by CathyG | Jun 7, 2015 | medical care
Responding to Abigail Zuger’s column in the New York Times. Zuger notes that today doctors spend most time prescribing for pre-illness, which means they try to predict the future.
I am amused by, “For people who feel fine… It is the patient … firmly planted in the here and now, while medical personnel spin wild tales of coming catastrophe…”
and
“In fact, our future of treating pre-illness will simply catapult us right back to a priestly past, as we offer up misty visions of the future and encourage the masses to see with us and act accordingly.”
Zuger’s image – emotional doctors versus patients demanding evidence – captures my experience perfectly. When I declined a mammogram, citing research in top journals, the doctor responded emotionally, literally throwing up her hands: “It must be better than nothing.”
Urging a bone density scan, she cited relative risk (50%) rather than absolute risk (3%). Outpatient surgical clinics require pre-op tests for despite published research consistently showing no difference in outcomes. Most doctors don’t know the Society for General Internal Medicine’s guidelines limit testing for asymptomatic adults.
Doctors eagerly embrace studies questioning the value of herbal or alternative options, but shrug off equally credible reports showing the low value of mainstream “preventive” medicine. In fact “preventive” really means “risk reduction” and often the reduction is so low as to be meaningless. Thus the line between science and magic become blurred, educated skeptics resist medical advice, and most doctors hate patients who know how to read statistics in the medical journals.
by CathyG | Apr 27, 2015 | sneakers
The latest version of my ceramic sneakers! I’m having fun with them.
They’re realistic but fanciful at the same time.
by CathyG | Apr 22, 2015 | single life
WSJ – April 22nd – A woman writes that her daughter is receiving her doctoral degree on the same day her son is getting married. Read the article here. They set the wedding date before they knew the exact date of “her event.” The daughter wasn’t consulted. And to add insult to injury, her role in the wedding involves tending the guest book.
Sue Shellenbarger, who has the job I’d love in my next life – writing about careers and family – consulted a family therapist and a wedding etiquette expert.
The etiquette expert says, essentially, let her vent and then “give her a hug and ask her what she thinks you should do. She may by this point be able to see that the wedding should go on as planned. If not, give her time.”
The expert does admit that “close siblings usually receive a bigger honor than tending the guest book.” (more…)
by CathyG | Jan 11, 2015 | stereotypes of aging
Stereotypes of aging got reinforced with this photo that got uploaded to Facebook today. I wrote :
“Another ageist stereotype. The man in the cartoon isn’t a 67-year old. Many – perhaps most – people in their late 60s do not need help. A lot of people in their 80s could dash up those steps. We don’t make fun of Asian, gay or black people. Why older folks?”
The response was predictable: “Perhaps we ought to have a sense of humor about our own health problems.”
So I wrote again:
“The danger of laughing at “our aches and pains” is that we tend to attribute health issues to aging when they’re more likely to be related to activity, food or side effects of medication.
“The problem is, when you encourage people to laugh at older people, then ALL older people won’t be taken seriously when they apply for a job or tell the doctors “No thanks, I don’t want that test.”
“The price of ‘cute’ is being treated like a child or a puppy.
“It’s like black people and watermelon jokes. Or jokes about women drivers, which used to be considered appropriate. It seems harmless till you realize the hidden message.”
by CathyG | Nov 30, 2014 | pollyanna views of aging
Today’s New York Times has an article on retirees who form “virtual villages” to combat loneliness and get things done.
Frankly, I don’t get it. If you live in a city, you already have a virtual village.
Some things are free. You can get groceries delivered to your door. I don’t take any meds but I could find someone to deliver them if I needed to. Besides Fresh Direct, we have InstaCart (which will do drug store runs) and Task Rabbit.
Some things cost money. You can take classes all over town. You don’t need a “senior” approved class. I live near a world-class pottery studio and am a fast bus ride way from all kinds of art classes, comedy classes … anything a person of any age might want.
Some thing are free. Many community colleges and universities allow people over a certain age to take or audit classes for free.
I belong to a regular gym. I take classes. Sometimes I can’t do all the moves – not because I’m old, in most cases, but because I didn’t do enough gymnastics as a child. No problem. Few people of any age can do all of the moves and all the instructors will suggest modifications. I also work out on my own with weights.
My city has tons of Meetup groups. They don’t ask your age. If you don’t want to go to a movie alone, join a group based on your interest, not your age.
We also have tons of opportunities to be useful with volunteerism – everything from tour guiding to animal rescue.
If I lived in the suburbs, I’d need a car, which costs $5-10,000 a year. Most cities have amenities for people over 65. Lots of things are free or almost-free, including food delivery.
Often you can get things free, too. I sometimes volunteer to usher for plays because if I don’t like the play, I can always say, “Well, at least I didn’t pay $50 and up to be annoyed.”
Mostly what bothers me is, why are these villages for retirees? Most retirees are healthy and able-bodied. Why are they subjected to stereotypes of aging?
In fact, I’d like to ask them, “Why retire?” I’ve tried a couple of times and got totally bored. I’m too busy to socialize with my age-mates at a happy hour or a movie. I spend time with people of all ages when I have something in common with them besides our decade of birth.
Right now I’m cursing the Internet because I can’t figure out how to get a blank page with a header in one of my blogs. I’m revising my website, which means rewriting pages and struggling with the demands of a new WordPress theme. I’m making videos, which is a hassle because I live near a noisy bridge in a noisy city and have to remove the background noise.
And if I didn’t have these things going on, I wouldn’t have the pleasure of a murder mystery that is a rare treat, not something I can do each day. I might write a mystery or do more comedy… but probably not. I love my pottery class but I wouldn’t be in the studio every day. There’s something about time stolen from work, contrasting with work, that leads to real enjoyment.
by CathyG | Nov 16, 2014 | dying with dignity
It’s long overdue. We’re hearing about people who want to die on their own terms. Ezekiel Emmanuel’s article, Why I Hope To Die At 75, should be required reading for everyone.
I get totally frustrated when I read (or hear) people say, “Medically-assisted dying is selfish.” The survivors are the ones who are selfish. They’re asking their “loved one” to hang around long enough to be stuck in a nursing home, where it’s not considered abuse to tie someone to a chair in diapers in front of a television set. Even if they visit every day for an hour, which is extremely rare, they’re asking the relative to put up with 23 hours of misery so they can have a single hour, not to mention the “feel good” emotions of saying, “My mom…” or, “My dad…”
We also forget that more and more of us are single and living alone. We’re used to solitude. We’re not used to sharing. Just adding a caretaker to our lives removes all possibility of a decent quality of life.
Emmanuel’s article gets it right. The people who chug along into their 90s are outliers. Getting pneumonia is a blessing. The idea is to die before you become disabled.
Ironically, if we knew we could pull the plug anytime on demand, many of us would choose medical procedures that prolong life
by CathyG | Oct 26, 2014 | stereotypes of aging
Re article in today’s NYT: What if Age Is Nothing But A Mindset.
In the paper issue of the NYT, a teaser subhead asks,”How far can positive thinking take us?”
Misleading!
Ellen Langer’s research is not related to positive thinking or even mindset. She creates interventions (scientists refer to “manipulations,” a word with neutral or even positive connotations in social science).
Langer just compares the results of those who experienced the intervention with those who did not. The people in the study were not asked to imagine or think anything; they just experienced.
Langer’s studies consistently suggest that these interventions are successful, but it’s another step to suggest that we can create our own intervention by mental gymnastics. That’s another research agenda.
What these results DO show is that people respond to environmental cues in ways that deserve further exploration.
This finding is important because people over 60 or 65 are exposed to negative cues every single day, even if they’re healthy and fit, simply by reactions of people they deal with. Doctors and most medical professions stereotype by age: in fact, many just use the age number to make recommendations, without considering the whole person and the context. (Just google “doctors stereotype aging patients” if you don’t believe me.)
Some young women in my gym have come up to say something like, “It’s nice to see someone your age…” or even the more subtle, “Did you enjoy this class?” – a question that the 20-somethings wouldn’t be asked. Even if the questioners mean well, I’m jolted out of my zone, where I’m just another person taking class, and reminded once again that I’m supposed to be “old.”
It’s always tempting to punch those people in the nose, thus demonstrating my lack of frailty. But I prefer to shock them with recommendations like, “Just stop going to doctors and you’ll age well, too.”
by CathyG | Oct 22, 2014 | pollyanna views of aging
Life’s “Common Core:” Ten requirements for teens that won’t get them into college but will make them better people, by Kristin van Ogtrop, was first published in Time Magazine and then reprinted in several places.
The #7 item reads: “Write a heartfelt thank-you note to someone over the age of 70. Even if this person hasn’t given you a holiday or birthday present, find something to thank them for.”
Are 70-year-olds just waiting around for a thank you note from a strange teen or young adult? This idea is SO insulting.
Like many people, Kristin van Ogtrop patronizes 70-year-olds as cute little people who need help. Why thank someone for something they didn’t do?
Better have the kids return to #6 and head to their local animal shelter to offer help. Or find a neighbor of any age who needs a dogwalker.
Actually this whole article is filled with silly assumptions. The #10 suggestion suggests that if you’ll race to the top you’ll knock people out of their way. Some do, some don’t.
And while a few 70-year-olds might welcome a thank you letter (I can’t imagine what the content might look like) I bet the vast majority will want to shove that letter up someplace the sun don’t shine.
by CathyG | Oct 13, 2014 | dying with dignity
The decision to die is a matter of values, not mental illness.
When conversations get difficult, or patients don’t do as they’re told, all too often the medical doctors turn to “psych consults.” A friend who’s married to a psychiatrist told me the hospital now tells “mental health professionals” to find patients incompetent when their decisions go against the hospital’s bottom line.
Psychiatrists can assess physiological components of mental illness; psychologists and some psychiatrists can help people change their thinking and behavior to become happier and enjoy smoother lives.
But what if your only option is living in “assisted care” with minimum-wage uncaring attendants, where you can be tied to a wheel chair in diapers and placed in front of a television for hours at a time, with tasteless food and frequent needle pricks for tests that don’t affect your longevity or well-being?
That’s the common nursing home experience and it doesn’t take a psychologist to see that a wish to die is completely rational.
A professional who diagnoses depression in this circumstance should be tied to a chair in front of a television set tuned to soap operas, wearing diapers, for at least 4 hours. Don’t tell him when you’ll be back. If he complains, say patronizingly, “Oh, are we feeling upset today?” and tell him he can’t have dessert after lunch. Throw in a few needle sticks and see how he feels at the end of the day.
by CathyG | Sep 15, 2014 | single life, stereotypes of aging
In an article about seniors who show up malnourished in emergency rooms, NYT author Judith Graham suggests social isolation might be a factor.
“Who likes to eat alone?” she asks rhetorically.
More and more of us live in one-person households by choice. Some people like to eat alone and it’s time everyone realized that’s a perfectly appropriate choice to make.
If a room is filled with noisy conversation I won’t eat, period. Stress isn’t good for digestion and anyway I want to enjoy my food.
When you like living alone (and census data shows more and more of us do), you obviously like eating alone. We don’t need stigmatizing comments or rhetorical questions with an agenda.
