A group of elderly adventurers are finding new ways to challenge and enjoy themselves in their 80s and 90s, and in the process changing the way society views the elderly. The New York Times just did an article Seeing Old Age As A Never-Ending Adventure profiling three adventurers, Ilse Telemanich, 90, Tom Lackey, 89, and Charles Smith, 89, pictured here.

Ilse goes hiking in South Africa, even on a sprained leg. Tom Lackey does "wing walking" -- flying over the English Channel strapped atop a single engine plane. Tom just took up the sport in the last 10 years, and has done 20 such flights. His goal for his 90th birthday this year is to be the first person of any age to wing walk across and back the English Channel. Tom,pictured wing-walking here, a self-described "adrenaline junkie," persisted with his new hobby even when members of his church saw his sport as nothing more than a "death wish." (They have since changed their minds, thankfully).

Paul Smith travels to exotic places such as the North and South Poles.

Paul, Tom, and Ilse are not alone. The percentage of elderly travelers going in for adventure travel has gone up as much as 70% in the last 6 years. In fact, Elderhostel, Inc. the travel company specializing in travel for the elderly, has changed its name to Exploritas, to keep up with the trend. One hospital in New York City has even started the nation's first medical fellowship in trauma treatment for the elderly, to deal with mishaps that the elderly may have on their adventurers.

When people hit a ripe old age, they often brag about it, and that is evidently true in the adventure travel area. Paul Smith told the Times that on his South Pole trip, "a woman got off the plane at base camp and started bragging about being 80. She was quickly put in her place. One of the fellows in our group tapped her on the shoulder and said, ‘I don’t want to prick your balloon, but there are three in our group who are older,’ ” Mr. Smith said. Ha!

I used to tell people that if old age did not agree with me, I would take up parachuting lessons, and one day not pull the string. Now I think I will have something to look forward to when I reach that point.

Wing walking may not be your thing, but individuals such as Paul Lackey remind us that, whatever your age, you can have fun and reinvent yourself by taking on new challenges and doing things you thought you would never do. Take it to the limit one more time.

To read the Times article, click here.

Felicia Curran
www.ElderAdvocacyLaw.com

New York Times health columnist Jane Brody, pictured here, has done a series of articles recently that you should read if you’re concerned about preventing osteoporosis. One of Brody's articles in particular, "Exploring a Low-Acid Diet For Bone Health" is a must read, because of studies it describes showing that eating vegetables can maintain healthy bones. Bet your doctor never told you to eat vegetables to prevent osteoporosis, did they? Read on.

Brody’s article starts off from 2 surprising facts: 1) Osteoporotic fractures are rare in Asian countries such as Japan, even though the Japanese eat almost no calcium-rich dairy products and 2) Countries such as the U.S. which consume the most dairy products have the highest rates of osteoporotic fractures. The Japanese, it turns out, have better bone health than we do, eating little dairy products. How could that be?

As Brody explains it, it has to do with the fact that the large amounts of meat we typically eat in the United Staes actually deplete the calcium reserves in our bones. She explains that our bones are the “storage tank" for calcium compounds that regulate the acid-[alkaline] balance of the blood. When the blood becomes even slightly too acid, alkaline calcium compounds are leached from our bones to reduce the acidity of the blood. Some foods speed up the leaching process because they metabolize in the stomach to acid by-products in the blood. Other types of foods metabolize to alkaline by-products, which protect bone health. Thus if we eat too much acid-forming foods, and not enough alkaline-forming foods, our body will withdraw calcium from our bones to restore the correct acid-alkaline balance in our blood.

Acid-forming foods include meat, fish, eggs, and most legumes (beans and peas, except lentils, which are alkaline-forming). Sugar, coffee, alcohol, and most grains are also acid-forming. Alkaline-forming foods include virtually all vegetables and fruits, many nuts and seeds.

With a few exceptions, such as hard-cheeses, most dairy foods “are metabolized to compounds that are essentially neutral” even though they contain calcium. Because dairy-eating countries such as the United States tend to eat lots of meat also, experts have concluded that countries that consume the most dairy products have higher rates of osteoporotic fractures because they also consume the most meat, poultry, and fish, which are calcium-depleting.

What about calcium supplements? Should you take them? Brody cites a review of scientific literature published in the Journal of Clinical Endocrinology and Metabolism, which says that most clinical trials show that milk, dairy foods and calcium supplements do not prevent fractures.

Bottom line: Replacing some of your meat and even fish with fruits and vegetables may be more effective than taking calcium supplements. Aim for at least 9 servings of fruit and vegetables a day. Before discontinuing calcium supplements, talk to your doctor (and bring a copy of Brody’s article -- many doctors will be unfamiliar with the low-acid diet but it will make sense to them if they read about it).

Brody has done 2 other articles about osteoporosis -"As Bones Age, Who's At Risk for Fracture" (on how to tell whether you’re at risk for osteoporosis) and http://www.nytimes.com/2010/01/05/health/05brod.html ]"Options for Bone Loss, But No Magic Pill[/url](a review of osteoporosis medications).

To read the Brody article on eating vegetables to prevent osteoporosis, http://www.nytimes.com/2009/11/24/health/24brod.html]click here.[/url]
To read the Brody article on “As Bones Age ...”,click here.
To read the Brody article on “Options for Bone Loss ..." http://www.nytimes.com/2010/01/05/health/05brod.html ]click here.[/url]

Felicia Curran
www.ElderAdvocacyLaw.com

The advocacy group California Advocates for Nursing Home Reform (CANHR) has announced that California governor Arnold Schwarznegger has signed the following CANHR-sponsored bills into law:


"SB 781 (Leno): The RCFE Eviction Protection Act This law will add requirements to eviction notices that will require the facility to inform residents of their rights when faced with an eviction and will require the facility to provide a list of resources available to identify alternative housing and care options.

AB 392 (Feuer/Jones): Restoring Long Term Care Ombudsman Funding_

AB 392 appropriates $1.6 million from the federal citation penalty account to the local ombudsman programs on a one-time basis. It helps replace part of the $3.8 million in funds for these programs cut by Governor Schwarzenegger in 2008. Co-sponsored by numerous other groups. AB 392 was signed by the Governor on August 6, 2009 and took effect immediately.

AB 407 (Beall): CCRC Closure Protections This law will impose requirements on a Continuing Care Retirement Community (CCRC) provider faced with a permanent closure to ensure residents have adequate time to find new housing and to ensure that residents receive adequate compensation should they be required to move. Co-sponsor: California Continuing Care Residents Association (CALCRA).

AB 329 (Feuer): The Reverse Mortgage Elder Protection Act of 2009 This law will prohibit any person who participates in the origination of the mortgage from referring the borrower to anyone for the purchase of other financial products. The bill would require the lender to provide the prospective borrower with a list of not fewer than 10 nonprofit counseling and would require the borrower receive a suitability checklist specifying issues the borrower should discuss with a counselor before the loan application is approved.

AB 1169 (Ruskin): CCRCs. Co-sponsored with CALCRA, this law will increase transparency in financial reporting and establish limits on the transfer of CCRC funds.

AB 76 (Yamada): Life and Annuity Consumer Protection Fund
Will eliminate the sunset provision and extend the $1 fee imposed against insurers for sales of annuities and life insurance policies sold in California. Fees from the Fund are distributed to the Department of Insurance and to the District Attorney offices to provide protections for consumers of life insurance and annuity products.

AB 215 (Feuer/Smyth): Posting Nursing Home Ratings
This law would require nursing homes to post ratings issued by the federal Centers for Medicare and Medicaid Services (CMS) in a visible, public location.

AB 1457 (Davis): Nursing Home Admission Contracts - Ownership Disclosure
This law would require nursing home admission contracts to contain an attachment that discloses the name of the owner and the name and contact information of a single entity that is fully accountable for all aspects of patient care and operation at the facility and would also require written notice to residents and their representatives containing the name and contact information for a new owner when a change of ownership takes place."

Another great job by CANHR getting laws passed that protect the elderly.

CANHR says it will post a more detailed list of bills signed or vetoed on its website www.canhr.org by the end of the week.

Felicia Curran
www.ElderAdvocacyLaw.com

The New York Times ran an article recently called “Invisible Immigrants, Old and Left with ‘Nobody to Talk to,’” profiling the hardships faced by the immigrant elderly – citizens of other countries, who come to the United States at age 65 or older. Elderly immigrants are America’s fastest growing segment of immigrants. In California, one in nearly three seniors is now foreign born.

Late life immigrants are a vulnerable population, at least in part due to a 1996 federal law that puts on immigrants a 5 year waiting period for Medicaid, SSI, food stamp and other “safety net” type benefits for low income individuals. In 2007, e.g. 16 percent of the immigrant elderly lived below the poverty line, compared to 12 percent for the non-immigrant elderly. Another 24 percent of the immigrant elderly are classified as “near poor.”

Poverty is only part of their problem. Elderly immigrants, according to the Times, are among the most isolated people in the United States, facing language barriers and culture shock barriers at a time in their life when they may need extra support from social service agencies or health care providers to maintain their health and independence. “They come to the U.S. anticipating a great deal of family togetherness. But American society isn’t organized in a way that responds to their cultural expectations.”

The article profiles several elderly immigrants, including Devendra Singh, pictured here, a widower from India, who moved to Fremont, California to be with his son and his family. His son decided his family needed their privacy, and Devendra is now living in a room he got off of Craigslist. He doesn’t sound like a happy camper. He told the Times, “In India there is a favorable bias towards the elderly.” But in the U.S. “people think about what is convenient and inconvenient for them.”

Devendra and other elderly immigrants are also resourceful. If they can't go back to their villages, they can still get out of the house. Devendra meets 5 days a week at a Fremont shopping mall with other elderly compatriots from India, pictured here.

The article describes the many volunteer and civic groups that have formed to try to help the elderly immigrants in the South Bay area of the bay area:

The Muslim Support Network, www.muslimsupportnetwork.org, a community group dedicated to helping senior Muslims find services to improve the quality of their life.


The Afghan Elderly Association, www.afghanelderlyassociation, an outreach group for elderly widows from Afghanistan.


CAPS, Community Ambassador Program for Seniors, www.capseniors.org, a community organization that has trains “ambassador volunteers” to act as liaisons between different elderly immigrant communities and the social services that they need.


And the Tri-City Elder Coalition, www.tceconline.org, a consortium of elder service groups partnering to provide services and advocacy to the elderly of the south bay.


What can you do to help? Seek out elderly immigrant support groups in your community who need your support, and get involved in making a change.

Felicia Curran
www.ElderAdvocacyLaw.com

The New York Times ran an article on Monday describing an innovative type of training for medical students thinking of specializing in geriatric medicine – spend a week or two in a nursing home. The article profiles how a medical student, Kristin Murphy, pictured here, spent two weeks at a nursing home in New York. She was given the mock diagnosis of “mild stroke that affected her right side, difficulty swallowing and chronic lung disease,“ and had to act the part. She said that the experience gave her an even greater desire to practice geriatrics.

The idea is to sensitize the medical students to the experiences of their elderly patients who are sick enough to be in a nursing home, and to make prospective geriatric doctors familiar with the types of places that their sickest patients may find themselves living. The attention that the training program is drawing to need for geriatric doctors is great, but most medical students who will agree to live in a nursing home in the first place are probably already highly sensitive, and the medical students who need sensitization the most probably won’t participate in this program to begin with.

A cardiologist doesn't need to have had a heart attack herself in order to know how to diagnose and treat heart problems. So why should a geriatrician need to know about the quality of life issues that confront residents of nursing homes?

A recent article by Jane Brody on what is special about geriatric doctors sheds some light on this issue. Jane Brody interviewed, R. Sean Morrison M.D., pictured here,
a geriatric specialist at Mount Sinai Medical Center in New York. Jane Brody asked Dr. Morrison how he would approach a new patient who is 85 years of age. Dr. Morrison said he would start with a series of questions: ''Tell me about yourself. What do you like to do? What are the things you would like to do that you cannot do anymore? What is your medical history? What medications do you currently take? What brings you here today?''

If you are elderly, Dr. Morrison explained, “You want a doctor who asks more than just about your medical conditions. . . . The doctor should ask about the effect of medical conditions on quality of life, and then should explore what improvements are possible. ‘The focus of care should be on quality of life. . . .Too often, doctors lose sight of this goal when the focus is on treating specific diseases.'’ Dr. Morrison gives the example of “ if a patient has serious arthritis and hypertension and cannot go to places without a readily accessible bathroom on the first floor because she takes a diuretic for high blood pressure, perhaps the blood pressure medication should be changed. The patient may prefer a different drug that carries a slightly greater risk of stroke if it means a better quality of life.“

So if quality of life is part of what the geriatrician needs to address, they need to educate themselves on the diminishments of quality of life that can come with old age, and nursing homes, unfortunately, will present many instances of diminished quality of life for the medical student to draw on.

The Brody article also has an excellent discussion of what questions you should make sure your parents’ doctor is asking at their doctors' appointment.

To read Jane Brody’s article, click here.

To read about Kristen Murphy's experience in the nursing home, click here.

Kudos again to Kristen Murphy and others for their efforts to walk a mile in another person's shoes.

Felicia Curran
www.ElderAdvocacyLaw.com