Commentary on article: “Why Are African Americans So Much More Likely Than Whites To Develop Alzheimer’s?”
This Washington Post article, “Why Are African Americans So Much More Likely Than Whites To Develop Alzheimer’s?” described the current sampling problems. Too few representatives from certain groups lead research to an warped result. I’m not sure the average person understands the effect of a poor sample on results. Here are two examples. The first is a photo of President Elect Truman holding a newspaper whose headline read: Dewey Wins. Dewey didn’t. The newspaper got it wrong because they called people to survey their voting preferences. In those days not all people had phones!
The second was a TV program; Hee-Haw. Nearly all urban critics panned it. However, the Nielsen Ratings showed it was quite popular in rural areas. The rating agency surveyed people in rural areas as well as cities. The program stayed on the air due to a more representative sample.
A truly effective treatment/cure for Alzheimer’s disease requires everybody. An effective treatment must also account for future population trends. Each decade, the US population becomes less white. We already have many mixed-race citizens. If we don’t understand the components of our genetic salad we cannot effectively ad-dress it. Everyone bears the costs, regardless of our racial background. It is in our national interest to reach out to all communities now so we all benefit in the future.
The article sited the Tuskegee experiment as a cause for hesitation by African Americans. The article did not mention a more modern version of inappropriate behavior; using the cancer cells of Henrietta Lacks without her consent. I hurt for her family. Recruiting more African Americans should address the Henrietta Lacks issue as well as Tuskegee.
I can also see the potential for greater help to minorities as we find ways to treat Alzheimer’s. Minorities shoulder a greater personal burden. My firm works with caregivers as well as seniors. We note that communities with fewer financial resources place an even greater burden on caregivers. Thus, the disease injures those who care as well as those who suffer. In The Washington Post article, other family members moved home to help. The article does not discuss the financial costs to these adult children. AARP estimated that caregivers could lose $569,000 in lost wages, lost promotions, reduced savings, and lost pension benefits. That’s a double-whammy I’m not sure our country could withstand. Please read this article from the Washington Post and pass it on.
If you put a frog in cold water it will stay there, even as the temperature is gradually increased until it’s cooked. However, if you drop a frog in hot water it will jump out. This illustrates to seniors’ lack of tolerance for hot weather.
Every summer there are warnings to check on the elderly, and make sure they are keeping cool and hydrating. Our seniors are survivors of a bygone age when there was little or no air conditioning; often only found in restaurants and movie theaters. The signs from that era showed the words with snow on the letters! Many seniors may consider it an expensive luxury, or an annoyance when the cool house is affects the joints. After all they have enjoyed many summers, and did just fine!!
What they don’t take into consideration is that their physiology is changing as they age. They become less tolerant of extreme temperatures. Also, they often don’t take into consideration that health issues, and medications play a part. Climate change has made summers hotter and today’s houses assume air conditioning in the way they are built.
The particular danger occurs when the air conditioning has been on for a while and then turned off. The senior, like the frog in cold water, feels too cold. As the house gradually warms, the body will attempt to adjust. Sometimes they fall asleep. They are unaware that the house is heating to the realm of being dangerous. This drowsiness or daytime sleep may interfere with taking medications or proper hydration.
When you call or check on seniors, if they speak more slowly, or have slurred speech, get help. If the senior is slower or more wobbly than usual answering the door, has evidence of confused mental processes, it is imperative to get them to medical attention.
Here are some very useful ways to avoid these problems. If the senior is feeling too cold, sweaters and socks are recommended. Protect the joints and keep the air conditioning on. Turn up the thermostat set point; even if the house is set in the high 70’s it will still be cooler than the outside air. Check for drafts. Perhaps the favorite chair is too close to a vent. Deflectors can keep the air circulating away from the senior. This way, the climate control will keep things from getting dangerously hot.
Caring for one’s self in summer is as important as protecting one’s health in winter. That goes double for seniors. Hydration in summer is important for everyone and especially seniors on “water pills”. Chronic conditions and other medications can also affect fluid balance. If the doctor prescribes an new medication, questions about fluid balance would be good to ask during the hot weather. However, not all seniors heed the need for drinking enough water. They may not feel thirsty. BTW: Children also have to be reminded to drink enough water because they get distracted easily.
Some seniors “theorize” that if they do not drink more, they will not need to use the bathroom as much. I have observed this pattern repeatedly. On one occasion it led to a severe drop in blood pressure which led to the senior passing out. On another occasion, the senior became so dehydrated that she had to be hospitalized. In both cases, the family was not aware of the senior’s decision not to drink. Therefore, be aware that this can happen, observe how much the senior drinks, (not how much they say they drink) and provide things they like.
The logic of some senior’s attitudes or responses escapes me but I did observe this pattern in another situation. Perhaps this perspective will help you as much as it helped me: My younger sister hated to take baths. She saw that our father used after-shave and it made him smell nice. One day, she was found with an empty bottle of his after-shave: she drank it. While my mother called the doctor, I asked her why she did it. She replied that she would “sweat” after-shave and smell nice so no more baths. Keeping this story in mind has reminded me to ask careful questions about fluid intake and not settle for generalizations. BTW: this sister also ate the mud pies she made.
We all know that “kid logic” is not the same as grown up logic. I am not sure that our society knows that sometimes senior logic works remarkably similar to kid logic. Not all senior suffer from these logic issues. However, please be aware that they can develop and manifest especially in summer.
This time let’s look at riding in cars with seniors. Taking Grandma with you for outings is a wonderful way to provide social contact and stimulation. Please include your seniors in activities this summer. The following are a few cautionary notes with cars.
I remember a wonderful trip that was a long drive. My Grandmother suggested she sit in the back. Sibling rivalry was in full bloom between me and my sister so Grandma sat between us. As we rode, she told us stories about when she was our age(s). She pointed out features along the way and told us about them: she had actually played in a hayloft! When we arrived at our destination, no one was whining, or had asked, “Are we there yet?”
Just a few tips to help you have pleasant summer trips with your seniors.
Describe Yourself in Three Words. This is one of the games I include in my Course; Preparing to Parent Your Parent. Participants offer all kinds of responses; attributes like insightful or patient. Others describe demographics; father, wife, or daughter. Some describe themselves as fans of sports or certain teams. A few describe their occupations or religious affiliation. I write all their responses on the board.
Then, I ask the group, “What kinds of descriptions are on the board?” We assign various categories. I ask the group, “What kinds of descriptions are NOT on the board?” This usually meets with silence. Often I must offer some categories. Typically, people do not describe themselves by their income level. I offer that option. Then, I ask the group to look for any self-description that includes a diagnosis. None!
This game highlights the difference in how individuals see themselves compared to how society sees seniors. An individual can be anyone of any age. When seniors describe themselves, they use a variety of terms. When society describes them, it is often diagnosis-first! Age is a stage of life, not a disease. Life has many aspects. Health is one of them; not the only one. Unfortunately, we see those who are aged as = ill.
There are consequences resulting from such a one-dimensional view. If others will only really listen when you talk about your chronic conditions, it encourages a mental focus on those conditions. If the only time you’re touched is in the context of a medical process, you will seek such contact through medical occasions. Are we driving seniors into these situations because those places fulfill their human needs? All ages need attention and human contact. We know that children may behave badly in order to get attention. We know that small children who do not receive regular, loving touch develop more slowly. I observe that seniors also respond to attention to their non-medical interests and kindly touch. It’s time to ask for modification in our society’s view of aging.
How did we become the society that treats one group differently? I suspect our original view of aging was reverence. The old ones were the elders (leaders) of the group. They acted as the library and history lesson. The old ones had an occupation; to teach or act as guide for the young. As society became more complex, the old ones were not as visible. Industrialization pushed some women, small children, and elders out of the workplace. In agricultural societies, all ages played some role and all worked as a team. Illness was present in all ages, not just the old.
Basic health improvements like clean drinking water and public sanitation reduced deaths, especially in younger people. Basic care reduced some infant and maternal mortality. The old were not spared. Every winter, pneumonia took the lives of elders. This disease was once called the “old man’s friend” because it ended suffering from other chronic (untreatable) conditions. Thus, our ideas of the meaning of “old” evolved. It became equal to “sick”. Contrast this pattern with today’s medical care. We can treat pneumonia and other many chronic conditions. Elders benefit as well younger persons.
Our viewpoint needs to evolve if we are to meet the real needs of our aging population. Seniors need less emphasis on more medical care; they want greater societal integration and quality of life. They describe themselves in three words in the same pattern as younger people; attributes, demographics, (former) occupations, sports fans, and religious affiliations. In 40 years, I have never met a senior who described herself by her diagnoses. Why should we?
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"A Senior Moment" is written by Ms. Sara Lieber, owner of Senior Sidekicks. Ms. Lieber has over 30 years of experience in senior care.