Newsletters

Family Health Magazine - Fall/Winter 2001

The Golden Years : Focus on Seniors

At age 68, Lillian Carter, President Carter's mother, joined the Peace Corps and spent two years working as a nurse in India. After dropping out of school at 14, H. G. Wells completed his doctoral dissertation at the age of 76. At age 80, Grandma Moses, who only started painting in her 70s, staged her first solo show. She then painted for another 20 years. In 1994, 100-year-old Ichijirou Araya climbed Mt. Fuji (12,388 ft.) in Japan. Seniors from across the generations have accomplished great things at a variety of ages.

According to a 2000 study by The National Council on Aging (NCOA), nearly half of Americans age 65 and older describe the present as the best years of their lives. A full 84 percent of those polled say they would be happy if they lived to be 90 years old.

"As a whole, people are living longer and healthier," says Robert Chen, M.D., Medical Director of the Saint Barnabas Geriatric Assessment Program. "In the past, old age was associated with disease. Now, older people have fuller lives and are interested in helping themselves stay healthy. It is a good time to be an older person."

Dr. Chen reports that older adults involved in the Senior Health Network at Saint Barnabas are eager to learn about computers, the internet, exercise, day trips, integrative medicine and other health-related topics. For many seniors, the period after retirement continues to be a time of learning and curiosity.

When Health Declines

In the same NCOA study, most respondents said the main indicator of the beginning of old age was not chronological age, but rather "a decline in physical ability or mental function." Aging is described as a risk factor for disease and dysfunction, and it may also result in the loss of peers or partners who succumb to illness.

"With increased age, we have a decreased ability to modify to stress," Dr. Chen relates. "This makes seniors more vulnerable than younger people if they do experience a health problem. The stress event-a broken hip, stroke or heart attack-can sometimes result in a drastic decline in a small amount of time. Fear of a recurrence of the event, such as a fall, can accelerate aging."

Often geriatric conditions have multiple factors that make treatment more complicated. A senior patient treated for a heart attack may also be taking medication for diabetes or osteoporosis. Beyond the medical issues, there may be concerns about cognitive functioning and the ability of the elderly person to continue living independently.

Meeting the Health Care Needs of Seniors

While the medical care of seniors has always been an issue, the aging baby boomer population has brought eldercare to the forefront on the agendas of most hospitals.

"We are preparing to care for a large senior population with a wide spectrum of needs," says John Bonamo, M.D., Executive Director of Saint
Barnabas Medical Center. "There was a time when the only choices were
acute care settings and nursing homes. We are trying to fill in the spaces with other levels of care that offer varying degrees of independent living."

Dr. Bonamo relates that in today's managed care environment, it too often falls to primary care physicians to evaluate and care for seniors. With their offices already inundated with patients, these physicians may not have the time or the expertise in evaluating the extraordinarily complex needs of the elderly.

The Geriatric Assessment Program

To assist seniors and medical professionals, Saint Barnabas created the Geriatric Assessment Program (GAP).

The GAP team includes a boardcertified geriatrician, a gerontological nurse practitioner and a social worker, all with expertise in the care of seniors. Team members offer consultative outpatient evaluations designed to assist older persons, families and physicians in addressing special health care needs.

To best identify possible problems, GAP uses nine areas of assessment. For example, the team reviews pharmacologic issues, helping to coordinate the administration of multiple prescriptions. Home assessments are performed to assess risks and devise solutions. Family members participate so that a support system can be created for the elderly person. Plans of care might include an optimized diet, exercise or physical therapy and adult day care opportunities.

In addition to instituting this program, Saint Barnabas Medical Center continues to address patient satisfaction issues related to seniors. For example, Dr. Bonamo says, the Emergency Department realized that some older adults who came by ambulance were not eating at the hospital because they had arrived without their dentures. To make sure their nutritional needs are met, the Department arranges for special soft
food to be available upon request until dentures are delivered.

The Role of Caregivers

Families are on the frontline of care for the elderly. The term "Sandwich Generation" emerged in the last decade of the 20th Century to describe those individuals who are caught in the middle of providing care for both children and an elderly parent or relative. Janice Monaghan M.S.W., L.C.S.W., Geriatric Care Coordinator for Senior Health Services at Saint Barnabas, relates that even under the best of circumstances, the role of can take its toll.

"It is impressive to hear the tasks people take on for their care recipients," says Ms. Monaghan. "Things like washing, cooking, cleaning, shopping, banking, helping with personal care, transporting the person to appointments and providing companionship. However, these tasks can generate feelings of anger, resentment, guilt, fatigue, frustration, fear, confusion, denial, discouragement, anxiety, depression and grief, and ultimately lead to caregiver burnout."

To prevent burnout, Ms. Monaghan and Dr. Chen recommend that caregivers care for themselves first and seek alone time with the help of programs such as respite care; recognize and cope with negative emotions, perhaps with the help of a support group; and seek support from family members and the community.

In Conclusion

Dr. Chen sees the next generation of seniors as a highly educated group that will demand expanded services and resources. For most people, he adds, the desire is to stay as healthy and independent as long as possible. "The most important goal of medicine is to increase the quality of our life, not just extend it," he says. Helpful phone numbers: The Geriatric Assessment Program, located in the Saint Barnabas Ambulatory Care Center, (973) 322-7988. Senior Health at Saint Barnabas, (973) 322-7979. Caring Partners Adult Medical Day Care Center (in partnership with Saint Barnabas and the Daughters of Israel), (973) 322-7988.

Some Famous Seniors at Age...

65 Kentucky Fried Chicken founder Colonel Harland Sanders became a successful businessman and remained active in his 80s.

69 Former President Ronald Reagan became the oldest person to be elected to the presidency.

74 Katharine Hepburn starred in On Golden Pond with 76-yearold Henry Fonda.

82 In 1994, Fred Lasby completed a solo around-the-world flight in his single-engined plane.

83 In 1789, Ben Franklin added bifocal glasses to his long list of inventions.

90 In 1971, Pablo Picasso was still at work as a painter, as was Georgia O'Keeffe in 1977.

98 In 1976, Dimitrion Yordanidis completed a marathon of over 23 miles in Athens, Greece.

[ Back to Newsletter Index ]

[ top ]