Panel: Growing 85-and-older population requires
changes in resources
By Lou Fancher Correspondent San Jose Mercury News
Confronting mortality and responding compassionately to the present and future needs of area residents as they grow older is the motivation behind "The Longevity Revolution," a series of expert panels and roundtable discussions happening in the East Bay.
Presented by the Jewish Federation and The Jewish Community Foundation of the East Bay, the first sessions of the six-part forum addressed how increased life expectancy -- the National Institutes of Health predicts the global, 85-and-over population will increase 351 percent by 2050 -- has redefined what age is considered the "oldest."
A February program at Congregation B'nai Shalom in Walnut Creek (and repeating in Berkeley Feb. 20) explored longevity's challenges. Nearly 100 attendees heard 20-minute presentations from several medical experts, including Avi Rose, executive director of the Jewish Family and Children's Services/East Bay. Having turned 60 only days before the Feb. 9 panel, Rose said he felt he'd joined a "new club" overnight.
"It's sobering and interesting," he said. "I'm aware I'm in the last third of my life. Maybe I will live until I'm 120, but probably not."
Rose divided conversations about aging into two groups -- excited, rewired "Boomers' buzz" and people suffering the physical, cognitive and financial hardships of longevity. Both groups are experiencing change while balancing their need for connection with a desire for autonomy, he said. Finding meaningful work or volunteer activities, securing housing, dealing with loss -- of vigor, agility and people -- and engaging in honest, realistic dialogue with family members happens under an umbrella of gradually relinquished independence.
"What is the role of the community?" Rose asked. Be a source of information, a center for learning and services, he answered.
Congregation B'nai Shalom Rabbi Aderet Drucker's introductory comments drew parallels between dementia and wandering in the wilderness. The former is ever-present in current headlines; the latter is a frequent subject in Jewish synagogues and seminars, where "d'var Torahs," or lessons, explore the spiritual ramifications of "midbar" (wilderness) experiences. Clinical psychologist Adam Rochmes picked up where Drucker left off, saying he is struck by how quickly conversations about aging turn to discussions about dementia.
"Dementia is not a normal condition of aging," he said. "It's a disease that has to do with things breaking down: the brain faster than other organisms."
Dementia is a family of conditions ranging from treatable to stable to progressive. Five million people are impacted in the United States alone, Rochmes said. Research is underfunded, Rochmes said, and as long-term care facilities fill up, families are enlisted. He told a "compilation story" pooling the factual features of dementia, a category which includes, but is not confined to Alzheimer's disease. The narration, the expected descriptions of forgetfulness combining with a caregiver's anger, sorrow and shame, drew a painful portrait.
"Early diagnosis is important," Rochmes said, "if only to allow a patient to participate in decisions that will affect the family's future. Living with dementia, not dying of it, is the challenge."
Dr. Jay Luxenberg, chief medical officer of San Jose-based On Lok Lifeways Luxenberg, said that although technology hasn't yet developed a super microchip for humans, other helpful innovations -- cataract surgery, elevators, wheelchairs and built-
in bed scales are low-tech examples. Web interfaces like Find My Friends, Facetime and numerous aging-related apps allow caretakers, even faraway family members, to track how long it takes staff to answer a relatives call button, or note whether or not grandpa visited the nursing care dining hall for dinner. MedReady offers an automated pill dispenser that signals (with light and sound) the time to take medication.
"If you don't answer, it calls your name," Luxenberg explained. "If that doesn't work, it calls and texts a caretaker. If they don't answer, it sends someone to the person's home.
"Until we find treatment for Alzheimer's and other age-related diseases, I'm glad we have technological tools to allow people to live independently," he said.
The panelists advised varied intellectual work and exercise to stave off Alzheimer's symptoms and progression (except when autosomal dominant gene tendencies render preventive efforts largely ineffective). "The brain is a muscle: the more you exercise it, the more cognitive reserve you'll have," said Rochmes, adding that medications that supercharge one of the brain's neurotransmitters are helpful.
Luxenberg predicted government's "odd consideration that housing is not a basic human right," reflected in low subsidies for senior housing, means securing homes or assisted living situations for an aging population will be "one of the major problems of the next 10 to 20 years."
The March forums, "Community Building," will present innovative, real-world examples for transition networks, aging-friendly communities, co-housing and meeting the needs of all generations. A Town Hall in June will earmark initiatives for enacting kavod (honor) in East Bay communities and organizations.