<![CDATA[Better aging through knowledge - East Bay Insights]]>Fri, 19 Aug 2022 17:49:30 -0700Weebly<![CDATA[Elder-law attorney asks: What's up with "Hemp CBD"?]]>Fri, 27 Sep 2019 15:55:00 GMThttp://elderstogether.com/east-bay-insights/elder-law-attorney-asks-whats-up-with-hemp-cbdI recently met with the founders of a company that makes hemp-based CBD products in various forms. They invited me to help organize a focus group for eldercare professionals to give feedback on hemp-derived CBD products. 
An elder-law attorney questioned the focus group process; I'll share the attorney's comments and my response:
"It sounds like an interesting effort. However, the legal question remains: how will they get senior living facility owners and others to believe that even a hemp based product is legal? There is resistance, due to many factors... In one assisted living place where my husband and I worked with a client we transitioned there from a hospital and then nursing home, the facility absolutely forbade anyone from using anything they thought looked like cannabis on their premises. As you are aware, lots of folks do not understand the difference between hemp and cannabis that gets you high. 
"Having a fabulous product that helps elders is one thing. Getting it into care facilities is quite another. After they have agreements that any particular facility will use/promote the product, I would be interested in participating in discussions about the best kinds of products. My mother-in-law used a combination of CBD/THC edibles for sleep and pain relief for the last 3 years of her life, age 93-96, with good success. We had to experiment a very long time to get the right dosage for her needs."

One reason I participated in this focus group was to learn more about how hemp CBD works. Hemp is legal in the U.S., and extracts derived through processing the hemp plant — fiber, seeds, oil— are used to manufacture textile and fabric products, skin creams, shampoos, breakfast cereals, and supplements sold over the counter. The local supermarket displays an array of hemp CBD products on a free-standing rack behind a locked glass door.  
Dietary supplements / foods containing CBD can’t be sold or shipped interstate, but “beauty and wellness” CBD products sold as lotions and creams can be bought, sold, shipped, and used freely anywhere in the U.S. Crystalled isolate -- i.e., a powdered form of the chemical CBD -- is an FDA-approved product. 
Problem is, CBD regulation is not clearly established. There's no particular "trusted" consumer CBD brand name. Since last year when the FDA approved the CBD drug Epidiolex (for severe cases of epilepsy), Big Pharma companies are entering the CBD market, and it’s probable that they’ll fund the medical research and clinical trials needed for high-quality evidence of hemp-derived CBD’s effects. Meanwhile, the big consumer packaged goods companies likely are investing in R&D for their CBD product introductions.

But an overwhelming amount of available info makes it hard to separate fact from fiction, which should precede the feedback process, don't you think? (I go to ProjectCBD.org for a reliable, independent, factual information on the topic.) 

The heart of the matter today appears in my colleague's statement,  "We had to experiment a very long time to get the right dosage for her needs." Without any clear guidelines or regulation, experimentation/trial-and-error is necessary to find the product, potency, and formulation that's most effective; and instead of buying unregulated CBD products from a supermarket, try a licensed, permitted cannabis dispensary (retail store). These businesses adhere to extensive laws provided by the state to manage operations. These regulations aim to protect consumers by providing a state-approved location to purchase cannabis products that are tested, analyzed, and clearly and accurately labeled. 

For insights into the FDA's approach to companies claiming that their hemp CBD products have health and wellness benefits, read this government response to one such vendor: https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/nutra-pure-llc-567714-03282019




]]><![CDATA[Music Awakens Memory: 10 tips when dealing with dementia]]>Tue, 10 Sep 2019 16:42:39 GMThttp://elderstogether.com/east-bay-insights/music-awakens-memory-10-tips-when-dealing-with-dementiaPicture
She couldn't remember my name... so I just sang, "When the moon hits your eye like a big pizza pie" and she joined in, belting out, "That's amoré!” Together we would warble about the stars in the sky, smiling in unison. 

Special old songs ignite memories, so deeply etched in our brains that they remain ours for life, even if we haven't recalled them for years.

Music is a key that unlocks the door to memories. Use that key to access the essence of an individual's spirit. 

If you saw the inspiring and moving 2014 documentary Alive Inside, you know that people living with dementia can recall memories at the sound of a song — and that brings comfort and a sense of identity and autonomy. 

Familiar music also can soothe during sundowning periods or moments when your loved one seems agitated or blue.

So grab your smartphone or tablet, and build a music playlist for your companion. Find song ideas by looking up lists of "hit songs from the 19xx's" (choose the decade when your companion was a teenager or young adult). Wikipedia has a linked list of popular song hits from all eras.

Or just try singing the old standard, “You Are My Sunshine,” or other popular or spiritual songs from your companion's 20s or 30s. It's likely he or she will relish the moment. Early Beatles songs do the trick, too! 

Here are ten tips for using music in a sweet, no-pressure way, to engage with a person who has dementia:

1.  Name That Tune: Hum or whistle the melody and see if your companion can guess the song or sing some lyrics.

2.  Finish the Lyrics: Sing the first lines of an old song with simple lyrics, then indicate your companion should sing the next line. American standards to try: "This land is your land, this land is ____" or "Do Re Mi" (as in "Doe-A-Deer").

3.  Photo album soundtrack: Choose a few favorite old photos to enjoy together while you play recordings of popular songs from the same era as the photos. 

4.  Sing-along: Ask your companion to sing you a song, and ask for permission to sing along.

5.  Play old favorites: If your companion can converse, ask about favorite singers and musical groups, then create a custom playlist of songs by those performers that you can play for him or her.

6. When conversation isn't possible: Sing or play music at a low level while touching his or her hand and smiling.

7. Enhance daily routines: While preparing a meal, or helping with other daily activities, play the "favorites" playlist.

8. Group singing: Print and hand out lyric sheets to friends at residential communities, then organize an a cappella crew. To find lyrics, dig through this music resource, and you'll find the words to Beatles and other classic rock and folk songs, and movie and musical soundtrack hits.

9. If lyrics are difficult to follow, engage your companion in drumming, clapping, or finger- or foot-tapping along with the rhythm, which can be soothing.

10. Sometimes music can trigger sadness or bittersweet feelings — even grief — so pay attention to your companion's reactions to each song, and be ready to give a hug or a kiss, and switch to a different oldie-but-goodie.

Weave a little melody and rhythm into your companion's daily routine and you will bring joy and help him or her take a little dance down memory lane. Music is a healing force!
]]><![CDATA[Healthy older adults can generate as many new brain cells as younger people]]>Fri, 06 Apr 2018 17:12:05 GMThttp://elderstogether.com/east-bay-insights/healthy-older-adults-can-generate-as-many-new-brain-cells-as-younger-peoplePicture
A team of neurobiologists at Columbia University and New York State Psychiatric Institute just released a study in which they found that older adults remain more cognitively and emotionally intact than previously believed. 

In rodents and primates, the ability to generate new hippocampal cells declines with age. Scientists believed that a similar decline occurred in aging humans, also. Wrong!

While the New York researchers tempered their announcement with the caveat that "older individuals had less vascularization and maybe less ability of new neurons to make connections," they found that even the oldest brains they studied produced new brain cells. 

The researchers autopsied hippocampi (a part of the brain used for emotion and cognition, and forming new memories) from 28 previously healthy individuals aged 14-79 who had died suddenly. This marks the first time researchers looked at newly formed neurons and the state of blood vessels within the human hippocampus soon after death! Study subjects were not cognitively impaired and had not suffered from depression or taken antidepressants, which the researchers previously found could negatively affect production of new brain cells.

"We found similar numbers of intermediate neural progenitors and thousands of immature neurons," they wrote. That said, healthy older adults do form fewer new blood vessels within the brain, and have a smaller pool of progenitor cells — constrained in their capacity to differentiate and self-renew.

The team leader writes that future research on the aging brain will continue to explore how neural cell proliferation, maturation, and survival are regulated.

As a neuroscience enthusiast / layperson, my main takeaway is that this is yet another indicator that dementia disorders may result more from lifestyle factors and disease, external factors. What do you think?

Journal Reference:
Maura Boldrini, Camille A. Fulmore, Alexandria N. Tartt, Laika R. Simeon, Ina Pavlova, Verica Poposka, Gorazd B. Rosoklija, Aleksandar Stankov, Victoria Arango, Andrew J. Dwork, René Hen, J. John Mann. Human Hippocampal Neurogenesis Persists throughout Aging. Cell Stem Cell, 2018; 22 (4): 589 DOI: 10.1016/j.stem.2018.03.015
]]><![CDATA[Tech that "watches" you at home: a solution for living alone at home longer?]]>Thu, 29 Mar 2018 15:58:43 GMThttp://elderstogether.com/east-bay-insights/tech-that-watches-you-at-home-a-solution-for-living-alone-at-home-longerThe Family Caregiver Alliance / National Center on Caregiving publishes a wonderfully informative newsletter. In today's edition, the FCA recommends learning about new and emerging tools that can afford continued independence with security for our aging population.

Personally I'm wary of "always-on" voice assistive technologies such as Amazon Echo/Alexa, and Google Home, but it's clear that they offer value in addition to corporate eaves-dropping and personal data leeching; Americans are rapidly integrating these gadgets in their home media systems. A slew of voice-controlled digital communications systems are headed our way. Check out AskMarvee, an Amazon Echo "app" (known as an "Alexa skill"), for example, which enables a person who's alone at home to connect immediately with family members. Or LifePod, another Alexa skill with a bit more "artificial intelligence" baked into it, which means the system proactively tracks the person's activities and reminds him or her to take meds, stretch, call the doctor, etc. 

The older generation's desire to remain independent also is driven by the absurdly high costs of assisted-living care, a huge problem that has sparked technology innovations. Dr. Eric Topol, in his book, “The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care," calls it “monitored independence,” and it is changing how older generations age in America. What do you think?]]><![CDATA[Virtual reality enhances well-being for the elderly]]>Sat, 30 Dec 2017 22:50:59 GMThttp://elderstogether.com/east-bay-insights/virtual-reality-enhances-well-being-for-the-elderlycopyright Linda Jacobson
​“For older adults who cannot travel or attend family events, the real world can become very small and stifling. But they may be able to escape their isolation to a degree through virtual reality.”
— NextAvenue.org, March 2017

British-born Alma, shown here, lived in Northern California and thought that she'd never again travel to her native land. So I outfitted Alma and her daughter with these lightweight goggles that have smart-phones snapped into the case. The gear lets you view special "360º" or "spherical" imagery — also called virtual reality. I launched Google Earth in street map view, then entered the address that Alma remembered, and whoosh! suddenly she and her daughter were "visiting" Fort Royal Hill, a park in Alma’s hometown of Worcester, England. A reserved 91-year-old suffering from lung cancer, Alma happily reminisced as she looked around, especially when she spotted the playground roundabout she enjoyed as a child. 

Catching on to how Google Earth works, Alma asked to visit the New Jersey home where she’d lived as a young mother married to a U.S. Air Force officer. This triggered memories of raising children “here.” Alma concluded her virtual reality adventures by flying through a whimsical 3D version of Van Gogh's Starry Night.

After Alma removed the headset, her daughter asked, "Isn't it amazing?" Alma said, "It's MORE than amazing! Wow!” She looked around her living room and said, "I can't believe I'm still here!” Two months later, she was gone. After Alma’s death, her daughters expressed gratitude for the pleasure their mother experienced while seeing Worcester one final time.    
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Better living through neuroscience
Alma was ill, but her brain was still sharp. She got lucky in the brain roulette game; 37% of Americans over age 85 have cognitive impairment, known as memory loss or dementia.

In conjunction with living longer, physically healthier lives, we are learning how to do the same for our aging brains.

Neuroscientists have learned this: stimulating the aging brain boosts recall and thinking scores of people who have memory problems.

After frail elders engage in a mentally stimulating activity, they communicate and interact more effectively than before. Caregivers report improved quality of life. Apparently this sort of activity can build “cognitive reserves” to replace damaged brain cells — and cognitive stimulation may help reduce symptoms associated with dementia.

Gentle Reader: cognitive stimulation is job #1 for maintaining brain fitness — because today there is NO medical treatment or prevention of dementia, one of the top ten causes for death worldwide.

Who you gonna call, if there’s no brain ghostbusters? Self-care is the place to start. Excellent diet, exercise, sleep, and stress management have been shown to reduce the risk of developing cognitive problems. And now scientists believe that pushing the brain’s thinking capacity puts another arrow in the cognitive quiver. 

“Approaches to Cognitive Stimulation in the Prevention of Dementia” is a report by European gerontologists. They analyzed studies of cognitive intervention strategies for people with mild memory loss or moderate dementia. They concluded that the practice of cognitive intervention (stimulation) has 3 fundamental goals, each using multiple strategies:

1— Educational training teaches people who develop memory problems about their symptoms, such as onset and duration of decline, and ways to cope;

2— Functional memory improvement uses memory aids (calendars, memory books, etc.), reality orientation (repeated presentation of name, date, time, place, weather, other basic info), and methods of loci (mnemonic systems for linking an item with a place);

3— Cognitive functioning techniques exercise your ability to memorize, calculate, perceive, and react, and include reminiscence therapy, a clinical intervention that evokes discussion of positive nostalgic experiences, increases motivation and focus, and fosters self-worth, psychological resilience and improved well-being (Yamagami et al., 2007*) 

Most elders love to tell and re-tell old stories. Why? Recalling and sharing life experiences produces the lovely neurotransmitter dopamine, which plays a role in human motion and emotion. Low dopamine levels lead to lack of motivation, fatigue, addictive behavior, mood swings, and memory loss. Hence, increasing dopamine levels likely improves mood and reduces memory loss. 

And if an elder is struggling with short-term memory loss (peoples’ names, meals eaten), the ability to recall and share long-term memories is a gift. 

Get back to where you once belonged

Reminiscence therapy is a fantastic application for mobile virtual reality (mobile VR); i.e., “immersive,” 360-degree, spherical imagery. 
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Cardboard mobile VR viewer, 2014 (Google pic)
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Ancestor of today's mobile VR viewer
French neuroscientists set out to prove this point in 2014, the year when low-cost "mobile VR" display devices (Google Cardboard, above; and Samsung GearVR, shown on Alma at top) appeared on the market:

In the journal Neuropsychiatric Disease & Treatment, neuroscientist Michel Benoit and his team described a feasibility study testing the hypothesis that visual cues provided by “image-based rendering virtual environments” to people with dementia can enhance production of autobiographical memories. They concluded that cues involving an environment related to the subject’s life increase the quantity of conscious recollections of memories.

Researchers today also are developing 360º video and real-time VR and augmented reality applications for cognitive assessment and training applications. An excellent overview of VR use in this field appears in a 2015 “Frontiers in Aging Neuroscience,” by Madrid researcher Rebeca Garcia-Betances and her team. 
Copyright Linda Jacobson
​My work showing virtual reality to the elderly

“Virtual reality-based cognitive rehabilitation systems support procedures for mitigating behavioral and psychological symptoms of patients having mild cognitive impairment and early-stage Alzheimer’s disease.” 
— American Journal for Alzheimer’s Disease and Other Dementias
copyright Linda Jacobson
In 2015, equipped with Google Cardboard viewer and iPhone, I showed NY Times VR and random 360º YouTube videos to residents and caregivers at assisted-living and dementia-care facilities in San Francisco, Berkeley, Oakland, Walnut Creek, and Alameda. They were mildly amused. Many recalled their kids’ ViewMasters. Some were dismissive, frustrated by the cheap optics.

In May 2016, I met two MIT grad students, Dennis Lally and Reed Hayes, who founded a company, Rendever, while attending B-school. Both in their 20s, they had seen older relatives languish in assisted-living facilities, and decided to create a business delivering mobile VR to offer engaging activities for frail elders. They teamed with other students to design an app, code a mobile architecture and prototype a method enabling one tablet device to control selection and presentation of curated, streaming 360º content displayed in multiple Samsung GearVR headsets and smartphones. 
copyright Linda Jacobson
​They planned to sell the gear and offer content-subscriptions to assisted-living and skilled nursing companies, and enable subscribers to add and deliver their own content to their relatives via VR, selling custom content-production services to subscribers (e.g., live-stream a wedding via 360-degree camera for remote observation). 

The MIT team asked me to compile feedback from senior-living providers, end users (residents, care-givers, activity leaders), geriatric health specialists, and 360º content developers.  

Demo content included 360º slide shows of scenic and historical landmarks, annotated photo tours of cultural sites, and spherical videos of circus performers, animals, underwater life, mountain-climbers, race-cars, orchestras, abstract art “walkthroughs,” NYTVR clips, and so on. Also, my favorite, Google Earth. 
copyright Linda Jacobson
After guiding hundreds of participants through experiences of 5 to 20 minutes in duration, I saw distinct engagement trends. Regardless of age, cognitive health, gender, or race, all preferred 3 genres:
— visiting exotic locales
— viewing natural and wildlife scenes
— flying and other out-of-body adventures

Typically a single viewing of each video or slideshow was sufficient. No one ever requested a repeat experience, with one exception: people couldn’t get enough of visiting familiar settings via Google Earth. 

In this setup, everyone in the group sees the same single scene, although they can each look around the scene independently. I observed these results at every care facility, in every city: When one participant recalled an old home address and the resulting street scene appeared, that person became excited, twisting around in their chair, pointing at recognized landmarks, marveling at changed foliage or new structures, gesturing to a garden or garage or window, saying “Look over there, by the red car! My father planted a magnolia tree right there!,” etc. 

Fellow participants responded enthusiastically as they learned something new about each other. This provides residents living together due to happenstance, not choice, to build interpersonal connection and enhance understanding, in addition to self-worth and motivation. It elevates conversation between resident and caregiver beyond, “Do you want to wear this jacket today?” or “It’s time for your shower.”

It’s exciting to bring these experiences to our elders, and all people who no longer freely have access to the outside stimuli that normally would enhance motivation and focus. These are the people for whom virtual reality applications can provide excitement and wonder that would otherwise be impossible for them to experience. 

Besides, there's nothing quite so rewarding as blowing the mind of a 90-year-old. As Alma said: It's MORE than amazing. Wow!!




*Yamagami T. Oosawa M. Ito S. Yamaguchi H. (2007). Effect of activity reminiscence therapy as brain-activating rehabilitation for elderly people with and without dementia. Psychogeriatrics , 7(2), 69–75
]]><![CDATA["10 ways to love your brain"- Alzheimer's Assoc.]]>Fri, 18 Sep 2015 00:43:08 GMThttp://elderstogether.com/east-bay-insights/10-ways-to-love-your-brain-alzheimers-assocConsumers must demand that dementia-care providers adapt their techniques to reflect new scientific findings -- meanwhile, we must rely on ourselves to care for our own brain health. The Alzheimer's Association offers this list of tips that may reduce the risk of cognitive decline.

The Alzheimer's Association advises us to:

1. Break a sweat. Engage in regular cardiovascular exercise that elevates your heart rate and increases blood flow to the brain and body. Several studies have found an association between physical activity and reduced risk of cognitive decline.

2. Hit the books. Formal education in any stage of life will help reduce your risk of cognitive decline and dementia. For example, take a class at a local college, community center or online. 

3. Butt out. Evidence shows that smoking increases risk of cognitive decline. Quitting smoking can reduce that risk to levels comparable to those who have not smoked. 

4. Follow your heart. Evidence shows that risk factors for cardiovascular disease and stroke – obesity, high blood pressure and diabetes – negatively impact your cognitive health. Take care of your heart, and your brain just might follow.

5. Heads up! Brain injury can raise your risk of cognitive decline and dementia. Wear a seat belt, use a helmet when playing contact sports or riding a bike, and take steps to prevent falls.

6. Fuel up right. Eat a healthy and balanced diet that is lower in fat and higher in vegetables and fruit to help reduce the risk of cognitive decline. Although research on diet and cognitive function is limited, certain diets, including Mediterranean and Mediterranean-DASH (Dietary Approaches to Stop Hypertension), may contribute to risk reduction. 

7. Catch some Zzz’s. Not getting enough sleep due to conditions like insomnia or sleep apnea may result in problems with memory and thinking.

8. Take care of your mental health. Some studies link a history of depression with increased risk of cognitive decline, so seek medical treatment if you have symptoms of depression, anxiety or other mental health concerns. Also, try to manage stress.

9. Buddy up. Staying socially engaged may support brain health. Pursue social activities that are meaningful to you. Find ways to be part of your local community – if you love animals, consider volunteering at a local shelter. If you enjoy singing, join a local choir or help at an afterschool program. Or, just share activities with friends and family.

10. Stump yourself. Challenge and activate your mind. Build a piece of furniture. Complete a jigsaw puzzle. Do something artistic. Play games, such as bridge, that make you think strategically. Challenging your mind may have short and long-term benefits for your brain.

Good luck, friends, and take care! Please call me if you'd like to talk about these strategies and more. 

]]><![CDATA[Table Tennis: world’s best game for your brain]]>Thu, 25 Jun 2015 15:59:43 GMThttp://elderstogether.com/east-bay-insights/table-tennis-worlds-best-game-for-your-braintable tennis rocksEveryone's brain wins
Did you know playing ping-pong can mitigate and possibly prevent dementia symptoms? Yes, TABLE TENNIS is the world’s best brain sport. 

Every assisted living community and memory-care community in the East Bay and beyond should provide residents with a ping-pong table.

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The fact that table tennis helps protect and enhance the brain has been documented by multiple scientific studies — and widely observed by  health-care participants involved in table-tennis programs designed for people who have neurological or brain impairment.

Other good news about table tennis:
  • No heavy playing equipment needed. 
  • Low risk of collisions, injuries, or falls. 
  • Improves your concentration and reflexes.
  • Easy way to burn calories — 30 minutes of high-speed table tennis can burn 270 calories in a 150-pound person.

Table tennis helps your cardiovascular system and improves overall fitness level.

Researchers at my alma mater Boston University recently discovered that cardiorespiratory fitness can change the brains of older adults. A physical activity that enhances cardiorespiratory fitness, such as table tennis, could lessen age-related brain decline. Scientists say that cardio fitness is “linked to the structural integrity of white matter fiber bundles in the brain in the older adults,” with no similar association for younger adults. 

Ping-pong’s perfect for people recovering from sports injuries or those having joint problems that make other high-speed sports not feasible. It’s the rare competitive sport that lets you indulge in fast movements without straining your joints. 

As a teenager in the ‘70s— back when joints had nothing to do with bone structure — playing ping-pong with my dad was one of our favorite ways to hang out together. Whether you play it in a community center or at home, table tennis offers a great way to bond with people while you lose weight. My sense is that playing a game that requires directly facing someone enables stronger bonding potential. 

Since young and old people can play it together, ping-pong can help improve communication and build relationships. Playing at home with siblings or parents can bring folks closer and enable more quality family time.

Beneficial for Older People
Table tennis improves reflex, eye-hand coordination, mental alertness, and speed of movement. It also improves balance and lowers the chances of falls and injuries, especially among older people. 

Bottom line: Table tennis can slow the process of cognitive decline that occurs with aging.

Here in the East Bay, some cities have weekly table tennis clubs set up by their Parks & Recreation Department. Or you can play at these great places:
Albany Table Tennis Center  
Alameda Table Tennis Center 
Concord Table Tennis Club
Fremont Table Tennis Academy
Pleasanton Table Tennis Center    

Walnut Creek's 55+ housing development Rossmoor even has its own award-winning table tennis clubhouse.

P.S.  “Table tennis” is the sport's official name. “Ping-pong” is a trademarked name owned by sporting goods maker Escalade Sports, and first registered as a trademark by game company Parker Brothers. It’s the name typically used for the recreational game, instead of the Olympic sport.

Naturally we know that a rose by any other name would smell as sweet . . . .

Interested in a table tennis club for older adults? Please email me and let me know!
]]><![CDATA[Elders in action: Senior Theater makes life better!]]>Thu, 21 May 2015 19:16:56 GMThttp://elderstogether.com/east-bay-insights/elders-in-action-senior-theater-makes-life-betterOakland City HallStageBridge Theater rollin' on the river: Big wheel keeps on turnin'
Exciting press coverage of how familiar music enlivens and soothes impaired elders in assisted living and memory-care makes me wonder about the health benefits of performing music, or performing on stage. So I googled it. 

Sure enough, “Research has shown that the arts have the amazing capacity to increase social engagement and improve health, cognitive functioning, quality of life, and longevity,” according to the National Endowment for the Arts.

As I write this, the National Center for Creative Aging is hosting its annual conference in Washington DC; according to its website, “Studies show that those over 65 involved in art programs have fewer doctor visits and take less medication.” 

Case in point: the effervescent joy and poise evident on stage in front of Oakland’s City Hall earlier this month during a live medley of '60s-era protest songs and love ditties performed by Oakland’s own StageBridge theater company.

StageBridge is the country’s most well-known senior theater company. Growing in popularity and influence, “senior theatre” is enjoying a nationwide boom. Sign up for the StageBridge newsletter and try to catch one of their shows! 

According to the Senior Theatre Resource Center in Portland, Oregon, there are some 770 senior theatre companies in the U.S. (an increase from 79 in 1999).

Senior Theatre performers range in age from 50 to 90+, with the majority in their 60s and 70s. Not only seasoned performers make this scene. It's ideal for people who have never acted before or did so in the past. That’s because Senior Theater incorporates techniques designed to accommodate a range of abilities, and scripts and repertoire reflecting the rich life experiences of those who have been ‘round the block a few times. 

For example, scripts feature mostly older characters in situations based on occurrences in older persons’ lives. Productions span multiple genres, including plays, follies, variety shows, and musicals, ranging from low-cost to extravagant staging. 

The East Bay’s own award-winning, nationally acclaimed StageBridge is the pioneer in this field.

StageBridge debuted in 1978 as an acting class at a senior center. Today, with more than 100 members (average age, 70), StageBridge creates and produces theatrical works for multigenerational audiences to showcase the rich, varied experiences of older adults. Every year the members stage several hundred performances, presented at schools, senior centers, and assisted-living communities in the East Bay and beyond. Most of StageBridge’s performance material is original, commissioned from local playwrights.

Headquartered in an historic church across the street from Oakland's Whole Foods market, Stagebridge also offers classes and workshops on acting, storytelling, playwriting, singing, and improvisation; matinee school performances providing specialized messages to students; and even summer camps for older adults. Fees are sliding scale.

Regardless of whether one has a physical disability, or struggles with memorizing lines or even speaking, the focus is on developing participants’ talents and offering a creative and social opportunity. The flexibility and adaptability inherent in senior theater make all the world a stage. 

Some performers memorize their lines, others read from cards. Some have physical limitations and use canes and walkers on stage. Some performers try to avoid going on stage with a walker or cane; I read an AgingWell magazine article on StageBridge that said: “One lung-cancer patient … hid her oxygen tank beneath a humongous skirt.”

Whether you're interested in performing or helping to stage plays, follies, variety shows, or musicals, senior theater provides a fantastic way to challenge your abilities, meet people, and savor the special team spirit that characterizes the theatrical production experience. 

If going to Oakland isn’t feasible, maybe you can place an ad in your community newspaper to create your own senior theater group. Dozens of senior-savvy scripts and production materials are available for affordable fees from ArtAge’s Senior Theater Resource Center.

Break a leg! Metaphorically speaking, of course. 
]]><![CDATA[New findings about diet & meditation for brain fitness]]>Mon, 04 May 2015 19:19:34 GMThttp://elderstogether.com/east-bay-insights/new-findings-about-brain-fitnessNeurons rockImage courtesy of DreamDesigns at FreeDigitalPhotos.net
As baby boomers age and our elderly population increases, I am helping more and more families find assisted living for loved ones living with cognitive impairment. With them in mind, and in honor of Older Americans’ Month, I’m sharing news for enhancing brain fitness.

A brilliant team of researchers recently published a report in Alzheimer's & Dementia (Journal of the Alzheimer's Association) documenting a specific diet that could significantly lower the risk of developing Alzheimer's disease, even if the diet is not meticulously followed.
 
Here’s the new brain diet: 
  • Every day, eat at least 3 servings of whole grains + a salad + one other vegetable + a glass of wine 
  • On MOST days, also nosh on nuts
  • And every OTHER day, eat beans
  • At least twice weekly, eat poultry and either blueberries or strawberries
  • At least weekly, eat fish

Nutritional epidemiologist Martha Clare Morris, PhD, and colleagues developed this cleverly acronymed dining program, dubbed the MIND diet. MIND stands for ”Mediterranean-DASH Intervention for Neurodegenerative Delay" (and DASH stands for Dietary Approaches to Stop Hypertension, found to reduce risk of cardiovascular problems that lead to heart attacks and strokes.)

The MIND diet encompasses 10 "brain-healthy food groups" -- green leafy vegetables, other vegetables, nuts, berries, beans, whole grains, fish, poultry, olive oil and wine -- and 5 UNHEALTHY groups: red meats; butter and stick margarine; cheese (darn it!), pastries and sweets (sigh), and fried or fast food.

We're told to limit unhealthy foods to less than 1 tablespoon of butter per day, and less than 1 serving each PER WEEK of cheese, fried food, and/or fast food. (Limiting cheese is going to be tough for me, I adore smoked mozzarella.)

But here's my motivation: the study showed that this diet lowered the risk of Alzheimer’s by as much as 53 percent in participants who adhered rigorously to the diet, and by about 35 percent in those who followed it moderately well. 

"With late-onset Alzheimer’s, genetic risk factors are a small piece of the picture," Dr. Morris said, pointing out that past studies suggest that what we eat may play a significant role in determining who gets Alzheimer's and who doesn't.

The study enlisted nearly a thousand volunteers already participating in the ongoing Rush Memory and Aging Project, which began in 1997.

Dr. Morris said, “The results need to be confirmed by other investigators in different populations and also through randomized trials,” emphasizing that is the best way to establish a cause-and-effect relationship between the MIND diet and reductions in the incidence of Alzheimer's disease.

That said, her team’s study showed that the longer a person eats the MIND diet, the less risk that person will have of developing Alzheimer’s disease. As is the case with health-related habits, Dr. Morris said, "You'll be healthier if you've been doing the right thing for a long time.”

Meditation is good for the gray matter

“Mindfulness” is a buzzword these days. Media pundits are chanting in unison about the beneficial effects of meditation. Makes sense that researchers are exploring the impact of meditation on people who have been doing it regularly and frequently for years. 

Scientists at UCLA’s Brain Mapping Center recently compared 50 people who had mediated for years with 50 who didn’t. People in both groups showed a loss of gray matter as they aged. Among those who meditated, the volume of gray matter did not decline as much as the ones who didn’t meditate. The gray matter is the tissue that’s packed with neurons. 

Researchers were surprised by the magnitude of the difference: a widespread effect of meditation that encompassed regions throughout the entire brain.

Each group in the study was made up of 28 men and 22 women ranging in age from 24 to 77. Those who meditated had been doing so for four to 46 years, with an average of 20 years.

Although the findings suggest a loss of brain tissue with increasing age regardless of meditation practice— they also suggest that large parts of the gray matter in the brains of those who meditated seemed to be better preserved.

The researchers caution that they cannot draw a direct, causal connection between meditation and preserving gray matter in the brain. Genetic brain differences and other factors (such as diet and exercise routines) may affect those who were studied.

“Still, our results are promising,” UCLA neurologist Dr. Eileen Luders said. “Accumulating scientific evidence that meditation has brain-altering capabilities might ultimately allow for an effective translation from research to practice.”

Original Research: “Forever Young(er): potential age-defying effects of long-term meditation on gray matter atrophy” by Eileen Luders, Nicolas Cherbuin and Florian Kurth in Frontiers in Psychology, January 21, 2015.    

]]><![CDATA[Assisted Living in the private home: 20 questions for evaluating in-home care providers]]>Thu, 16 Apr 2015 18:06:22 GMThttp://elderstogether.com/east-bay-insights/assisted-living-in-the-private-home-20-questions-for-evaluating-in-home-care-providersThe SF East Bay area is rich with in-home providers of non-medical care services for people who need “assisted living” but don’t want to move to communal housing. Some providers are agencies basically serving as match-makers, recruiting, hiring, and deploying caregivers. Some providers are hands-on caregivers who work directly with their clients, who pay them directly.

If you’re evaluating a home-care agency or caregiver, these questions might help guide your interview process. Be sure to ask for several client AND personal references and contact ALL those reference people to ask how to make the most out of your interactions with the caregivers. 

Interview questions for in-home care agencies

1) How many years has your agency been caring for seniors in our community?
2) Can your agency provide me with documentation of liability coverage? 
3) How do you check your workers' national and local criminal and driving records?
4) Are all your caregivers employees who are protected by Workers’ Compensation?
5) Are all your caregivers bonded and insured for theft?
6) What is your method for tracking caregiver arrival and departure times at a client’s home?
7) Do you provide “around-the-clock” telephone service?
8) What is your backup coverage if a caregiver cannot make it to work?
9) What is the minimum quantity of hours required per shift or per week or month?
10) Which “personal care” services do you provide, including bathing, toileting, and mobility assistance, and what kind of social or cultural activities will you enable?
11) What transportation services can you provide for clients and how much do you charge extra for driving or escorting on mass transit?
12) Does your agency have an office where I can meet your staff?
13) Do you provide a written document clearly describing care services, rates and special fees?
14) Is it possible to be assigned the same 1 or 2 caregivers for all visits?
15) Does your agency make periodic supervisory visits to a client’s home?
16) What is your written policy regarding client’s rights, your company’s code of ethics, Workers’ Compensation and HIPAA compliance?
17) Can you provide, rent, or sell emergency monitoring systems, medication solutions and other safety technology?
18) When can your agency provide a free in-home assessment so I can determine whether to work with you?
19) What happens when clients don't feel good about their assigned caregiver?
20) What homecare licenses or certifications do you hold?

Interview questions for in-home caregivers

1) Can you provide 5 or 6 personal and professional references?
2) How much liability coverage do you carry on your business insurance policy? 
3) How many years have you been a caregiver and why did you start?
4) Are you bonded?
5) What is your method for tracking and reporting arrival and departure times at a client’s home?
6) May I phone you any time during the week, or at night?
7) How many hours per week and which days would you available for me?
8) What is your backup coverage if you cannot work when scheduled?
9) How many hours are required at a minimum for a single shift? During a single month?
10) What type of "personal care" services do you provide, such as bathing, incontinence, and mobility assistance?
11) Do you drive clients in your car? What type of car? Can it hold a walker or wheelchair?
12) Do you work alone or with an assistant? 
13) What recreational or cultural activities do you help clients enjoy?
14) Do you provide a written document describing your care services, rates and special fees?
15) What is your documentation explaining client’s rights, your code of ethics, and HIPAA compliance?
16) Please describe any challenging situation that you’ve had with a past client, and how you managed the situation? 
17) Can you help me rent or buy emergency monitoring systems, medication management devices, and other safety technology?
18) Will you provide a free in-home assessment before starting service?
19) How quickly can you start work?
20) What type of homecare certification or licenses do you hold?

For referrals to excellent SF East Bay in-home care agencies, 
or to compare communal vs personal assisted living, 
please call Elders Together at 510-926-0699 or email me.

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