Specialist in Issues of Midlife & Older Adults

seniors

Have You Heard of NORC’s = Naturally Occurring Retirement Communities

NORC’s = Naturally Occurring Retirement Communities

 

Not Exactly like the Village Model

 

Recently, I’ve been involved with the Village Movement and working on organizing a new Village in my home town. I’ve been a fan of the Villages idea for years since I learned about the Beacon Hill Village where the movement started in 2002.

 

The Village model involves a local grassroots, nonprofit Village forming where members join for annual fees ranging from $200-900 across the country and then have access to a range of services. Members join in activities together, recommend service providers to each other, are provided with a very well screened list of other service providers, provide volunteer services for each other, and can receive a host of volunteer services themselves.

 

The NORC’s, from what I understand, are a little different. They range in shape and size across the country so each of them are a little different, too, reflecting their communities and members. There is no membership fee so the NORC’s are usually affiliated with a not for profit organization, government grants, donors and other fund-raising sources that allow them to offer services for no charge to members.

 

NORC Movement Founder Fredda Vladeck

 

The founder of the first NORC is Fredda Vladeck whose wonderful interview I read yesterday: Naturally Occurring Retirement Communities: An Interview with Fredda Vladeck.  

 

Fredda was a geriatric social worker in NYC in the mid-1980’s and began to notice a lot of older people coming in to the ER with issues that could have easily been addressed – and prevented – at home if they had had the support and knowledge.

 

Many of these people lived at Penn South Mutual Redevelopment Houses in Chelsea, a cooperative housing development built in 1962 by the International Ladies Garment Workers Union. There were 6,200 residents with 5,000 them seniors.  

 

Many of them were old labor organizers who had devoted their lives to the unions and so did not have traditional family support systems. Fredda designed a unique program to empower these people to age in place – her program became known as a NORC.  Now there are dozens in NYC alone and hundreds across the US.

 

NORC WOW’s

 

The NORC’s are not just located in housing complexes, there are also NORC WOW’s – Naturally Occuring Retirement Communities Without Walls in communities such as the St Louis NORC which consists of a 3 square mile neighborhood.  NORC’s typically have over 50% of the population as older adults and can result from:

  • In-migration: a location where retirees move because of things like access to services and quality of life,
  • Evolution: where a community naturally ages together, and
  • Out-migration: where younger working folks tend to move to other locations leaving older people behind.
For more information about this fascinating “aging in place” movement,  click on http://www.norcs.org/  .

Are We Giving Up on our Oldest Adults Benefiting from the Internet?

The Digital Have-Not’s – Our Oldest Adults – Closing the Gap

 

(Click on the link above to read a good summary of this issue written by blogger Laurie Orlov.)

 

Are we as a society just giving up on the 75+ age group as far as encouraging and teaching them about the valuable information, tools, and community they can find online?

 

People point out there is scarce funding to reach these people – they are the digital have-not’s. I think they are the digital “would be’s” if there were helpers to teach them about the benefits (connection with friends and family, health information, interesting stories, etc.) of online and to teach them how.

 

Locally-focused online communities focused on aging, grassroots reviews leading to accountability of service and product providers, social connection, information-sharing… this has to be one answer. Again, with some help to teach how.

How Music Improves the Memory of Dementia Patients

 

A new, beautiful film called “Alive Inside” has premiered in New York City this month. The film features the story of a 92 year old gentleman with dementia named Henry Dryer who basically was almost noncommunicative until music came back into his life. He had loved music when he was young and now that he listens to music regularly, he sings songs, carries on brief conversations, can recall some memories and even dance.  He has “come alive”.

 

The film tracks the lives of seven patients with dementia, including Henry, who have benefitted through the work of a nonprofit called Music & Memory which donates iPods and personalized music to people with dementia. “Music imprints itself on the brain deeper than any other human experience. Music evokes emotion, and emotion can bring with it memory… it brings back the feeling of life when nothing else can,” says renowned neurologist Oliver Sacks who appears in the film.

 

To read more, click here

It’s Vital to Recognize Depression in Aging Adults

 

This is a very good, short article on why it is so important to recognize the signs and symptoms of depression in older people. They may not recognize that they themselves are depressed so it is imperative for caregivers and loved ones to be on the lookout. Undiagnosed depression can lead to isolation and even suicidality. Most cases of depression can be cured. This article is written by an older gentleman who has over 30 years experience working in retirement community and health facility administration. He includes reminders and tips for fighting depression in this article.  Recognize Depression in Older People – You May Save A Life

Drug Dependence Rising Among Baby Boomers

 

A new report from the Substance Abuse and Mental Health Services Administration:

 

“Illicit drug use generally declines as individuals move through young adulthood into middle adulthood and maturity, but research has shown that the baby-boom generation (persons born between 1946 and 1964) has relatively higher drug use rates than previous generations. It has been predicted that, as the baby boom generation ages, past year marijuana use will almost triple between 1999/2001 and 2020 among persons aged 50 or older. Nonmedical use
of prescription-type drugs has been identified as a concern for this population.”
To read the complete report:  Illicit Drug Use Among Older Adults

What Do We Call Ourselves as a Group as We Get Older?

 

What do we call ourselves as a group as we get older? Seniors? Elders? Crones? Older adults? Geezers? Will baby boomers always just be called baby boomers? What else can we call ourselves when referring to our demographic cohort?  Here’s a good article on this called Elderly No More from the New Old Age Blog which is such a wonderful blog on aging.

 

Questions to Ask Your Doctor – About Being Empowered As a Patient

Here is a list of questions you can draw from when you or your loved one goes to see the doctor. I hope they are of use to you. – Nancy

 

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This first section is written by Sagar Nigwekar, an internal medicine physician, and Jim Sutton a family practice physician assistant.

 

Top 5 Questions To Ask Your Doctor

1. How will I know that my treatment is working?

2. How will the medication or treatment you are prescribing treat my condition?

3. Is there more than one condition that could be causing my problem?

4. What exactly is my condition, and what caused it?

5. What symptoms should I look for that means I should contact you or seek immediate help?

 

Additional questions to consider asking:

Are there treatment choices that don’t involve medications?

How long will it take for me to feel better?

If my symptoms get worse, what can I do on my own before I see you?

Is my medical condition permanent or temporary?

 

Questions You Should Ask About Your Medications

 

Any time you are prescribed a medicine you should ask these questions:

 

Can I take a generic medicine or is this available over the counter?

Can you review my instructions with me?

At what time should I take this medication?

Should I take it with or without food?

Can I take it with other medications?

What are the possible risks and side effects of this medication?

What is the reason for taking this medication, and how does it work?

Will this medication interact with any other medication I am taking?

 

Additional questions to consider asking

 

Can my medication be stopped suddenly or does it need to be stopped slowly?

Do I need to follow any restrictions (alcohol, driving, and work)?

Do you think a pill box will help me?

How long will I need to take my medicine?

If I do not tolerate this medication then what are my alternatives?

What should I do if I miss a dose?

Where do I store this medication at home?

 

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This next part is based on an article by Ginny Dillon, a business development consultant for hospitals and health care in Dallas/Fort Worth:

 

Physicians are under pressure to see patients in a timely, effective, and efficient manner. Take a little time, organize your thoughts, come prepared and your visit could be much more productive.

 

What to bring with you to your doctor’s appointment:

 

Pad and pen… you will likely receive recommendations and many patients forget them as soon as they leave the office.
A list of your medical problems
A list of your medications
A list of your prior surgeries
A copy of pertinent studies (MRI, X-ray, etc)
A copy of pertinent medical records (valuable for second opinions).
Dress appropriately. The physician will need to see the area of concern.

 

Organize your thoughts. A new orthopedic history (questions your doctor will ask you) may include:

 

When did the problem start?
What were you doing?
Have you started taking any new medications?
Have you changed your exercise program?
What makes the pain worse?
What makes the pain better?
Do you have pain at night?
Does it awaken you?
Any numbness, tingling or weakness?
Any morning stiffness?
Pain getting up from a seated position?
Pain walking on hills?
Shoulder patients consider what motion causes your symptoms.
Do you have any mechanical symptoms (catching, locking, clicking, etc)?
Do you have any instability (does the joint feel loose)?
Do you have any swelling?
How does the pain affect your quality of life?
What have you tried so far to obtain relief (physical therapy, injections, medications, exercise, etc)?
After the exam and discussion of the findings, your doctor will likely present you with alternatives. Here are some questions you can consider asking at this point in your visit:

 

What are the possible diagnoses?
Is further testing necessary (If the test will not change the plan of care, then it is possible that you do not require further tests)?
Is an MRI or expensive imaging necessary (many times it is not)?
What are the non-surgical, surgical alternatives available to treat my condition?
What are the possible risks, side effects of the treatment?
What will happen if I choose not to have surgery?
What does the literature or research recommend (many physicians still practice based on anecdotal experience [which might be appropriate, depending on the situation])
Here are some specific considerations for surgical patients:

 

What are reasonably forseeable risks of the surgical procedure?
What are the realistic goals of the procedure (relief of pain, functional improvement, etc)?
What is my “expected recovery time” (recovery means different things to different people… be VERY CLEAR about your goals)
When can I use my arm/leg?
When can I l use my arm/leg for activities of daily living?
When can I use my arm/leg against resistance (lifting objects or putting weight on your leg)?
When can I drive?
Do you know what I do for a living? When can I return to work?


Older Adults in Mill Valley

As Mill Valley Commissioner on the Marin County Commission on Aging, in October 2009 I presented my annual report to the Mayor and City Council members on the status for baby boomers and older adults living in Mill Valley. Here is a link to my report presentation notes – I hope you will find it helpful to give you an idea of some of the opportunities and challenges for older people in Mill Valley as of autumn, 2009. Some things have changed – statistics, numbers, contact information perhaps, so do note that this report is from 2009.  Older Adults in Mill Valley

Fall Prevention

Fall Prevention. Falls are a high priority concern for middle age and older people since they are at increased risk for bone fractures and other fall-related injuries. Using a cane or eventually a walker helps many individuals to be steadier and more confident while walking. Some of the reasons, clients cite for falling are: tripping on something, their legs just “giving out”, and feeling dizzy. One often overlooked cause of unsteadiness and lightheadedness is dehydration. As we age, our sense of thirst tends to decrease – so it is important that we consciously make sure to drink plenty of water every day. An easy way to help fight the dehydration that can occur over the course of the night is to keep a glass of water on your night stand. When you wake up, sit up and drink the water before getting out of bed. Also, squeezing your calves and circling your ankles *before you get out of bed* will help increase your lower body circulation and make you feel steadier when you do get up and on your feet. For more fall prevention tips, check out   http://www.mayoclinic.com/health/fall-prevention/HQ00657   .

What Do Seniors Do Online

WHAT DO SENIORS DO ONLINE? VISIT FACEBOOK AND YOUTUBE, OF COURSE. Ben Parr. Mashable, the Social Media Guide.

http://bit.ly/8WQk6S (downloaded Dec. 21, 2009, Nancy Rhine)

We’ve known for a while that Facebook users are getting a lot older, but now new data released by Nielsen reveals that the number of seniors (65 and older) using the Web has increased by 6 million in the last five years. Not only that, but nearly half of online seniors visited Facebook or YouTube last month, making them their third and fourth most visited online destinations.

The research confirmed a trend that we’ve seen in recent years: That more seniors are becoming active on the Web. In November of 2004, there were 11.3 million active seniors online. In November 2009, that number jumped by 55 percent to 17.5 million. In addition, they spend more time on the Web, totaling an average of 58 hours a month in front of the browser.

While those numbers didn’t surprise us, we were interested in data that Nielsen collected on their browsing habits. Take a look at these two tables. The first reveals the most common activities among active online seniors. The second shows the top ten Web sites and online destinations that this demographic visited last month:

A majority of online seniors check their e-mail, print maps, play around with photos and check the weather. All of these tasks seem utility-based, but then again, we expect that these numbers would be similar in almost any other demographic. Come on — who here hasn’t checked their e-mail, mapped something out or paid their bills online in the last 30 days?

The more interesting data comes from the top 10 online destinations table. While Google Search was an obvious winner, Windows Media Player is a bit of a surprise until you realize just how many Web sites embed the thing. However, the rise of Facebook to number three on this list, when a year ago it was the number 45 most visited Web site by seniors, is a huge sign of just how mainstream social networking has become. YouTube at number four is another confirmation of this trend.

This is just what happens when new technologies become more accessible and more mainstream. Let us know what you think of these trends in the comments.