Los Angeles Jewish Home

Studies are proving that cognitive exercise enhances memory and reduces the risk of Alzheimer's disease and other forms of dementia. Now, new software programs are helping to keep a generation of older American minds young and fit.

At the forefront of this innovative technology is the Dakim Power Cognitive Fitness System. Currently in use at the Jewish Home, Dakim (pronounced day-kim) is a highly interactive, touch-screen computer designed to challenge, stimulate, and entertain while exercising the mind.

Ease of Use

One of Dakim's strengths is its user-friendliness. As a plug-and-play system, pre-loaded with software, access is immediate.

"It's appearance is less intimidating than a desktop computer," notes Dan Michel, CEO of Dakim, Inc. Michel invented the system to help his father, who suffered from dementia. "We worked hard not to have the unit look like a work station computer. There is no keyboard, no mouse. It's a touch-screen system that literally speaks to you."

The computer has a built-in camera which takes your picture when you first register. The very next session, it greets you by name. (Dakim even remembers birthdays.)

Once users get into their workout, a variety of interactive exercises awaits them. Dakim comes loaded with brain games, some of them designed to make the user feel like a contestant on a game show. With its Internet connection, the machine automatically downloads new exercises almost daily to keep cognitive training fresh and interesting.

Creative Programming

The secret to successful programming, says Michel, is to keep the games challenging enough to be stimulating – not too tough to discourage, nor so easy that players will be bored. The level of difficulty rises as the user becomes more proficient.

Programming is based on the latest research into cognitive science and the emerging field of brain fitness. Chief scientific advisor on the project is Dr. Gary Small, professor of psychiatry and bio-behavioral sciences, and Director of the UCLA Center on Aging.

Each Dakim session takes about 20 minutes to complete, and every session works all six cognitive domains. These include short-term memory, long-term memory, language, calculation, visuospatial orientation, and critical thinking. But we haven't even mentioned the most important part.

It's a Lot of Fun!

In one short-term memory game, you view movie clips from the 30s and 40s. Then you are asked to remember things like where a particular scene took place, or what the dialogue was about. Users get hooked, and keep coming back for more.

"It's fun, self-directing, and exciting," says Jewish Home CEO-President, Molly Forrest, who took Dakim for a test drive and had a ball. Best of all, users are independent. "You don't need anyone looking over your shoulder to talk you through the program."

Encouraging seniors to move aggressively into the information age is a priority at the Jewish Home. "It makes sense for myriad reasons," Forrest notes. "Technology is opening the door for all of us to engage our minds, improve our memory, and reach out to the world."

Research confirms that regular interaction with programs like Dakim are more than just entertaining. The Bronx Aging Study, conducted by the Department of Medicine at the Albert Einstein College of Medicine found that seniors who regularly engage in mentally stimulating activities can significantly reduce their risk of dementia.

"Cognitive fitness is an essential element of a healthy lifestyle," notes Forrest. "It can improve our health and preserve our independence as we age."

For an online introduction to the Dakim system, and additional information on the benefits of cognitive fitness for seniors, visit www.dakim.com.

Kathleen Doheny is a Los Angeles-based journalist who also writes for WebMD.com, healthday.com, Weight Watchers, the Los Angeles Times and other publications.

Labels: Alzheimer's, Cognitive Exercise, Cognitive Fitness, Dakim, Doheny, Feature Articles, For the Mind, Memory

These days, you don't have to look far to find an alternative remedy for just about anything that ails you. There is echinacea for the common cold, ginkgo biloba for memory loss, herbs for circulation and digestion, and teas for relaxation.

Every open-minded person welcomes new solutions to health challenges. As a physician, I am also concerned with the medical basis and validity of these treatments. That's why I took a year's sabbatical from my teaching at USC to delve into the science and art of alternative medicine.

The result was my book, What Your Doctor Hasn't Told You and the Health Store Clerk Doesn't Know: the Truth about Alternative Medicine and What Works.

In the course of my research, I discovered many effective remedies. I also found that, in the search for answers and safe solutions, patients are often caught between a rock and a hard place.

The Rock and the Hard Place

The rock is the physician who often lacks the time, training, or inclination to discuss alternative remedies. Sensing this, patients are often reluctant to raise the subject with their doctors.

The hard place is the helpful health store clerk who seems to have a product for whatever ails you – yohimbe for libido, saw palmetto for the prostate, ginseng for low energy – but knows nothing of the science behind it.

I visited two dozen health stores where many clerks seemed to have an impressive body of knowledge. Most learned what they knew from their store manager, who, in turn, learned from a previous manager.

Tips for the Consumer

So, how can you evaluate a remedy? Should you try acupuncture for fibromyalgia, chiropractic for back pain, Reiki for cancer pain? My book provides a thorough evaluation of all these therapies and more. But in the meantime, here are a few guidelines for the informed consumer:

First – if it sounds too good to be true, it usually is! Be wary of the argument that physicians don't have answers but alternative practitioners do. Two wrongs don't make a right. Be a critical consumer of all claims, no matter who makes them.

Second – if your physician refuses to discuss alternative therapies, find another physician. Your doctor needs to know about every alternative treatment you are considering or receiving. For example, gingko, ginseng, red clover, aspirin, and estrogen all effect blood-clotting.

Likewise, your alternative practitioner needs the same information about any traditional Western medicines you are on that may interact with alternative treatments.

Third – be aware that herbal remedies are not controlled by the FDA. In a study done by The Los Angeles Times, 10 bottles of St. John's Wort were tested for their contents. The results were shocking: the active ingredients varied from 35 to 135% of the amounts claimed on the labels.

Look for remedies that are labeled "USP" (U.S. Pharmacopeia), the stamp of approval of the official authority for prescription and over-the-counter medicines. Another way to protect yourself is to buy from large chain stores, such as Costco or CVS. These chains require testing of the products they sell.

Finally, remember there is a powerful connection between mind and body, between belief in a remedy and its actual efficacy. As long as an alternative medicine or therapy is not dangerous and is perceived to be working, there is no good argument against it.

In my next article I will explore specific types of alternative treatments. For now, whenever considering alternative remedies, it's best to recall the Latin saying, caveat emptor – let the buyer beware.

Dr. Edward L. Schneider heads the largest private center for research and education on aging, the Andrus Gerontology Center of the University of Southern California. He also serves as Dean Emeritus of the Leonard Davis School of Gerontology and Professor of Medicine at the USC Keck School of Medicine. Dr. Schneider has written or co-written twelve books, including Ageless: Take Control of Your Age & Stay Youthful for Life, and published more than 180 scientific articles on topics related to aging.

Labels: Alternative Medicine, Feature Articles, For the Body

Interview with Dr. Fernando Torres-Gil,
Author of The New Aging: Politics and Change in America

Dr. Fernando Torres-Gil is the Associate Dean of the UCLA School of Public Affairs and Associate Dean of Academic Affairs. He holds appointments as Professor of Social Welfare and Public Policy and is the Director of the Center for Policy Research on Aging. A former Professor of Gerontology and Public Administration at the University of Southern California, Dr. Torres-Gil continues there as an Adjunct Professor of Gerontology. He was appointed by President Clinton as the first Assistant Secretary for Aging in the U.S. Department of Health and Human Services.

Q. Your book, The New Aging: Politics and Change in America, published in 1992, examined how the retirement of the baby boomer generation would affect how we age. Have most of your predictions come true?

A. I believe most have been on the mark. The need for public programs today is more urgent than ever. There will be no "retirement" for baby boomers, at least not the kind we fantasized about. The pending old age of 80 million people comes at the very time the U.S. is confronting serious crises. When I wrote the book, I was concerned that many baby boomers would awaken at 65 to find that they have not saved, that there was no social safety net, and no equity in their home. The crises have occurred far faster than I ever imagined.

Q. Yet you believe the economic events of the past year provide us with a great opportunity.

A. The baby boomers may well become our next generation of gray panthers – a new generation of senior citizen activists. Our parents and grandparents faced their great adversity when they were young – during the Great Depression, WWII, and the Cold War. Baby boomers, who've had it relatively easy throughout their lifetime, will face their great test when they're old. Our country simply has not prepared for increased longevity. The nation is going to need an engaged citizenry to make up for this.

Q. Another challenge may be that boomers still haven't admitted to the fact that they're aging.

A. This may be the existential crisis of the moment. If there is a silver lining to the mismanagement of the Federal government in the last eight years, it is that those of us who are aging can no longer deny the fact. I am hoping that the crises in finance, savings, and housing will arouse a generation to begin asking what can be done to turn things around.

Q. What is the impact of the intersection of diversity and aging that you discuss in your book?

A. During the next 20 years, our current ethnic minorities will become the new majority. We will expect them to be productive and to pay sufficient taxes to cover the services baby boomers will require from government. If we don't invest in these young immigrant communities today, we may not have the tax base to fund the social programs we'll need tomorrow.

Q. It seems that Los Angeles could be an epicenter of such changes.

A. We have struggled with the tension that sometimes occurs with growth and demographic change, but we have managed to rise above it. I believe L.A. County has the highest degree of tolerance and acceptance of diversity and plurality of anywhere in the country. We continue to remain economically viable specifically because of the influx of Armenians, Persians, Asian Pacific Islanders, Central Americans, and Latinos. L.A. County has really shown that it can prosper from diversity, and we remain a role model for the rest of the country.

Q. We have a large and growing population of family caregivers, a situation that is already considered a national crisis. How can cities and municipalities provide assistance?

A. Caregiving is a preoccupying priority, given the difficulties faced by loved ones. It is not only about identifying individuals in need, but about enabling them to receive services in their homes and communities. There is also the issue of the huge and frequently invisible sacrifices that caregivers make, whether it's an inability to keep working, the pressures of caregiving, or high stress levels that can cause health problems. We need to build up a caregiver workforce made up of immigrant minority low-income workers. The challenges of caregiving will cut across race, income, and political affiliation.

Q. The Department of Public Health has predicted a rise in the incidence of Alzheimer's disease. Will this also increase the need for both family and professional caregivers?

A. Alzheimer's and other dementias will be our HIV/AIDS crisis for the older generation. We have made great strides in addressing the issues of HIV and AIDS and responding to the needs of that population. We must develop an equally effective response to the increase in Alzheimer's and the growing number of older persons who are physically unable to care for themselves.

Q. Employers continue to lose millions of dollars as employees take time off to care for older family members. What can we do to mobilize the workforce to help with the issue?

A. During the years when baby boomers became young parents, employers began providing daycare centers and a variety of childcare options. Employers may need to think about adding adult daycare centers to the mix. But we need to consider the balance between economic development and the potential losses due to caregiving support. Businesses have two essential roles – to create jobs and to make profits, which provide tax revenues to support social programs. Ultimately, federal and state governments must provide programs that take the burden off of employers. Having said that, I still believe employers should play a role in providing assistance to workers who have caregiving responsibilities.

Q. What are your thoughts about land use planning, housing, and transportation for our aging population?

A. All too often cities and municipalities allow developers to create housing for individuals who will be aging in the wrong place. When people grow old and are isolated, they will not have the transportation, social services, and healthcare services they need. Decisions are being made to disperse and isolate an aging population, when, instead, we should be promoting smart growth, high density, affordable, accessible housing in places that provide health and social services.

Q. You co-wrote a book with experts in aging from Israel and Australia that was published in 2007, called Lessons From Three Nations. What do these two countries have in common with the United States?

A. Israel has an intense history with immigration because it actively sought out Jewish refugees from around the world. All refugees who come to Israel are entitled to a universal system of health, long-term care, and social benefits, thereby reducing the burden on the private sector. Israel addresses the needs of their immigrant elderly far better than the U.S. or Australia.

Australia created a very generous multicultural policy in the 1970s that welcomed immigrants from around the Pacific Basin. It gave that country tremendous economic vitality. Now however, they have a large influx of immigrant elders, and do not have the national policies to respond. So they are trying to find a balance.

The U.S. has a longer history of absorbing immigrants and a successful record of assimilating second- and third-generation immigrants. What we lack is universal health, long-term care and social services. We are still very much an individualistic society and in conflict over reforming immigration policies. The three countries have different experiences. What we have in common is that our populations are getting older and each one of our countries needs immigrants and minorities to replace our aging workforce.

Q. Do you have any final thoughts about how we can prepare for our aging population?

A. We have to accept the reality that we are growing old and becoming more diverse. Furthermore, we should see these two situations as an opportunity to keep the elderly in the community. We must find ways to make cities and municipalities user-friendly and accessible, so individuals can age in place. I would encourage our public officials to do all they can to invest in the younger immigrant and minority communities because they will be our next generation of taxpayers. I would also encourage everyone to look at aging and diversity as a tremendous asset.

Reprinted with permission from THE LINK, the official newsletter of the Los Angeles Commission on Aging.

Barbara Meltzer is the founder and principal of the Los Angeles-based Public Relations and Marketing Agency, Barbara Meltzer & Associates. Her personal experience as a family caregiver sparked an interest in aging issues and advocacy. In 2007, she was appointed by Supervisor Zev Yaroslavsky to serve as a Commissioner on the Los Angeles County Commission on Aging. Barbara Meltzer can be reached at Barbara@meltzerpr.com.

Labels: Aging, Alzheimer's, Baby Boomers, Dementia, Feature Articles, Meltzer, Policy, Retirement, Torres-Gil

Before selecting a senior living community, it is important that you and your loved ones investigate all your options. Use the web, seek referrals from doctors, healthcare professionals, and friends and colleagues who are actively searching.

If possible, find a location that is convenient for visits. Keep in mind that regular contact with family is important to one's emotional well-being.

Make sure the home is the best possible match for your needs and that you understand exactly how the home will be paid.

Visit – and Visit Again

Listen to what others say about senior facilities. Visit several residences that are close by and feel good to you – and be sure to visit more than once. Drop by unannounced, not just on Visiting Day. You and your loved ones will spend a great deal of time in this setting, so you will want to observe the staff and facilities at different times of the day and week.

If the facility is licensed for residential care, assisted living or skilled nursing care, ask to read their latest inspection reports, including the fire marshal survey and local health department or social services agency reports.

Be Environmentally Aware

When visiting, pay attention to the details that will make a difference in care and treatment. As you would in evaluating a new home or neighborhood, use all your senses.

Are the rooms and common areas clean and in good repair? Can you detect any unpleasant odors? If you don't like the way a home looks or smells, cross it off your list. If your first impression is negative, you will never feel comfortable.

If you are satisfied with the interior spaces, continue your evaluation outside. Look for safe, attractive, and well-maintained outdoor areas.

Person to Person

Someone once said that the best part of any real estate deal is the neighbors who come with it. Do the current residents look content and engaged? Do they exhibit signs of compassionate and attentive care?

Be sure to note if residents are involved in meaningful and rewarding activities. Ask to see a schedule of activities and evaluate it honestly and critically. Does the list include items you think would be appealing?

Ask your guide how many residents are assigned to each aide or LVN. Are licensed nurses on duty around-the-clock? Take note of the interactions between caregivers and residents. Are they sensitive, thoughtful, humorous, personable?

Everyone's Favorite Time of Day

Meals are an important part of everyone's day, as a delight to the senses and an important social opportunity. Are dining areas well-designed and pleasantly lit? Are meals attractively presented? Ask to see sample menus.

Choice in our meals is one of the most commonly cited pillars of independence, and is so important to our sense of well-being. Do residents participate in planning the menu? If so, ask about a menu-planning committee, and how it works. Ask also if kosher or vegetarian food is available, and if substitutions may be requested.

Medical Services

The highest quality senior living communities offer a wide range of physical and rehabilitative therapies. Ask about the existence of these services and if residents are involved in their own treatment plans. Look for any special accommodations for seniors recovering from strokes or injuries.

If your physician does not make regular visits to a facility, find out how medical care is handled. If care is not provided in specialty clinics on-site, or in the event of an emergency, ask which hospital(s) residents are sent to if they become ill.

Is there a wing or on-site facility for residents with Alzheimer's disease or other dementia? Ask to tour this area and look for features of enlightened care, including special floor plans, natural lighting, and outdoor access. Note if residents have personal items in their rooms, and if restraints are being used.

Governance

A residential facility is, above all, a community of elders who deserve to be honored and respected as self-determining individuals. Does the home have resident and family councils? Is a grievance procedure available to residents? Are visiting hours flexible?

Any senior community should strive to match the goal of the Los Angeles Jewish Home, creating a safe, comfortable, and rewarding environment for residents and those who care about them.

To download the Jewish Home's Senior Living Community Evaluation Checklist, click here.

A 35-year veteran of senior housing and healthcare issues, Molly Forrest is the Chief Executive Officer-President of the Los Angeles Jewish Home, one of the foremost multi-level senior living communities in the U.S. and the largest single-source provider of senior housing in Los Angeles.

Labels: Feature Articles, Forrest, Research, Senior Living

While health care professionals are proficient in physical and even mental caregiving, few receive training or coaching in how to provide spiritual care. A holistic approach to care and interpersonal relations requires that not only the needs of body and mind are tended to, but the spiritual as well.

How does a health care professional provide spiritual care in a multi-religious or even a setting devoid of religion? The answer is to become aware of spiritual needs rather than focusing on religious requirements. What is the difference? While not everyone may practice a religion, every person has a spirit.

Four specific needs are suggested in an article titled "Spiritual Needs of Patients: Are They Recognized?" (Highfield, Carson. Cancer Nursing 6 1983: 188). These primary human needs are spiritual, but not specifically religious. While many persons fulfill these needs through religious practice, many others do not. But virtually everyone, whether practicing a religious tradition or not, has these same fundamental spiritual needs.

1. The need for meaning and purpose

Everyone needs a reason to get out of bed in the morning. Many of the best dementia care units provide "chores" that residents are responsible for (like watering the flowers or sweeping the room) as a method of lending meaning, motivation, and purpose to the day at hand. People who are aware of no purpose in their lives often become listless, depressed, angry or withdrawn. "Why can't I die? I am no good for anyone anymore!" are familiar laments by people who have lost their sense of meaning.

2. The need to give love

A person needs to give love, not just to receive it. In fact, many depressions develop not because the individual has no one to love them, but because of an inability or lack of opportunity to love others. Instead of having a focus outside of themselves, the focus of these people is directed inward – to a recent health setback, a perceived slight, or the latest ache or pain. All of us have a very real need to be concerned, connected, and involved in something beyond ourselves and our immediate interests.

3. The need to receive love

All people have a need to be loved. Many studies suggest that if infants are not cuddled they do not thrive. The same is true for people of advanced years. Sometimes love is hard for a person to receive out of fear of becoming dependent or indebted to someone else. Yet the need to be loved, and know that we are loved, remains an essential component of our well-being.

4. The need for forgiveness, creativity, and hope

Finally, there is the need for forgiveness, creativity, and hope. Every person needs to feel as though their future is open and holds possibilities. Sometimes, people need to be able to release and forgive the past in order to move on. But every individual needs to feel as though they are a player in the creation of their own future. We all need the hope that tomorrow will be livable and worth living for.

Each one of us is trying in some way to fulfill these spiritual needs through what we do, how we feel, and how we respond to life's twists and turns. If any one or more of these needs are unfulfilled, spiritual distress arises, a distress that is often beyond the purview of physicians and nurses, but makes perfect sense to the spiritual caregiver.

Within every social or caregiving encounter we have with a senior, we have a new opportunity to become aware of and attentive to their spiritual needs – looking not only at the body and mind, but also at the spirit, with an approach that respects the needs of the "whole person."

Rev. Donald Koepke is the director emeritus of the Center for Spirituality and Aging (CSA), a program of California Lutheran Homes and Community Services, headquartered in Southern California. Rev. Koepke has presented many workshops on spirituality and aging. He is also the producer of the DVD, "Caring for Elders: Body, Mind and Spirit," which presents the concepts of the author, psychiatrist and Holocaust survivor, Viktor Frankl, as applied to aging. For further study on spirituality and aging visit the CSA website at http://www.spiritualityandaging.org/.

Labels: Feature Articles, For the Spirit, Koepke, Religion, Spiritual Care

"Want to live to 100?" asks Jewish Home resident Edna Shankman, 95. "Choose your parents carefully!"

While it doesn't hurt to have family members who are living to 90-plus (or to have a great sense of humor), over a decade of research reveals that healthy lifestyle choices are the prime factor in determining who will be winners in the ultimate lottery.

The longest lived among us, the 'super-elderly,' are still a unique group. They evoke curiosity, fascination and even national pride. Everyone is eager to learn their strategies for successful living. (Wikipedia maintains an entire page about the world's oldest people that is updated daily.) Ask almost anyone if they would like to join this exclusive club, and you'll probably get the same answer: "Yes, if a high quality of life can be maintained."

The good news is that it can, and that more and more of us will become members of the "100+ Club" in the decades to come.

More Good News

Research shows that, where longevity is concerned, most of us are in the driver's seat. That's because lifestyle choices, in combination with genetics, are the dominant factors in how long each of us will live.

A healthy diet is a vital component, especially one with an abundance of antioxidants like those contained in certain fruits, vegetables, and even red wines. But it turns out that there is an even more significant predictor.

"Exercise trumps everything," says Dr. Edward L. Schneider of USC's Andrus Gerontology Center. It's so important that it even beats weight control. "If you're overweight and exercise," Dr. Schneider says, "you'll probably live longer than someone who isn't overweight and doesn't exercise."

Daily doses of moderately strenuous exercise (like power walking) are the foundation of cardiovascular health and one path to a long and meaningful life. But no one lives long through exercise alone. Holistic wellness – in body, mind, and spirit – makes a vital contribution to every proven strategy for successful aging.

Top Recommendations of the Experts

Social Inclusion
There is nothing so important to our well-being as a sense of belonging. Studies of five areas around the world where people are extraordinarily long-lived found that seniors remained a vital part of the family dynamic and traditions. The equation is simple: when we are valued, we thrive.

Belief System
The practice of faith is valuable in many contexts. Faith can be cherished as a personal relationship with G-d. It can provide the philosophical underpinnings of our values and belief structure. It is also a supreme example of the all-important sense and practice of belonging – to a tradition, a worldview, and a people.

Socializing
Daily interaction – whether in the course of work or volunteering, at mealtimes, on the phone with friends and family, or through social networking – provides stimulation for the mind and spirit. Studies show that it is rare to live a long and satisfying life without it.

Attitude
Finally, a positive attitude helps make positive things happen, whether it's exercise, inclusion, social success or practicing your faith. Most importantly, optimism is one way – our best way – of saying yes to life.

What Jewish Home Residents Say

At the Jewish Home, the average age is 90, with twenty-eight residents age 100 or older, and sixteen 99-year-olds poised to hit the century mark this year. Jewish Home residents also live, on average, two to three times longer than seniors at typical residential facilities.

Talk to some of the Jewish Home's super-elderly for advice, and you get a sense of just how important a great attitude is to successful aging and a long life.

"Start each day with a smile and stay interested in everything around you," advises Eli Persky, 93. "Watch a movie, play sudoku, keep your mind active and engaged!"

"I have to stick around!" says Claire Bizar, who is 102. "Why? Because my family wants me to. Love is what keeps me going."

Morris Steinberg, 97, swears by his daily regimen of walking, weight training, and T'ai Chi. "Working out keeps me going and helps my brain."

Edna Shankman, 99, who chose her parents so carefully, emphasizes the importance of the positive attitude. "I used to be a worrier," she says, and reminds us, "But you have to learn to go with the flow." These days, she only worries about the important stuff. Like what? "Like what to wear!"

Kathleen Doheny is a Los Angeles-based journalist who also writes for WebMD.com, healthday.com, Weight Watchers, the Los Angeles Times and other publications.

Labels: Aging, Doheny, Feature Articles, Longevity, Super Elderly