Los Angeles Jewish Home

Marie Matz recalls the day Rose Wayne struck up a conversation with her. It began with a simple hello, and as they spoke, the two women, aged 86 and 101, discovered how much they had in common, beginning with a love of conversation!

Marie and Rose became good friends, and continue to enjoy conversation and knitting together. Over time, the bond between them has grown stronger. "If she's sick," Marie says, "I worry."

New friendships, and the speed at which they are formed, can seem almost miraculous. Yet they happen all the time because, as social scientists point out, we are all, at every age and stage of life, highly social creatures.

Surveys of seniors reveal that one of the most cherished features of residential communities is the opportunity to form new friendships.

Being socially engaged, studies suggest, improves memory and other cognitive skills. Socially-inclined people tend be more active and to carry that energy in their faces. This, in turn, invites more people to engage and interact with them.

Why Friendships Are Good for You

Socially active seniors not only appear more energetic, but studies show they may actually live longer and feel better. And their mental agility benefits from the interpersonal interaction. Among the more intriguing findings are that:

Friendships boost your longevity.
In a study published in the Journal of Epidemiology and Community Health, researchers following nearly 1,500 seniors for a decade discovered that people with a strong social network are likely to live longer.

These findings were duplicated in another study of 1,200 older adults conducted by Biomed Central Geriatrics.

Social activity boosts your thinking skills.
In a study of more than 2,000 older men and women, people who engaged in one or two social activities regularly did much better on cognitive skills tests, according to a study published in the International Journal of Epidemiology.

Volunteer work is more satisfying (and rewarding) for seniors.
In a study comparing how adults over 60 and under 60 feel about their volunteer work, researchers found that older adults reported greater improvements in life satisfaction from their work than did younger volunteers. This was especially true among older adults who volunteered for many hours. Older adults also perceived their health as being better than the younger volunteers did. The study was published in The Journals of Gerontology Series B: Psychological Sciences and Social Sciences.

It All Starts with a Smile

Social researchers and cognitive behavioral therapists agree that a few simple steps can enrich our social skills and bring the rewards of friendship into our lives:

Smile!
A pleasant smile while maintaining eye contact is the best invitation to conversation, and almost naturally leads to a remark that initiates conversation. Try it!

Be proactive.
This can take the form of a simple greeting or sharing your impression of a specific event that affects both you and the person you're addressing. Remember, a generous impulse is never wasted.

Build Rapport.
Discover common interests as soon as you can. These can stimulate discussion, give you the confidence to speak more openly about yourself, and put you and your partner on firm ground.

Listen and Learn.
The more you know about your partner, the more you will find opportunities to make helpful and appropriate remarks or suggestions. Knowing who you are talking to also helps you relate your experience to theirs.

Overcome Shyness.
It really can be as easy as that. Experts tells us that focusing on other people's experience is a great escape from ourselves, especially when we are self-conscious to the point of shyness. Ask someone about themselves, and give yourself the challenge of remembering exactly what they tell you.

Keeping the Door Open

Residents at the Jewish Home agree that opportunities to engage with others begin with each new day. And they believe the same applies to seniors everywhere who have a mind to take part in what's going on.

With a little effort, and by keeping the door open, seniors who see themselves as 'loners' can soon find themselves table-hopping, just for the pleasure of catching up with friends and acquaintances.

Political or current events discussions can be a wonderful way of stimulating discussion and bringing opinions to the fore. Often, it is common experiences or shared values that bring seniors together for those invaluable exchanges that blossom into friendship.

It's a wonderful feeling to be accepted for who you are, and, as the data and the testimony of Jewish Home residents show us, well worth the effort we put into it.

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, Friendship, Longevity

The horrific earthquakes in Haiti and Chile and the suffering they inflicted have led to a remarkable outpouring of assistance from around the world. The scale of this humanitarian response has led many of us to reflect on the nature of giving.

Material help, like money or food for disaster victims or for the homeless in our own community, is just one of the ways we can, and do, give of ourselves. Some — in war and peace — give their life for others, for their country, or for an ideal.

But giving can also become a way of life. Each of us can choose to share our love or energy, time or advice at every opportunity. We can take a moment to listen or share a thought or a smile that makes someone feel understood, recognized, not alone.

A Culture of Giving

Jewish tradition has quite a lot to say about our personal responsibility to give. The Torah teaches us to protect the "widow and the orphan," which extends to all of the vulnerable in our society. And Judaism puts great emphasis on the concept of "tzedakah." This is a complicated word that draws much of its beauty and authority from its dual focus on doing what is right here and now, and acting in the pursuit of justice.

Thus, by acknowledging his or her cultural identity, a Jew is required to give, especially to relieve poverty and suffering. Tzedakah is not 'merely' an ideal. It is not something we choose to do when we happen to be feeling generous, but an obligation of our tradition and culture.

Giving of this type was exemplified by those many American Jews who worked and risked their lives in support of the Civil Rights Movement of the 1960s. One woman involved in that struggle recalled that her actions were motivated by the principle from the Torah not to stand idly by when others are facing a difficult plight.

Giving as the Basis of the Community

In order to create a true community, must we each contribute in some way? Almost everyone I ask responds 'yes' to this question. But more than just enjoying the benefits of belonging to a community, people seem naturally motivated and energized to contribute, and are often creative about finding opportunities to do so.

For seniors who no are no longer independent, these opportunities are not as obvious as they once were. But by contributing our love and energy, time or advice, we can create the sense of community almost anywhere. A simple gesture of warmth, friendship, or conversation with others at a nursing station or attending an activity or a class — and actively participating at those events — is an act of giving that helps bring the community alive.

Meaning from Each and Every Day

I hear from many seniors who are experiencing a lack of meaning in their lives. Some feel that their time of giving in life — whether this was discovered through raising their family or having a successful career — is over, and with it went much of the meaning of their lives.

To those who wish to find meaning by giving to others, I suggest that the simple acts of kindness and generosity, or participation in community wherever and whenever the opportunity arises, are real and valuable moments of giving.

Indeed, every opportunity we take to contribute to the life and well-being of the community is a win-win. Others gain from what we give, and we ourselves gain immeasurably from the act of giving.

Rabbi Anthony Elman serves as Rabbi of the Jewish Home's Grancell Village Campus. His professional background is multifaceted, encompassing the fields of law, social work, and psychotherapy. Rabbi Elman has been with the Home since his ordination and graduation from the Academy for Jewish Religion-California in May 2007

Labels: Community, Elman, Feature Articles, For the Spirit, Giving, Judaism, Philanthropy, Tzedakah

Alcohol and substance abuse among seniors is a subject many would prefer to avoid, yet it is one of the most overlooked health issues of our time. Millions of older Americans have developed treatable chemical dependencies that go undetected because their symptoms mimic other disorders associated with aging.

The tragedy for many of these older adults is that they don't receive treatment. Instead, they experience a precipitous decline in health and quality of life that might otherwise have been identified and reversed.

Recognizing the Problem in a Loved One

Aging has its share of challenges, to be sure, but when the health of a loved one seems to be in a downward spiral, and there is no other diagnosed condition, a secret dependency or addiction may be involved.

When assessing a family member, allow for the common complaints of aging, but ask yourself if this is 'normal' for your loved one. Be alert for clusters of symptoms that can include: sleep problems, memory or cognitive loss, shakiness, bruises, haggard appearance, neglected hygiene, anxiety or depression, inability to concentrate, and self-isolating behavior.

Any one of these should be cause for concern, but two or more in combination should be your red flag.

The Accidental Addict

Many older adults become dependent on psychotropic medications like tranquilizers, anti-depressants, and Benzodiazepines for anxiety. Patients may begin to 'self-prescribe,' taking more of the drug for the same or a heightened effect, and then doctor-shop to obtain medications.

High doses, interactions with other meds and drinking at the same time can be highly dangerous practices.

Alcohol and Late Onset Addiction

Stressful or painful life transitions such as retirement or the loss of a spouse can result in unhealthy coping behaviors. In these conditions, a habit of social drinking developed at a younger age can escalate to a dependency.

For a variety of reasons, mostly having to do with the diminishing quantity of liver enzymes, older adults do not metabolize drugs or alcohol as efficiently as they did when they were younger. Over 70% of all hospital admissions of adults aged 60+ are related to problems with alcohol or medications.

Family Intervention

Spouses and loved ones should approach older adults with care and respect, choosing a time when the person is sober or lucid. Many people find the idea of alcoholism or addiction shameful, so it is best to avoid words like "addict."

Medical conditions are common among seniors, and conversation may include these concerns as potential consequences of their alcohol or medication abuse. Some families find the help of a professional interventionist to be valuable. If a suspected problem has not yet become full-blown addiction, a brief intervention by a trusted physician is often successful.

Treatment for Older Adults

Successful treatment of addiction in seniors recognizes generational values and emphasizes respect. Many people age 65+ were taught never to air their "dirty laundry" and to rely entirely upon themselves. Reaching out to others for help may not come as easily for a senior as it might for a younger adult. Additionally, it's helpful to remember that older adults, like all of us, are most comfortable with age group peers.

Treatment of seniors also includes a slower detoxification process. A multidisciplinary care plan may include medical monitoring, psychological, spiritual and wellness care, and ongoing Twelve Step group support.

To learn more about senior addiction issues, or for additional resources and contacts, click here.

Carol Colleran is a pioneer of older adult addiction treatment at Hanley Center in West Palm Beach, Florida, and led the development of the Life Stages Track for Boomer program. She is co-author of Aging and Addiction: Helping Older Adults Overcome Alcohol or Medication Dependence

Labels: Addiction, Aging, Alcohol, Chemical Dependence, Colleran, Drug Abuse, Feature Articles, For the Mind, Intervention, Substance Abuse

As we age, many of us find it is harder to fall asleep. We may awaken more frequently during the night, and have a tougher time getting back to sleep.

Studies show us that seniors have less Stage III and IV deep sleep and fewer episodes of Rapid Eye Movement (REM) sleep, when dreaming occurs. As a result, we may find ourselves feeling tired, discouraged, and depressed after a series of 'sleepless' nights.

The good news is that there are several things you can do — starting tonight — to improve the quality and quantity of your sleep and your functioning during the day.

Creating a Good Environment for Sleep

Heavy curtains or drapes can shield your sleeping area from unwanted noise or light. If soundproofing is difficult, consider a sleep machine that provides soothing sounds that help lull you to sleep.

If you have a clock radio or clock with a bright digital display, turn the light away from your eyes. Consider a new mattress or pillow. A few cents per night spent on a good mattress and pillow can be an excellent investment.

Dedicate your bedroom to two activities only — sleep and sex. Move that widescreen TV to another room. Leave your books, knitting, to-do list outside the bedroom. Your brain needs to associate walking into the bedroom with rest and sleep.

Practice Good Sleep Hygiene

When you enter the bedroom, turn off the mental tape for tomorrow's plans. Endlessly revisiting the next day's concerns impinges on your time and place of rest.

Worrying at night is unproductive and even self-destructive, but many of us have a hard time breaking out of the pattern. Cognitive behavioral therapy (CBT) can make you aware of bad habits, and help you practice more productive, sleep-inducing habits.

Reduce Your Stimulants

If caffeine sensitivity is a concern, eliminate caffeinated coffee or teas after noontime. Recent studies indicate that caffeine's detrimental effect on sleep can last longer than previously thought.

Read labels, and remember that there is caffeine in Coke, Dr. Pepper, Iced Tea, Snapple flavored teas, and many other beverages. Chocolate is loaded with caffeine, so reduce or stay away from it in the evening.

Health Issues and Sleep

If you get up at night to urinate, consider not drinking beverages for a couple of hours before bedtime. This is a characteristic problem for men with enlarged prostates.

A variety of other conditions can also interfere with sleep, including arthritis, emphysema, and heart disease. Ask your physician for ways to make sleep easier if you have these conditions.

Many older individuals suffer from sleep apnea. This breathing interruption disorder is particularly prevalent among the overweight. Sleep apnea is easily diagnosed in a sleep lab, and there is an effective treatment that uses a small mask and pressurized air. Another sleep-disturbing condition is Restless Legs Syndrome, in which individuals have involuntary leg movements during the night.

Treating Insomnia

A number of studies now show that cognitive behavioral therapy is a more effective treatment for insomnia than medication. This therapy begins with many of the techniques described above to optimize your sleep environment.

It is also recommended that you go to sleep and wake up at the same or nearly the same time every day. If you can't fall asleep after 30 minutes of trying, you should leave the bedroom, then return in 30 minutes.

Sleep therapists also teach relaxation and meditation techniques to prepare the mind and body for sleep.

Medications in a Pinch

If you are desperate to break the insomnia cycle, a sleeping pill can be a reasonable option. But don't reach for antihistamine-heavy, over-the-counter sleep aids that will leave you feeling groggy the next day.

Prescription medications are preferred, and come in short, intermediate and long-lasting versions such as Sonata, Ambien, and Lunesta. Stay away from long-acting agents like Restoril. Rozerem is meant for those who have a hard time falling asleep but do not awake frequently.

Finally, don't give up trying! With a little planning, practice, and perseverance, you should be able to find the solution and begin enjoying the daily benefits of a good night's sleep.

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: Feature Articles, For the Body, Medication, Sleep

Interview with Dr. Nitin Nanda: Treating Seniors' Mental Health

Dr. Nitin Nanda is Chief of Psychiatry and Behavioral Health at the Los Angeles Jewish Home. He also serves as medical director of the Lisa and Ernest Auerbach Geriatric Psychiatry Unit, a part of the Brandman Research Institute at the Home's Joyce Eisenberg-Keefer Medical Center.

Q. What are the most common mental health issues seniors face today?

A. A number of concerns arise as people age, including depression, memory loss, and other cognitive issues that can interfere with day-to-day functioning. Anxiety disorders are also common, as is substance abuse, primarily alcohol.

Q. Are medical conditions a risk to mental health?

A. Yes, many times medical conditions directly affect a patient's emotional well-being. It's very important to understand that mental health issues are not a part of normal aging. Unfortunately, because depression has been associated with aging, it is often under-recognized and under-treated. Unaddressed emotional needs can lead to a significant decline in both mental and physical health and functioning.

Q. What prompted the Jewish Home to open the Auerbach Geriatric Psychiatry Unit?

A. Mental health and emotional wellness are vital components of successful aging, and as a provider of a full continuum of care, the Jewish Home believes it is important that we be able to provide these specialized services here on campus.

Q. How do you address a patient's mental health needs at the Auerbach Unit?

A. First with an expert staff that provides patients with a comprehensive geriatric evaluation, both psychiatric and medical. Both teams, psychiatry and medicine, make sure that medical issues are being treated and drug interactions are monitored.

Second, we perform a memory evaluation and work-up, and determine if there are any psychosocial or 'life' stressors, such as conflicts with, or the loss of, loved ones, challenges to independence, financial situation and so on that affect a patient's sense of well-being. With our philosophy of treating the whole person, we are well-prepared to provide whatever therapies — including physical, speech, and occupational therapies — are needed.

Q. How important are preventive measures to senior mental health, and what can seniors and their families do to look after themselves in this way?

A. We have created a list of ten warning signs of mental health problems in seniors (see the sidebar). If there is any cause for concern, we encourage seniors or their families to contact their family physician sooner rather than later. Also, the Home now offers a monthly Emotional Wellness Clinic on each of our campuses. These are open to the public and are intended to improve the quality of life for our residents and all of our senior community.

Q. Who can participate?

A. Anyone over 55 may be seen in our clinics for an evaluation of their psychiatric and medical history and symptoms, and receive helpful information and referrals about treatment options.

Q. When do you recommend inpatient mental health services for seniors?

A. When symptoms can't be managed on an outpatient basis, hospitalization is recommended to closely monitor and treat our patients. A number of issues can become unbearable for seniors, particularly depression, which can be life-threatening. Severe depression can interfere with daily functioning and cause people to isolate themselves and feel hopeless and helpless. Symptoms can come on suddenly. We look for agitation, insomnia, personality changes, apathy, and changes in dietary habits.

Q. What kind of assessment or treatment can you provide that you couldn't provide on an outpatient basis?

A. Hospitalization may seem like a drastic step, especially to seniors who are ailing and frightened, but it provides an opportunity for a full neuropsychiatric and medical assessment to see if the condition is treatable, to make sure there are no underlying medical problems causing the condition, and to help improve the situation as quickly as possible. The inpatient team — a geriatric psychiatrist, geriatric internist, program director, charge nurse, social worker, activity therapist, dietician, and pharmacist — sees the patient daily, typically for 7 to 10 days, though sometimes less. Patients are transitioned back to their regular lives and physician's care when target goals for their well-being are met.

For additional mental health resources,click here

Robin Heffler is a Los Angeles-based journalist whose writing and editing span the fields of health, social services, education, law, the environment, religion, arts, and culture. Her work has appeared in the research publications of UCLA, USC, and Cedars-Sinai Medical Center, as well as in the Los Angeles Times and The Forward.

Labels: Aging, Auerbach Geriatric Psychiatry Unit, Feature Articles, Heffler, Mental Health, Nanda, Psychiatry, Warning Signs

The transition from a private home or apartment to a senior living facility requires physical, emotional, and, perhaps more importantly, attitudinal adjustments. It also requires generous time to discuss, evaluate, and then make the move.

Experts agree that the key for a successful move is understanding that the change itself can result in an overall better quality of life. It is best to keep in your thoughts and your discussions that the purpose of transitioning to senior care is to enhance their physical, psychological, and social well-being.

The Challenge of Change

Change is difficult at any age. Consider how good it feels to return home, even after an enjoyable vacation. Our first response is usually "it feels so good to be home." That's because our minds and bodies experience new environments as an additional stressor.

New places put new demands on us, requiring us to remember where we are, to learn how to access resources, and to make new plans for how our needs will be met.

Home, by contrast, is easy and familiar, a place where we accomplish our movements by rote — from getting a drink in the middle of the night to finding the TV remote!

The Learning Curve

A new setting can take at least three months — and often twice that — for a senior to "learn." Even with full acceptance that the move to a senior living community is a positive step, the learning curve can be steep. The right preparation can make the move a lot easier.

One helpful approach is to step back and look at the big picture. Consider or discuss all options and emphasize what will be gained rather than lost. Many tremendous benefits are often hidden or overlooked in the pressure wrought by change. The fact is that most seniors gain rather than lose independence.

Transitioning

Rather than embarking on a move abruptly, keep an eye out for opportunities to ease gently into a new situation. Try visiting a new residence during the lunch hour. Have lunch there with your parent (or loved one). An ordinary activity, like dining, can help familiarize you or a loved one to a new environment.

On your next visit, stay a little longer after a meal. Participate in a social activity that appeals to you, whether it's a game of cards or watching a favorite show or movie.

In all interactions with staff, try to be comfortable accepting assistance, and remember they are experienced professionals who are committed to their work.

An Emphasis on New Freedoms

After making a move, seniors sometimes compare their new homes to living on a cruise ship. It's true! You move in, the room is fresh and clean, and the place is yours. Meals and snacks are provided for you around the clock.

You have the opportunity to take a variety of educational, artistic, or recreational classes. Exercise classes or individual workouts can restore or improve health. Spiritual activities and support can provide a new sense of fellowship and well-being. Through social opportunities, new friendships are developed and old friendships rediscovered.

Transportation worries are over, and life opens up in new ways. Seniors are now free to take in a movie or museum, or to go shopping whenever they like. For many who have been struggling to keep up their own homes, it is a tremendous relief to have someone else take care of everything.

In an age when more and more senior living facilities are sensitive to the needs of the whole person, seniors are leading far more enriched lives full of meaningful activities that make each new day an opportunity to enjoy all that life has to offer.

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: Aging, Feature Articles, Forrest, Moving, Senior Care, Senior Living, Transition