Caregiving, Laced With Humor - The New York TImes

“My grandmother, she’s not a normal person. She’s like a character when she speaks. Every day she’s playing like she’s an actress.”

These are words of love, and they come from Sacha Goldberger, a French photographer who has turned his grandmother, 93-year-old Frederika Goldberger, into a minor European celebrity.

In the photos, you can see the qualities grandson and grandmother have in common: a wicked sense of humor, an utter lack of pretension and a keen taste for theatricality and the absurd.

This isn’t an ordinary caregiving relationship, not by a long shot. But Sacha, 44 years old and unmarried, is deeply devoted to this spirited older relation who has played the role of Mamika (“my little grandmother,” translated from her native Hungarian) in two of his books and a photography exhibition currently under way in Paris.

As for Frederika, “I like everything that my grandson does,” she said in a recent Skype conversation from her apartment, which also serves as Sacha’s office. “I hate not to do anything. Here, with my grandson, I have the feeling I am doing something.”

Their unusual collaboration began after Frederika retired from her career as a textile consultant at age 80 and fell into a funk.

“I was very depressed because I lived for working,” she told me in our Skype conversation.

Sacha had long dreamed of creating what he calls a “Woody Allen-like Web site with a French Jewish humor,” and he had an inspiration. What if he took one of the pillars of that type of humor, a French man’s relationship with his mother and grandmother, and asked Frederika to play along with some oddball ideas?

This Budapest-born baroness, whose family had owned the largest textile factory in Hungary before World War II, was a natural in front of the camera, assuming a straight-faced, imperturbable comic attitude whether donning a motorcycle helmet and goggles, polishing her fingernails with a gherkin, wearing giant flippers on the beach, lighting up a banana, or dressed up as a Christmas tree with a golden star on her head. (All these photos and more appear in “Mamika: My Mighty Little Grandmother,” published in the United States last year.)

“It was like a game for us, deciding what crazy thing we were going to do next, how we were going to keep people from being bored,” said Sacha, who traces his close relationship with his grandmother to age 14, when she taught him how to drive and often picked him up at school. “Making pictures was a very good excuse to spend time together.”

“He thought it was very funny to put a costume on me,” said Frederika. “And I liked it.”

People responded enthusiastically, and before long Sacha had cooked up what ended up becoming the most popular character role for Frederika: Super Mamika, outfitted in a body-hugging costume, tights, a motorcycle helmet and a flowing cape.

His grandmother was a super hero of sorts, because she had helped save 10 people from the Nazis during World War II, said Sacha. He also traced inspiration to Stan Lee, a Jewish artist who created the X-Men, The Hulk and the Fantastic Four for Marvel comics. “I wanted to ask what happens to these super heroes when they get old in these photographs with my grandmother.”

Lest this seem a bit trivial to readers of this blog, consider this passage from Sacha’s introduction to “Mamika: My Might Little Grandmother”:

In a society where youth is the supreme value; where wrinkles have to be camouflaged; where old people are hidden as soon as they become cumbersome, where, for lack of time or desire, it is easier to put our elders in hospices rather than take care of them, I wanted to show that happiness in aging was also possible.

In our Skype conversation, Sacha confessed to anxiety about losing his grandmother, and said: “I always was very worried about what would happen if my grandmother disappeared. Because she is exceptional.”

“I am not normal,” Frederika piped up at his side, her face deeply wrinkled, her short hair beautifully coiffed, seemingly very satisfied with herself.

“So, making these pictures to me is the best thing that could happen,” Sacha continued, “because now my grandma is immortal and it seems everyone knows her. I am giving to everybody in the world a bit of my grandma.”

This wonderful expression of caring and creativity has expanded my view of intergenerational relations in this new old age. What about you?

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Martina McBride Launches Country Retirement Community - People

Martina McBride helped unveil plans for a $95 million senior living community south of Nashville, designed to provide a welcoming home for aging members of the music industry.

"Residents can still contribute music, make music, record music and perform music here and that's very unique," McBride told PEOPLE on Wednesday at the launch of The Crescendo, a community of 180 independent living condos and a nursing facility that will feature a recording studio and a performance hall.

"The music industry is such a special industry," she adds, "and I think it's really important for people who transition into assisted living or independent living to be able to have people around them that have a point of reference."

Apartments in the complex, which is expected to open in 2013, will cost between $300,000 and the low $600,000s, but McBride says a fund will be available to assist those who need financial help. "It won't be just the exclusive, top-tier people in the music industry who can afford to live here," she says. "Everyone that contributed can come. We need to take care of our own."

At 42, McBride is a long way from retiring, but she can imagine a day – some 40 years down the road – when she and pal Faith Hill might be found gabbing by the pool at The Crescendo. "Maybe so!" she says with a laugh. "It's definitely a place that I would want to come and spend some time in my later years."

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Researchers Collect Advice from Older Adults - ALFA

Six years ago, Cornell University gerontologist Karl Pillemer had an idea: to ask the oldest Americans – the people who have been called the “Greatest Generation” for their practical advice for solving life’s major challenges. Pillemer had earlier conducted a number of studies on senior living, so it was natural that he targeted senior living communities for many of his respondents. A research partnership with Brookdale Senior Living, in particular, provided many interviewees for the project. The project as a result explored the advice of seniors on how to age fearlessly and well. The lessons offered in the book cast old age in a new light from a senior’s perspective.

One surprising finding is the generally positive view the 1200 respondents in the study hold about old age. A typical response came from an 81-year old man: “Embrace it. You still enjoy life, and there’s still purpose in your life. A 94-year old woman suggested: “My advice about growing old? I’d tell them to find the magic.” Old age is very different from what seniors anticipated – and it vastly exceeds their expectations. People felt freer to pursue interests and clearer about their life goals and how best to spend their time. Many described their life after 70 as a quest or an adventure. Overall, seniors interviewed for the book offer this lesson: The time young people spend worrying about aging is truly wasted, because it’s likely to be much better than they expect.

When asked about how people can help insure a positive and enjoyable old age, there was remarkable consensus on one point: The need to maintain strong social connections and to engage in meaningful roles as we age. The book confirms earlier research that this kind of social connectedness helps promote psychological and physical health in later life. But beginning in late middle age, people struggle to remain engaged in relationships and productive roles, as life transitions such as retirement, widowhood, and health problems occur.

Respondents in the study recommended that starting around age 60, everyone needs to become aware of the possibility of becoming isolated and take steps to stay engaged. They suggest that more introverted people should “learn to be social” in their 70s and beyond, actively seeking out new relationships to replace ones that are lost. They also endorse taking advantage of volunteer and educational opportunities. Lifelong learning was especially endorsed by the oldest Americans; indeed, a frequent recommendation was “stay curious.”

Many seniors also included the following lesson for aging: Plan carefully for where you will live in old age. Based on their own experience and those of parents and peers, they counsel younger people to begin to think about living arrangements when they are still active and healthy – both to increase their options for where they can live, but also to reduce responsibility and anxiety on the part of their children. As part of this lesson, a number specifically recommended considering a move to a senior living community. The seniors noted that some people unnecessarily suffer with insecurity, isolation, and inconvenience to stay in their homes, even though the benefits of senior living would be enormous.

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Drinking in Assisted Living - The New York Times

How likely is an assisted living resident to have a drinking problem?

The short answer is: nobody really knows. But a study by a University of Pittsburgh team, recently published in Research on Aging, provides some useful clues. More than 800 aides working in assisted living facilities in Pennsylvania were asked in a questionnaire about behaviors they had observed, or had evidence of, in the elderly people they cared for. Their responses suggested that:

-Nearly 70 percent of assisted living residents drank alcohol.
-More than a third drank daily.
-Twelve percent had abused alcohol (defined as drinking enough to cause “physical or psychosocial harm”) in the past three months.
-Almost 20 percent had experienced an apparent influence on their health from alcohol use in the past three months.

You might ask why the researchers relied on reports from nursing aides, who provide the bulk of hands-on care in assisted living, instead of asking residents themselves. One reason, admitted Nicholas Castle, a leading health policy researcher at the University of Pittsburgh, is that the team didn’t have the money to train and pay interviewers for an extensive multistate investigation that would provide a deeper understanding of this largely overlooked issue. That’s one limitation of this approach.

But as many readers pointed out the last time we talked about drinking and aging, denial is not just a river. “People tend to underestimate their consumption,” Dr. Castle said. He was not sure that residents would provide more accurate information than nursing aides, who are deeply involved with residents. “They tend to know what’s going on,” he said.

Alcohol misuse or abuse does not appear to increase with age, but it may have more serious consequences for people in their 80s, as the great majority of assisted living residents are. Their tolerance for alcohol changes; the amount they have drunk daily for years can become more intoxicating, more apt to cause falls, depression, high blood pressure and other accidents and illnesses.

In assisted living, too, most people take multiple medications and also show at least some cognitive decline. “With their changing metabolism and the possible interactions with prescription drugs, they may not need to drink a lot to have problems with alcohol,” Dr. Castle said.

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'The Talk' is never easy - Autoweek

The discussion with my father was, to be frank, painful. No, not that discussion--the birds-and-the-bees talk was a cakewalk compared with the one in which I asked him to stop driving. I had been thinking that we needed to talk for a while. He was in his late 80s, and his eyesight and hearing were declining, not to mention his reflexes. I had ridden with him in his pickup on a short drive from his house to the hardware store, and it had me terrified. It was as if he was on autopilot, not really noticing the world around him.

I worried for his safety and the safety of others. He lived in a rural area, and his ability to drive represented freedom and independence. After my mom died, he was eating most of his meals out of the house and that represented the bulk of his social activity, and he needed to be able to drive. Public transportation is nonexistent where he lived, and after a lengthy discussion, we came up with a compromise we could both live with: He wouldn't drive out of town, and he would not drive at night. When he wanted to visit our house, about 40 miles away, we would go and get him.

My dad was a member of what has become known as the Greatest Generation. He fought in Europe in World War II and was a self-made man. He was a strong man in every sense of the word. His son telling him that he shouldn't drive anymore was not something he thought he'd ever hear. It's not something I thought I'd ever have to say to him, either.

I tried using logic on him, repeating the words back to him--parents love that stuff--that he told me when I first got my driver's license. I remember him telling me that driving a car is one of the most serious things I'll ever do, just before handing over the keys to the olive-green 1968 Pontiac Catalina that had been the family car. He told me that when I was behind the wheel, I was responsible not only for my actions, but that I had to look out for the other guy.

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Sleep Apnea Linked to Silent Strokes, Small Lesions in Brain - Science Daily

People with severe sleep apnea may have an increased risk of silent strokes and small lesions in the brain, according to a small study presented at the American Stroke Association's International Stroke Conference 2012.

"We found a surprisingly high frequency of sleep apnea in patients with stroke that underlines its clinical relevance as a stroke risk factor," said Jessica Kepplinger, M.D., the study's lead researcher and stroke fellow in the Dresden University Stroke Center's Department of Neurology at the University of Technology in Dresden, Germany.

"Sleep apnea is widely unrecognized and still neglected. Patients who had severe sleep apnea were more likely to have silent strokes and the severity of sleep apnea increased the risk of being disabled at hospital discharge."

The researchers found:

-Ninety-one percent (51 of 56) of the patients who had a stroke had sleep apnea and were more likely to have silent strokes and white matter lesions that increased risk of disability at hospital discharge.

-Having more than five sleep apnea episodes per night was associated with silent strokes.

-More than one-third of patients with white matter lesions had severe sleep apnea and more than 50 percent of silent stroke patients had sleep apnea.

-Even though men were more likely to have silent infarcts, correlations between sleep apnea and silent infarcts remained the same after adjustment for such gender differences.

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Bargaining for a Child’s Love - The New York Times

ECONOMIC malaise and political sloganeering have contributed to the increasingly loud conversation about the coming crisis of old-age care: the depletion of the Social Security trust fund, the ever rising cost of Medicare, the end of defined-benefit pensions, the stagnation of 401(k)’s. News accounts suggest that overstretched and insufficient public services are driving adult children “back” toward caring for dependent parents.

Such accounts often draw on a deeply sentimental view of the past. Once upon a time, the story line goes, family members cared for one another naturally within households, in an organic and unplanned process. But this portrait is too rosy. If we confront what old-age support once looked like — what actually happened when care was almost fully privatized, when the old depended on their families, without the bureaucratic structures and the (under)paid caregivers we take for granted — a different picture emerges.

For the past decade I have been researching cases of family conflict over old-age care in the decades before Social Security. I have found extraordinary testimony about the intimate management of family care: how the old negotiated with the young for what they called retirement, and the exertions of caregiving at a time when support by relatives was the only sustenance available for the old.

In that world, older people could not rely on habit or culture or nature if they wanted their children to support them when they became frail. In an America strongly identified with economic and physical mobility, parents had to offer inducements. Usually, the bait they used was the promise of an inheritance: stay and take care of me and your mother, and someday you will get the house and the farm or the store or the bank account.

But of course what was at stake was never just an economic bargain between rational actors. Older people negotiated with the young to receive love, to be cared for with affection, not just self-interest.

The bargains that were negotiated were often unstable and easily undone. Life expectancies were considerably lower than they are now, but even so, old age could easily stretch for decades. Of course, disease, injury, disability, dementia, insanity, incontinence — not to mention sudden death — were commonplace, too. Wills would be left unwritten, deeds unconveyed, promises unfulfilled, because of the onset of dementia or the meddling of siblings. Or property was conveyed too early, and then the older person would be at the mercy of a child who no longer “cared” — or who could not deal with the work of care.

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