Caring Currents

If there's a senior driver in your family, it’s important to remember that even non-prescription medications can have powerful side effects.

I was reminded of this recently when I interviewed Laura Juel, an occupational therapist at the Duke Driving Program in Durham, North Carolina. Juel evaluates the driving skills of elderly people, and educates them on changes in their physical, thinking, and visual skills and recommends ways to compensate for these deficits to keep them safe on the road. In some cases, she has to tell an older person that it's time to give up driving for good.

Juel’s oldest client yet, a 98-year-old, came in for a driving assessment after he had two traffic accidents in a single week. Juel gave him a variety of driving tests, and found no significant problems: “He was sharp as a tack,” she says.

It turned out that the man had had a cold and was taking over-the-counter cold medication, and that the medication slowed his reaction time, resulting in the accidents...  Read more

Most seniors today take a dizzying number of prescription medications. According to the National Institute on Drug Abuse (NIDA), although seniors represent just 13 percent of the U.S. population, they consume one-third of the prescription drugs.

In most cases, prescription medications improve the lives of elderly people by doing everything from lowering blood pressure to easing chronic pain. But the explosion in drug use by seniors has a potential dark side: drug dependence and addiction.

According to NIDA director Nora Volkow, prescription drug abuse is a serious and growing public health problem for people of all ages. To date, NIDA and other government agencies have focused most of their attention on prescription drug abuse by young people, but Volkow points out that the elderly are particularly vulnerable to this problem because they take far more medications than any other age group. Older people are also at high risk for drug interactions and for negative side effects because of the changes in metabolism that accompany aging...  Read more

Several recent studies confirm the notion that age confers a certain measure of wisdom. For example, researchers at the University of Texas found that people 60 and older reported more feelings of peace and calm than did their younger counterparts. And a study in the journal Neurobiology of Aging concluded that older people are better able to control and regulate their emotions than younger people are.

If you're caring for an elderly parent or relative, you may be skeptical of these findings, especially if you're frustrated by loved ones' refusal to take steps that seem logical for their own health and safety.

For example, you may find your parents' refusal to leave their cluttered, unmanageble home for an assisted living facility unfathomable -- and extremely unwise. You're baffled by how stubbornly your parents resist your reasonable arguments (and the lure of the glossy brochures you bring by to tempt them)...  Read more

With all the recent media attention on senior drivers, it's important to keep in mind that most elderly people drive cautiously -- and safely.

John Locher, director of the Senior Ombudsman Program at the California DMV, made this point in a recent interview: "As a general rule, most seniors are safe, mature, responsible drivers," he told me. "They tend to restrict themselves. A lot of seniors will tell you, 'I don't drive at night anymore.' "

Locher also points out that there is a lot of bias against senior drivers. "Look how traffic accidents are handled in the media," he says. "If little Johnny has a major car accident, there will be a single headline. But if an elderly person causes a car accident, it's in the paper for days."

He cites the example of the elderly man in Santa Monica who hit the gas instead of the brake and killed 10 people at the local Farmers Market...  Read more

The Senior Ombudsman Program, an innovative new program at the California Department of Motor Vehicle's (DMV), helps the elderly and their families navigate the tricky terrain of senior driving.

In its first year, the program's small staff has given over 600 educational presentations to civic groups, senior centers, and other organizations. They also help individual seniors. For example, if a senior fails the license renewal exam, says John Locher, who heads the program, an ombudsman can review his case to see if remedial action can be taken. "This doesn't mean that every senior is going to keep his license," he says. "But he is going to get a fair hearing."

Often, according to Locher, an elderly driver may just need a few refresher driving lessons to enable him to pass the driving test. In other cases, some safety restrictions -- no driving at night, for example -- permit a senior to stay on the road...  Read more

It turns out that Baby Boomers would rather talk to their parents about almost anything except their driving. In fact, in a recent survey by Caring.com and the National Safety Council, adult children agreed that given the choice, they'd even prefer to talk to their parents about death over driving.

A Charged Issue The "Mature Drivers Survey" underscores the fact that seniors and driving safety is a deeply charged issue for contemporary families. More than a third of the adult children surveyed said they'd prefer to talk to their parents about selling their home, or even about their funeral wishes, than about giving up the car keys.

Safety Concerns Their reluctance to broach the subject doesn't mean adult children aren't concerned about their parents' driving. A quarter of survey respondents believed their parents should limit their driving, and one in ten felt their parents should be required to restrict their driving, or shouldn't be driving at all...  Read more

The father of a friend was despondent when his license was taken away. Cars had always been a major part of his life: He'd owned a series of Cadillacs, and his last car was a Jaguar. He cherished and pampered his cars, washing and waxing them in his free time, or opening up the hood to tinker with the engine. He and his friends would even sit in the car when they got together; it was his refuge from the chaos of the household. Once, in the heat of an argument, his son blurted out, "You love your car more than you love the rest of us!" and my friend's father conceded, without particular shame, that this was true.

My father's friend lost his license at the age of 87 because he couldn't pass the written DMV test. He insisted on taking the test again. And then again. But he failed each time. His family wanted him to keep his Jaguar because they thought this might make the transition easier, but he refused, declaring that it would be too painful to see the car when he knew he would never drive it again...  Read more

We don't usually talk about "aging" and "creativity" in the same breath -- but research shows a powerful link between creativity and positive health outcomes for older people.

One of the leading pioneers of this research is Dr. Eugene Cohen, director of the Center on Aging, Health and Humanities at George Washington University in Kensington, MD. Dr. Cohen was the principal investigator for the Creativity and Aging Study, which examined how participation in the arts affects the physical and mental health of seniors.

The study compared the ongoing health status of two groups of seniors: One group participated in an intensive community arts programs (including chorale singing, writing, drawing, and jewelry making) run by professional artists; the other group did not.

Researchers found that the seniors in the arts program were in better overall health and reported significantly less depression and loneliness than those in the control group...  Read more

In his book, The Art of Aging, physician Sherwin Nuland points out a positive aspect of aging that's often overlooked. He argues that the losses we experience as an inevitable part of aging can sharpen our appreciation of what we do have: the time that remains ours to savor while we can.

Nuland's book made me think about people I know who are making an art of aging. Their lives all share a common theme: Each of them has discovered, in old age, an interest that keep their minds and/or bodies active, and gives them deep pleasure.

One friend's father, for example, an ophthalmologist, became a gemologist after retirement, redirecting his keen eye and highly trained motor skills to the selection and setting of gems. Another friend's father took up the banjo. A third became a photographer, making daily bus excursions around San Francisco to chronicle the life of his adopted town...  Read more

Many young people assume that sex is one of the many things you give up as you age, along with late night parties and extreme sports. This was probably never the case, but it's certainly not true today, as people are living longer -- and healthier -- and have access to Viagra and other performance enhancing drugs.

Consider the following:

• A study published in the New England Journal of Medicine found that a majority of older adults are sexually active and consider sexual intimacy an important part of life.
• The topic of sex and aging is becoming part of our popular culture. There are a number of new books on the subject, for example, including Better Than I Ever Expected by Joan Price, who writes a lively blog with the same name. And the movie, "Away From Her," starring Julie Christie, explores the issue of romance between Alzheimer's patients in a nursing facility.

The good news is that...  Read more

In honor of Mother's Day – now just ten days away – I asked several close friends what they missed most about their mothers. Their mothers all died within the last few years, and the loss is fresh and very raw.

My friends all had very different relationships with their mothers, but their answers to the question of what they missed most were remarkably similar. Most of all, they missed the fact of having a mother, someone whose love was a simple, all encompassing part of life.

• "I miss having my mother in the world," one said.
• "She was always watching over me," said another. "I miss that." 
• Said a third, "We all feel this in my family: When my mother died, we lost our greatest fan."

A psychotherapist once told me that a child's mother is his or her first "ecosystem." Like the air we breathe and the ground we walk on, our mother sustains us  -- even if we aren't aware of it much of the time...  Read more

A tsunami of older drivers will be hitting the highways over the next few decades as Baby Boomers grow old -- by 2020, 1 in 5 drivers will be 65 or older.

If you've been dealing with elderly parents whose driving is shaky, the image of roadways teeming with senior motorists may strike you as an excellent plot for a horror film. But there are specialists out there gearing up for our aging future.

Japanese automaker Nissan, for one, is taking steps to design cars that are more senior–friendly. To that end, the company has developed a special suit that simulates the physical experience of the older driver. The suit isn't flattering: It includes dark glasses, bulky gloves, a neck brace, heavy casts on the limbs, and a thick belt around the waist. But it's not meant to be pretty -- it's purpose is to help engineers in their 20's and 30's understand what it feels like to drive a car when you're 75 years old...  Read more

Last week I wrote here about Andy, an elderly man in San Francisco whose neighbors have taken care him for the last eight years. 

I also asked about the elders in your life: Are they receiving the support they need? Unfortunately, social isolation is a widespread problem for the elderly. Isolation has been associated with depression, health problems, and premature death (one study found that social isolation poses a health risk comparable to cigarette smoking).

Without the help of his neighbors, Michele Mason and Randi Myrseth, Andy would now be in a nursing home. The final years of his life would also have been far lonelier, since he's a widower and has no children. Thanks to Michele and Randi, Andy was embraced by a broad circle of neighbors of all ages. Before his health deteriorated, Randi and Michele's husbands would take Andy to the ballpark to see his beloved SF Giants, and he spent alternative holidays at their homes...  Read more

It turns out that strong social ties can actually prolong the lives of elderly people, according to a study conducted by Finnish researchers and published in the Journal of Gerontology in 2006. The researchers found that, over a ten-year period, risk of death was 2.5 times higher for elderly women with low levels of social support, when compared with those who had strong social connections. But Randi Myrseth and Michele Mason weren't thinking about statistics or reports when they stepped into the life of Herbert Anderson (Andy) eight years ago – they were simply helping an elderly neighbor.

Randi and Michele are friends who live on the same street in San Francisco. In April 2000, Peggy Anderson, an elderly neighbor who lived up the block with her husband, Andy, was mugged by a teenager. Randi and Michelle heard about the attack shortly after it happened, and went to the hospital to see if there was anything they could do...  Read more

The statistics on caregiving in the U.S. tell a powerful story:

• There are an estimated 36 to 38 million caregivers in the U.S., according to a 2004 survey by AARP and the National Alliance for Caregivers.
• AARP estimates that the total unpaid value of labor by caregivers is at least $350 billion per year.
• Caregivers are at increased risk for heart disease, arthritis, cancer, diabetes and other stress-related diseases.
• Caregivers suffer depression at twice the rate of non-caregivers.

A confluence of factors make caregiving different – and more challenging – today then it was in the past, according to Suzanne Geffen Mintz, who heads the National Family Caregivers Association and is a caregiver herself.  In her book, A Family Caregiver Speaks Up: "It Doesn't Have to Be This Hard,"  Mintz points out that people today are living longer; at the same time, our society is far more mobile, healthcare costs are prohibitive, and more women are working outside of the home...  Read more

The answer is obvious in cases when a parent has serious vision problems, or advanced dementia. But if your parent is simply slowing down – becoming more forgetful, for example, or suffering from a chronic age-related condition – it's hard to determine if and when his driving slips from competent to hazardous to himself and others.No one wants to rush her parent off the road. Sure, it's better to be safe than sorry, but don't assume that just because your parent is over 80, he should no longer be driving. Experts agree that age alone shouldn’t be the determining factor in whether a person should give up the car keys. And it's not a decision to be taken lightly, since doing so often means slamming the door on mobility and independence. But the consequences of waiting too long to stop driving are even more terrible to contemplate. So what should you do? Driving experts have some advice:* Go driving with your parent before you have reason to suspect he has a driving problem, if possible...  Read more

If you're taking care of an elderly parent, spouse, or other relative, you may not be eager to read a book on the subject. In your scarce-to-nonexistent reading time, you'd probably prefer to catch up on world events or escape into that new novel by your favorite author. But if you can, take a glimpse at this recently published book: An Uncertain Inheritance: Writers On Caring For Family, edited by Nell Casey. The essays in this anthology will help give you perspective on your own caregiving experience. As caregivers know better than anyone, there's little glory or glamour in the position -- and few happy endings. And yet, being a caregiver demands courage, compassion, tenacity, resourcefulness, and an open heart – in short, qualities that most of us would use to describe a hero. An Uncertain Inheritance underscores the every day heroism of being a caregiver, without romanticizing the experience one bit...  Read more