Los Angeles Jewish Home

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.”

Labels: Aging, Feature Articles, For the Spirit, Healthy Aging, Music, Nancy Sokoler Steiner, Seniors

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.

Labels: Family, Family Dynamics, Feature Articles, For the Mind, Rosett

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.”

Labels: Aging, Bruise, Bruising, Feature Articles, For the Body, Healthy Aging, Nancy Sokoler Steiner, Skin, Solar Purpura

by Lee Rothman, M.Ed., M.A.

The health benefits of yoga for a growing senior population are too numerous to mention. We could almost say that yoga and meditation provide a foundation for the high quality of life we all seek in our elder years.

Through the regular breathwork and purposeful movement of yoga, we improve flexibility, joint health, muscle tone, and balance. And the list doesn’t stop there. Lower blood pressure, improved circulation, and better sleep all contribute to our well-being. The most recent research also points to multiple psychological and cognitive benefits, including a decrease in anxiety and depression, a greater sense of well-being, and improvements in attention, concentration, and memory.

These benefits have long been recognized by seniors at the Jewish Home, where yoga continues to be one of our most popular fitness programs. But yoga and meditation have equally important spiritual benefits which form an important part of the most rewarding practice.

From its origins in the second century, B.C.E, yoga and spirituality were considered inseparable. The Sanskrit word yoga has the literal meaning of ‘yoke’ or ‘union,’ suggesting the important connections of its physical, mental, and spiritual components.

Our Western perspective has largely emphasized the asanas, or physical postures, and pranayama, or breathing exercises. When appreciated as a comprehensive system through the practice of meditation, yoga expands to encompass the spiritual.

Spirituality, from a yogic perspective, embodies a relationship with something greater than we are — a source of being that we have come from. As such, the spirituality presented through yogic teachings easily complements our religious beliefs, whether we identify ourselves as Jewish, Christian, Hindu, Muslim, etc.

In yoga, we experience the spiritual by activating our awareness. That awareness comes with a practice that involves asanas, pranayama, and meditation. Asanas are the various postures one goes through in a yoga session, like the cobra pose, downward dog, and tree pose, to name a few. Asanas are designed to stretch muscle groups in your body and improve blood flow throughout the body. Joints and ligaments are lubricated, cholesterol is lowered, respiration improves, and your immune system is strengthened.

However, there is also a spiritual aspect of the asanas. Asanas are designed to take us through a range of experiences in the course of one yoga session. Since effort is required and stress may occur, practicing the asana teaches us how to maintain mindfulness in times of stress.

Mindfulness is a practice that enables one to live fully in the present moment. Your awareness is completely centered on the here and now. You are not worrying about the future or thinking about the past. If you are concentrating on these words, the present moment is all that exists and you are living where life is happening.

The meditation that is part of a comprehensive yoga practice may be as simple as sitting silently with eyes closed, focusing on the breath. Or it might involve chanting a mantra out loud with accompanying hand movements.

By cultivating mindfulness through meditation, you begin to enjoy your life just the way it is, not for how you want it to be in the future or for what it was in the past. This heightened acceptance of the present moment leads to a spiritual awareness, and with it, a greater enjoyment of your life.

A regular meditation practice enables one to pause and observe the ‘reactive’ aspects of our mind without taking action. It is as if we become a proverbial fly on the wall inside ourselves. Suddenly, we can observe our world and our responses to it, then decide how we want to act upon them. Meditation tends to foster more purposeful and thoughtful action, and less reaction. Some schools of yoga (notably Kundalini) take the view that the regular practice of asanas and pranayama prepares one to meditate.

So, how do we combine the physical aspects of yoga with those that foster spiritual development? And how does this marriage manifest itself in our behavior on a daily basis? (Many yogis refer to this as taking it “off the mat.”)

With a regular yoga and meditation practice, we learn to live our life with greater integrity, honesty and respect for ourselves and others. We understand that our words have power and affect others, so we choose them more carefully. We learn to treat ourselves and others with greater kindness and compassion.

We still feel angry, impatient, frustrated and hurt. However, with the regular practice of pranayama, we learn to take a breath or two before we respond. Yogic breathing helps to calm our mind and thoughts. We abandon damaging habits, and our thinking becomes more positive. We cease judging others so negatively, with the realization that we are no better than they are. As we develop a more extensive practice, we understand deeply the concept of the oneness of all life, and glimpse the highest attainment of our spiritual existence.

Labels: Asanas, Feature Articles, For the Spirit, Kundalini, Lee Rothman, Meditation, Pranayama, Staff, Yoga

The act of becoming a bar mitzvah, a public acknowledgment of a young man’s obligation to fulfill the commandments, is a traditional part of Judaism. In today’s society, the spiritual commitment of young women is often celebrated as well. For most of the Jewish Home’s female residents, becoming a bat mitzvah was unheard of when they were twelve or thirteen.

This was true for Jewish Home resident Marilyn Matty. As a young girl, she and her sister attended Sunday school, but not Hebrew school. As a married woman, she learned to keep a kosher home. Marilyn became involved in a Conservative synagogue and, as a pianist, worked with the choir. As life brought its share of challenges, her connection with Judaism was loosened. One day, about three years ago, she realized she wanted to go back to her community and began attending synagogue again. “That was the beginning of my feelings of getting back to Judaism,” Marilyn recalls.
After moving to the Jewish Home in February 2010, the feeling became even stronger, leading her to become a bat mitzvah on November 5, 2011, at age 85. View photos of Marilyn here.

Rabbi Anthony Elman, the Jewish Home’s Director of Spiritual Life, worked closely with Marilyn for 1 ½ years in preparation for her bat mitzvah. He regards this as a valuable part of the overall work of the Home’s rabbis in enhancing the spiritual life of residents and of the Home itself. “We try to respond to the desire of individual residents to develop further in their spiritual tradition,” said Rabbi Elman. “We also provide learning opportunities to a range of resident groups and meaningful prayer services. Our goal is to create a climate for the whole community where the spiritual dimension of life is valued and respected.” In Rabbi Elman’s view, the Home’s rabbis are here not just to allow observant Jews to continue their religious practice, but to give an opportunity for all residents to live spiritually rich lives.

When he addressed Marilyn after she had read from the Torah, he said: “You, Marilyn, are truly worthy of being called to the Torah as bat mitzvah. You achieved the necessary learning and read from the Torah beautifully. Kol hakavod for that – all honor to you. But becoming a bat mitzvah is much more than learning and reading. In my eyes, it is who you are as a whole person who merits this honor today. Walking in the footsteps of our father Abraham, you exhibit the principle of chesed – loving kindness. It is a giving from the heart – not just on a whim, but in a solid, robust, long-lasting kind of way. I have been truly moved by how you have gone out of your way to help and support others, and to practice bikur cholim – visiting the sick.”

Here, in her own words, is Marilyn’s story of accomplishing this great spiritual achievement.

This week’s parsha, Lech Lecha, is the story of Abraham and Sarah. It tells the story of leaving your present home and going toward the unknown. God told Abraham to leave his land, his birthplace, and go to a place God will show him, and he will become a great nation. Abraham took his wife, Sarah, and started on a journey to a new, and unknown, life.

Leaving your familiar home to go to the unknown is scary and uncertain. Like Abraham, I believe a message from God gave me the choice to stay in my home or search for another place to live, with no guarantee of a great nation. With the able assistance and guidance of my daughter, Tina, we found the Jewish Home, Grancell Village. This was the unknown to me, a new place, new room, and new faces, and maybe not a great nation, but a lot of love. Abraham headed west to Canaan and I headed east to Reseda.

After Abraham and Sarah lived in Canaan for 10 years, we are told that Sarah was barren, she had no children. Commentators have suggested that this repetition means she physically had no children, but spiritually she had so many as she inspired so many people.

I in turn find this inspiring. I will talk later about a woman at the Home who inspired me so much, and changed my life.

Sarah decided that the best way for Abraham (and perhaps her) to start a family was for Abraham to take Sarah’s servant, Hagar, as a concubine, with Sarah’s blessing. I see this as a great act of giving, of generosity. I think it was a mitzvah from Sarah’s heart.

Like Sarah, doing something for someone else is very important to me: visiting residents who are ill, seeing new residents or seeing someone who needs company. I have made reaching out to others a part of my life at the Home, and it gives me great pleasure. But if we go back to the story of Abraham, Sarah, and Hagar, we see that there might sometimes be a downside to giving.

When Hagar became pregnant with Abraham’s child, she scorned Sarah, and this was very painful for Sarah, who perhaps had hoped that her relationship with her servant Hagar wouldn’t change.

Sarah told Abraham how badly Hagar was treating her, and he said she should do whatever she wished. Sarah was horrible to Hagar and made her life miserable.

Hagar ran away from her mistress, and, in the desert, she met a stranger in her path. Unknown to Hagar, this was an angel, a messenger from God. He asked her what she was doing and Hagar said that her mistress was unkind and she ran away. The angel of God told Hagar to return back to Sarah and that she, Hagar, would be granted many descendants, so many descendants that they would be uncountable. So Hagar returned home and had a son whom they named Ishmael – “God heard” – that is, God heard Hagar’s pain.

Why did Sarah do such a generous thing as give her servant to her husband for them to have a child? She hoped this would be like a child to Abraham and herself (so that Sarah would bring up the child), and fulfill God’s promise that Abraham would become father of a great nation. Sarah gave, but then it seems she regretted giving; she became filled with bitterness. This makes me question: can giving sometimes go too far?

A true mitzvah is one of giving unconditionally. But I also know that too much giving can deplete one’s resources. As well as giving, I’ve learned the importance of balance in my life. I personally find pleasure particularly in playing blackjack, bridge, reading, and allowing time for hair, nails and chit chat – things that are about fun rather than suffering. These allow me to go on being a person who can be with others in distress.

As we get older, we have to make choices and changes, especially when we are no longer able to be independent. It’s a big adjustment for everyone, but I believe God had pointed the way for me. The Jewish Home has given me a place and I’m finding communal living both beautiful and challenging. My choice to come to the Jewish Home’s Grancell Village was not at first an easy one, but it soon filled by heart and soul with joy. I adjusted, met a lot of people, and satisfied myself with love from the new feeling of community.

Being part of the Jewish Home community brought me back to Judaism, which had become misplaced from my life. I became aware of my hunger, so I started studying Hebrew and Torah, which led on to this exciting moment in my life.

When I first arrived at the Jewish Home, I met a woman who changed my life. She was a young 96 years and always eager to learn. We started reading the Torah weekly and asked questions of the Rabbi. Spending regular time with May Blank inspired me to fully understand and appreciate life. Like Sarah was to countless others, May was an inspiration to me. We developed a great friendship, so that at the end of her life she called me her “sister.” Memories of May will me daily and help carry me through to my Bat Mitzvah. May her soul rest in peace.

There was another woman who became important to me – a wonderful, brave person, Miriam, was part of a “learning threesome” with May and myself, and we became known as “The Three Ms.” Miriam was blind, and had lost a leg, but was active with us, learning and contributing her knowledge and wisdom, until her end.

There are so many wonderful people here at the Jewish Home, that my life is blessed with friendship and love.

I would like to thank Rabbi Elman for being my teacher and guide, helping me to take my place more fully as a Jewish woman. The story does not end here: I plan to continue studying Torah so as to learn and deepen my understanding of our beautiful Jewish heritage. I would also like to thank Rabbi Wendy for her support.

As I look out to the congregation and see my loving family, which include my devoted children and their spouses, grandchildren (and their spouses), sister, two nieces and a nephew, I feel such love for you all. Thank you all for being here with me today as witnesses – and my special gratitude to those of you who are participating in this service this morning. I am intensely proud of my family.

I know that my mother is giving me her blessing because this is the anniversary of her death. Rest in peace, Mom.

Finally, I wish to thank my entire Jewish Home family for their love, and for making this a wonderful Jewish community in which to live.

Once again, I am THIRTEEN!

Labels: Abraham, Around the Home, Bar Mitzvah, Bat Mitzvah, Bible, Elman, Feature Articles, Jewish Home, Jewish Home Residents, Judaism, Marilyn Matty, Remarkable Residents, Sarah, Staff, Thirteen, Torah

During the month leading up to Rosh Hashanah, I am going to be making a lot of noise here at the Jewish Home’s Grancell Village.

At lunch time every weekday, I will be visiting 18 dining rooms and blowing four powerful blasts of the shofar in each one. The residents and staff love these moments, and so do I. But they are intended to be more than mere fun.

The shofar, of course, is the herald of the New Year. It is also a call to prepare ourselves for Rosh Hashanah and Yom Kippur — the “Days of Awe.” So what kinds of preparation are appropriate?

We are all familiar with the “outer” preparations for family gatherings at the New Year. There are the dinners we will share; the clothes we will wear in synagogue in honor of the occasion; the beautification of the synagogue itself, the flowers and the white coverings for the Torah scrolls.

But when we look beneath the surface, and let the sound of the shofar touch our hearts, we hear the call for another kind of preparation — the beautification of our selves, deep down inside. The way we do this is through personal reflection. This is the true call of the shofar, and the grandest task in Elul, the month before Rosh Hashanah.

In preparation for the New Year, I find it helpful to ask ourselves a few important questions, such as:

• Of all the things I have accomplished in the past year, what pleases me most or makes me most proud? In what ways did I live up to my highest standards?


• How have I let myself down by failing to live up to these standards, or being less of a mensch than I could have been?


• Have I apologized to people I’ve wronged? Can I find the courage to do that?


• What can I do that will make my life and the lives of others a little better in the coming year?


• What can I do next year that will make me more proud of who I am?

On Rosh Hashanah and Yom Kippur, we commune with a compassionate and forgiving G-d, and realize that it is also time to forgive ourselves. It is important to understand that acknowledging the ways we have fallen short does not mean we should beat ourselves up. Far from it!

Our goal should be to come out of Yom Kippur free from sense of guilt or failure, and inspired to improve ourselves in the coming year. That is why the end of Yom Kippur is such a joyful time.

At the New Year, we will share apples and honey with families and friends, and wish each other a happy and sweet new year. We will ask to be written into the Book of Life for a good year ahead.

Our preparation in the coming weeks enables us to come confidently before G-d to make that plea. May the sweetness of the New Year arise from your true striving to become the best person you can be.

I wish you and your family a Happy, Healthy, and, yes, a Sweet New Year.

Labels: Days of Awe, Elman, Feature Articles, For the Spirit, New Year, Preparation, Rosh Hashanah, Shofar, Yom Kippur

It’s 2:15 a.m. Out of a deep sleep, you awaken to clanging noises in your kitchen. Not long ago, you would have thought someone was attempting to get into the house. But with everything that’s gone on lately, you realize it is actually someone trying to get out. It’s your mom. She’s ‘wandering’ again.

Recently, you’ve noticed she is having memory problems. It’s been harder for her to recall what was just said. Now she’s forgetting the day, the date and other little features of daily life. Learning new things seems especially challenging for her, and she is starting to make up details to fill in the parts of stories she’s forgotten.

At first, it was possible to chalk it all up to getting older. After all, there are many challenges to deal with as the years advance. But things have really begun to change for the worse.

Mom can’t sleep through the night. She wakes up disoriented and confused. During the day, she believes she has appointments that have never been made. She talks about going to see friends or family who have long ago passed away or moved. She gets mad and lashes out when she is prevented from doing things you know she can no longer do.

Sometimes Mom seems depressed. It is harder and harder to take care of her personal needs, and she doesn’t seem to understand why you want her to take a shower. Sometimes she even forgets who you are.

It seems that her symptoms are coming on faster and faster, and, since she took that fall last week, things have gotten so much worse. Her doctor prescribed some medication, but it really isn’t helping.

You get out of bed and go downstairs to try to help Mom back to bed. She isn’t settled until 4 a.m. You don’t know what you’re going to do. One of these days you might not be able to get to her in time.

Mom has dementia, and now you’re worried about her safety. You need someone to help you figure out what to do next.

The preceding scenario is a composite of several we’ve heard from families caring for loved ones with various forms of age-related dementia.

At the Jewish Home’s acclaimed Auerbach Geriatric Psychiatry Unit (AGPU), we counsel families on mental health services for their senior loved ones, and provide short-term (acute) intensive treatment for seniors experiencing stressful mental or emotional challenges.

More than 50% of patients treated are suffering from acute dementia. The goal of our small, specialized hospital unit is to help restore seniors to an optimal level of functioning so they may safely return to their home or residential setting.

While most people do not need to be admitted, the staff at the Auerbach Geriatric Psychiatry Unit can help you sort through your options, gain new insights on dealing with dementia, and where to go for additional help.

If you have a loved one who is experiencing acute mental health challenges, please call the Jewish Home’s Auerbach Geriatric Psychiatry Unit at (818) 758-5042. A helpful staff member will either talk with you immediately or get back to you promptly.

Labels: Aging, Alzheimer's, Auerbach Geriatric Psychiatry Unit, Dementia, Feature Articles, For the Mind, Luke Jackson, Memory, Parents, Wandering

For a senior, a hip fracture can be as life-threatening as heart disease or cancer. Sadly, nearly one in four older women who fracture a hip will die within a year. For men, the odds are even worse. A year after a hip fracture, one-third will not survive. Of those who do, many will not be able to walk without a cane or walker.

The reasons for such poor outcomes after hip fractures are not clear, however loss of mobility and independence play an important role. Immobility also leads to depression, a loss of motivation, and, in many cases, even the will to thrive and live.

Since we don’t want one, let’s look at ways to prevent these potentially devastating accidents.

Fall Proofing Your Home

Most falls occur in the homes, that were built without the needs of senior residents in mind. Many contain slippery floors and poorly-lit hallways, and stairs.

To fall-proof your home, start with your kitchen and your bathroom, the two most common sites for falls. Grab rails are a must in the shower and next to the shower, bathtub and sink. They don’t have to look industrial. There are nice designer shapes and colors from which to choose.

If you use throw rugs in the bathroom or kitchen, make sure they are fixed to the floor. Re-organize your kitchen to ensure that commonly-used items can be easily reached. And don’t store anything so high that you need to stand on a chair or stool to reach it.

Be sure hallways and staircases are well-lit and clutter-free. For more information on how to make your home safer, visit www.homemods.org.

Change Those Shoes

High heels and smooth-soled shoes must go. Personally, I prefer the security of shoes with non-skid bottoms. If you encounter a wet or slippery surface, your shoes can make the difference.

While you’re at it, retire those running shoes with lots of elevation. They simply put too much space between the soles of your feet and the surface on which you’re walking.

Improve Your Balance

There are several ways to improve your balance and thereby prevent falls. Perhaps the best method was devised by the Chinese, and is called T’ai Chi. The gentle motions of T’ai Chi have been shown in clinical trials to reduce falls and their resultant hip fractures in seniors.

If T’ai Chi is not for you, there are other balance exercises that a physical therapist can show you. Your physical therapist or physician can also coach you on how to avoid landing on your hip if you do take a fall.

Strengthen Your Bones

We all lose bone mass after the age of 40 or so. For women, this process accelerates after menopause due to a loss of estrogen. What can we do to slow down and even reverse this process so that we’re not at risk for fractures?

Surprisingly, the best way to strengthen bone is through exercise, both the aerobic and strength-training types. Just 30 minutes of walking at two to three miles per hour will build bone mass. Light weight training will strengthen your bones as well as improve your balance.

Get Sufficient Vitamin D

Another way to prevent fractures is by getting enough vitamin D, which has been shown to prevent falls. Your skin manufactures vitamin D after exposure to the UV rays in sunlight.

Unless you get out in the sun for a considerable amount of time each day, it is unlikely that you are getting enough vitamin D, and you will need to take a supplement of 1,000 IU a day.

Have a Bone Scan

If you are over age 50, you should have a DEXA scan. This x-ray of your hip and spine will determine if you have osteoporosis (severe loss of bone matrix) or osteopenia (moderate loss of bone matrix). If you do have these conditions, you are at greater risk for hip fracture.

There are several options for treating osteopenia and osteoporosis. Consult with your physician to see if estrogen, etidrionates such as Fosamax, SERMs such as Rolaxifene, calcitonin, or parathyroid hormone, are right for you.

Reducing the risk of a hip fracture and its consequences is something you can start working on today. By taking the steps outlined above, you should be able to protect yourself from this potentially devastating injury.

Labels: Aging, Bones, Falling, Feature Articles, For the Body, Hip Fracture, Schneider

Why do some people age gracefully, while others do not?

Why do individuals differ so greatly in their ability to roll with the punches? How is it possible for one person to be content and engaging despite significant physical challenges, while another in relatively good health is constantly grumpy and discouraged?

One reason is the way each person deals with the reality of suffering in life.

A matter of meaning

No one likes to suffer. After all, to suffer is to experience continual, undeserved pain of the body, mind, and spirit. To suffer is to feel pain that will not go away. Yet suffering, we must realize, is in the eye of the beholder. One person can be in pain without suffering, just as another can suffer without being in physical pain.

People who feel pain but do not suffer are unsurprised by pain. They recognize pain is a part of life, and a reminder they are alive.

Looking at their present situation, these individuals may not find meaning or purpose at the moment, but they expect to discover it someday. They understand they are human — vulnerable, finite, imperfect.

In contrast, people who suffer without physical pain believe they deserve a pain-free life. To their way of thinking, limitations should be managed, controlled, manipulated, and mastered. These individuals cannot easily find meaning or purpose in their present situation, because the pillars upon which they built their lives have been threatened or destroyed. They are in spiritual distress, hurting in the soul as well as the body.

Viktor Frankl, the noted Viennese psychiatrist and Holocaust survivor, coined this formula:

D=S-M, or despair (D) equals suffering (S) 'minus,' or without, meaning (M). Despair is the combination of pain with a sense of meaninglessness.

The other side of the coin is that having a sense of meaning in our lives can inure us to almost any pain. Frankl quotes Martin Heidegger, the existential philosopher, by noting that a person with a 'why' to live can deal with any 'how.'

Responses to pain

We all suffer, but to varying degrees. It's what we do with our pain that distinguishes people who age 'spiritedly' from those who do not.

Caring health and wellness professionals always consider how their patients respond to pain as individuals. Are they, as older adults, able to transcend pain and suffering to see the value and purpose in life? Do they realize they can find meaning in spite of pain, and sometimes even through that pain?

Unfortunately, health and wellness professionals sometimes cope with their patients' suffering by avoiding its complexities. That's because, in dealing with the suffering of others, professionals must often confront their own pain, vulnerability, and limitations. But professionals who have yet to come to terms with their pain may be closed or insensitive to their patients' pain and suffering.

Another way health and wellness professionals may deal with suffering is to try to fix it, as if they have the power to remedy another's suffering.

The truth is no one can fix another's pain. If Frankl is right and D does equal S-M, only the sufferer can work through his or her despair, because only he or she can judge this suffering to be meaningful, valuable, or worthy. Most sufferers do not seek 'answers.' They need companions who will listen to them and support them while they are suffering.

The gift of growth

My personal trainer once said the same words my high school track coach used to shout many years ago: "No pain, no gain." This cliché might be controversial in a senior wellness/fitness setting, but it turns out it is true in spiritual caregiving as well that growth comes whenever life is challenged.

Recommended Reading

• Albom, M. Tuesdays with Morrie. New York NY: Doubleday, 1997
• Byock, I. Dying Well: The Prospect of Growth at the End of Life. New York NY: Riverhead Books, 1997
• Eiesland, N. The Disabled God: Toward a Liberatory Theology of Disability. Nashville TN: Abingdon Press, 1994
• Frankl, V. Man's Search for Meaning. New York NY: Simon and Schuster, Inc., 1959
• Frankl, V. The Will to Meaning. New York NY: A Meridian Book, 1988
• Kurtz, E. and Ketcham, K. The Spirituality of Imperfection. New York NY: Bantam, 1992
• Lustbader, W. Counting on Kindness. New York NY: The Free Press, 1991

Labels: Feature Articles, For the Spirit, Koepke, Staff

You can’t find your keys. Or you open the refrigerator door but forget why. Or you can’t remember the name of someone you’ve met several times. Situations like these can create frustration and even fear in middle-aged adults. Could these be early signs of Alzheimer’s disease (AD)?

Relax and enjoy a sigh of relief, because episodes like these are common in middle age, and are most likely features of normal, age-related memory change. The key words here are “normal” and “age-related.” For many of us, these normal changes can begin around 35 years old.

How do we distinguish normal, age-related memory lapses from AD? There are several factors, including the severity and frequency of the forgetting; the extent to which forgetting interferes with your work or social life; and whether or not you are able to benefit from using a calendar, notes, or other mnemonic devices. It’s also important to understand that AD is much more than a memory disorder. It involves cognitive, behavioral, and even personality changes.

The Differences are Striking

To illustrate the difference between age-related memory changes and AD, consider the thought process and steps you might take when your keys are lost.

Most of us look in the places where we usually leave our keys. Then we check the purse we just used or the pockets of any jackets we recently wore. Then we would widen our search to include less likely places, such as the front door or car, and eventually other places where they might be.

The fact that you can remember the likely places requires memory and cognitive abilities that a person with AD usually cannot muster. A person with AD might find the keys by searching randomly, or might forget what he was looking for and abandon the search altogether.

Consider another scenario: it is common to get lost while driving to a location we have only been to occasionally. However, a driver with early stage AD might get lost even on frequently driven streets.

A routine of doing two errands together, such as going to the bank and then the supermarket, can be challenging. A person with AD who goes to a different branch of the bank, though still in the neighborhood, might not be able to find the way to the supermarket. The inability to recognize and implement the necessary adjustments to the routine is a cognitive deficit common in Alzheimer’s disease.

More examples of the contrast between the age-related memory changes and AD are included in the “Know the 10 Signs” section of the Alzheimer’s Association website: www.alz.org.

Memory Improvement — It's for Everyone

There are a number of tips we can all use to improve our memory, or to make forgetting less costly or time-consuming. Follow the adage: “A place for everything, and everything in its place.” Try to leave your keys in the same bowl, on the same hook, or in a specific pocket of your purse.

Write things down and frequently update your “to do” list. Maintain a detailed calendar with upcoming appointments, birthdays, and even events that recently occurred. Although this might sound obvious, if you jot down a phone number, make sure to write the person’s name next to it.

Set an alarm clock or timer to remind you when to leave for an appointment. It also helps to say out loud or to yourself things you want to remember, even something as simple as why you are going into a room.

Make Connections in Your Mind

This is especially helpful if you pair a word with a visual image. If you meet someone named Mike, try to picture a microphone. Annabelle? Envision a bell. To make it easier to remember the names of people you meet, repeat the name silently to yourself a few times, and then try to use it aloud with the person in your conversation. If you forget a name, try reciting the alphabet in your head since hearing the first letter will often jog your memory.

In general, to improve memory, focus your attention on one thing at a time. Listen closely when you’re in a conversation rather than focusing on the next point you want to make. Stay in the moment and avoid letting your mind wander.

If you become upset when you do forget something, first calm yourself with a few deep breaths. Give yourself a chance to remember. These techniques can help your memory and, in doing so, reduce anxiety you may have about signs of AD.

If you do have concerns about your memory or that of a loved one, regardless of age, please have an evaluation by a physician or psychologist with specialized training in this field.

Labels: Feature Articles, For the Mind, Rosett, Staff

We are all exposed to research findings in the media that present prevailing wisdom on health and dietary issues only to reverse itself six months later with the publication of a new finding.

Coffee, alcohol, wine, and chocolate have been hot topics over the past several years. But the most common confusion I encounter in the clinical setting results from misinformation patients and families receive regarding the amount of salt and water we should consume on a daily basis.

Most Americans understand that adding extra salt to food is not healthy for them, and that excess salt can contribute to high blood pressure and heart disease. Unfortunately most people do not understand that the normal American diet already contains an extremely high amount of sodium, as salt is measured in most prepared foods, averaging 4,000 mg per day. This is much higher than the American Heart Association guideline of 1,500 mg per day.

It is estimated that limiting sodium intake to recommended levels could save 150,000 lives each year by reducing complications from high blood pressure and heart disease.

Surprise — It's Not the Salt Shaker

Many patients feel they are not at risk for excess sodium if they don't add extra salt to their foods at the table. However, sodium added to foods from a salt shaker only accounts for 5% of the sodium consumed in the regular American diet. Ninety-five percent comes from processed foods themselves.

It comes as a surprise to most of my patients that many common foods contribute to high sodium intake. Most canned soups have nearly 1,000 mg of sodium in one serving, which is two-thirds of the daily limit in one meal. One small package of soy sauce also contains nearly 1,000 mg of sodium.

With such a high sodium content in everyday foods, many patients exceed their daily limit before lunchtime. Patients with the diagnosis of heart failure are often the most vulnerable to excess sodium intake, which commonly leads to excess water retention in the legs and lungs and is a common reason for heart failure admissions to the hospital.

By eating fewer processed foods, and adding more fresh fruits, vegetables, and whole grains to your diet, you can help keep your sodium intake well within the recommended guidelines.

Water — Large Quantities are Not for Everyone

Water consumption is another dilemma for patients. It is generally assumed true that drinking several large bottles of water a day may be good for a young, healthy person. But for patients with certain medical conditions, such as heart failure or kidney disease, large amounts of water can actually compromise their conditions.

Depending on the severity of their particular condition, physicians often limit patients daily water intake to one-two liters (two-four 500ml bottles) per day. The American Heart Association recommends less than two liters of fluids per day for patients with heart failure and patients with end stage kidney disease often are recommended to drink about one liter per day.

Well-informed about the benefits of hydration, patients are often surprised that they are drinking more fluids than the recommended amount and that drinking too much fluid can make them sicker.

It is always advisable to discuss your particular fluid and sodium restrictions with your physician because these two essential nutritional elements can have an enormous impact on your health.

Labels: Casillas, Feature Articles, For the Body, Staff

Every form of giving begins with personal involvement.

Like many people whose lives are forever touched when a vulnerable parent is lovingly cared for, the Heslovs, Lynne and Michael, came to regard the Home and its staff almost as an extension of their family.

It is a relationship they cherish to this day.

Several years ago, life took an unexpected turn for the Heslovs when Michael's father, Arthur, was diagnosed with Alzheimer's disease. His mother, Jerrie, went through several difficult years of caring for Arthur, but as he became more dependent and withdrawn, Michael and his brothers feared her health would give under the strain.

“We feared we could lose both our parents to the demands of the disease,” Michael says. “Then we learned about the Jewish Home's Goldenberg-Ziman Special Care Center for seniors with Alzheimer's and related dementias.”

As marvelous as the Home's acclaimed Goldenberg-Ziman Center is, the choice to move an ailing parent from their home is rarely as easy one.

“It is an agonizing decision,” says Lynne. “You have guilt. But when we brought Arthur to the Home, we knew he was in such good hands. It made the decision easier.”

“The quality of care at the Jewish Home was far better than it would have been at home, under the best of circumstances,” adds Michael, who was introduced to the Home by former Board of Directors Chair Dave Swartz. “They were so much better equipped to deal with his needs.”

The Home provided all the medical and physical care Arthur required, freeing the entire Heslov family to provide love and support he needed and deserved.

“We told my father he was going to a place for a few days for some testing,” Michael recalls. “Though we told him his stay would be temporary, my father was so expertly cared for and engaged that he never expressed a desire to return home!”

In her daily visits, Michael's mother, Jerrie, noted how carefully groomed Arthur was, his clothing always freshly pressed. The Home's staff members were as loving and involved in his concerns as if they'd been members of his own family.

Lynne recalls that the staff took Arthur out to the garden, which he always loved, and to music and art presentations. “Things like this gave us all such peace of mind,” she says.

After two years at the Home, Arthur passed away. In appreciation for the care he received, Jerrie took on the responsibility of co-chairing the Home's gala Reflections dinners in 2007 and 2008.

Michael, who is a co-partner in the real estate development company of Soboroff Partners, has contributed his expertise to the successful effort to establish the Home's new Gonda Healthy Aging Westside Campus.

As chair of the Board's Budget and Finance Committee, Michael understands the Home's financial challenges and the need for creative solutions. “Some 75-80% of the Home's residents are subsidized by the generosity of the community,” he says.

After serving for two years, Michael was elected to the two-year position as Chair of the Home's Board. At 39, he is one of the youngest executives ever to hold this position.

Michael points out that the exceptional level of care and attention our seniors receive is due in large measure to the contributions of the community.

“It is an honor,” he says, “to commit my time and energies to an organization that is doing so much to improve life for our most vulnerable seniors and their families. Both Lynne and I are passionate about the Home's care for our elderly, at every stage of need.”

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: Alzheimer's, Board of Directors, Feature Articles, Heffler, Heslov, Why We Give

In the Jewish tradition, life-cycle rituals such as becoming Bar or Bat Mitzvah serve as turnstiles, ushering us from youth to adulthood. It may also happen that ritual thrust us forward into the next stage of life, whether we are fully prepared or not.

There is, however, no specific time that ritual identifies to mark the passage from adult middle age into our elder years. Nor do we wake up one morning and say with certainty, “Today is the day I shall become old.” Instead, we recognize in gradual stages the process by which we come into our own as fully mature human beings.

For many of us, this time of life may be accompanied with physical or cognitive changes and challenges. Setbacks to the body can come at any time or age through accident or illness, whereas the full flowering of our awareness — our awakening to wisdom — is earned through years and years of experience and is never attained before its time.

The challenges of aging are not to be underestimated. The smoothly-running, well-trusted body that has been our companion faces an inevitable decline. It is not surprising that age-related depression is frequent among the elderly — we are not wrong to mourn our losses.

But what is truly the primary function of that beloved body? According to Jewish tradition, it is the vessel in which the soul dwells. The soul, or essence, of a human being is eternal. It lives on after the body's demise, not only in the memories and deeds of those it has left behind on the earthly plane, but in the great infinity that is its Creator.

Judaism teaches that ever since G-d breathed life into Adam, the original human being, it has taken three entities to create every person — the father, the mother, and G-d himself.

The divine spark that is the innermost essence of the human being's soul at birth cannot be extinguished by the years we record in this life. I suggest, rather, that our souls advance through the decades of life in a direction counter to the “age-related” decline of the human body.

Indeed, the eternal soul present at our births grows brighter as the years pass, gathering spiritual experience with every breath allotted to us in the course of our days.

If the soul ultimately returns to G-d, does it not make wonderful sense that its divine spark would be enlightened through worldly experience when it comes to dwell in its eternal home?

I sometimes picture our years of earthly life as a time in which the soul grows in brilliance until the physical self can no longer contain its radiance and it returns at last to the sheltering arms of the Divine Parent.

From this perspective, if we approach eldering as a time not of age-related physical decline but of age-related spiritual abundance we can find comfort, strength, and hope to assuage the assault of worldly years on the body.

With a creative outlook on the soul's advance through life, we shift our point of view from a focus on the body's decline to one of embracing the realization that we are all fueled by the ever-evolving power of the soul.

When we do so, we can all claim our elder years as a rich harvest and a comfort, partake of the bounty of the maturing spirit, and delight in the fruits that ripen for us even as our physical existence is challenged.

For, in the end, we all become pure spirit, sheltered under the wings of a wise and compassionate Creator, at rest in our true and everlasting home. And we, along with those whose lives we have touched, will be wiser for the journey.

Rabbi Rita Hertzberg leads synagogue services and provides spiritual guidance and pastoral care and counseling for the resident community of the Jewish Homes Eisenberg Village Campus. Among her well-attended spiritual education and outreach programs are her weekly Judaism class and the popular “Get Together with Rabbi Rita.”

Labels: Aging, Feature Articles, For the Spirit, Hertzberg, Judaism

I was about to board my flight back to Los Angeles and turn off my cell phone — I was being thrifty with the battery since I had forgotten where I left my travel charger — when a journalist called urgently asking for a comment on Paul McCartney's recent admission that he was having trouble remembering the lyrics to some of his old songs. I envisioned him singing “She loves you — hey, hey, hey …”

“So you're trying to get me to go on record that Paul McCartney is getting Alzheimer's? I won't do that,” I said in anticipation of where the interview was going.

I flashed back to 1993 when Ronald Reagan announced that he was suffering from this devastating illness, which robs the mental life from millions of Americans. Back then, reporters kept asking me to speculate about whether Reagan might have been slipping mentally while serving as our commander in chief.

For our former president, his senior moments may have been early warning signs of further cognitive decline. In fact, an analysis of his progressive extemporaneous speech errors during debates over the years pointed to such subtle progressive deficits.

But for the average aging Baby Boomer like Sir Paul, middle-aged pauses and senior moments do not necessarily mean that rapid mental decline is inevitable. The risk for Alzheimer's disease is only about 10 percent for people age 65 or older. Misplacing keys or struggling to find a word is what we all joke about as we age.

Sure, our memory abilities are not quite what they were when we were in our twenties, but age-associated memory impairment is an expected and quite common experience of aging. Approximately 85 percent of people 65 years or older complain that they often recognize a face but can't recall the name that goes with it.

How can we tell if this normal memory loss will progress?

It's not easy, even for doctors. We often look for risk factors: age, family history, or other illnesses like diabetes or Parkinson's that predispose someone to neurodegeneration. If your memory challenges symptoms begin to interfere with your everyday life, if others start commenting on them, or if you find yourself worrying about them, it may be time to discuss it with your doctor.

Because of the general fear and denial about Alzheimer's disease, many people ignore early symptoms. That's not always a great idea, since the earlier you get help, the better your chances of staving off future symptoms. Clearly, it's easier to protect a healthy brain than to try to repair one once damage has set in. We don't yet have a miracle cure for Alzheimer's disease, but there are treatments that improve symptoms and keep people functioning better, longer. In general, earlier intervention translates to better outcomes.

The emotional impact of the illness is huge. We may joke about our memory lapses, but behind the humor is anxiety and fear. I have spent a good part of my career studying and caring for patients and families who have had to cope with this tragic mental struggle. And although I'm an expert, I initially refused to accept the fact that the illness was causing subtle personality changes in a close friend and mentor. I looked for almost anything else that could explain his symptoms — a possible medical condition, a depression, or maybe a drug side effect — but I eventually had to face the fact that his mind was drifting away and I couldn't stop it.

When Sir Paul McCartney was 16, he wrote “When I'm Sixty-Four.” Now that he's 67, I'm not too worried that he may not remember a few of his old lyrics – chances are that his senior moments won't progress too quickly over the years. I, on the other hand, wish I could remember where I left my cell phone charger.

Originally posted on Huffington Post. Copyright Gary Small, M.D.

Dr. Gary Small is a professor of psychiatry and director of the UCLA Center on Aging at the Semel Institute for Neuroscience & Human Behavior. His research, supported by the National Institute of Health, has made headlines in the Wall Street Journal, New York Times, and USA Today. Scientific American magazine named him one of the world's leading innovators in science and technology. Dr. Small lectures throughout the world and frequently appears on The Today Show, Good Morning America, PBS, and CNN. He has written five books, including The New York Times best seller, The Memory Bible.

Labels: Aging, Alzheimer's, Feature Articles, For the Mind, Memory, Small

According to legend, Traditional Chinese Medicine (TCM) was invented 4,500 years ago by Huangdi, known as the Yellow Emperor, in collaboration with his physician.

To better understand this type of medicine, which is increasingly popular with Westerners, I visited China a decade ago.

On my trip, a TCM practitioner took me on a tour of one of the country's hospitals. In contrast to the smell of disinfectant encountered in American hospitals, wonderful aromas greet you when you enter a TCM hospital. Similarly, while the pharmacy occupies a small part of the first floor of many hospitals in the U.S., the pharmacy is the first floor of a TCM hospital. Shelf after shelf in the pharmacy hold the ingredients of Traditional Chinese remedies: herbs, animal parts, and chemicals.

Ingredients New to Westerners

Seahorses are considered a key ingredient in treatments for a number of conditions, ranging from impotence to heart disease. Rhinoceroses have been hunted to near extinction in order to acquire their prized horns, which are then ground into a powder, and used for a variety of ailments. Shark fins cooked in soup are thought to cure cancers. Tiger bones were used to treat arthritis until tigers were on the verge of extinction, so the Chinese government banned their use in 1993. Popular herbal ingredients include gingko biloba and ginseng.

During my tour of the hospital, I entered a patient's room and watched a Chinese practitioner as he sat on the bed next to the patient and administered a concoction of TCM ingredients. While Western medicine often treats patients with a single pill for a specific ailment, Traditional Chinese treatments consist of a tea with 10 to 20 separate ingredients.

I was very impressed by the “hands on” approach and the obvious caring relationship between the patient and the physician. But I was very surprised to see an intravenous pole at the other end of the bed with the modern antibiotic Amoxicillin being infused into the patient. I asked the doctor about this apparent incongruity.

“Here in China, we use the best of the West and the best of the East,” he said. I learned that treatments for serious medical conditions like cancer and heart disease are very similar to those used in the United States. However, for day to day preventive care, the Chinese take a different approach.

Examining Chi, Yin, and Yang

When a TCM practitioner is examining a patient, he will look at the hands, tongue, eyes, and skin of a person. In this way, he is looking at the patient's chi, or vital force. Chinese doctors are concerned about the flow of chi, and look for signs that it may be interrupted.

They also examine the balance of opposing forces in the body, the yin and yang. Yin is thought to be wet, slow, soft, and tranquil, and often described as a feminine force. By contrast, yang is hot, hard, dry, and aggressive, traditionally masculine attributes. In examining the balance of these forces, Chinese doctors may conclude that the patient's chi is not flowing properly. Over four millennia, they have come up with many ways to correct such imbalances.

Acupuncture and Acupressure

One TCM treatment is acupuncture. The Chinese believe that chi flows along meridians in the body, and that placement of acupuncture needles at specific points along these meridians can help restore the flow of chi, bringing yin and yang into proper balance. A few years ago, the National Institutes of health convened a consensus conference on acupuncture. It found support among American physicians for using acupuncture to treat specific conditions such as headaches and arthritic pain. Today, the practice is used with varying degrees of success. Fortunately, there is very little risk from having acupuncture as long as the needles are sterilized or disposable.

In addition to acupuncture, a TCM practitioner can use acupressure, which is pressure placed at specific points along the same meridians that are used in acupuncture. Other treatments include cupping, where a heated cup is placed over the skin; moxibustions, the burning of herbs close to acupuncture meridians; massage; and qigong, a combination of breathing and meditation exercises.

So, do I recommend that you try Traditional Chinese Medicine? For serious medical conditions, I would seek a physician trained in the latest Western medical practices. I believe that the main danger of seeking out TCM is that a patient might postpone receiving proven modern treatments for treatable conditions. But for those who want to see how their chi is doing, or whether their yin and yang are in balance, there is very little danger in trying Traditional Chinese Medicine.

Dr. Edward L. Schneider headed the largest private center for research and education on aging, the Andrus Gerontology Center of the University of Southern California from 1986 to 2004. He is now 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 14 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: Chinese Medicine, Feature Articles, For the Body, Schneider, Traditional Medicine

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