Pantechnicon; Elderly IV: Health And Housing

Hello I'm Eleanor stout and this is Ben technic on the knightly magazine on entertainment the arts and ideas. Throughout this week on technican has offered a practical guide for those in the pre retirement and retirement periods as national and regional known experts in the field discussing financial planning employment home health care. Tonight's top picks are health hospice care and housing. Generally we all desire a healthy vigorous and satisfying old age but there are many common misconceptions about health and mental attitudes of those over 65. We're learning however that senility is not inevitable and aging that old age need not impair creative effort and that people over 65 can have far more active sexual lives than has been generally thought possible. Dr. Alexander Leith who was chief of medical services at Massachusetts General Hospital has. Certain about the key factors which affect our own prospects for a long life daily vigorous exercise the correct mental attitude. Low fat diets long lived relatives a good work rest ratio and a life orientation to society. Dr. Lisa by the way is the author of use in old age which describes

experience with three separate cultures located in Pakistan Russia and Ecuador. The common link between these people is that they don't really live beyond 100 years of age. And Dr. Leith was investigating the conditions which allowed this to happen. Dr. Lee is with us tonight discussing the physical aspects of old age and how to remain healthy in retirement. While Dr. Stanley Kass a psychiatrist from the Tufts University Medical School comments on when and how to psychologically prepare for retirement. I think the best thing to do is to prepare for retirement from age 30 35. One young that you know because from 30 to 35 the process begins. It begins in your body in the sense that you lose one to one of the half percent of the size the structure of the efficiency of every organ system in your body. It begins in your social life because your parents age and die you watch them page. It begins with your children growing up

becoming adolescents and rejecting your way of life. Your style of doing things or accepting it as the case may be but the balances are always there between loss and restitution. And at age 35 it begins with the dimming of some of your dreams of what you might do with your work. And then of course it depends on what the meaning of work is and the tolerance for leisure that you have. A lot of people like to say it's a puritanical ethic of work keeping your hands busy and idle. Work binds up so many things more than ethics. It binds up the inner world in which we live as well as the outer world. We have two worlds if you will and then the representation between of both worlds. You know in a world if we are people who are afraid of the memories our past of our experiences and our accomplishments in the way we relate to people. If we're not one of the German logic elite that you mentioned before the what we call now the drive to Kratz who'd ski at 70 or fly an airplane with a detour or go from one how relaxed

some. God bless them. That's right. They go from one career to another in the Spanish-American War veterans that were study that the V.A. clinic like have starting again kept remarrying kept finding new things to do with new challenges to conquer. But these are rare people for the majority. It's pretty clear that from age 30 35 on say in 40 the peak of club activities and social activities for most people take place in the 40s in the 50s and 60s. And by 65 the peak of political social activity in the sense of participating in vivid ongoing current events and political ongoing maneuvering having influence may also peak. I don't want to give you illustrations or different peeks through these phases of life. Your physical ability is certainly going to peak. You know some of it will peak in your early 20s your sexual prowess maybe peak then even though the quality of sex may change. And as you go through life you're making a kind of questioning

inventory. How will I disengage from that which I spent so much time in dating him all through the years. And then the quality of the disengagement is something one needs to consciously plan for. How does one go about planning it you might say to the degree that one is able I think what you develop as many interests as possible remade as physically fit as is possible and remain as in contact and involved with as many things as possible. It's an interesting thing but from animals to man the brain increases in weight the more it's a challenge just like a muscle increases in value and strength. It's interesting linger in your gut. Even apes and chimpanzees. You keep challenging them. And for people who are isolated apathetic withdrawn unable to involve themselves in the athletics of life we are going. Current life. Their capacity to do things get can more and more constricted to where soon they are doing just the things of daily living we call them ADL activities of daily living and

they will tell you this sense of time changes. They get up in the morning they have breakfast and get ready for lunch or do some shopping and it's half a day's go in the afternoon there what's their favorite program on TV. Get ready for supper. There's a physician more interested in whether people can live to a ripe old age whether it's 90 hundred or even over 100 and still remain healthy and vigorous Jori themselves as if that is the case. I wanted to see that because we see so many of our own people in this country suffering from debility and so nobody we thought there might be some lessons learned not only thought you know it really is just a fascinating thought. Think of these three different cultures. Was there any connecting link though that you found between these three cultures. Any thread you feel that has kept them alive longer than most of us will ever be kept alive. Well I think that longevity is a multifactorial matter there

isn't a single factor with the reason I wanted to visit three communities was to learn whether we might identify any common denominators in a few things did come through. Certainly genetic factors play a role. The old people had elderly relatives or brothers or sisters or parents who also had lived to a ripe old age and were so I think that is one factor. There are all groups of engage in a great deal of physical activity of farming communities and everybody's working on the farm. And he started a very early age is just good. On through to their last days the physical activity which we know conditions the heart of the loans is an important factor. The diet I think use important and there were common features in Hone's in the book about the calories were markedly restricted in the amount of animal protein and fat loss who was largely vegetarian diet in the caucus is it's the

dairy economy at least now so that the die had hit more median in the animal fat but still the figures that Professor consoler Murray had collected indicated that the average diet in the area that we were visited was between 40 and 60 grams of fat a day which is to be contrasted with one hundred two hundred fifty in the average American diet. So it's still quite low. You know that some 70 percent was you know of that. So there are quantitative differences I would say local irking tea in largely vegetarian carbohydrate would apply to all three of these areas and then the fourth factor in addition to genetics. He was a collectivity and seemed to be the psychological factors. You know it took me a little while before I realized the importance of this but you know all of three of these areas. The older you get the more venerated you are the higher your social position and you

continue to interact in the mainstream of the man you want to keep on living you can contribute more and more the older you get as opposed to our current our present society gets put on the shelf in return. They may restrict a little bit to physical activities but they continue to serve useful functions in their community and therefore they have a reason for her staying alive. But your meaningful purpose in life may change drastically. It's not a static situation and we are not static. Even though our lifestyle is difficult and we are not static. And so as these things are lost to you you've got to find a meaningful purpose in your life or just get down to the activities of daily living. And then the styles vary. The solutions are very unique very individual to the degree one has conscious control of the destiny which should prepare for. I think that's the intriguing thing about let's say running. You have to push yourself beyond the initial resistance of your body and your nature to be able to endure and running. But once you get by at this tremendous satisfaction the same is true with people who are

often stay dry. Once they're involved they enjoy it and they're glad they did it. In most cases I think many 85 people here old people would be insulted by the question because they feel they've got a right to speak. And this one man in his 80s said to me all I've got left is my future. I'm going to have you on this one. So I think it depends on your inner structure. If looking to the past makes you contact the inner demons that we all live with the. It's that of angels but images in your mind of your inner dialogue that are critical to evaluating. Be careful. Don't do this don't do that. Don't get up and stick your neck out. People will think you're saying I'm crazy. You know one of a thousand things then of course this person will not do it. I don't so many people who refused to go into the street after 65 or 70 because the memory loss might be apparent to someone they've read or they may not be able to recognize the face and the need to go together. Usually one could accept

that with the changes in proteins that have nothing to do with a person's worth over morality. There have to be benign memory changes as you get into the 70s and 80s. It's inevitable you will not remember as well as you were that there's nothing you're talking about a lack of protein is there nothing in our diet that we can do in order to stay mentally agile longer. I would like to say I know an answer to that. I do have some ideas and I hope they will be accepted purely as what we know at the moment which is incomplete. I do believe that the idea of very high dosage ointments is probably not wise. And there are some complications. But with my geriatric population I put them all in a very adequate dose of vitamin C because I do believe that the intactness of certain cell membranes and the utilization of oxygen by the brain. And a whole host of other things American reactions are dependent on adequate nourishment including protein. I think the whole

digestive tract. You know this is fasting. May I. Yes side for a moment. In 24 to 48 hours you replace the whole lining of your digestive tract. Because of this and being so roughly treated in your brain you have a certain number of brain cells that are set at birth. You never get anymore and you never replace those you lose yet your brain grows you say and the more you didn't grow. But that's fine by the time you're an 18 and 19 year old adolescent usually has finished rowing not by number of cells but the complex into weaving of connections between the cells. The axons and then writes beautiful certain curators not connecting up all kinds of things that's why the adolescent will become political evolution abstract aware of things he never saw before and so sensitive because his brain has literally permitted this to happen whereas a 10 year old might be very insensitive and unaware of these things and laugh at things that 10 years later he will be removed. With aging too we achieve other connections in our brain

which have to do with judgment wisdom kind of mature outlook to life a conservatism and an appreciation of life. These are real physiological psychological major cities they interweave among each other to keep them intact. I would say requires healthy blood supply healthy nutrition healthy going into action. First of all one should watch one's calories and avoid being overweight because that are important and I think if one were to reduce the amount of meat in meat products and meat that animal fat that one needs to meet. So you once again stated two or three times a day as we often do. You know realize that this should be the major source of calories for the meal. And then. I think that's important and I think that would fill up one's caloric requirements with

whole grains with beans with vegetables. With fruits with notes. This sort of thing. And then I think if we you would reduce a little bit the pastries and sweets and. A lot of the monks. Well the evidence is that alcohol in moderation. Is not bad for one and maybe even have some Sulu Briest value. There's have been some studies to indicate that the person who takes one drink a day and his latest her drug war in the person who doesn't drink at all. I think if one can manage with just one drink if the problem is how do you stay how do you stop. When professors used to say what is Tuesday meant here three years nearly and we've been listening to Dr. Alexander Leith chief of medical services at Massachusetts General Hospital along with Dr. Stanley Cath from Tufts Medical School discussing the physical and mental aspects of the pre retirement and retirement

period. Dr. gass has pointed out that we don't die of old age we die of the diseases which bring on death. And for those who are terminally ill a new program has been introduced in the United States specifically New Haven Connecticut and Providence Rhode Island. It's called Hospice Care which is an alternative to hospitalization for the terminally ill. The model for hospice care is St. Christopher's hospice in London. A 54 bed facility dedicated largely to cancer patients. The idea of hospice care is to add daily comfort and value to the terminally ill through pain control personal caring and family support. Kenneth when SIL is a minister who served as a visiting chaplain at the London hospice and is now dedicated to the development of hospice care in the United States. I don't think people are afraid of death as so much as they are of the process of dying and therefore they're afraid of being abandoned and afraid of going on an agony and dying an agonizing death. I think a couple other ingredients are involved in a healthy death.

This is termed death with dignity I don't because a cliche I thought it was I was but I don't think it is I. I think it's it's it's it's really possible for people to die with dignity and to die with dignity you've got you got to be able to exercise some control of your life right right to the end. You've got to realize and you have to be supported in making decisions. Whatever little decision you can still make. Feeling a part of society being asked your opinion on little matters every day matters so that you are part of the family life or whatever. Whatever group you're a part of I think. I think maintaining a healthy sexuality is is a very important ingredient and in a dignified I don't mean what do you mean when the sexuality in the very broadest sense then leaven has done some things on and on sexuality and the aging is just absolutely fascinating. For example you know that suicide the suicide rate is very high among that among the

retired among the aging and wealthy among the males I know the highest rate of suicide is among I don't know if they find out that are among those who have very poor sexuality which in the broadest sense means simply the feeling that somebody thinks you're attractive for some reason and not ugly. And as long as a person can and can't have that feeling of being in some way attractive to somebody and have some way of interacting with the persons of that that that sense of beauty that sense of worthwhileness gets enhanced. This contributes greatly I think to add to the sense of dignity. And this is one of the elements then in the hospice which is the program that your own father's happens in their own life. Yes you know I would say yes the dying with dignity as a whole is the is the name of the game what we want to do what we're striving for is to enable people to to experience as much quality high quality of life.

In the amount of time of they have left as is possible and you've got to find out what it is they need or what their needs are and support them in those needs. Again help them make their decisions help them feel that their little bare little room is their own castle that you are a guest and not a they're not the guest and it is the truth which is the way they would feel either a nursing home or a hospital and I think there is one other thing they have to have the assurance and the understanding and in the assurance that nobody is going to prolong their life artificially. Is this knee the main reason why the hospice plan was set up and why does the hospice in relation to going to a hospital for example write off a hospice Hospice is a is a is the place to go or it's really remore than a place to go. A hospice is a kind of of a philosophical stance that's got some place and letter of it.

It's a stance toward life. Which is geared toward helping a patient probably feel better and experience life more joyfully and abundantly maybe than he ever has before. That seems utterly ridiculous but that's the aim and this happens. This rotation is terminally ill posed for a patient who has no more than six weeks to live. It began because of a woman by the name of Cicely Saunders who was a social worker to begin with and then became a nurse kept asking all kinds of questions about about the suffering of cancer patients. She said she kept bugging the doctors all of you and said Do cancer patients really have to suffer and they said you know they finally said The way you would say to a kid I suppose you could come in or you will shut the door you know go out and they said if you want to find out you know for goodness sake study medicine but get off our backs they just didn't want to bother with it and this is the whole this is a hole. Another thing I have with the

stance of the medical professional toward the dying patient after they've done everything they can do for them in quotes they don't know what else to do because there isn't anything else to do and it's an embarrassment and these people were an embarrassment to the doctors and Cicely Saunders. Well one of our favorite lines is Mr. Grant is dying and everybody is walking past his room no why. You know why or why why is this man being shunned. And secondly why is he in agony. And they said study medicine so she studied medicine at a relatively late time in her life. And then she she became an M.D. and and then bugged her peers about why is that why are these people being abandoned and why are they suffering and they finally said to her Look here's a here's a here's our ward of eight beds and these people are going to die in two three weeks and they're all they've all got a lot of pain. Do Would you want to do but get off our backs and. And it was at that particular point or what must have been a dozen years ago in our town

that she began to experiment with pharmacologist began to experiment with a pain control program. Kenneth when so minister an advocate of hospice care for the terminally ill discussing pain control one of the three tenants of hospice care along with personal caring and family support during the second part of tonight's program on the pre retirement and retirement periods. We take a look at housing means and types of available housing with Virginia Jeffrey director of social services for the women's educational industrial union along with her assistant Miss Gail Friedman. First however Dr. Sandra Hull a psychologist at MIT who specializes in problems of old age especially relating to housing talks about the psychological stresses of moving and housing in general. The vast majority of people at that point in time are not really even thinking about moving away. They may be thinking about taking a vacation traveling to visit relatives elsewhere in the country.

But they are not considering giving up the home that they lived in bought raise their families in. Have all their memories have all their memories in and all. That's not a typical time when most American people think about moving. Even though we seem to see that in retirement villages and and in mobility it's not happening. When you look at the census data. In saying it you sort of think of people when they get to be age 60 everybody had self to get away from that it's very there's a New England winters and you get a very deceptive as a matter of fact. Even the people who do do that come home to New York or New England or what have come not the other half of the year if they go down there for three months. But that's a very select group. The vast majority of retirees are working people

who have their major investment not only emotional but financial investment in their in their home. They don't even think of it in terms of it being now outsized because their children are not living there but they do think of it very much in terms of let's keep these rooms here so that Johnny and his wife and the grandchildren can come home and visit. So part of the retention of that home is for the purpose of. Running the family run the family together at holiday time. Having a space for relatives to visit. As a psychologist then would you say that it is far healthier mentally healthier for people to stay in their homes rather than pick up and go self. I wouldn't be willing to say that because I believe that people should have awareness of the kinds of choices that they have. I think what is a problem emotionally with can be greatly stressful is waiting

till the last minute till a crisis situation whether it's a financial crisis a health crisis. Or some other kind of neighborhood crisis to decide that you're going to be forced to pull out something you've got a lot of investment in. It's the almost involuntary having to move and the not the not considering the various options that you might have. The host may be to. Join in the growth just as you like or it may be a widow. And for financial reasons they may want to sell their house. So health reasons thing they want to make a plan to go to a warmer climate and get the pure physical reasons not being able to maintain and still plowing. So one of the greatest traumas of people people.

One of the things that we see now particularly since we're in the downtown section in the Back Bay Area is that a lot of the older homes that had lower rents the people the original owners are dying and they are we sold and they're being made into condominiums or high rental apartments. And so that forces out an older person he just can't he or she can't afford that rise. Well let's talk about the only options that are available to people who are nearing pre turn here and have to start thinking about what sort of a house they're going to live in. First of all just assuming that they want to remain in the know in one area but they can't afford to remain where they are so they have to start thinking about housing in New England where do they start and I know as a doctor. Who had a big house. In one of the suburbs. She is gradually planning to give up her practice doing it in a very intelligent way. She has recently sought her big house.

Move to an apartment but has built a small house down near the Cape where she plans for her time and now there's a person who was so naturally is able to plan and who works she works with older people she is very well aware. Of the need to plan for some sort of retirement. One of the feelings that I have though about the retirement period is that is the concern of losing your spouse. So that loneliness is quite a factor and if you so you've always had your own home you cherish the privacy at the same time you don't want to be lonely either. So what what kind of housing facilities are there for people who really are concerned about that. I think some of the new senior citizen housing and his eye kind of a need because it's a safe place for older people to live. Generally the rents are either in the moderate or in the low income and some of them have market rents also categories. People are getting together and doing things socially.

There are social services available so that if they need to find out something about medical care or. They have a problem with money resources or whatever they can go to the social service person. They are very often planned trips together. The sort of place where it's a sort of a collection of apartments but people can share a dining room or recreation facilities that you're talking about. I think there are two separate ways of handling that. Some senior citizen housing is has there or the people have their own separate apartments. And that's one type and then the second type that you were just referring to is congregant living room and that is something that's just really started. In this area might have started somewhere else before. But in this area it's fairly new and people are waiting to see what will happen. With that type of living situation the lowest income level would be through the public housing which is the Boston Housing Authority level and that some others want to plan for that. A person would apply

for public housing by going down to the Boston Housing Authority of 53 State Street and filling out an application in the case of the senior citizen then they would be asked or given a choice of three places that they could put in on the application and then they're put on the individual lists for those places. How long was the willingness to have an idea. It's very long. I called this week to find out a client came in to see me and she said that she'd applied for public housing in 1974. To me. Interesting Well that is not very long because I called them and I said well how far down on the list is she and I said well on those for those particular places that she applied to the list goes back to the 1960s. We've been listening to Dr. Sandra Hall psychologist at MIT followed by representatives from the women's educational industrial union was with General Geoffrey and Gail freedom.

Thank you for joining us tonight. Come back tomorrow and discuss legal aid and consumer protection for the elderly in our weeklong series offering a practical guide to the pre retirement and the time of any agencies of telephone numbers which may be discussed during the series is available in list form by writing WGBH radio Boston 21:30 Hola. This is all new stuff within you with the unpleasant goodies.