left behind, that is.
Life goes on
In cases when the death is that of a close loved one, the early days after death can seem like a surreal blur. How can the world go ticking on as normal when [loved one] is dead?
But incontrovertibly, it does, so we can only ask again: how?
And, we get to choose that, to a degree. The above-linked article about grief gives a “101” rundown, but it’s (by necessity, for space) a scant preparation for one of the biggest challenges in life that most of us will ever face.
For many people, processing grief involves a kind of “saying goodbye”. For others, it doesn’t, as in the following cases of grieving the loss of one’s child—something no parent should ever have to face, but it happens:
Dr. Ken Druck | The Love That Never Dies
(with warning, the above article is a little heavy)
In short: for those who choose not to “say goodbye” in the case of the death of a loved one, it’s more often not a case of cold neglect, but rather the opposite—a holding on. Not in the “denial” sense of holding on, but rather in the sense of “I am not letting go of this feeling of love, no matter how much it might hurt to hold onto; it’s all I have”.
What about widows, and love after death?
Note: we’ll use the feminine “widow” here as a) it’s the most common and b) most scientific literature focuses on widows, but there is no reason why most of the same things won’t also apply to widowers.
We say “most”, as society does tend to treat widows and widowers differently, having different expectations about a respectful mourning period, one’s comportment during same, and so on.
As an aside: most scientific literature also assumes heterosexuality, which is again statistically reasonable, and for the mostpart the main difference is any extra challenges presented by non-recognition of marriages, and/or homophobic in-laws. But otherwise, grief is grief, and as the saying goes, love is love.
One last specificity before we get into the meat of this: we are generally assuming marriages to be monogamous here. Polyamorous arrangements will likely sidestep most of these issues completely, but again, they’re not the norm.
Firstly, there’s a big difference between remarrying (or similar) after being widowed, and remarrying (or similar) after a divorce, and that largely lies in the difference of how they begin. A divorce is (however stressful it may often be) more often seen as a transition into a new period of freedom, whereas bereavement is almost always felt as a terrible loss.
The science, by the way, shows the stats for this; people are less likely to remarry, and slower to remarry if they do, in instances of bereavement rather than divorce, for example:
Timing of Remarriage Among Divorced and Widowed Parents
Love after death: the options
For widows, then, there seem to be multiple options:
- Hold on to the feelings for one’s deceased partner; never remarry
- Grieve, move on, find new love, relegating the old to history
- Try to balance the two (this is tricky but can be done*)
*Why is balancing the two tricky, and how can it be done?
It’s tricky because ultimately there are three people’s wishes at hand:
- The deceased (“they would want me to be happy” vs “I feel I would be betraying them”—which two feelings can also absolutely come together, by the way)
- Yourself (whether you actually want to get a new partner, or just remain single—this is your 100% your choice either way, and your decision should be made consciously)
- The new love (how comfortable are they with your continued feelings for your late love, really?)
And obviously only two of the above can be polled for opinions, and the latter one might say what they think we want to hear, only to secretly and/or later resent it.
One piece of solid advice for the happily married: talk with your partner now about how you each would feel about the other potentially remarrying in the event of your death. Do they have your pre-emptive blessing to do whatever, do you ask a respectable mourning period first (how long?), would the thought just plain make you jealous? Be honest, and bid your partner be honest too.
One piece of solid advice for everyone: make sure you, and your partner(s), as applicable, have a good emotional safety net, if you can. Close friends or family members that you genuinely completely trust to be there through thick and thin, to hold your/their hand through the emotional wreck that will likely follow.
Because, while depression and social loneliness are expected and looked out for, it’s emotional loneliness that actually hits the hardest, for most people:
Longitudinal Examination of Emotional Functioning in Older Adults After Spousal Bereavement
…which means that having even just one close friend or family member with whom one can be at one’s absolute worst, express emotions without censure, not have to put on the socially expected appearance of emotional stability… Having that one person (ideally more, but having at least one is critical) can make a huge difference.
But what if a person has nobody?
That’s definitely a hard place to be, but here’s a good starting point:
How To Beat Loneliness & Isolation
Take care!
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How Tight Are Your Hips? Test (And Fix!) With This
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Upon surveying over half a million people; hips were the most common area for stiffness and lack of mobility. So, what to do about it?
This test don’t lie
With 17 muscles contributing to hip function (“hip flexors” being the name for this group of 17 muscles, not specific muscle), it’s important to figure out which ones are tight, and if indeed it really is the hip flexors at all, or if it could be, as it often is, actually the tensor fasciae latae (TFL) muscle of the thigh. If it turns out to be both, well, that’s unfortunate but the good news is, now you’ll know and can start fixing from all the necessary angles.
Diagnostic test for tight hip flexors (Thomas Test):
- Use a sturdy, elevated surface (e.g. table or counter—not a bed or couch, unless there is perchance room to swing your legs without them touching the floor).
- Sit at the edge, lie back, and pull both knees to your chest.
- Return one leg back down until the thigh is perpendicular to the table.
- Let the other leg dangle off the edge to assess flexibility.
Observations from the test:
- Thigh contact: is the back of your thigh touching the table?
- Knee angle: is your knee bent at roughly 80° or straighter?
- Thigh rotation: does the thigh roll outward?
Interpreting results:
- If your thigh contacts the surface and the knee is bent at around 80°, hip mobility is good.
- If your thigh doesn’t touch or knee is too straight, hip flexor tightness is present.
- If your thigh rolls outwards from your midline, that indicates tightness in the TFL muscle of the thigh.
Three best hip flexor stretches:
- Kneeling lunge stretch:
- Hips above the knee, tuck tailbone, engage glutes, press hips forward, reach arm up with a slight side bend.
- Seated hip lift stretch:
- Sit with feet hip-width apart, hands behind shoulders, lift hips, step one foot back, tuck tailbone, point knee away.
- Sofa stretch:
- Kneel with one shin against a couch/wall, other foot forward in lunge, tuck tailbone, press hips forward, lift torso.
It’s recommended to how each stretch for 30 seconds on each side.
For more on all of the above, and visual demonstrations, enjoy:
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Want to learn more?
You might also like to read:
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Plant-Based Alternatives for Meat Recipes
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝How about providing a plant-based alternative when you post meat-based recipes? I appreciate how much you advocate for veggie diets and think offering an alternative with your recipes would support that❞
Glad you’re enjoying! And yes, we do usually do that. But: pardon, we missed one (the Tuna Steak with Protein Salad) because it’d be more than a simple this-for-that substitution, we didn’t already have an alternative recipe up (as with the salmon recipes such as the Chili Hot-Bedded Salmon and Thai Green Curry Salmon Burgers).
Our recipes, by the way, will tend towards being vegan, vegetarian, or at least pescatarian. This is for several reasons:
- Good science suggests the best diet for general purpose good health is one that is mostly plants, with optional moderate amounts of fermented dairy products, fish, and/or eggs.
- Your writer here (it’s me, hi) has been vegan for many years, transitioning to such via pescatarianism and ovo-lacto vegetarianism, and so the skill of cooking meat is least fresh in my memory, meaning I’d not be confident writing about that, especially as cooking meat has the gravest health consequences for messing it up.
Note on biases: notwithstanding this writer being vegan, we at 10almonds are committed to reporting the science as it stands with no agenda besides good health. Hence, there will continue to be unbiased information about animal products’ health considerations, positive as well as negative.
See also: Do We Need Animal Products To Be Healthy?
…as well as, of course, some animal-based classics from our archives including:
We Are Such Stuff As Fish Are Made Of & Eggs: All Things In Moderation?
Finishing with one for the vegans though, you might enjoy:
Which Plant Milk? We Compare 6 Of The Most Popular
Some previous articles you might enjoy meanwhile:
- Pinpointing The Usefulness Of Acupuncture
- Science-Based Alternative Pain Relief
- Peripheral Neuropathy: How To Avoid It, Manage It, Treat It
- What Does Lion’s Mane Actually Do, Anyway?
Take care!
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Antibiotics? Think Thrice
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Antibiotics: Useful Even Less Often Than Previously Believed (And Still Just As Dangerous)
You probably already know that antibiotics shouldn’t be taken unless absolutely necessary. Not only does taking antibiotics frivolously increase antibiotic resistance (which is bad, and kills people), but also…
It’s entirely possible for the antibiotics to not only not help, but instead wipe out your gut’s “good bacteria” that were keeping other things in check.
Those “other things” can include fungi like Candida albicans.
Candida, which we all have in us to some degree, feeds on sugar (including the sugar formed from breaking down alcohol, by the way) and refined carbs. Then it grows, and puts its roots through your intestinal walls, linking with your neural system. Then it makes you crave the very things that will feed it and allow it to put bigger holes in your intestinal walls.
Don’t believe us? Read: Candida albicans-Induced Epithelial Damage Mediates Translocation through Intestinal Barriers
(That’s scientist-speak for “Candida puts holes in your intestines, and stuff can then go through those holes”)
And as for how that comes about, it’s like we said:
See also: Candida albicans as a commensal and opportunistic pathogen in the intestine
That’s not all…
And that’s just C. albicans, never mind things like C. diff. that can just outright kill you easily.
We don’t have room to go into everything here, but you might like to check out:
Four Ways Antibiotics Can Kill You
It gets worse (now comes the new news)
So, what are antibiotics good for? Surely, for clearing up chesty coughs, lower respiratory tract infections, right? It’s certainly one of the two things that antibiotics are most well-known for being good at and often necessary for (the other being preventing/treating sepsis, for example in serious and messy wounds).
But wait…
A large, nationwide (US) observational study of people who sought treatment in primary or urgent care settings for lower respiratory tract infections found…
(drumroll please)
…the use of antibiotics provided no measurable impact on the severity or duration of coughs even if a bacterial infection was present.
Read for yourself:
And in the words of the lead author of that study,
❝Lower respiratory tract infections tend to have the potential to be more dangerous, since about 3% to 5% of these patients have pneumonia. But not everyone has easy access at an initial visit to an X-ray, which may be the reason clinicians still give antibiotics without any other evidence of a bacterial infection.❞
So, what’s to be done about this? On a large scale, Dr. Merenstein recommends:
❝Serious cough symptoms and how to treat them properly needs to be studied more, perhaps in a randomized clinical trial as this study was observational and there haven’t been any randomized trials looking at this issue since about 2012.❞
This does remind us that, while not a RCT, there is a good ongoing observational study that everyone with a smartphone can participate in:
Dr. Peter Small’s medical AI: “The Cough Doctor”
In the meantime, he advises that when COVID and SARS have been ruled out, then “basic symptom-relieving medications plus time brings a resolution to most people’s infections”.
You can read a lot more detail here:
Antibiotics aren’t effective for most lower tract respiratory infections
In summary…
Sometimes, antibiotics really are a necessary and life-saving medication. But most of the time they’re not, and given their great potential for harm, they may be best simultaneously viewed as the very dangerous threat they also are, and used only when those “heavy guns” are truly what’s required.
Take care!
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Science of Stretch – by Dr. Leada Malek
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This book is part of a “Science of…” series, of which we’ve reviewed some others before (Yoga | HIIT | Pilates), and needless to say, we like them.
You may be wondering: is this just that thing where a brand releases the same content under multiple names to get more sales, and no, it’s not (long-time 10almonds readers will know: if it were, we’d say so!).
While flexibility and mobility are indeed key benefits in yoga and Pilates, they looked into the science of what was going on in yoga asanas and Pilates exercises, stretchy or otherwise, so the stretching element was not nearly so deep as in this book.
In this one, Dr. Malek takes us on a wonderful tour of (relevant) human anatomy and physiology, far deeper than most pop-science books go into when it comes to stretching, so that the reader can really understand every aspect of what’s going on in there.
This is important, because it means busting a lot of myths (instead of busting tendons and ligaments and things), understanding why certain things work and (critically!) why certain things don’t, how certain stretching practices will sabotage our progress, things like that.
It’s also beautifully clearly illustrated! The cover art is a fair representation of the illustrations inside.
Bottom line: if you want to get serious about stretching, this is a top-tier book and you won’t regret it.
Click here to check out Science of Stretching, and learn what you can do and how!
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Why Fibromyalgia Is Not An Acceptable Diagnosis
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Dr. Efrat Lamandre makes the case that fibromyalgia is less of a useful diagnosis and more of a rubber stamp, much like the role historically often fulfilled by “heart failure” as an official cause of death (because certainly, that heart sure did stop beating). It’s a way of answering the question without answering the question.
…and what to look for instead
Fibromyalgia is characterized by chronic pain, tenderness, sleep disturbances, fatigue, and other symptoms. It’s often considered an “invisible” illness, because it’s the kind that’s easy to dismiss if you’re not the one carrying it. A broken leg, one can point at and see it’s broken; a respiratory infection, one can see its effects and even test for presence of the pathogen and/or its antigens. But fibromyalgia? “It hurts and I’m tired” doesn’t quite cut it.
Much like “heart failure” as a cause of death when nothing else is implicated, fibromyalgia is a diagnosis that gets applied when known causes of chronic pain have been ruled out.
Dr. Lamandre advocates for functional medicine and seeking the underlying causes of the symptoms, rather than the industry standard approach, which is to just manage the symptoms themselves with medications (of course, managing the symptoms with medications has its place; there is no need to suffer needlessly if pain relief can be used; it’s just not a sufficient response).
She notes that potential triggers for fibromyalgia include microbiome imbalances, food sensitivities, thyroid issues, nutrient deficiencies, adrenal fatigue, mitochondrial dysfunction, mold toxicity, Lyme disease, and more. Is this really just one illness? Maybe, but quite possibly not.
In short… If you are given a diagnosis of fibromyalgia, she advises that you insist doctors keep on looking, because that’s not an answer.
For more on all of this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- Managing Chronic Pain (Realistically!)
- How To Eat To Beat Chronic Fatigue ← yes, including how to do so when you are chronically fatigued. In other words, this isn’t just dietary advice, but rather practical advice too
- When Painkillers Aren’t Helping, These Things Might
Take care!
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