Los Angeles Jewish Home's Blog


Tapping the Power of Music — Part I

By Nancy Sokoler Steiner

"Music gives a soul to the universe, wings to the mind, flight to the imagination and life to everything." — Plato

Sometimes, the things we like aren’t so good for us. Fortunately, that isn’t the case with music. It doesn’t have any calories, can often be obtained for free, and doesn’t require any special skills or abilities to be enjoyed.

In fact, music has shown a host of benefits, both physical and emotional. That’s one of the reasons it plays such a large role at the Los Angeles Jewish Home.

In terms of physiological changes, a Cochrane Review study (a study which looks at many studies) found that music reduces pain, sometimes enough to decrease required dosages of pain medication. Studies with cancer patients have shown that music therapy decreases heart rate, respiratory rate and blood pressure. And researchers in Europe have found that exposure to music can both raise the levels of antibodies and lower the amount of stress hormone levels.

Studies on the emotional impact of music show similar benefits. One study done with college students, for example, found that listening to music conferred more positive emotions. Not only that, but the music intensified already positive emotions.

“We humans know instinctively that music has primal power,” says Elena Mannes in her book The Power of Music: Pioneering Discoveries in the New Science of Song (Walker & Company, 2011). “Historians and anthropologists have yet to discover a culture without music.”

Los Angeles Jewish Home Resident Tess Friedman, 87, describes music this way: “It elates me.”

Friedman joined the Home’s choir when she came here four years ago. “It’s a way to not let yourself be old and to forget about aging,” she says about singing. “You can change your whole attitude and behavior for the day.”

Caryl Geiger, Activities Director for Residential Care, sees this effect among many residents. Professionally trained in piano and voice, Geiger directs the Home’s choir. “Everybody leaves [practice] happier than when they came in,” she says.

Lee Zuckerman, 89, was delighted to rediscover the joy of song when he joined the choir six months ago. He’s always enjoyed music – his son even became a composer – but hadn’t sung since he was in his high school choir. “I love music. I feel joy when I sing.”

But you don’t have to sing in order to experience music at the Home. In addition to enjoying the choir’s performances, residents can take advantage of a variety of musical offerings. Concerts are offered almost every Sunday afternoon, and there are also programs on Jewish music and regular sing-alongs. In addition, violist and music historian Joel Lish presents weekly music appreciation classes.

“All levels of residents respond to the music,” says Lish, founder and director of the Palisades Symphony. “Some sing along, clap to the rhythm or even play along on an imaginary instrument.”

Music will always be an integral component at the Jewish Home. As author and researcher Elena Mannes says, “Anyone who has been transported by Bach or Mozart, moved to weep by a national anthem or hymn, stirred to dance by a rock rhythm, or transported in time by the notes of a pop tune from the past knows the power of music.”

Nancy Sokoler Steiner Nancy Sokoler Steiner is a freelance writer and author based in Los Angeles. Her work has appeared in Los Angeles Times Magazine, The Jewish Journal of Greater Los Angeles and Lifestyles Magazine, among other publications.

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Complex Dynamics in the Families of Older Adults

By Amy Rosett, Ph.D.

Whenever I ask people in an audience if their family is complex, nearly everyone raises their hand and softly laughs. Families often are an important source of support and unconditional love, but frequently they are also a source of stress, guilt and angst. And they can be all of these at the same time. Despite the multitude of possible family structures, small or large, there are generally similar dynamics within families. These dynamics shift as parents age and their needs change.

As people are living longer, it is more common to know couples married 55, 65, and even more than 70 years. But they usually don’t age in a parallel way. Thus one may be fortunate to have good physical health and cognitive abilities, while the other is more frail and/or confused. Sometimes one person is physically healthier while the other has stronger cognitive skills. Whatever the specific pattern, there are inevitable changes in how they manage as a couple when they need to take more care of one another.

Sometimes the one giving the care tries to keep these changes from their adult children. There may be well-intentioned reasons to try to hide the worsening condition, such as protecting the dignity of their spouse, guilty about being a burden to their adult children, wanting to remain an independent couple, and assuming it is expected to shoulder this responsibility. However, by hiding the need for increased care, problems often develop in the family, such as poorer communication, emotional distance because of this lack of candor, and wearing down, both physically and emotionally, due to the pressures of being the sole caregiver.

Furthermore, if one spouse is developing Alzheimer’s disease or another form of dementia, the changes almost always involve more than memory loss. These include other cognitive difficulties, behavioral problems and personality changes. Thus, one’s loving spouse of 56 years might seem depressed, have anger outbursts, and even become verbally or physically abusive. Covering up such changes often is depressing, and could compromise the safety of either person. Informing the medical doctor may lead to medications and other interventions that can alter the progression of the disease. Talking with the family may lead to getting the emotional and physical support they need.

The family dynamics become more complex regarding the adult children. One of the most common examples of this change is a “role reversal.” The adult children start to make “parental” decisions about caring for their parents. The parents become more dependent on their children. Some families accommodate to this shift graciously. They still allow the parents to be as independent as possible and work together as a partnership.

Unfortunately this role reversal frequently creates stresses for both generations. From the parents’ perspective, there is a fear of being a burden to their children. But there is also a fear that their needs and wants will be ignored by their family. Older adults often express guilt because their children “have their own life to live.” Frequently it is true that the adult children are busier with raising their own children, their work, and economic pressures. Nonetheless I’ve observed that most adult child experience more stress when they do not know what is actually happening with their parents.

From the adult children’s perspective, sometimes there is resentment about the increased responsibilities of caring for their parents. Often they have anxiety about making the correct decisions, balancing various recommendations about a particular situation, and a general worry about their parents’ worsening health.

The complexities of the family dynamics multiply when there are several adult children. Some of the stresses might stem from unresolved sibling rivalries. At the time that their parents need more help, it is unlikely that such long-standing conflicts will be settled. However, if the adult children recognize this dynamic and agree to focus only on the current concerns, it helps them to work together.

Even in the most supportive families, it is usually difficult to sharing the responsibilities of helping the parents in a way that seems fair to everyone. This is complicated by the fact that usually the siblings have varied abilities to help, especially when only some live near the parents. Specifically, some siblings may have more money, time, proximity, energy, and emotional wellbeing to participate than others. It is very helpful if everyone accepts that the amount of direct care provided most likely will never be “even.”

It is important to have frequent communication among the siblings, and when appropriate to include the parents. Find ways that each person can contribute, even if it is from a distance. They should work toward their strengths. Those who live further might coordinate visits to let the siblings who live close to take a short vacation.

One common problem is that a visiting adult child has wonderful ideas of how to improve the situation, makes changes and then leaves. In fact, those who live closer and have more contact with the doctors and other professionals should have a greater voice, but also be open to listen to what others might have to contribute.

Overall, families function best when the parents and adult children have frequent and open communication, including via email, Skype and telephone conference calls. There needs to be a willingness to be flexible, especially as the needs of the parents change. The family will face numerous decisions. It helps to consider many opinions during the process, but agree upon one solution, even if everyone is not pleased.

When all this can be done with the older adults’ participation, the likelihood of family stresses, guilt and angst will be reduced. I’ve yet to meet the family which has eliminated such negative feelings, but reducing them is a realistic goal. Finally, it is important to recognize that positive aspects of family, the support and unconditional love, can increase even during the often difficult adjustment to the shifting needs of the older adults.

Amy Rosett, Ph.D.Dr. Amy Rosett is a licensed psychologist who works with adolescents, adults and older adults, with a specialization in clinical geropsychology in Encino, CA. She provides individual, couple and family psychotherapy, as well as a free monthly caregiver support group. She offers consultation services for individuals and families dealing with aging, long term care placement, and caregiver issues, as well as for professionals.  In addition, she provides talks to the general public and professional training on a variety of topics including older adult mental health issues, understanding dementia and other cognitive impairments, and elder abuse. Dr. Rosett received her Ph.D. from the California School of Professional Psychology in 1990. She was a clinical instructor for third year medical students at the David Geffen School of Medicine at UCLA. Dr. Rosett served on the Board of Directors of Psychologists in Long-Term Care and is currently the Immediate Past President of the Los Angeles County Psychological Association. Dr. Rosett can be reached at 818-705-1870 or by emailing http://Therapists.PsychologyToday.com/rms/92204.

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Why Does Aging Skin Bruise So Easily?

By Nancy Sokoler Steiner

You don’t remember bumping into anything, but there it is: A big, angry-looking purple bruise on your forearm. How did it get there, and why do bruises like that seem to be popping up on your arms and legs more frequently as you age?

“These kinds of bruises, referred to as solar purpura, may start occurring in your 50’s, and become more common as time passes,” says David E. Sawcer, MD, PhD, Assistant Professor of Clinical Dermatology in the Keck School of Medicine at USC. “They happen closer to the surface of the skin than other bruises, and are not usually caused by trauma.”

Bruises come from injury to the small blood vessels (capillaries) near the skin’s surface. Blood leaks from the capillaries and remains trapped under the skin. Normal bruises are usually tender, change colors, and go away after a week or two. Solar purpura, on the other hand, don’t hurt, and often get darker, progressing from red to deep purple before they fade. They can take several weeks to disappear.

Why it Happens

As our skin ages, its structure begins to weaken. The outer skin layers grow thinner and the capillary walls become more fragile. At the same time, the layer of fat under the skin thins, providing less padding and insulation.

“Day-to-day activity is enough to cause solar purpura,” says Dr. Sawcer. “The capillaries in the skin are more easily damaged because they become thinner and less protected.”

Although bruising can’t be avoided, sun exposure worsens it by weakening the skin. Also, blood-thinning medications, such as Coumadin and aspirin, contribute to bruising by slowing the blood’s ability to clot. Corticosteroids, prescribed for a variety of conditions including rheumatoid arthritis and asthma, cause thinning of the skin, which also promotes bruising.

On rare occasions, bruising may indicate medical conditions such as clotting or coagulation disorders. If your bruises are painful, you experience abnormal bleeding in other areas, or you start bruising when you’re ill, be sure to see your physician. If you see bruising on a loved one and worry about physical abuse, you should know that bruising caused by abuse tends to appear on different parts of the body -- such as the face, neck, back and chest – rather than on the hands, arms and legs. Still, it’s a good idea to talk to your loved one if you have any concerns.

What Can You Do

Sun exposure makes the skin weaken more quickly, so protecting yourself from the sun can help delay this process. Keeping skin well moisturized can also lessen bruising. Do both at one time by using a moisturizer with sunscreen.

The most effective treatment for bruises is time. Eventually, the body reabsorbs the blood, and the bruise disappears. Cosmetics may help hide bruises in the meantime.

“People tend to be concerned about bruises because they’re deeply colored and look serious,” says Dr. Sawcer. “But despite their appearance, they’re generally not something to worry about.”

Nancy Sokoler Steiner Nancy Sokoler Steiner is a freelance writer and author based in Los Angeles. Her work has appeared in Los Angeles Times Magazine, The Jewish Journal of Greater Los Angeles and Lifestyles Magazine, among other publications.

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