by CathyG | Sep 14, 2014 | pollyanna views of aging
I’m SO sick of those cheery posts “What’s good about getting old.”
If it were REALLY so good, would we have to keep making the point? You don’t see anyone writing about, “It’s great to be a man,” or even, “It’s great to be a woman.” Nor does anyone write, “It’s great to be black,” or, “Why I like being gay.”
Like this one from a mom blog:
There are so many good things about getting older:
1. You stop trying to impress people
2. You see things more clearly
3. Others tolerate your idiosyncrasies
When you stop trying to impress people, you’re giving up. You’re saying you’re not going to advance socially or professionally, so why bother?
Then again, I’ve never worried too much about impressing people with my wardrobe. When I was attending an academic conference several years ago, one guy came up to me to say, “You don’t care, do you? You’re wearing shorts to the opening event!” I hadn’t thought about it, frankly.
Seeing things more clearly can be painful. I shudder when I read a news article about anything medical. It’s usually wildly inaccurate. Anyway, what’s the good of seeing clearly if you aren’t taken seriously because you’re “too old?”
Finally, the reason people “tolerate your idiosyncrasies” is that they’ve bought into the stereotypes of aging. I’ve had my idiosyncracies for a years. People just thought I was weird. In fact, I discovered that one colleague who wrote reference letters for me (reference letters remain a quaint custom in academic job hunting) began each letter with, “Cathy may be somewhat eccentric, but …”
Now when I do something out of the norm, people assume it’s due to age. Sorry, folks: I was a maverick before I knew what it meant.
They think it’s “normal” when you lose thing or bump into walls.
Anyway, everybody ages differently.
Recently a young woman came up to me in the locker room at my gym, right after zumba. She said, “You are amazing! I want to be like you when I’m your age.” Thankfully she was about 20 years off when she guessed my age.
So on the one hand, I showed off a little. I told her my secret: work out 3-4x a week religiously and stay away from doctors.
But on the other hand, there area lots of women as fit as I am or more. What about that 90-year-old who ran marathons? If I did more age-appropriate things I’d be surrounded by women who were equally fit. But I like zumba.
by CathyG | Sep 9, 2014 | medical care
“Nearly 70% of lung cancer occurs in the Medicare population.” That’s the scare statistic the authors of this article use to incite fear and indignation: “Oh no, they’re killing Granny.”
The statistic is probably accurate. But some of these people are in their 80s and 90s. Lung cancer screening makes sense, at best, till age 74. Some elderly folks have other medical conditions that would preclude treatment, regardless of screening outcomes. And when you’re in your 80s and 90s, you could be treated for lung cancer only to end up with some form of cognitive impairment and/or incarceration (I use that word advisedly) in a nursing home with a loss of dignity and independence.
The article reports, “From 2002 to 2010, the NLST evaluated the impact of low-dose computed tomography—or CT—scans in more than 53,000 individuals and demonstrated a 20% reduction in lung-cancer mortality.”
That number is meaningless. We need to know the number of survivors in the screened group vs the number in the non-screened group. If these groups are self-selected the results will be muddled even further because there are differences in people who successfully seek screening vs. those who don’t seek screening or don’t have access.
It’s hard to trust any screening recommendations from radiologists and cancer centers, who stand to profit from screening and from investigating false positive. Here are links to published research studies showing far less impressive results. If newer research is available, let’s see the links.
“Cumulative lung cancer incidence rates through 13 years of follow-up were 20.1 per 10,000 person-years in the intervention group and 19.2 per 10,000 person-years in the usual care group (rate ratio [RR] …” In other words, intervention – presumably this screening – saved less than one person-year.
http://www.ncbi.nlm.nih.gov/pubmed/22031728
“Overdiagnosis is of particular concern in lung cancer screening because newer screening modalities can identify small nodules of unknown clinical significance. Previously published analyses of data from the Mayo Lung Project, a large randomized controlled trial conducted among 9211 male cigarette smokers in the 1970s and early 1980s indicated that overdiagnosis might exist in lung cancer screening…”
http://www.ncbi.nlm.nih.gov/pubmed/16757699
Let’s forget about lung cancer screening and use the money for massage.
by CathyG | Sep 7, 2014 | pollyanna views of aging
I’m tired of hearing that 50 is the new 30 and 60 is the new 40. Here’s what’s different as you get to the 60 mark and beyond.
1 – It’s harder to predict where you’ll be 5 or 10 years from now – sometimes even one year.
When you’re 40 or 50, if you’re healthy, the odds are very high that you’ll be the same for another five to ten years. You can make plans. It makes sense to invest in long-term growth stocks and your new business.
When you’re in your sixties, with each year, you’re less sure. Sure, some 70-year-olds and 75-year-olds are running marathons and businesses. But it’t not unheard of to keel over with a completely unexpected stroke or heart attack. Often, says a cardiologist I know, the first symptom of heart disease is a fatal heart attack.
2 – You stop saying, “Never say never.” Some things just won’t happen. You don’t have enough time.
3 – You realize you won’t outlive everything you own. Why buy more clothes? The t-shirts I have now will last another 10-15 years.
4 – You become comfortable with the idea of dying. It’s gonna happen. It’s more about dying a good death than living a long time. I’m more scared of going into a nursing home than I am of dying.
5 – You realize your days are limited and you want to make each one count. So you resent sitting around in waiting rooms or wasting your time on things that don’t contribute to your welfare or anybody else’s. You don’t have time to suffer fools gladly.
And, if you’re like me, you don’t hesitate to tell them, using language as colorful as possible.
by CathyG | Sep 3, 2014 | stereotypes of aging
Cartoon circling around Facebook, suggesting that people get all saggy and baggy as they age.
First of all, a lot of the time you can prevent sags and bags with exercise, if you start early enough.
And second, there’s not much you can do about sagging and bagging, in some cases. It goes with the territory. Even if you’re totally fit your skin won’t hang the same way as you age.
We don’t make fun of disabled people. Why is this funny?
by CathyG | Aug 31, 2014 | medical care
Today’s Wall Street Journal had yet another story by a disillusioned doctor: Why doctors are sick of their profession
Jauhar actually offers a balanced view. He points out that doctors were warned they would kill the goose that laid the golden eggs; many doctors still perform unnecessary surgery. I am healthy and rarely see doctors, yet when I had a small ovarian cyst, a doctor tried to persuade me to undergo a complete hysterectomy! I switched doctors and had an outpatient procedure in just a few hours.
The irony is that managed care often doesn’t prevent unnecessary or wasteful treatment. The term “preventive care” should be replaced with “risk reduction medicine.” Much of a primary care doctor’s work involves screenings of perfectly healthy, asymptomatic people that cannot be justified by research findings.
Doctors are still trained to memorize molecular structures but they need courses in statistics and decision making. Recently the WSJ published a review by a cardiologist who insisted that deaths from heart disease were down by 60%. I looked up the numbers: the reduction was 172/100,000 and that doesn’t account for things like errors in coding causes of death.
And while doctors complain bitterly about lack of respect, many of them persist in making elderly patients (and those close to end of life) suffer with unnecessary treatment. Just read any list of comments in a NYT article. I’ve heard first-hand accounts of 90-year-olds given colonoscopies, paid by Medicare; a doctor writes about aging Alzheimer’s patients getting painful needle tests for diabetes, ordered by a doctor, who can’t be stopped. yet few insurance companies give them what they need – massage, good food and privacy. I’ve heard even more horror stories of doctors who disregard DNR orders and who think they’re doing a service by keeping someone alive for a meaningless, drugged-up existence in a nursing home.
Finally, doctors have limited accountability. It is very, very hard to sue a doctor. Doctors make claims on their websites (and in practice) without disclaimers and disclosures of conflict of interest. Eye doctors actually place ads in their office magazines (“Want great vision? Talk to us about …”) without warning that these procedures do not always turn out well and sometimes make vision worse.
by CathyG | Aug 12, 2014 | health care waste
The New York Times article (Unkind Life For Young and Old, Aug 7) highlights yet another way the US wastes money. It costs $100,000 a year to maintain an aging prisoner, and prisons aren’t exactly geared for “aging in place.” They have unsafe stairwells, a ban on canes and of course no geriatricians on staff.
Geriatric prisoners rarely pose a threat to society so there’s little reason to keep them.
Jamie Fellner, author of a Human Rights Watch, was quoted in another article as saying, “Age should not be a get-out-of-jail-free card.” But why not? In some countries, people over 70 do not go to prison, period. I doubt that we’d see many people over 70 suddenly going on crime sprees; the rare cases of white collar crime, like Madoff, could be handled with supervised probation or fines.
by CathyG | Aug 6, 2014 | health care waste
The New York Times :Why We Should Know The Price Of Medical Tests. http://nyti.ms/1ooBGQP
My comment:
Oh come on … the outrageous amount we spend on health care isn’t driven by saving a few bucks here and there on price-shopping.
Just for starters, Medicare pays $300 million a year for pre-op tests for outpatient cataract surgery, when research shows these tests have no impact on outcomes. Then there are billions spend on “end of life” care because doctors and hospitals disregard DNR and DNI, even when the correct forms are in the charts.
And the billions spent on “preventive care” that doesn’t prevent anything; at most you get risk reduction, usually a small amount.
And the inflated hospital charges ($147 for a Tylenol, $500 for a bag of salt water). I’d be willing to bet that 30-50% of these “medical tests” are not even necessary.
So now they want sick people to shop around to save a few bucks? And a hospital can say, legally, that prices are secret so you can’t even if you want to?
No wonder we’re not hearing much about the Mafia. They’re probably running the medical industrial complex.
by CathyG | Jul 15, 2014 | dying with dignity
In this article, Addressing Capacity, Dr. Mark Lachs notes that 40-50% of people over 85% have some form of cognitive impairment.
In one example, a woman refuses to admit caretakers to her home. “What if there’s a fire?” she’s asked.
If she says, “I’m willing to take the risk,” she may just not be aware of what’s going on.
If she says, “I’ve lived a long life and I am willing to take that chance to maintain my privacy and independence. I can wear a life alert pendant.”
Dr. Lachs notes that people have the right to make that choice. I wish more doctors did.
by CathyG | Jun 21, 2014 | stereotypes of aging
(1) Your own personal cyanide pill. At this point, modern medicine can only do so much for you. If you want to check out, you should be able to do so, on your own terms, without explaining to anyone.
If you’re worried about upsetting your family, you should get access to a hitman from your local Mafia enclave. They’ll make it quick, clean and painless. Your family will be told, “An unfortunate accident and she had no pain at the end.”
(2) The right to use 4-letter words, including the F-word, any time, especially when you’re talking to a doctor, an insurance company, or some broker who cold-called you to transfer your IRA to his company. You’d be surprised how much gets done after you call somebody a mother-fucking idiot.
(3) The ability to make a citizen’s arrest of anyone who calls you “honey” or “dear,” especially in a professional setting. If they grew up in South Philly, they can plead mitigating circumstances.
(4) The right to knock somebody on their ass if they grab your arm without permission, thinking they’re being kind and helpful, when in fact they’re being patronizing and controlling.
Alternatively, you can hand them your big heavy backpack and say, “Oh, that’s so nice, dear – how about carrying this for me?” all the way to the door of your gym.
(5) The right to opt-out forever from all age-related mailing lists, especially those invitations from AARP and those newsletters from health care agencies, hearing aid companies and hospitals.
by CathyG | May 23, 2014 | Uncategorized
The social aspects of aging are by far the most difficult, in my experience, and the least understood. Often we experience altercasting – the way we’re pushed into roles and respond to those involuntary roles through a social interaction.
The brief video on social aspects of aging underestimated the cruelty associated with aging, which can be experienced any time after 35 or 40. It is true that some cultures treat older people better than the US does. However, it’s not clear what roles are appropriate or why special roles should be reserved for people over 60.
I do many things that are not age-appropriate – in my late sixties, I wear shorts, work on the Internet, take classes, workout – and every so often someone will say something that reminds me I’m older than most of the group. I’ve also found that any quirk or unusual quality is attributed to aging, even though it’s something that hasn’t changed for years. Age is the strongest signifier of status – even stronger than gender, sexual preference or (usually) race.
Another social phenomena is the toleration of negative stereotypes of aging. I remember watching a TV morning show years ago, where an “older” women was being interviewed because she did skydiving. The anchor was smiling in a patronizing way, as if to say, “That is so cute.” Similarly we see thousands of Youtube videos showing older women dancing, which is supposed to be amusing. One movie reviewer (wish I’d kept the clipping) wrote that, “It is funny to see older people enjoying themselves.” Can you imagine saying that about black people or disabled people?
Vernon Jordan wrote a book about growing up black. In one episode he was sitting at a table reading a book in a home his mother was cleaning. The lady of the house exclaimed, “Why, Vernon can read!” Most of us would be horrified, yet we tolerate a similar view from social and public media. We see a video of an elderly woman dancing and say, “Why, this old lady can shake her butt!”
I have never liked children and have no interest in activities that would put me around children. I’m not getting mellower; I’ve always been direct and outspoken and I’m still that way. The difference is that many people (especially medical people) expect to deal with sweet, docile old people; it has been necessary to use some colorful language to get them to pay attention, especially when I’m there alone. I don’t necessarily want “respect.” I just want to be treated like an adult who’s paying the bills; I deserve respect as a customer, not for my age.
Moreover, while other cultures treat the elderly with respect, preliterate tribes would leave elders behind when they were too weak to go on the tribal journeys. Some would kill and eat the elders. If you asked, I think many people would rather experience those customs than be locked up home with extreme pain, no meaningful life and the high probability of abuse.
