Silver Inning Foundation’s Journey- A Cascade of Unconventional Approaches

MUMBAI , INDIA / SOCIAL MEDIA / MAY 22nd 2013

Case Study: Silver Inning Foundation’s Journey- A Cascade of Unconventional Approaches : by : Anjali Saigal ,NMIMS University Part Time MBA(Social Entrepreneurship) , Under Guidance of Dr Manjari Srivastava

Case Synopsis

A major challenge that India is facing  is the progressive ageing of the population, including the risk of a growing gap between the generations. Especially as fast developing new technologies increase the distance between the younger and the older generations. Silver Innings Foundation (SIF) was formed to address the micro and macro level issues of the elderly to create an elder friendly world. It had decided to proactively use Information and Communications Technology (ICT), Social media and networking to sensitize the community and society towards the cause of Elderly and promote intergenrational programmes and empower elders in their own community / locality. It has attempted to bring young people and seniors together and tackling the “digital divide” Other inclusive activity like Foot D Ball to Stop Elder Abuse, youth tying purple band to senior citizen etc were successfully implemented. In June 2011 it became a part of The joint action committee (JAC) consisting of 23 organizations which work for the welfare of senior citizens in Maharashtra/Mumbai and decided to go on state-wide agitation from June 2011 against the non-implementation of 1999 National Policy of Older Person, (NPOP).

Additionally SIF  provided a  wide range of innovative, good quality services for elderly based on their changing needs. It wants to have an age integrated society and promote intergenerational activities to ensure social cohesion. 

The Study 

Sailesh Mishra was reflecting on his journey  as a  founder president  of Silver Innings Foundation (SIF)  while waiting for his flight to UN headquarters in New York where he was invited to participate in Third Session of the prestigious ‘Open-ended Working Group on Ageing(OEWG). An idea germinated by him took shape in 2008 with help of four individuals, Hendi Lingiah, (France), Prof Parul Kibliwala (India, SNDT Women’s University), Swati Ingole (MSW, Mumbai, India) detailed background in Appendix 1 in form of Silver Innings Foundation to address the micro and macro level issues of the elderly to create an elder friendly world. Sailesh left his corporate job for his passion to work with Senior Citizens, which he believed was the most neglected and ignored segment.  He wanted the government, the public at large to give the elderly their rights and to take responsibility for their development.  He wanted them to take efforts to integrate older people in their daily activities and not isolate them.  The turning point in his life was the death of an resident staying in Dignity Lifestyle Township for the elderly and for who suffered from dementia. The son of the deceased man living in Canada when informed about his father’s death, coldly asked them to cremate the body. That is when Mr. Mishra realized that there was a need to sensitize elders and their family members about ageing.  It was evident to him that the Indian society was changing rapidly. The value systems and family structure once India was proud of have seen a sea change. Nuclear family had been on the rise and sometimes even the aged parents were left to fend for themselves. Senior citizens homes or old age homes/communities were no longer alien concepts in India. It was a solution sought by most from the so called modern and educated generation. A majority of the old age homes or day care centres did not cater to the senior population suffering from Alzheimer’s and dementia. There were only a handful like Helpage India , Dignity Foundation.  Mr. Mishra initially set up a website with a couple of friends, to sensitize people about the issues relating to ageing and elders concentrating on Alzheimer’s and Dementia. 

He wanted to move away from “push” (one-way) communications and to move towards a type of communication in which the seniors and youth can interact with, listen to and engage constituents. The decision was taken to proactively use Information and Communications Technology (ICT), social media and networking to facilitate in the sensitization of the community and society towards the cause of elderly and promote intergenerational programmes and empower elders in their own community / locality.

Silver Innings Foundation (SIF) was established with a vision is of creating an elder friendly world in which ageing becomes a positive, rewarding experience. Its mission was to uphold and secure the rights of elderly and actively work towards improving their quality of life by networking, advocating and researching elderly issues and providing a wide range of services according to their needs. Its objectives listed as the 10 commandments was to mainly to work with elderly and to provide wide range of innovative, good quality services for elderly based on their changing needs and to utilize their experience, knowledge and skills for the betterment of themselves and society.  

 The organization was registered as a trust in 2008 with five trustees and five office bearers. The office bearers including the founder president Mr Sailesh Mishra was involved in day to day working of the organization. There were only two paid staff and 85% of the work was done by Mr Mishra, Bhavesh Chheda handled the creativity and technological aspect and the Mr .Chittranjan contributed to only 5% by assisting in networking and linkages.  Volunteers and consultants were recruited programwise as per the requirement.

SIF was started with seed funding from Unltd India in 2008 and until they got tax exemption certificate, the fund requirement till date is mostly met by personal savings and small donations from friends, relatives and well wishers. Accumulating financial resources to set up this foundation or to scale up had been a challenge since day of inception as evident from their account statements in Appendix 3. Alternative and cheaper ways like social media were essential in promoting the cause and sensitizing the people.

Social Media and SIF

The “New Web” has been incremental in transforming the way people interact and even the way they think. It has started to occupy a vital portion of many organizational and business strategies at all levels. The need for utilizing these technologies for non profits is becoming more evident.

Social media platforms have the ability to help NGOs by providing various strategic tools for engagement as follows.

• It has been imperative in building relationships with stakeholders and communities and also networking and fundraising.
• It has been facilitating campaigning to a large and sometimes even specific group allowing for more reach at a cheaper cost.
• With the huge and steady increase in the numbers of social media users worldwide and across various platforms (pcs, Mobile phones etc.), social media has become an opportunity for non profits to share their messages with the masses using free tools available to support the vision and objectives of such organizations.
• Social media has attempted to bridge the ever-increasing divide between the youth and the elderly.

The computer and the Internet are not usually associated with senior citizens, but SIF  decided to use the Internet to highlight the plight of the elderly in the city. The first thing they did in 2008 was float a virtual space online and launched a one-stop information portal www.silverinnings.com which served as a single-point destination for senior citizens. They put up information on helplines, old age homes, and police station numbers. Additionally they also began addressing issues like ageism, Alzheimer’s, dementia care management and memory loss, which had been affecting a number of senior citizens included information on how to make a will too.

The foundation’s creative head, Bhavesh Chheda analyzed the internet usage patterns among senior citizens across the country decided to set up an exclusive blog space where senior citizens could

• Discuss important issues and the problems they were facing.
• Senior citizens would be able to interact with each other and share their problems and also combat one of the key issues of loneliness.
• It provided space for the youth to interact with their elders

SIF and Its Unconventional Approaches

Sailesh Mishra’s main intention with SIF was to network with likeminded organization and not to work in isolation but in partnership with other service oriented organization. 

In a first-of-its-kind initiative they conducted training for senior citizens in partnership with Sterlite Foundation in three centres in Mumbai to familiarize them with computers and technological advances that go with it. They provided training in regional languages to make the senior citizens understand better. It served dual purpose as the knowledge and teaching classes would keep them occupied and it would also yield opportunities for retired senior citizens to have a second career. They strongly believed that technology could bridge the gap and create synergy between the youth and the senior citizen bringing them on a common platform.  

To create awareness it used ‘Silver Inning Newspaper’ which was created in ‘Paper.li'  that automatically creates an online Daily Newspaper about topics related to senior citizen Alzheimer , Dementia. Subscribers would receive their online newspaper each day filled with top stories around the same content topic. It’s a great way for you to automatically aggregate online content relevant to your topic and push it out to your online community. Till date they have had 88 subscribers belonging to different age groups.

SIF became a referral NGO 24 x 7 Senior Citizen’s Referral Helpline that was started by The Nargis Dutt Memorial Charitable Trust along with Dial ‘1298’ for Ambulance in association with Help Age India, Harmony for Silvers Foundation & The Federation Of Senior Citizens' Organizations Of Maharashtra (FESCOM) in 2010. It was set up with the aim to be a one-stop destination for information for the elderly and their family members and has been receiving more than 100 calls daily since. The calls relate to information regarding the elder care by families but more relate to senior citizens who have been harassed by their family members/ friends. Many cases are specifically related to legal and property maintenance.

In 2011 pilot project “Foot D Ball to Stop Elder Abuse” along with Team Alfresco FC –Mumbai.  This event used a holistic approach to promote ‘Sports for Development’ through Football. SIF believed that fusion and synergy between youth & elders will help them to achieve their vision of creating elder friendly world where ageing becomes a positive and rewarding experience.

This intergeneration activity with sports for development concept through football was tried for first ever time in this part of the world for promoting Elder Cause and to create awareness about Elder Abuse in civil society. Football has been one of the most patronized sports around the world. Organizations driven by local social entrepreneurs, use the power of the beautiful game to positively transform their communities. Development through football has been an important issue within the development cooperation and social work sectors. SIF recognized the potential that football and other sports could unleash when systematically included in processes of social change. Football especially has the power to unite people and cultures all over the world. As a team sport it promotes fairness and tolerance, leapfrogs gender boundaries and fosters mutual understanding, thereby contributing to the positive development of personality and character.

It also introduced Purple Security Band inscribed with the words stop elder abuse during the match . It involved the youth tying these purple bands to the elders. The rationale behind this was to create awareness amongst the youth and opening channels of communication between the youth and the senior citizens.

 

SIF and  Advocacy

Elder Abuse as explained by SIF occurs with the family. It can be in any form most prominent being the children and grandchildren disrespecting the elders, back answering them, intentionally disturbing them , play television music systems etc very loudly . Government is also doing a lot through its Legislative & Executive Machinery for Senior Citizens by laying down an extra ordinary National Policy on Older Persons 1999 and the Maintenance & Welfare of Parents & Senior Citizens Bill, 2007 etc but Government Abuse of Senior Citizens is lethargy in their implementation. Judiciary, although empowered and instructed to expedite cases of Senior Citizens, little progress is achieved (Ruparelia, n.d.).

On 15 June 2008 SIF launched an Online Petition to address the issue of Elder Abuse and this  was one of the effective medium to create awareness and petition the Central and State Government and the Society at large with the problem and recommendation.

The petition broadly classified elder abuse in different categories and it laid emphasis that the problem of elder abuse has to be dealt with on both ‘micro’ and ‘macro’ levels. Also, a multi-pronged approach which was required from different professionals who have an adequate understanding of the phenomenon of elder abuse, the dynamics of ageing, abuse within and outside the family, cultural and societal influences, of appropriate helping strategies to implement this knowledge and listed down  recommendations .

In response to the injustice and neglect of senior citizen, 16th August 2010 was observed as a National Protest Day.  It supported a  demand a separate Ministry and Elder Right protection Law for 90 million Elderly in India. It requested the government to view of active NGO and stake holders before finalizing the new National Policy for Older Persons (NPOP) of 1999. In June 2011 it became a part of The joint action committee (JAC) consisting of 23 organizations which work for the welfare of senior citizens in Maharashtra/Mumbai and decided to go on state-wide agitation from June 2011 against the non-implementation of 1999 National Policy of Older Person, (NPOP). The joint action committee demanded declaration of State Policy for Senior Citizens, which the committee has claimed is lying unimplemented since 2002. It also insisted on formation of State Council of Senior Citizens and Commission, under the Chairmanship of the Minister of Social Justice for effective promotion and coordination of the concerns of senior citizens and establishment of multi-service day care centres, so that they can be utilized in social activities and for improvement in physical and mental health of the elderly. Activists have claimed that has been no support or funds from the government, agencies, or corporate sector for the elderly, in the state that has around one crore senior citizens (60 +), out of which 66 per cent are poor, while 90 per cent lack social or health security. They further asserted that in the 2011-12 state budget the government has conveniently ignored the implementation of those policies which it had deemed as vital for the welfare of the elderly (Mishra, 2010).

As a result of nationwide activity, there has been some semblance of positive action from the Central Government such as concessions in Income Tax structure, Railway fares, quantum of Old Age Pension, eligibility criteria for concessions etc. There are also numerous glaring disparities in payment of pensions to retirees from different sectors, causing severe hardship in some cases. These need to be highlighted and their redressal sought. 

The UN Open-ended Working Group on Ageing (OEWG) was established by the General Assembly in 2010. SIF got accredited to the same in 2011 with the purpose of strengthening the protection of the human rights of older persons in India . SIF was represented by Sailesh Mishra  at Third Session held in 2012. On the opening day, the Indian ambassador gave a rosy picture of the current scenario of health care for the elderly in India. He even had the nerve to say, “Why do the elderly need rights? Their development is the responsibility of the society and their families. What can the government do?

He was asked to make an opening statement on the floor of the house the next day and was amongst the six that made oral presentation that day. He emphasized on major five gaps that need immediate attention (Appendix 6) through National and International Instrument (Mishra, Official Statement of Silver Inning Foundation, 2012. He Observed that of the member states, Costa Rica and Argentina were the most passionate about promoting the cause of gerontology. These two would even hold a briefing for NGOs every morning. But the EU and the USA were extremely against the state having a stake in elders care, because they do not want to spend on it. An interesting dimension to this issue, he noted was that the Western countries, while reducing budgets assigned to social welfare, are aggressively studying the family concepts prevalent in south Asian countries, where parents and their children live together all their lives. But by contrast, we in India are going towards the Western concept of nuclear families and even smaller units. Where does that leave our elders?

But what he took away from his UN outing was the inspiration he felt after meeting people who had been working for the cause of elder care for decades which also motivated him to believe that he was on the right track and he still has a lot to learn.

SIF and Others.

SIF strongly believes in collaborating and networking to provide a better platform. Of all the players working in this space only Dignity foundation is working in isolation and catering to a niche group. Rest all like ARDSI (Alzheimer’s Society India) , Helpage , Harmony , FWA (The Family Welfare Agency) etc support each other immensely by sharing resources and knowledge. SIF also networks and has build relations with other NGO’s not related to senior ctizens like Mobile Creche , magic bus.

What’s Next

A child never writes to a grandparent maybe only school compositions directed to the teacher's eyes only. SIF used strategy for getting kids and senior citizen to talk to each other on paper to promote cross-generational written communication.  

Additionally it wants to create opportunities for intergenerational interaction and accelerate its efforts and include innovative strategies that synergize and move in concerted direction towards an age-integrated society where intergenerational interaction is natural across the domains of family, community and the workplace. 

Overcoming scarcity of financial resources needs to be addressed for reaching this goal. How can it grow its reach and cater to other social groups ? It has started experimenting with  entrepreneurial activities which include consultancy for  senior citizen residences , day care centres, providing training on soft skills to develop paramedical staff to take care of the elderly and latest being matrimonial services for the 50+ .

Generating funds by developing entrepreneur activities appears to be the most feasible solution. Though it will reduce dependence on donations and grants and make SIF financially sustainable but is it appropriate to generate funds from already neglected section of the society ?

Acknowledgment

I acknowledge with gratitude the guidance by Dr. Manjari Srivastava  in preparing this case study. But for her timely and prompt inputs this would have been a seemingly arduous task to accomplish.

I take this opportunity to profusely thank Mr Sailesh Mishra for his valuable time, inputs and constant help and support in my effort all along.

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Credit: Reports and photographs are property of owners of intellectual rights.
Seniors World Chronicle, a not-for-profit, serves to chronicle and widen their reach.

Senior Citizens to Impact 250 Loksabha Seats in coming Election

MUMBAI , INDIA / POLITICS / APRIL 15th , 2013 

By Sailesh Mishra

Indian Politics ‘Newest’ Vote Bank: Senior Citizens to Impact on 250 Loksabha Seats in coming Election

Taking a cue from recent study “Social Media & Lok Sabha Elections”, by IRIS Knowledge Foundation and supported by the Internet and Mobile Association of India (IAMAI), on how Facebook and other social media will impact 160 seats in coming Election, what immediately came to my mind was Elder Population impact on Indian Democracy. I have been trying to market this idea since launch of Silver Innings in April 2008. 

As on 2012 Senior Citizens Population in India is 100 million (10 crore) that comes to roughly 10% of Total Population.  But when we take into account the Total Voting Population i.e. 18+ age group, then Senior Citizens becomes roughly 26% of Voting Population, here I have not taken into account Senior’s influence on Family voting. 

Indian Parliament has 543 constituencies / seats and this 26% strong Vote Bank of Senior Citizens will surely impact more then 250 constituencies. This ‘new’ Senior Citizens Vote bank always existed but no one including elders ever realised their strength . This time 2013/14 Parliamentary and State Election will be change in new thought process towards our elders , they deserved to be respected and cared for as our great tradition need to travel in this new speed changing society . 

I would be happy if any research agency or students take up this interesting subject of ‘Senior Citizens Voting Impact on Indian Politics‘. 

In recent times, since last 3 years there has been contestant activity by most of the political parties to woo Senior Citizens by organising onetime events, trips, goodies etc , but they have failed to make a concrete Long Term Policy & Programme for doubling Ageing population . Government , Politicians and Political parties are Ageing but they don’t bother about Ageing population , which many demographer describe as ‘ Silver Tsunami ‘ , which will have huge economic and social impact on India’s growth . Not to forget the same story will repeat in most of the developing countries. 

Due to advocacy and awareness campaign like ‘ 16^th August National Protest Day’  by organization’s like AISCCON, Silver Inning Foundation and a united front called Join Action Committee (JAC) since 16^th August 2010 , of more than 32 All India organisation’s working for and with Senior Citizens and newly formed  Pension Parisad ; there has been marked improvement in channelizing & mobilising Senior Citizens as united group demanding basic rights from central and state governments . Senior Citizens pan India, has been slowly realizing their strength and can’t be fooled any more by this goodies of politicians.

Social Media including Facebook and Twitter, has added new type of activism and in fact renewed the whole advocacy movement, Silver Innings a pioneer in social media usage for ageing and many youth and elders have taken this technology route for outreach and mobilising elders and their family.

Iam happy that , Elders like always will give shape to our Future , whatever they demand today will be for betterment of more then 85% of total population. This strengthen my firm view that ‘Our Elders Are Change maker’s ‘, the change we all want to see.

About Author: 

Sailesh Mishra is Founder President of 'Silver Innings' a socail enterprise and Silver Inning Foundation, a NGO working with Senior Citizens and has more then 6 years hard core activist experience in Ageing domain . His unique PR and ICT tool usage for Ageing has made him Internationally known Gerontology Consultant.  He may be contacted at silverinnings@gmail.com

 

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Credit: Reports and photographs are property of owners of intellectual rights.
Seniors World Chronicle, a not-for-profit, serves to chronicle and widen their reach.

SWEDEN: Several elderly show well preserved memory functions, say researchers

UMEA, Sweden  /  Umea University  /  Integrative  Medical  Biology  /  April  27,  2012

Maintain your brain:  The secrets to aging success

Aging may seem unavoidable, but that's not necessarily so when it comes to the brain. So say researchers in the April 27 issue of the Cell Press journal Trends in Cognitive Sciences explaining that it is what you do in old age that matters more when it comes to maintaining a youthful brain not what you did earlier in life.

"Although some memory functions do tend to decline as we get older, several elderly show well preserved functioning and this is related to a well-preserved, youth-like brain," says Lars Nyberg of Umeå University in Sweden.

Education won't save your brain -- PhDs are as likely as high-school dropouts to experience memory loss with old age, the researchers say. Don't count on your job either. Those with a complex or demanding career may enjoy a limited advantage, but those benefits quickly dwindle after retirement.

Engagement is the secret to success. Those who are socially, mentally and physically stimulated reliably show better cognitive performance with a brain that appears younger than its years.

"There is quite solid evidence that staying physically and mentally active is a way towards brain maintenance," Nyberg says.

The researchers say this new take on successful aging represents an important shift in focus for the field. Much attention in the past has gone instead to understanding ways in which the brain copes with or compensates for cognitive decline in aging. The research team now argues for the importance of avoiding those age-related brain changes in the first place. Genes play some role, but life choices and other environmental factors, especially in old age, are critical.

Elderly people generally do have more trouble remembering meetings or names, Nyberg says. But those memory losses often happen later than many often think, after the age of 60. Older people also continue to accumulate knowledge and to use what they know effectively, often to very old ages.

"Taken together, a wide range of findings provides converging evidence for marked heterogeneity in brain aging," the scientists write. "Critically, some older adults show little or no brain changes relative to younger adults, along with intact cognitive performance, which supports the notion of brain maintenance. In other words, maintaining a youthful brain, rather than responding to and compensating for changes, may be the key to successful memory aging."

More information: Nyberg et al.: "Memory aging and brain maintenance."http://dx.doi.org/ … .2012.04.005 

© Medical Xpress 2011-2012 


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Credit: Reports and photographs are property of owners of intellectual rights. 
Seniors World Chronicle, a not-for-profit, serves to chronicle and widen their reach.

USA: Too Many Pills for Aging Patients

NEW YORK, NY / The New York Times / Personal Health / April 19, 2012

By Jane E. Brody

Yvetta Fedorova

My 92-year-old aunt was a walking pharmacy, and a month ago it nearly killed her. The episode also cost the American medical system several hundred thousand dollars.

Overmedication of the elderly is an all too common problem, a public health crisis that compromises the well-being of growing numbers of older adults. Many take fistfuls of prescription and over-the-counter medications on a regular basis, risking serious and sometimes fatal side effects and drug interactions.

A series of research-based guidelines, recently updated and published in The Journal of the American Geriatrics Society, calls attention to specific medications most likely to have calamitous effects in the elderly. If adopted by practicing physicians and their patients, the guidelines should help to avert the kind of costly, debilitating disaster that befell my aunt.

A Crisis Among the Elderly

In early March, my aunt was hospitalized for an episode of extreme weakness, sleepiness and confusion. She was found to be taking a number of medications and supplements: Synthroid, for low thyroid hormone; Tenormin and Benicar, for high blood pressure; Lexapro, for depression; Namenda, for symptoms of Alzheimer’s disease; Xanax, for nighttime anxiety attacks; Travatan eye drops, for glaucoma; a multivitamin; vitamin C; calcium with vitamin D; low-dose aspirin; a lutein supplement; and Colace, a stool softener.

Diagnosis at the hospital: low sodium, prompting a stoppage of Lexapro, known to cause such a side effect, and substitution of the antidepressant Viibryd. Noting her confusion, the hospital neurologist also added Aricept, another treatment for Alzheimer’s disease, although she is only suspected of having this condition.

Her cardiologist doubled the dose of Tenormin, stopped the Benicar and added another blood pressure medication, Apresoline. This caused a precipitous drop in blood pressure to 70/40 (120/80 is normal), leaving her completely disoriented and unable to stand or sit up.

After 10 days in the hospital, as she was being discharged, my aunt collapsed and started turning blue. CPR was administered (which fractured three ribs), followed by resuscitation in the emergency room and then transfer to intensive care, where she suffered three seizures. She was put on Dilantin to control them.

She developed double pneumonia, and the end seemed near. A do-not-resuscitate order was issued. One night, when she was too agitated to fall sleep, she was given a dose of Ativan, a sedative, that left her unable to wake up for 30 hours.

Miraculously, she responded to antibiotics and administration of oxygen, and she has since been discharged to a rehabilitation facility where she is steadily getting stronger, less confused and refreshingly feisty.

Older adults like my aunt are the largest consumers of medications. More than 40 percent of people over age 65 take five or more medications, and each year about one-third of them experience a serious adverse effect, like a bone-breaking fall, disorientation, inability to urinate, even heart failure.

With the support of the geriatrics society, an interdisciplinary panel of 11 experts in geriatric care and pharmacology has updated the so-called Beers Criteria, guidelines long used to minimize such drug-related disasters in the elderly. After reviewing more than 2,000 high-quality research studies of drugs prescribed for older adults, the team highlighted 53 potentially inappropriate medications or classes of medication and placed them in one of three categories: drugs to avoid in general in the elderly; drugs to avoid in older people with certain diseases and syndromes; and drugs to use with caution in the elderly if there are no acceptable alternatives.

For example, instead of a sedative hypnotic — like the Ativan given to my aunt — that can cause extreme sedation, serious confusion and mental decline in older adults, the panel notes that an alternative sleep remedy, perhaps an herbal or nondrug option, is safer. Many sedating antihistamines, in a class of drugs called anticholinergics, should be avoided in older adults because they can cause such side effects as confusion, drowsiness, blurred vision, difficulty urinating, dry mouth andconstipation, the panel concluded.

Mineral oil taken by mouth can, if accidentally inhaled, cause aspiration pneumonia, and many commonly used anti-inflammatory medications, including over-the-counter drugs like ibuprofen and naproxen, increase the risk of gastrointestinal bleeding in adults age 75 and older, as well as in those age 65 and older who also take medications like prednisone and warfarin.

In adults over age 80, the team warned, aspirin taken to prevent heart attacks “may do more harm than good,” and any antidepressant may lower sodium in the blood to dangerous levels, as happened to my aunt.

The team said its criteria should be used by physicians and patients within and outside of institutional settings. But the experts also emphasized that the guidelines should not override a doctor’s clinical judgment or a patient’s needs and values, nor be used as grounds for malpractice disputes.

The Patient’s Responsibility

The geriatric society’s Foundation for Health in Aging has produced a one-page “drug and supplement diary” that can help patients keep track of the drugs and dosages they take. They should show the list to every health care provider they see. The form can be found atwww.americangeriatrics.org/files/documents/beers/MyDrugDiary.pdf.

Too often, people with multiple health problems have one doctor who does not know what another has prescribed. A new prescription can lead to a toxic drug interaction, or simply be ineffective, because it is counteracted by something else being taken.

There is nothing to be gained, and potentially much to lose, by failing to disclose to health care professionals the use of prescribed, over-the-counter or recreational drugs, including alcohol. Nor should any chronic medical condition or prior adverse drug reaction be kept from your doctor.

Whenever a medication is prescribed, patients should ask about side effects to watch for. If a bad or unexpected reaction occurs or the drug does not seem to be working, the prescribing doctor should be told without delay. But patients should never stop taking a prescribed medication without first consulting a health care professional.

Nor should they add any drug or supplement to a prescribed regimen without first consulting a doctor. Even something as seemingly innocent as ibuprofen, acetaminophen, St. John’s wort or an antihistamine purchased over the counter can sometimes lead to dangerous adverse reactions when combined with certain prescribed medications or pre-existing health problems.

But just because a drug is on one of the lists in the Beers Criteria does not mean every older person would be adversely affected by it. The drug may be essential for some patients, and there may be no safer alternative. When all is said and done, a doctor must weigh the benefits and risks.

First published: April 16, 2012. Updated: April 19, 2012

Copyright 2012 The New York Times Company
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Credit: Reports and photographs are property of owners of intellectual rights. 
Seniors World Chronicle, a not-for-profit, serves to chronicle and widen their reach.

FRANCE: Urban heat amplifies death risk for elderly

CHARLOTTESVILLE, Virginia / Environmental Health News / April 13, 2012

Older people living in urban areas that do not cool down sufficiently at night are twice as likely to die during heat waves than those living in the suburbs, finds a study from Paris, France.

The impact of heat islands on mortality in Paris
Laaidi, K, A Zeghnoun, B Dousset, P Bretin, S Vandentorren, E Giraudet and P Beaudeau 


Synopsis by Kai Zhang

At least 35,000 people died as a result of the record heatwave that scorched Europe in August 2003 

During heat waves, elderly people living in city areas where night temperatures remain higher are more likely to succumb to the heat than those in nearby suburban areas where temperatures dip when the sun goes down.

Researchers found that night temperatures matter when they studied the 9-day hot spell that hit Paris, France, in 2003. The average temperature differences between the city and the suburb varied about 1 or 2 degrees during nights and days, respectively.

Yet, even with these slight temperature changes, older people living in the city had twice the risk of dying from the heat than those in the suburbs, according to a study published in the journal Environmental Health Perspectives.

The results suggest that certain areas of cities where heat concentrates – called urban heat islands – contributed to the disaster in Paris because they cooled down more slowly at night compared to the suburbs. These heat intensive areas are more common near city centers and tend to retain heat more than suburban areas due to the pavement and buildings made of heat-trapping cement and concrete.

The findings increase understanding of how these urban heat islands impact human health. This is important as rising temperatures associated with climate change may increase the number and intensity of heat waves. The study also tests the use of satellite images to more precisely identify the heat intensive areas that are more likely to affect people.

Overall, more resources, improved communication with the public and better city planning could help reduce deaths due to prolonged summer heat waves, the authors suggest.

Urban heat islands increase the intensity of prolonged hot temperatures – heat waves – for those who live in the heart of cities. Heat waves are associated with increased hospital admissions and death, especially in the elderly and children. These age groups are more vulnerable to the higher temperatures because their bodies cannot adjust to the heat as well as healthy adults.

In general, heat waves mainly affect city dwellers, because more people live in cities where the heat concentrates. The temperature differences found between urban and suburban areas depend on time of a day, location, season and other factors.

But, too few ground-based weather stations make it difficult to estimate the differences. Thus, how urban heat islands contribute to the health effects caused by heat waves is not well studied.

In this study, researchers used more than 60 satellite images to identify and compare temperature differences between an urban area in Paris and in the suburban area Val-de-Marne during the heat wave in August of 2003. They estimated the daily mean, maximum and minimum surface temperatures and the day/night differences from the images. The estimates were a substitute for temperatures measured directly at city and suburban weather stations.

The heat patterns were then compared to human health data collected from a previous study that included people 65 and older. They examined 241 persons who died in the studied regions during the heat wave and matched them with 241 persons of similar age, sex, city region and demographics who survived. They adjusted for age and other factors.

Satellite images show that downtown Paris was a heat island with higher day and night temperatures than the suburban area. The difference in average high and low temperatures between the city and suburbs during the 9-day heat wave where study subjects lived was about 2 degrees and 1 degree Fahrenheit, respectively.

Although higher temperature differences were seen in the day than at night, the researchers found that a major risk factor was night temperature, not day temperature. The researchers estimated that it doubled the risk of death in the older person living in Paris than a similar person living in the suburban area.

These results highlight the importance for public health practitioners to target resources to elderly people living in hot spots. This study also suggests the need for urban planners to create more parks with grass and trees and implement other measures that will minimize urban heat islands and reduce heat-related health effects.

Copyright © 2011 Environmental Health Sciences.  

In lighter vein:  Hot pants in anti-burka ban protest by Henry Samuel in Paris. Courtesy: atomicshogun.com

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USA: Religion Makes People Happier--But Why?

WASHINGTON, DC / US News & World Report / News / April 12, 2012

By Philip Moeller


While it provides many health benefits, pinning down the precise effects of belief in God is difficult

Choral singing is great for health: It engages people mentally and physically. There is also a strong social networking benefit of a shared activity that is often emotionally uplifting. Now, if this experience occurs in a church service, does it produce even greater well-being and happiness? Is there, in short, a God dividend?

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The benefit of choral singing "is pretty cool, really," says Ellen Idler, a professor of sociology at Emory University. Singing can get everyone in the church literally on the same page, moving their bodies and voices in unison, usually with stirring songs. "The singing can be very important" to improving well-being and happiness, she says.

It's also true, researchers say, that people who regularly attend religious services enjoy a boost in their happiness. However, research findings don't agree on how much of the benefit is religious and how much derives from the benefits of social networking and being with other like-minded people.

There is overwhelming research evidence that people can live longer if they actively engage in formal religious activities and follow their faith's behavioral prescriptions. This is especially true for religions that espouse healthy diets and discourage smoking and alcohol.

Research conducted decades ago on Mormons, Seventh Day Adventists, and the Amish "found stunningly lower mortality rates in these religious groups," Idler says. "Overall, they really are much healthier than the rest of us ... In some of them, the mortality rate is 25 percent, 30 percent, or even 50 percent lower, which is really astonishing."

These groups were chosen, in part, because they keep extensive genealogical records. They also advocate healthful lifestyles that set them apart from other religious groups as well as the broader public. However, later research with broader groups has found that religious observers generally enjoy happiness and mortality benefits.

"Regular and frequent religious attendance does seem to be one of the significant predictors of less stress and more life satisfaction," says Scott Schieman, a professor of sociology at the University of Toronto. "It just puts people in touch with like-minded congregants," he says, and thus produces many of the benefits of a strong social network. "It's a period of time when you can actually connect with others and you're not alone in your beliefs."

To identify a deity "bonus," though, is much harder. "You have to break it down into components and look at religious activities and religious beliefs," he explains, "and you have to look at them during times of stress. Is it the activity? If so, which kind of activity? Is it the belief? If so, is it [a belief in] life after death" or some other belief?

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Idler grants that some of the most dramatic health benefits of religious observance involve faiths that require adherence to positive lifestyle behaviors. "Some people may write it off as nothing more than a result of lifestyle issues," she says. "My perspective on that is that if you want to have people follow a really restrictive lifestyle over their entire life, you have to have something that holds them together and perpetuates it. You could take religion out of the equation and it would fall apart."

"No matter if it is ancient burial practices or modern injunctions against smoking, the mechanism for the effect of religion on health seems to be that religion provides an effective social control mechanism for compelling behaviors over the course of their lifetimes that may deny individuals freedom, pleasure, or stimulation, but which appear to promote survival," Idler wrote last year in a paper that reviewed studies about religion's impact on mortality.

She also notes the ubiquity of religious symbols and imagery that add meaning and richness to religious observance.

Janet Ramsey, a pastor and theology professor at Luther Seminary in St. Paul, Minn., sees such symbols as part of a broader religious narrative that undoubtedly adds support and meaning to people's lives. In her research, she says, "people in a faith tradition find ways for their lives to intersect with that larger narrative" and a "much deeper, symbolic life."

"There is power there that gives meaning to life, and it also helps people as they get older with their self-identity and aging," Ramsey adds. "It makes you feel like you are part of an ongoing relationship that is bigger than yourself." In her research, she adds, being in a religious organization was not more beneficial in this regard than being spiritual but not active in an organized religion.

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Feeling that we are part of something larger than ourselves can be tremendously comforting and supportive, Schieman agrees. "There's an assumption that most people want to feel that there's a sense of order, a sense of certainty [in life] rather than a cold randomness," he says. "Religion provides answers to a lot of these questions and if not answers, at least a big answer: There is God. There is a sense of meaning."

This sense of support produces great comfort and help to people as they get older, and especially as they near the end of their lives, Ramsey says. "The approach of death, coupled with a loss of control during the last days of life, can easily lead to anxiety and anger," she recently wrote. "Spirituality is one pathway among others that appears to mediate end-of-life anxiety by allowing older persons to remain peaceful, even when facing their own death and losing personal control."

Religion and spirituality also can help people achieve a sense of closure about their lives that includes a very important stage of forgiveness—to others, but also to themselves. "Some language and beliefs and rituals are provided [by religion] that help people with their needs for forgiveness," Ramsey says. "We finally make peace with the things we have done."


Copyright © 2012 U.S.News & World Report LP   ________________________________________

Credit: Reports and photographs are property of owners of intellectual rights. 
Seniors World Chronicle, a not-for-profit, serves to chronicle and widen their reach.