Looking for your “senior self…”

Do you believe this? You make better decisions about your later-in-life financial situation if you “see” your senior self. Research at Stanford University has documented the “disconnect” we often feel with our older selves. The studies suggest we have a “third person perspective” about aging and “may even view our older selves as strangers.” As a result, we are not making judgments grounded in our long-term best interests.

The study that caught my eye involved spending and saving..The subjects were asked to “allocate $1,000 across four options.” These included 1) buying something nice for someone special, 2) investing in a retirement fund 3) planning a fun event or 4) putting money into a checking account. Each participant in the research study wore goggles and sensors through which they explored a virtual environment that, at some point, led them to a mirror. Half of the subjects saw the image of their current self in the mirror and the other half saw a future-self computerized photograph of what they were likely to look like decades hence including “jowls, bags under the eyes, gray hair.” You get the picture.

Those who saw themselves as “old” put nearly twice as much money into retirement. A sub-set of subjects viewed a digitally-aged photo of someone else–but it was only those participants who actually saw their own digitally-aged photograph that put more money into retirement savings. The decisions these subjects made regarding the $1,000 allocation demonstrated the power inherent in more clearly envisioning our aging selves.

The findings are consistent with the “large body of literature that shows emotional responses are heightened when you give people vivid illustrations.” For example, “donors give more to charities when they hear from a victim” and “pulmonologists smoke less than other doctors because they look at dirty lungs all day.”

Statisticians report 36% of older adults do not save anything at all for retirement. And the percentage of people who believe they will not have enough money put away for retirement is 80%. Pretty sobering; actually it’s not “pretty” at all.

Maybe we need those goggles and sensors in local banks and department stores—maybe that’s what it will take to prompt better judgments when it comes to what we save and what we spend on a day by day basis. Hey, maybe there’s a business here?

Let’s play this out. I envision a drive-through kiosk. You get your photo taken at one end and a digitally-enhanced photo awaits you at the other end. Maybe you tape the enhanced photo of your aging self to the dashboard of your car? Or maybe you tape it inside your checkbook or your bathroom mirror. See what happens.

I kind of like this idea. Do you? If you launch it as business enterprise and it makes money, put half of it in savings.                        Previously published in Mail Tribune Healthy Aging column, 2013

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Watch Your Step

I’ve blogged about falls in the past (Don’t Fall for This 1 & 2) but talked mostly about fall risk in the home.  Last weekend Sharon and I were in Decatur, Georgia for a family wedding and the issue of falls once again came up.

We stayed at hotel about 5 blocks from Sharon’s sister (mother of the bride) and brother-in-law.  Each day we would walk to their home for some family gathering both before and after the wedding.  As it turned out, each walk was treacherous.   The city of Decatur, lovely as it is with grand old homes and lovely shops and restaurants, had crumbling sidewalks.   The stately trees that give the city its beauty were also pushing up the sidewalks and creating trip hazards.  At one point while walking Sharon stubbed her toe when a section of the sidewalk was raised about one and half inches higher than the previous section.  A painful face plant was barely averted.

With the economy just now recovering from the “great recession” it is no surprise that in city after city roads and sidewalks have deteriorated due to deferred maintenance.  In Hillsboro, Oregon, another place we visit and walk often (two-year-old grandson in the area) we have also encountered uneven sidewalks.  However, where one of these hazards has presented itself the city (or someone) has sprayed the trip area yellow.   Better than doing nothing.

I have spent many years living and working in Asia and still go there on occasion (China last May and Vietnam last October).  Sharon always worries that “something might happen.”   Little did she realize that in most of these places the greatest danger tourists face is traffic (Ho Chi Minh City has thousands of motor scooters and drivers that pay no attention to pedestrians) and Jakarta, Indonesia has sidewalks with massive opens to sewers below.  Walking in many foreign cities is probably the greatest risk most tourists will face and sometimes are totally unprepared for it.

Also, a word to the wise from a seasoned tourist.  Take care of your feet before you leave. Trim your toenails so you don’t have problems away from home.  Bring really good walking shoes that provide plenty of ankle support.  I have a pair of leather dress loafers that are just too soft to provide good support.  More than once I have caught myself walking on an uneven sidewalk or street and my foot has started to roll.  This ankle roll situation is the cause of many serious and painful sprains and can result in ruining a great vacation.

Finally, around the house.  Sharon and I have been developing a Fall-Risk, In-Home Safety and Accessibility assessment tool as part of our Age-Friendly Innovators non-profit mission.  We go into people’s homes (at their invitation) and do a careful analysis of the fall risk potential of the residents (using data from the Centers for Disease Control and Prevention).  When we complete the assessment we provide the homeowners with a report on things they should change immediately to reduce fall and safety risks (such as removing or anchoring scatter rugs and installing CO detectors).  We also advise them on things they should change in the near future and things they would need to change if accessibility/mobility became issues.  One example of a near term change is something we ourselves discovered.  When we built our new “age-friendly” Lifelong Housing Certified home we installed raised flower and vegetable beds in the backyard.  The landscaper put gravel under this section of the yard.  We quickly discovered that the gravel and accompanying odd shaped tile pavers were difficult to walk on and were in fact a trip hazard.  I spent a painful week removing the gravel and pavers and laying down about three inches of decomposed granite.   Once the granite settled in it provided a lovely, firm, walking surface.  The only person that misses the gravel is our dog Lucy who had learned that when she came to us with a rock in her mouth we would bribe her with a treat to get the rock.

Watch your step.

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Helping the Helpers

I read an article from the New York Times recently discussing the legions of family caregivers looking after elders.  In this article the primary caregiver is a 78-year-old women caring from her 85-year-old husband who as vascular dementia.  I have linked the full article on our Facebook page: www.facebook.com/agefriendlyinnovation.  There are millions of these family caregivers nationwide including sons and daughters and other relatives.

This story is personal for me as my sister Barbara (Babs) was the caregiver for our mother for many years.  Although my mother was mentally alert almost to the end she had great difficulty walking and was very hard of hearing.    At the time Babs was a widow living alone in her small home in Camas, Washington.  When our father passed away it just made good sense for mom to move in with Babs.  I only wish that what Sharon and I know now about aging-in-place we had known when my mother moved in with Babs.

The home had narrow hallways and not-so-wide doors.  The only bathroom was microscopic and barely accommodated one adult, let alone two.  Mom’s son-in-law, a carpenter, did install a ramp to make it easier to get mom to the car for appointments.  Family caregiving is not a 9-5 job, it is 24/7 and by all accounts the toll on the caregiver is great.   The New York Times article cited a National Alliance for Caregiving report that found even caregivers over age 75 were putting in 40 hour weeks of care.  In reality, the job never ends as long as the loved one is at home.  Still for most families helping keep a aging loved one at home is preferable to a nursing home.

Inevitably my mother did have a condition that put her in the hospital for a period of time and then she was released to a rehabilitation facility.  At that point my siblings and I gathered and decided that mom could not go home to our sisters’.   It just wasn’t workable any more.  What we did was research adult foster homes in the Vancouver, Washington area where my sister and mother were living.  We found a facility that was more like a group home but with 24 hour care.  Mom had her own private bedroom, an accessible bathroom across the hall and well-prepared meals. The staff in that facility were very caring and came to love our mother very much.   On night, about a year after she moved into the adult family home, she went to sleep and didn’t wake up.  My other sister by her bedside.

I’m not sure what exact point I am trying to make with this story but I thought it worth sharing.  Our nonprofit, Age-Friendly Innovators, is all about helping people plan for the future…..whatever that future might bring.

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Home Alone

In late 2013 Sharon and I founded Age-Friendly Innovators (www.agefriendlyinnovators.org) a 501(c)(3) nonprofit organization with a mission to help older adults safely stay in their home for as long as possible.  This is called “aging-in-place.”  Perhaps you have come across this term as it is appearing in the mainstream press (New York Times, Wall Street Journal, USA Today, etc.) quite often.  As a matter of fact if you are interested in these articles I have linked many of them to our Facebook page www.facebook.com/agefriendlyinnovation.  They make great reading and have a lot of good ideas.

One project underway by Age-Friendly Innovators is the development of a Fall-Risk, Home Safety and Accessibility Assessment tool that we hope to convert into an “app.”  The assessment tool consist of a fall-risk assessment based upon Centers for Disease Control and Prevention (CDC) research, a health profile with 32 questions to better understand the health of the resident and 87 specific questions relating to home accessibility, fall hazards and fire risk.  Late last year we received a grant from the Chaney Foundation to conduct 50 free in-home assessments as part of the beta testing of the app.

To date Sharon and I have conducted dozens of assessments.  It is a delicate task to be invited to meet with someone (most often a single woman) in their home to discuss health issues, fall risk and accessibility.  However, fall prevention is a high priority for older adults and we have written on that subject in previous blogs.

What we have learned to date is that each and every home situation we encounter is unique.  However, there are some common threads.  In the case of older single women often times the “home” is the last remaining vestige of a long happy marriage where the husband has passed and there is a sense of loss and loneliness.  In some cases children have moved away from the valley and perhaps don’t call or visit as much as one would hope.  Sometimes the home has not been maintained as well as in the past and shows signs of disrepair.  In other cases mobility issues have created challenges that have been met in unusual ways, including sleeping in the living room in front of the TV, or not leaving the home for extended periods of time because of lack of transport or fear of falling.

I bring up this subject because according to the 2010 U.S. Census for Jackson County there were 13,400 households made up of a woman living alone, representing 16.1 percent of all county households.  In addition, the number of females 65 years and older living alone totaled 7,039 (8.5 percent of all county households).  The rate of females 65 years and older is almost two and half times higher than males over 65 living alone.  (Note:  these figures do not include those living in nursing homes, assisted living facilities, etc.).  As baby boomers reach age 65 (10,000 per day nationwide and continuing at that rate for another 18 years) these numbers locally will only increase.

Age-Friendly Innovators is planning to create a fund to help those we encounter in our assessment process who have limited fixed income but need some minor modifications such as CO detectors, grab bars or carpet tape to secure throw rugs.  We are calling this “Grandma’s Porch.”  We are also collaborating with Rogue Valley Habitat for Humanity to help make larger home repairs or modifications to improve accessibility.

As a community we need to be more aware of these thousands of older adults living alone among us.  Sometimes they live right across the street but are never seen.  Can we do better in reaching out to those that are alone or may need help with transportation, small repairs, a little yard work or other chores?  Isn’t this what “livable communities” as all about?

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“Back at you–Alexa!

This blog borrows heavily from the Changing Aging website (www.changingaging.org) and a May, 2015 blog by Alexa Elheart, who I’m concluding is a young woman who wants we oldsters to shape up a little.  I did some heavy-duty editing of the original blog but her main points are worth thinking about…

Alexa writes…”Many older people feel embarrassed to reveal their true ages. The truth is society has it completely backwards, Getting older is actually the best part of life! Don’t believe me?” She raises three considerations….

1) You Have Better Social Skills?

Alex believes, “As people age, social skills increase. In a study conducted in 2010 at the University of Michigan, 200 people were given “Dear Abby”-style letters asking for advice. Researchers found that “subjects in their 60s were better than younger ones at imagining different points of view, thinking of multiple resolutions and suggesting compromises.”  Dear Alexa.  “I think we may need a few more illustrations here but the concept is rather heartening.”

2) You Gain Perspective?

Alexa says, “Another great part of getting older is realizing what’s most important and what you don’t really need to spend time worrying about.”  She cites Oprah Winfrey’s comments,  “Recognizing the time that you wasted and the things that you worried about that really didn’t matter…that’s really the hardest part, that’s really the only regret that I have.”  Alex agrees with Oprah,  “When you’re young, you tend to give yourself an inordinate amount of stress, However, as you get older and have the luxury of looking back on your experiences , you can start to see the unnecessary pressure you may have put on yourself.”   Fair point Alexa–but there may be other perspectives than just Oprah’s on this topic. Hope my response to your blog is not a stressor.

3) You Have the Opportunity to Give Back?

Alexa says, “While there are some twenty somethings who have the means to contribute substantially to their communities, the majority of people in their twenties don’t have that privilege–whether that’s due to a lack of funds or an inflexible work schedule. However, when you get older and find yourself with a much more stable lifestyle, both professionally and economically, it becomes less prohibitive to donate money, time or talent to your community. Alexa challenges older folks to “Go on–take your superior social skills, perspective, and sense of community and make the world a better place! You have amazing and unique things to offer, and your experiences really have the capability to improve the world around you.”

I say to Alexa. “You can contribute at any age–you did by posting your blog. What’s next? Make it good.”

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Little Free Libraries

Have you heard about the Little Free Library? I am borrowing with a abandon from a recently published blog describing their presence in on lucky neighborhood in Seattle, Washington. In this case, a loving husband gave his writer/reader/blogger wife the sturdy little structure as a gift.

According to “The Little Free Library Book” (Coffee House Press, $25), there are 25,000 of these pedestal libraries worldwide, spread across 50 states and 80 countries. “The basic definition: a box of books, posted in an accessible spot, often in a residential yard near a sidewalk. The key to having a Little Free Library is to release control. Take a book, leave a book. A lot of people feel an obligation to reciprocate.”

As the happy, but a little hesitant-at-first Seattle blogger (Mary Ann Gwinn) phrases it, “Do I want my neighbors to think that I actually bought and read “How to Hook a Hottie,” which sat in my Little Free Library for a week before someone took it away?” She adds,”I think of … reader-service librarians, and how their mission is to find each person their book. Who am I to judge? Why worry if people are judging me? My motto is, Every Book Its Reader. And someone did finally take that Bob Hope biography.”

We have a little free library built by a creative, woodcraftsman friend sitting on a table on our patio ready to be installed. I am starting with children’s’ books. Maybe we could place a bench nearby and we would get to observe—parents and grandparents reading to their little ones—or vice versa. I have numerous copies of “Good Night Moon.” I bet they disappear quickly.

What is your Little Free Library story? Send them — bizarre, inspiring, off-the-wall, to mgwinn@seattletimes.com, or leave a comment online. Want to start your own? Go to littlefreelibrary.org.

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Don’t Fall for This Part 2

Sharon and I have both blog about fall prevention in general but I want to get very specific….floor coverings such as mats and throw rugs are dangerous.  Two questions.  1. Are these floor coverings in good condition or noticeably worn or torn?  2. Do the floor coverings bunch up or slide when you walk on them?

If you answered “yes” to either question the best advice we can give you is to get rid of those rugs or mats.  If you can stand the thought of getting rid of grandma’s old throw rug or that cute fuzzy mat in the bathroom here are some suggestions from the National Association of Geriatric Care Managers and the International Rug Safety Insitute:

  • Recognize surface changes from one room to another (i.e. carpet in living room to linoleum in the kitchen) can present balance issues.
  • Purchase carpets, rugs, runners and mats with “slip resistant” backing or padding, remembering that such materials become less effective with repeated washings.
  • Consider thick, cut-to-fit rubber shelf liner under a carpet.
  • Carpets should be high density, low pile.  If replaced, use the same color as previous carpeting to reduce likely visual disorientation.  Recognize that color changes can visually cue the resident to the boundaries between surfaces.  Note:  bold patterns, and black on blue backgrounds can lead to misjudgments of spatial distances.
  • If a new mobility devices is required (such as a cane or walker), assure the introduction to walking on various surfaces is well monitored.  Older adults with delays in light/dark adaption, decreased contract sensitivity, poor depth perception or limited peripheral vision will also need more careful monitoring.
  • If mats, scatter rugs or runner replacements are not possible due to financial constraints, etc., apply double-faced adhesive carpet tape or heavy duty masking tape (rolled around spread fingers five times) and secured around the edges of the rug or mat.
  • Consider Press and Stick Rug Grippers (available at Lowes, Home Depot, local flooring and carpet outlets or Amazon).  Press into each corner of the carpet.  Recheck adhesive periodically and replace if you see a powdery substance that indicates deterioration.
  • Choosing aesthetically pleasing carpets, rugs and runners that meet personal preference is always balanced against functional floor coverings that promote safe navigation.

Falling can be a lifetime game changer.  Get a grip.

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You and Me at 83…

Let’s say I’m eighty-three years old. I’m not that old—but let’s assume I am, just for the purposes of this blog. Let’s assume you’re in your eighties too.

Where would we like to live? It’s a relatively easy question for both of us, I suspect. We’d like to be comfortably situated in our own homes. I know I’d like to be independently observing my personal morning rituals and managing my own activities of daily living.

If either of us were in chronically ill or physically frail and had a need for constant medical attention, living independently might not be possible.

That’s what I used to think. An article in the “Atlantic” (www.theatlantic.com) and a new report in Kiplinger (April 2015) titled “6 Simple Things You Must Know About Aging in Place” altered my view.

Here’s the story. It’s about Ellen, who is an 82 year old widow living in Anaheim California. “One Wednesday morning last year she got on the scale, as she does every morning, and It read one hundred and forty-six pounds—wasn’t that a little high? Ellen felt vaguely troubled as she poured herself a bowl of oat bran.” As Ellen ate her cereal, the phone rang, and a friendly voice from the health clinic where Ellen was a patient expressed concern about Ellen’s weight—which “had jumped three pounds from the previous day.”

The friendly voice knew that because Ellen’s scale had transmitted the information through a wireless connection. Because Ellen had a history of congestive heart failure, a three-pound weight gain in a 24-hour period was a potentially dangerous situation. There was likely to be fluid build-up that would complicate her already-existing medical issues. She needed treatment immediately.

So now you may be thinking—that friendly voice (not a mechanized one by the way—a real person) probably told her to come into the clinic. Or maybe, the voice said “Call 911 and get to an emergency room.” Nope. The friendly voice said, ‘We’re sending a car to pick you up,” which they did. Ellen’s health provider gave her no-fee transportation from her home to the health clinic over the next few weeks, as well as appropriate medical treatment, until her health situation stabilized.

Had this not occurred, Ellen might have languished. Perhaps she would have eaten less because she was afraid she was gaining too much weight. She may have experienced a life-threatening cardiac event. She could have ended up in the hospital for days or weeks undergoing painful—and expensive—treatment.

The California-based clinic system that supported Ellen in this way is appropriately named CareMore (www.caremore.org) and it specializes in patient-centered approaches that also seem to avert huge medical costs. As their website says—“That’s what we do.”

This is impressive health care. According to the Atlantic article, CareMore has a hospitalization rate 24% below average and hospitals stays are 38% shorter. Overall costs are 18% lower than average. And the surveyed satisfaction rate is well above 90%. (And remember 80 year olds can be hard to please…)

When I’m in my eighties—that’s the kind of health care I want—coordinated, integrated, tuned into my personal needs and preferences. You too?

Whatever you may think about the Affordable Care Act President Obama signed into law in 2010, these are the kind of innovative approaches included in it. These ideas effectively combine common sense with technology— or as some system-watchers put it, “It’s about improving the quality of our country’s health care, but at a reduced cost.
It’s really about–you and me at eighty-three.

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What about Lucy?

Last month Sharon and I presented at the American Society on Aging (ASA) “Aging in America” conference in Chicago.  The program was packed with presentations on a wide variety of subjects relating to aging, but one in particular caught our attention.

In recent years we have tried to plan for aging and end-of-life decisions and issues.  We drafted wills; we executed durable powers of attorney and updated our advanced directives.  We purchased plots in the Jacksonville Cemetery.  We even built a lovely, age-friendly, Lifelong Housing Certified single story home that features all manner of innovations to help us “age-in-place.”  All set right?  Well, what about Lucy?

If you have followed this blog for long you know that we added a new member to our family last September; a cute little Cavalier King Charles Spaniel puppy we name Lucy.

At the Chicago ASA Conference we attended a workshop titled “Aging in Community with Pets:  Insights, Innovations and Advance Planning.”  There it was….advance planning for Lucy.  How could we forget Lucy?

We heard from Amy Shever, Executive Director, 2nd Chance 4 Pets, an all-volunteer animal welfare organization that strives to reduce the number of companion animals that are unnecessarily euthanized each year due to the death or incapacity of their human companions.  The facts are stunning, after the tragedy of September 11 over 800 pets were orphaned.  At present over 500,000 pets are orphaned each year due to the death or disability of their human companion.

Here is what 2nd Chance 4 Pets (www.2ndchance4pets.org) recommends:

  1. Identify Caregivers – Identify individuals who would be willing to care for your pets in the hours, days, or weeks after an emergency as well as individuals who would be willing to adopt your pets should you die or become incapacitated.
  2. Prepare Written instructions – Describe, in writing, how your pets should be cared for.  To make sure your wishes are carried out, document your instructions and let others know where your instructions are located.
  3. Set Up a Fund – You currently pay for food, supplies, and medical care for your pets.  Should anything happen to you, these expenses will still need to be taken care of.  Consider setting aside funds to cover temporary or permanent care of your pets.  Pet trusts are legal in Oregon.

Ok Lucy.. We’ve got you covered.


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Better Living By Design: A Symposium You Must Not Miss

Even if I were not one of the people organizing and planning it, I would absolutely want to be present for this event!  Saturday May 16, 2015, thinking homeowners and forward-looking building professionals will come together to rock the house (literally and figuratively)!

The all-day (9-3 pm) Symposium is titled “Better Living By Design: Making Our Homes More Adaptable for All Ages.” The location in downtown Medford, Oregon is the Rogue Community College/Southern Oregon University Higher Education Center (RCC/HEC). The fee is $20 and includes lunch and morning snacks. CEUs available too.  Does it get any better than this?

Here is the line-up of speakers:
Alan Delatorre PhD Portland State University, Institute on Aging, Age-Friendly Cities Project; Title: “Baby Boomers Evolving Housing Preferences Will Shape New, Innovative Options: Stand Ready!” Overview of demographics and the opportunities on the horizon across the state and in southern Oregon.

Susan M. Duncan R.N., National Accessibility and Home Modifications Specialist. Designer and founder of The ABCs of Accessibility® Topic: Home Modifications Title: “Peeling Back the Layers of Home Access Modifications” You have questions about renovating an older home to be sure you can still easily live in it at age 80-plus…. even if you or your spouse needs a wheelchair or walker … ?  Susan has the answers. She is a pistol of a presentor!

Leigh Anne Jasheway MPH, Faculty, University of Oregon, well-regarded area Humorist. Her presentation is titled: “Watch Your Step: Oh, I Forgot, There Aren’t Any.” Leigh Anne uses all-to-true stories and anecdotes plus hilarious “Improv” routines to prompt us to laugh out loud at the decisions we make and  at our aging selves. (Laughing is aerobic exercise so this event even has some calorie-burning opportunities.)

The day ends with the tour of two local homes certified to the Lifelong Housing Standard. There are only five of these in the state and you will see the exterior of all five and the interior of two of them.  It will change the way you think about aging.

Register on the Age-Friendly Innovators website www.agefriendlyinnovators.org or by calling 541-261-2037.  Space limited so make the reservation now!

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