Benefits of Telling Your Life Story
It’s now called “life review” rather than “talking about the olden days,” but research shows recording your life story can serve as a legacy for future generations, bring a sense of accomplishment and peace and even ease depression. Click here to view article.

Reminiscing about the “good old days” was once considered almost a sign of senility, an indication that an older person wasn’t adapting to today’s world but instead clinging to bygone days. Yet research is showing that telling stories about one’s life through a more formal practice, known as life reviews, has many benefits for seniors.

Over the past decade, studies have shown that reviewing one’s life can:

• Ease transition into old age.
• Further personal growth and promote self-discovery.
• Increase acceptance and sometimes satisfaction with one’s life.
• Improve self-esteem.
• Lower or prevent depression.
• Socially engage people who have dementia.
• End isolation by promoting social interaction, either with others in a class or with interviewers.
• Reduce chronic pain.
• Improve cognitive function.
• Help staff in nursing homes, hospitals, etc. to view client/patient as a complex individual with a lifetime of experiences—both good and bad.
• Give the opportunity to review accomplishments and remember life’s joys and challenges.
• Provide a bigger picture of an individual’s life and place in the world.
• Help older adults create a permanent historical record about their lives as well pass on their wisdom and values to future generations.

Life narratives are a natural outgrowth of the phase of life between our 60s and 80s when we look back and assess our lives, seeing our mistakes and our accomplishments, determining what we learned. It’s also a natural impulse to want to pass on the lessons we’ve learned to family, friends and future generations.

For those close to death, life reviews become more of an imperative. Hospitals, senior centers, hospices and other settings for dying or very ill patients are using this practice, coined dignity therapy or reminiscence therapy, to bring closure to lives. One scientist found that dying individuals were most frightened by the idea of not existing after death and were comforted by the idea of creating a document that would outlast them. Hospice workers and other caretakers are being trained to interviewing the dying, which can ease anxiety and depression at the end of life.

What to Write About

There are many ways to write a life review. One is to use a simple form that lists the facts and opens the door to deeper storytelling:

• Date and place of birth
• Names of parents
• Childhood: siblings, stories, schools, friends
• Marriage(s): date, place, name of spouse
• Education: school, college, university and other
• Designations, awards and other recognitions
• Employment: jobs, activities, stories, colleagues, promotions
• Places of residence
• Hobbies, sports, interests, activities
• Charitable, religious, fraternal, political and other affiliations
• Achievements
• Disappointments
• Individual attributes, such as a sense of humor

Another way is to answer more thought-provoking questions, such as “What did you want to be when you grew up?” (see sidebar).

For some people, the most important action is passing on what they’ve learned to another generation. One woman who was dying of cancer created a video of herself interacting with her children. Her message to her daughters: “I won’t be there when you start dating. I won’t be there when you get married. These are some of the things I want to tell you that I believe it’s important that you do with your life.”

Some want future generations to know what life was like before electricity or television, while others want to rid themselves of painful memories. One man who suffered from alcoholism all his life wanted his children and grandchildren not to repeat his mistakes. Others “rewrite” history to come to terms with sometimes painful facts. For others, it’s not the big events in life that are important but the smaller memories, like walking in the woods with dad. Each person may have a different reason or style, but what’s important is the telling and listening that helps create a sense of peace or relief.

The author of the blog Fierce with Age suggests making a master list of every regret you’ve had. “What have you done to yourself or to others that you wish you could take back? What have others done to you? What other disappointments or just plain bad luck has life brought your way? When you’ve recorded everything you can possibly think of, go through the list again. This time, cross off every item for which you’ve already made amends and every item you can no longer do anything about. What you will be left with is a to-do list that you can still address. Time to stop writing, thinking and brooding about your to-do list. Close your journal and do what you can to make amends, fix the situation, apologize and/or forgive.”

Forms of Life Review

Life review techniques can be formal or informal. Individuals can write (or record) their own life stories, perhaps prompted by online templates or suggested questions (see sidebar). Family members or professionals can serve as interviewers. Classes, both online and locally taught (through senior centers or other organizations), can provide the advantage of sharing stories with others.

One of the more well-known proponents of the “guided life review” is Dr. James Birren, founding dean of the School of Gerontology at the University of Southern California, who offers several methods for a “guided biography” both online and through on-site classes. For example, his “Guided Autobiography” class “helps individuals organize their life stories. Guided by a trained instructor, participants are led through themes and priming questions that evoke memories of events once known but filed away and seemingly forgotten. Writing and sharing life stories with others is an ideal way to find new meaning in life as the uncertainties of the past, and the contradictions, paradoxes and events of life are put into perspective. Participants feel stronger and have a growing appreciation of their lives.“

For those who want to write their own life story, the website Lifebio provides a template and online questions. For people who want more help and direction, the Association of Personal Historians offers 670 “personal historians” who can help you write your story (for a fee, of course).

With today’s accessible printing technologies, you can easily turn your written life story into a printed book, complete with photos. You can also create high-quality videos or audio recordings, which allow you to pass on to future generations a “live” rendition of yourself.

To jog your memory, use old photos, either from your life or the times you lived through. Go back in family history with online genealogy programs.

There’s even an International Institute for Reminiscence and Life Review, which brings academic scholars together “to further define reminiscence and life review as an interdisciplinary field of study in the areas of practice, research, education, volunteer and individual application.”

“The known advantages of doing [life reviews] ” wrote member John A. Kunz , “include improving the attitudes of younger adults toward older adults and vice versa, finding meaning in life, improving problem-solving skills, assisting with the grief process, increasing emotional support, strengthening self-esteem, decreasing depression and anxiety, and developing interventions for individuals with dementia.”

Questions to Get You Started

Sometimes open-ended questions about your life can bring up memories that will prove fertile for writing a life review. Here are some examples:

• How would you describe your mother to someone who had never met her?
• What is a key lesson you learned from your father?
• Describe your childhood home, inside and outside.
• What did you want to be when you grew up?
• What were your most memorable experiences from high school?
• Have you found true love? Describe what true love means to you.
• What is the hardest part of being a parent?
• What is the greatest invention that has come along in your lifetime so far? Why was this invention important to you?
• What does it take to succeed in life?
• What was the best time of your life? Why?
• It’s been said that, “The best things in life are free.” Is this true?

Source: Aging in Alabama

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Long-term Care Faces Challenges
The increased need for more long-term care, partially caused by an aging baby boomer population, is accompanied by a predicted shortage of care workers. At the same time, the premiums for long-term care insurance are rising, and one large insurer plans to charge single women more. Click here to view article.

By any measure, the current prospects for long-term care (LTC) are not encouraging. First, the sheer size of the aging baby boomer population will mean a greater need for LTC at the same time the pool of paid caretakers will be shrinking.

Moreover, LTC insurance policies are getting more expensive. Because of the high costs of paying claims, several insurance giants are no longer accepting new customers, and all are increasing premiums. In the face of rising costs of claims, most LTC insurance companies are becoming more cautious about who they insure.

One expert suggests ways to improve the labor shortage, while others offer ideas for lowering the costs of individual LTC insurance coverage.

Aging and Unprepared Population

By 2030 the number of Americans age 65 and older is projected to be about 72 million, or about 19 percent of the total U.S. population (up from over 40 million, or 13 percent, in 2010) (data from Society for Certified Senior Advisors webinar, “Baby Boomers and 65+: The Long Term Care Challenge,” by Robert Semro, a policy analyst for the Bell Policy Center).

By 2050, when the last baby boomers turn 85, the number of Americans age 65 and older is projected to grow to almost 89 million, or about 20 percent of the total U.S. population. At the same time, the number of Americans who need LTC is expected to increase from approximately 12 million today to 27 million in 2050.

Between 2004 and 2008, the number of seniors at risk of outliving their resources increased by nearly 2 million households. More than one out of every three seniors was determined to be economically insecure in 2008.

Many boomers are not realistic about retirement costs and, due to insufficient savings, are not prepared for their own retirements. Working longer may not be enough because many boomers are unaware of the potential cost of LTC and do not save adequately. (See sidebar for LTC costs.)

Shortage of Care Workers

Because the overall labor pool will be smaller in the future, compared to the increase in older people, experts on aging predict a shortage of qualified LTC workers. Today, families often take care of elderly parents, but because of declining fertility rates, fewer adult children will be available to handle that chore (“New Areas of Reform on the Long-term Care Labor Force Crisis,” presented to Society of Certified Senior Advisors by Lisa Rill).

In order to meet the demand for LTC services in the near future, a new pool of qualified workers is needed, Rill states. She believes that LTC workers such as CNAs and home health aides are undervalued and underpaid, partly due to society’s prejudice against the elderly. One solution to attract and keep better workers is to increase pay and benefits, as well as create more opportunity for career advancement. Just as crucial is redesigning the models of care, so clients have a bigger role in their own care. This would create a more efficient setting and would allow workers to become more directly involved in client care.

In 2007, Medicaid covered nearly half of the nation’s nursing home expenses, according to the Congressional Research Service. Because the government is a leading player in LTC, through Medicaid, experts say that the government needs to raise the training requirements for skilled LTC workers as well as work with public and private sectors to find solutions.

Changes in Long-term Care Insurance

In the last two years, many of the big insurance companies, including MetLife and Prudential, have stopped selling new LTC insurance policies. Experts blame declining revenues on insurers’ underestimation of the number filed claims; underpriced policies, particularly for those sold more than a decade ago; and low interest rates over the last four years, which means lower returns on investments made by the insurance companies and significant impact on the reserves needed to pay future claims.

To compensate for these losses, most major insurers are raising their rates for policyholders, requesting average increases of 20 to 28 percent. For those who can’t afford to pay the increase, this means dropping the policy and losing any money already invested.

For females, the news is even worse. Because women outlive men on average by five to seven years and represent almost 80 percent of the population in assisted living facilities, they cost insurance companies more. As a result, Genworth, the nation’s largest LTC insurance provider, plans to increase rates for females by as much as 40 percent for single women applicants. Married women are not as severely impacted.

Also, many insurance companies are now requiring a paramedical exam with fluids, the same exam required for most life insurance and disability income policies. It consists of your medical history, height and weight measurements, blood pressure, pulse and urine and blood specimens.

In the face of these changes, and the fact that LTC insurance is less expensive at a younger age, insurance experts recommend that those who plan on getting LTC insurance should do it sooner rather than later. While that gives the insurance carrier more time set aside reserves for future claims, that also leaves a longer period of time for insurance companies to raise their rates.

Suggestions for Reducing Costs

Most financial experts say the best time to buy LTC insurance is while you are healthy, preferably before your 70s.. But if you’re too late to do that, options exist to reduce the high costs.

Coverage time: The average amount of time spent in a nursing home is three to five years, and the LTC insurance payout generally kicks in after 90 days of facility care. Financially it might make sense to get as much coverage as you can afford for a shorter period of time, say two to three years rather than five.

Hybrid products: Some life insurance policies offer the option of withdrawing up to a certain percentage, typically 2 percent, toward end-of-life care. These policies typically require repositioning more of the applicant’s assets to accomplish the same level of protection that a traditional LTC insurance policy would offer. Hybrid products allow the insured to make withdrawals for LTC expenses without penalties or charges. Similarly, some annuities are offering LTC benefits.

Marriage benefits: Some insurers are offering “shared care” policies that allow a married couple to take out separate but connected plans and transfer the benefits if one of the spouses needs LTC. For example, if the policies provide a four-year benefit period for each spouse, then the couple has a combined benefit of eight years, which either of them can use. Should one spouse die without ever using the policy, the survivor “inherits” the policy and has an eight-year benefit period.

For those who have assets to protect and who can manage the premiums, LTC coverage can be a useful component of a family’s financial planning. If you’re just starting out looking for LTC policies, financial experts recommend finding someone who specializes in LTC planning and is not restricted to representing only one insurance company. An independent representative can shop around because policies’ prices and benefits vary widely, and factors of age, health and where someone lives play an important role.

Sources

“Changes in store for long-term care insurance,” Dec. 2, 2012, Pittsburgh Post-Gazette

“Long-Term Care Insurance Becoming Tougher For Women To Purchase,” Feb. 2013, Forbes

“Navigate a Course for Long-Term Care,” May 2012, Kiplinger

“Studying your long-term care insurance options more important than ever,” May 25, 2013, the Oregonian.

Average Costs for Long-term Care

The U.S. Department of Health and Human Services calculated average costs for U.S. long-term care in 2010:

• $205 per day or $6,235 per month for a semi-private room in a nursing home.
• $229 per day or $6,965 per month for a private room in a nursing home.
• $3,293 per month for care in an assisted living facility (for a one-bedroom unit).
• $21 per hour for a home health aide.
• $19 per hour for homemaker services.
• $67 per day for services in an adult day health care center.

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New Research Explores Cure for Alzheimer’s

http://www.csa.us/email/spirit/ssarticles/0813MedNews.html
As scientists look for causes as well as preventative measures for this form of dementia, they are examining not just physical factors but also “social,” such as age of retirement and an individual’s own concerns about memory. Click here to view article.

Although Alzheimer’s disease is the focus of much research, the bottom line is that there is still no cure. Nor are scientists sure what causes this form of dementia, though several workable theories exist.

Most recently, a study by the French government agency INSERM found that people who delay retirement have less risk of developing Alzheimer’s disease or other types of dementia. The study of half a million people in France, the largest study of this kind to date, backs the general theory of aging that says” if you don’t use it, you lose it,” referring both to physical and cognitive function. In this case, working longer seems to keep people more mentally challenged as well as socially active.

Along those same lines of cognitive function, it was reported at the Alzheimer’s Association conference in Boston in July that people with certain types of cognitive concerns were more likely to have Alzheimer’s pathology in their brains and develop dementia than those who had no such complaints, leaving the conclusion that health care workers should listen to patients’ own sense of their health. For example, people with more concerns about memory and organizing ability were more likely to have amyloid, a key Alzheimer’s-related protein, in their brains. For this reason, leading Alzheimer’s researchers are identifying a new category called “subjective cognitive decline,” which is people’s own sense that their memory and thinking skills are slipping even before others have noticed (“Dementia’s Signs May Come Early,” July 17, 2013, New York Times).

A Growing Problem

Alzheimer’s is a serious problem, not just for the individual, but for society as a whole. More than 5 million Americans live with Alzheimer’s disease, and 15.4 million friends and family members provide care, according to the Alzheimer’s Association.

Compounding the human toll, Alzheimer’s is now the most expensive disease in the U.S., topping cancer and heart disease, according to a new study by the nonprofit RAND Corp. (“Costs of Alzheimer’s disease could bankrupt Medicare,”wcbv.com).

Researchers are still trying to fully understand the illness’s process and how to prevent or stop the disease, which robs people of their memory and the ability to function. Although scientists can’t be sure about which factors determine Alzheimer’s disease, the Alzheimer’s Association lists these hallmarks:

• Plaques, microscopic clumps of a protein called beta-amyloid peptide.
• Tangles, twisted microscopic strands of the protein tau (rhymes with “wow”).
• Loss of connections among brain cells responsible for memory, learning and communication. These connections, or synapses, transmit information from cell to cell.
• Inflammation resulting from the brain’s effort to fend off the lethal effects of the other changes underway.
• Eventual death of brain cells and severe tissue shrinkage.

Research Path

Research is taking several paths (“Alzheimer’s Treatments: What’s on the Horizon?” Mayo Clinic).

Plaques: Two strategies aimed at beta-amyloid are immunizing the body against it and blocking its production. An early Alzheimer’s vaccine to reach clinical trials mobilized a person’s own immune system to attack beta-amyloid. However, researchers stopped this study when some participants developed acute brain inflammation.

The second approach blocks the production of plaques either through intravenous (IV) infusions of a product from donated blood, which contains naturally occurring anti-amyloid antibodies from the donors; or by reducing the amount of beta-amyloid formed in the brain.

Tau: Researchers are looking at a way to prevent tau from forming tangles.

Inflammation: Researchers are studying nonsteroidal anti-inflammatory drugs, which have had varying results.

Insulin resistance: Researchers are looking to see if insulin changes in the brain may be related to Alzheimer’s. A trial is testing an insulin nasal spray to determine if it slows Alzheimer’s progression.

Heart-head connection: The risk of developing Alzheimer’s appears to increase after due to conditions that damage the heart or arteries, including high blood pressure, heart disease, stroke, diabetes and high cholesterol. To counteract this, researchers are looking at whether drugs used to treat those conditions may also help people with Alzheimer’s or reduce the risk of developing the disease. They are also interested in whether healthy living with known heart benefits, such as exercising and a heart-healthy diet, may help prevent Alzheimer’s disease or delay its onset.

In fact, one study reported that up to half of Alzheimer’s cases worldwide could be prevented through lifestyle changes and treatment of chronic medical conditions such as diabetes, as reported at the Alzheimer’s Association International Conference in July 2011 in Paris. Modest reduction in seven risk factors for dementia, including smoking, obesity, sedentary lifestyles and midlife high blood pressure, could have a huge impact, said Deborah Barnes, an associate professor of psychiatry at the University of California, San Francisco (“Researchers Say Reduction in Risk Factors Could Lower Rate of Alzheimer’s Disease,” July 19, 2011, WebMD Health News).

Cognitive and social activities: Researchers are looking at whether cognitive activities such as memory training or social interaction may help prevent or delay Alzheimer’s.

Current Therapy Options

Several different medications are used to treat Alzheimer’s symptoms such as memory loss, problems with thinking and reasoning, and issues with sleep (“Alzheimer’s Disease Therapy Options, WebMD).

These treatments boost performance of brain chemicals that carry information from one brain cell to another. Although these treatments don’t stop the underlying decline and death of brain cells, they can slow the progression of symptoms for a few months or even years. All of these medications can have side effects, which can be pronounced in older people.

The U.S. Food and Drug Administration has approved two types of medications to treat Alzheimer’s — cholinesterase inhibitors (Aricept, Exelon, Razadyne, Cognex) for the early to moderate stages of Alzheimer’s; and memantine (Namenda) to treat the cognitive symptoms (memory loss, confusion and problems with thinking and reasoning) for moderate to severe stages. Both medications have side effects.

Evidence indicates that sensory treatments such as music therapy and art therapy can improve Alzheimer’s patients’ mood, behavior and day-to-day function. By stimulating the senses, these treatments may help trigger memory recall and enable Alzheimer’s patients to reconnect with the world around them.

Similarly, storytelling can be therapeutic for people who don’t communicate well, according to research that reported people became more engaged and alert, happier and better able to communicate in general. At least two studies found that writing memoirs has therapeutic effects for those suffering from dementia, calming them down and increasing self-esteem.

Beyond that, individuals can take steps to help Alzheimer’s patients (see sidebar, “Tips for Coping.”)

Tips for Coping:

Caretakers can take simple steps to make life easier for a person with Alzheimer’s disease.

• Monitor personal comfort. Check for pain, hunger, thirst, constipation, full bladder, fatigue, infections and skin irritation. Maintain a comfortable room temperature.
• Avoid being confrontational or arguing about facts. For example, if a person expresses a wish to visit a parent who died years ago, don’t point out that the parent is dead. Instead, say, “Your mother is a wonderful person. I would like to see her too.”
• Redirect the person’s attention. Try to remain flexible, patient and supportive by responding to the emotion, not the behavior.
• Create a calm environment. Avoid noise, glare and too much background distraction, including television.
• Allow adequate rest between stimulating events.
• Acknowledge requests and respond to them.
• Look for reasons behind each behavior. Consult a physician to identify any causes related to medications or illness.
• Don’t take comments or unkind remarks personally and remember that talking about your experiences with others can be therapeutic and lead to helpful insight and needed encouragement.
• Contact the Alzheimer’s Association for support and information; 24/7 helpline: 1-800-272-3900

Source: Adapated from Alzheimer’s Association

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Alzheimer’s disease is a rising epidemic. As the sixth-leading cause of death in the United States, Alzheimer’s takes a terrible toll on individuals living with it, as well as caregivers, families and friends.
These numbers are staggering but together, we can make an impact. We can put an end to Alzheimer’s and other dementias.
Today, you have the opportunity for your gift to go twice as far. The Pine Family Foundation of Austin, Texas, has generously agreed to give $300,000 to the Alzheimer’s Association if we can
raise that same amount by September 30.
Because you’re interested in research, I know you’ll appreciate the foundation’s strong commitment to fighting this disease – and to ultimately finding a cure. The foundation’s support has advanced our understanding of the molecular mechanism of Alzheimer’s pathology, and has driven the development of potential drug candidates for treatment or prevention of Alzheimer’s.

Ray Pine, Founder of The Pine Family Foundation

Help us seize this exceptional opportunity by making a gift during this special challenge match. Your tax-deductible donation of $50 can become $100, or a gift of $100 can become $200.
When you give by Sept. 30, your gift can have twice the impact and help us continue to advance vital research and enhance care and support for all affected by Alzheimer’s disease and other dementias.

An estimated 5.2 million Americans of all ages have Alzheimer’s disease in 2013.This includes an estimated 5 million people age 65 and older and approximately 200,000 individuals younger than age 65 who have younger-onset Alzheimer’s.

Prevalence

The number of Americans with Alzheimer’s disease and other dementias will grow as the U.S. population age 65 and older continues to increase. By 2025, the number of people age 65 and older with Alzheimer’s disease is estimated to reach 7.1 million—a 40 percent increase from the 5 million age 65 and older currently affected. By 2050, the number of people age 65 and older with Alzheimer’s disease may nearly triple, from 5 million to a projected 13.8 million, barring the development of medical breakthroughs to prevent, slow or stop the disease.

Alzheimer’s disease is the 6th leading cause of death in the United States overall and the 5th leading cause of death for those aged 65 and older. It is the only cause of death among the top 10 in America without a way to prevent it, cure it or even slow its progression. Deaths from Alzheimer’s increased 68 percent between 2000 and 2010, while deaths from other major diseases, including the number one cause of death (heart disease), decreased.

While ambiguity about the underlying cause of death can make it difficult to determine how many people die from Alzheimer’s, there are no survivors. If you do not die from Alzheimer’s disease, you die with it. One in every three seniors dies with Alzheimer’s or another dementia.

Impact on Caregivers

In 2012, 15.4 million family and friends provided 17.5 billion hours of unpaid care to those with Alzheimer’s and other dementias — care valued at $216.4 billion, which is more than eight times the total sales of McDonald’s in 2011. Eighty percent of care provided in the community is provided by unpaid caregivers.

Nearly 15 percent of caregivers are long-distance caregivers, living an hour or more away from their loved ones. Out-of-pocket expenses for long-distance caregivers are nearly twice as much as local caregivers.

More than 60 percent of Alzheimer’s and dementia caregivers rate the emotional stress of caregiving as high or very high; more than one-third report symptoms of depression. Due to the physical and emotional toll of caregiving, Alzheimer’s and dementia caregivers had $9.1 billion in additional health care costs of their own in 2012.

Cost to the nation

In 2013, the direct costs of caring for those with Alzheimer’s to American society will total an estimated $203 billion, including $142 billion in costs to Medicare and Medicaid. Total payments for health care, long-term care and hospice for people with Alzheimer’s and other dementias are projected to increase from $203 billion in 2013 to $1.2 trillion in 2050 (in current dollars). This dramatic rise includes a 500% increase in combined Medicare and Medicaid spending.

Nearly 30 percent of people with Alzheimer’s and other dementias are on both Medicare and Medicaid, compared to 11 percent of individuals without these conditions.

The average per-person Medicare costs for those with Alzheimer’s and other dementias are three times higher than for those without these conditions; the average per-person Medicaid spending for seniors with Alzheimer’s and other dementias is 19 times higher than average per-person Medicaid spending for all other seniors.

Alzheimer’s disease facts in each state

The 2013 Alzheimer’s Disease Facts and Figures report contains data on the impact of this disease in every state across the nation. Click below to see the effect that Alzheimer’s is having in your state.

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Songwriter pens humorous musical to tell the story of mother’s Alzheimer’s

http://www.startribune.com/entertainment/music/218927241.html

Alzheimer’s is no laughing matter, but singer-songwriter Jonatha Brooke, whose mother had the disease, is trying to find the humor in it. She has written a one-woman musical that tells the story of a daughter and mother trying to cope during the final stages of Alzheimer’s.
Read the article >>

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