The Healing Power of Optimism – A Positive Outlook Can Improve Quality of Life and Health

The Benefits of Staying Positive

There are many benefits associated with staying positive. This is supported by the fact that a continually growing body of research points to the benefits of viewing things in a positive light rather than negatively. Researchers believe that positive thinkers have no lasting negative effects since they are able to handle the effects of stress much more effectively than negative thinkers. Stress leads to fatigue, headaches, insomnia, and many other health issues which can in many cases be attributed to negative thinking.

                                                                                  Photo Credit: Philips Communications

Focus on the Positive

During a drastic life change such as losing a job, loved one, or chronic illness, it is often hard to view things in a positive light. There are many times when the blame is focused inward which compounds the stressful effects. Optimists focus on the good and what they can change in the situation rather than assume the solution is out of their control. When it comes to a chronic illness or the loss of a job (especially when a company is doing regular cutbacks, etc), there often are not many things a person could have done differently. The key to managing stress is believing one can make a change and then working little by little to implement the change.

Life Events and Their Correlation with Attitude

One long-term study conducted by Harvard researchers looked at 99 of the 1944-1945 graduating class members. The graduating members answered questions from surveys and the researchers rated the questions from positive to negative. The study found a strong correlation over the years with those who had always been positive, those who changed from negative to positive in their early to middle adulthood and those who went from positive to negative over the course of the study. They found that those who had always been positive and those that changed from negative to positive fared the best. On the contrary, those that changed from positive to negative and those that remained negative throughout had many more health complications. Their overall health situation was also much worse.

Why Does Pessimism Lead to Harmful Health Consequences?

As discussed above, pessimism in early adulthood that was not corrected led to health risks in later adulthood. What was causing the elevated health risk? When the body is stressed, it produces a hormone called cortisol. This hormone was great for our ancestors who needed to be alert in situations of peril. However, many day-to-day stressful activities such as a mean boss can lead to elevated cortisol levels. Scientists have known for years that elevated cortisol levels interfere with learning and memory, lower immune function and bone density, increase weight gain, blood pressure, cholesterol, and more.

A Case Study of Positive Thinking

One last case study is in regards to a doctor who studied 750 Vietnam War veterans. These veterans were prisoners of war that were abused and tortured. Dennis Charney, MD, dean of Mount Sinai School of Medicine, had all 750 veterans take a test and noticed one thing in common. Those who did not develop post-traumatic stress disorder or suffer from depression or depression-related symptoms had optimism at the top of the list of ten things that set them apart from the other veterans. Next to optimism was selflessness, humor, a belief in a higher power, and that there was meaning behind their lives and risks – all aspects of a positive outlook.

Jacob Edward is the Manager of Prime Medical Alert and Senior Planning in Phoenix, Arizona, USA. Jacob founded both companies in 2007 and has helped many Arizona seniors and their families navigate the process of long-term care planning. Senior Planning provides assistance to seniors and people with disabilities in finding and arranging assisted living in Phoenix, as well as applying for state and federal benefits.

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Promoting Advance Directives, Reducing Medicare Spending

*This article was extracted from a longer, in-depth, paper written during my internship with a policy forum in Washington, D.C. 

More and more people are living to the age of 100. As our longevity increases, it is crucial to have an advance directive to make health care decisions, which may reduce the overall cost of end-of-life care. While Medicare guarantees access to health insurance for individual Americans and lawful residents aged 65 and older, the program faces significant fiscal challenges over the long-term. Advance directives may reduce Medicare spending since older adults can opt out of aggressive medical intervention by dictating their wishes in the event of a life-threatening illness. As Congress continues to debate over the best way to fix Medicare, costs will likely increase if older adults continue to ignore advance directives.

Living Will document with pen, closeupAbout 27.4 percent of Medicare expenses for the elderly are spent in the last year of a person’s life. Advance directives can reduce that percentage because older adults may not prefer lifesaving machines that impact costs. If a person wants to avoid lifesaving machines without having an advance directive, doctors will keep such people alive at the expense of other patients. The latter will be deprived of necessary medical treatment and hospitals may become overcrowded. Also, these machines and other medical resources will contribute to the cost of care because they are expensive and scarce. Unless people write binding living wills, families are reluctant to “pull the plug,” and medical professionals are afraid of being sued if they do. Increasing the use of advance directives is necessary for preventing such problems.

Studies have shown that adults are more likely to complete advance directives that are written in everyday language and less focused on technical treatments. However, many people are currently unaware of advance directives and even fewer complete them. Since advance directives are very lengthy and tedious to complete, most seniors prefer family surrogates. The present state of healthcare systems also compounds the problem. For instance, there are only two states that offer living will “registries.” Residents can file their living will and allow doctors and other healthcare providers to have access to their documents. However, the Washington State living will registry has been closed by the state government because of lack of funds, among other problems.

If insurance pools take into account the costs spent on people that will never get well, premiums for younger and healthy people are going to be very expensive. It is difficult when people are without an advance directive and do not want lifesaving machines. At the same time, if such people wish to have invasive and aggressive medical treatment in poor prognosis states, then health systems should accommodate and respect their wishes.

Advanced directives are not only for the elderly. Our society is getting older, and people have to deal with it. Health professionals need to determine effective ways of promoting advance directives among elderly patients. For example, a study showed that a replicable intervention mainly targeting doctors achieved a moderate increase in advance directives among older ambulatory patients. Future interventions may need to address doctors’ attitudes and comfort discussing these documents since patients cite their physician most often as the one who influenced them most to make a health behavior change. Increasing the use of advance directives among elderly persons is essential since it reduces Medicare spending and the national budget concurrently.

Living wills and health care proxies need restructuring hence these documents have to be well prepared to reduce confusion, jargon, and ambiguity. It is also vital for healthcare institutions to advocate and support the use of advance directives. More states should invest in the living will “registries” and promote advance directives to increase enrollment. If a patient has an advance directive and requests lifesaving machines, families and health professionals should respect their wishes. In the long run, advance directives are necessary because they can reduce the overall cost of end-of-life care for individuals and families.

Sophie Okolo is the Founder of Global Health Aging.

Why Growing Old in the U.S. Sucks…and There is Nothing (Something) We Can Do About It

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I am close to thirty years old. According to the latest data from the World Bank, I can expect to live another 45 to 50 years (Current U.S. life expectancy 78.7 years). However, the quality of those years is up for debate. Our current baby boomer population, on average, is sicker than their parents. The childhood obesity rate for children across the world, but especially in the US, has led many to the conclusion that this generation will become the “sickest generation” in the history of mankind. On top of this, with the population of Americans aged 65 and older expected to double within the next 25 years, there will no doubt be a strain placed on an already taxed healthcare system.

Of course many will argue that numerous aspects of our health are the result of our own personal decision making. This is very true but consider for a second that many individuals, maybe some within your own community, do not have a choice. Maybe they don’t have access to healthy eating options. Maybe they live in an area that exposes them to environmental pollutants. Maybe their occupation requires labor that over time will contribute to chronic pain. For many individuals, we live in a society where the choice has been taken from them or made on their behalf.

For all of us, aging can and possibly will be a difficult process. The unfortunate reality is that we live in a country that has the best intentions, but poor execution. I personally look forward to my next 40-50 years, but I know that many others are not. We must consider that the aging process is not created equal, and that there are many who are and will be unjustly dealt an unfair hand. Aside from the education and outreach initiatives conducted with regard to healthy living and chronic disease, there must be a greater emphasis on policy implementation that catches those at risk. According to the Global AgeWatch Index, Sweden is the best country in the world for the elderly. With reduced costs and an individualized approach, Sweden puts forth a strong effort to ensure the quality of life of its aging population. These efforts illustrate that it’s not impossible for strides to be made in improving or at least maintaining our country’s aging populace.

To give everyone a fair chance, there must be equality at the starting point. It is not enough to expect that public health interventions and education for those at risk for the development of chronic disease will suffice as a method to prevent potential long term health problems. There needs to be more of an effort to eliminate that “risk” to begin with to ensure that children born today, no matter location, race, or socioeconomic status are born with the same expectation of a healthy life. So maybe there is something we can do about it. With time, effort, and collective sacrifice, all Americans can have the opportunity to experience their potential 78.7 years in full health and vitality.

Udo Obiechefu is an E-Tutor for the Master of Health Promotion and Public Health program at Robert Gordon University.

Caring for the Needs of the Aging Workforce

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As the American population continues to age, there is an opportunity and a need to adequately respond to the unique needs of older adults. Ensuring a social structure that considers the needs of the aging is important, particularly as it is projected that by 2030, the number of Americans 65 and older will double and comprise nearly 20% of the total population. Comprehensively responding to the needs of the aging should include measures that protect the health, well being, and quality of life of older adults.

Included among the social changes that have been observed within the aging population in the U.S. is that more older American adults are delaying retirement and choosing to remain in the workforce past the traditional retirement age of 65. The desire to remain employed stems from improved quality of life among the aging and the capacity to continue working. However, for many older Americans, there is also a need to continue working due to economic pressure. According to recent research, 75% of Americans that were nearing retirement in 2010 had less than $30,000 available in their retirement accounts. With dwindling access to Social Security funds and the projected extension of the eligibility age to receive Social Security funds to 67 years of age in 2017, financial insecurity for the aging is requiring older workers to remain employed beyond the time they may have considered retirement.

There are benefits to older adults remaining in the workforce – both individually and occupationally. It has been noted that among older adults who remain employed, their cognitive capacity is less likely to diminish as compared to their non-employed peers due to mental engagement within the workplace. Additionally, research has shown that employers value the presence, contribution, and input of older workers and report that older employees exhibit knowledge related to job tasks, respond resiliently to job-related stressors and changes, and are willing to learn new tasks quickly. Added financial resources are also a significant benefit for older Americans who remain employed beyond retirement age.

Recent economic crises, however, have left few immune to financial loss. For older adults, financial loss as a result of the “Great Recession” have led to this need to continue working and raise enough money on which to live after retirement. For older adults who lost their jobs during the recent economic downturn, many reported that they continued searching for employment with little luck due to hiring preferences in many industries for younger employees. This represents a persistent area of vulnerability for the aging, as financial uncertainty after retirement remains a reality for many.

Diana Kingsbury is a PhD student and graduate assistant in prevention science at the Kent State University College of Public Health.

Alzheimer’s and Parkinson’s: A Great Threat to the U.S. National Budget

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Since the last Presidential Election, the national budget has been a sore spot for Republicans and Democrats, the two major political parties in the U.S. While government programs such as the Affordable Care Act (ACA) are leading debates on reducing the national budget, politicians are oblivious of a looming threat to the budget. People with Alzheimer’s and Parkinson’s diseases require constant and very expensive care. Also, these debilitating illnesses can prevent affected persons from working, which may have a devastating long-term impact on the budget.

Alzheimer’s disease (AD) is the sixth leading cause of death in the U.S. and an estimated 5.4 million Americans currently suffer from AD. If current population trends continue, the number of people with Alzheimer’s disease will increase significantly unless the disease can be effectively treated or prevented. The U.S. population is aging and the risk of Alzheimer’s increases with age. For instance, Alzheimer’s usually begins after age 60 and the number of people with the disease doubles for every five-year interval beyond age 65. About five percent of men and women ages 65 to 74 have Alzheimer’s disease and it is estimated that nearly half of those age 85 and older may have the disease. Parkinson’s disease (PD) is the second most common neurodegenerative disorder after Alzheimer’s disease and affects one million people in the United States. Symptoms of PD include muscle rigidity, tremors, and changes in speech and gait that worsen as the illness progresses over time. PD is more common in the elderly and most often develops after age 50. Sometimes, Parkinson’s disease occurs in younger adults. When a young person is affected with PD, it is usually because of a form of the disease that runs in families.

With strong research investment, heart disease deaths in the U.S. fell by 13 percent in the past decade. Alzheimer’s deaths rose by 68 percent from 2000 to 2010 and continue to increase. The issue is not how, but why we cannot increase our investment in research into fighting these diseases that have a tremendous impact on both the individual and society. Alzheimer’s and Parkinson’s get comparatively less funding than other top diseases because they are more common in the elderly and largely ignored. Stigma is another reason why it is hard to raise money since people with Alzheimer’s and Parkinson’s rarely talk about the disease. Also, Alzheimer’s is different from other diseases because Alzheimer’s patients rarely lead marches to fight for more funding since their memory is impacted. It is important to our nation’s economic future to reduce the deficit, but we cannot ignore the importance of investing in Alzheimer’s and Parkinson’s research. As the nation’s older populations grow, the cost of care for these diseases will rise dramatically. In fact, Alzheimer’s is expected to cost the U.S. more than $1 trillion annually and persons who leave the workforce to care for an affected family member impact economic productivity. Increasing funding for Alzheimer’s and Parkinson’s will require difficult choices and shared sacrifice in spending reductions and increased revenues.

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As the U.S. Congress continues to agree or disagree on the best way to fix Medicare, a government health program, the national budget will likely increase if there is no dramatic increased investment in research into fighting Alzheimer’s and Parkinson’s disease. The devastating statistics continue to increase and rising health care costs pose a great problem to the U.S. economy.

Sophie Okolo is the Founder of Global Health Aging.

Fighting Loneliness – Pet Therapy for the Elderly

For many, retirement and old age is a welcome stage of life with few responsibilities, and a lot of time to pursue interests. To others, it brings on that dreaded feeling which no amount of pills and doctor appointments can cure – loneliness. According to AARP, over a third of Americans over 45 years are lonely. Retirement, decreased mobility and income source are all contributing factors to increased social isolation. Studies show that loneliness puts the individual in greater risk of diseases and illness, and greatly impacts their well-being and quality of life.

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A variety of interventions are in place to combat loneliness in the geriatric population. They focus on various high risk groups and employ various individual and group approaches. There are also several programs in place, including social and cultural outings, health promotion, community engagement and group support. However, few show direct improvement in reducing loneliness among the elderly. A study comparing eighteen different interventions in Netherlands concluded that only two of them significantly reduced loneliness – one, an individual, at-home intervention for the elderly with chronic disease, and two, a group intervention in a residential home that included discussion and coffee breaks. There is limited success in identifying and employing interventions that significantly reduce loneliness

Another lesser known intervention to battle loneliness is the use of companion animals. Pet ownership and interaction positively contribute to the overall wellbeing of elderly citizens as pets can instil a sense of responsibility and purpose in the elderly, and provide much solace from loneliness. The role of Animal-assisted therapy (AAT) is increasingly being explored in elderly care. AAT is a formal, documented process with scheduled sessions and a treatment goal. AAT most commonly uses dogs, but is not restricted to fish, rabbits, cats, horses and dolphins. AAT should not be confused with service animals, and animal-assisted activities (AAA). Service animals and AAA are more spontaneous and do not necessarily have a treatment goal. Both AAT and AAA can help in increasing social behaviors, interaction with people as well and decreasing loneliness among the elderly.

In addition to temporary animal companionship, several organizations also look to provide seniors with the opportunity of pet ownership. The ‘Seniors for Seniors’ program is employed among many non-profits and animal shelters across the United States. This program looks to place adult dogs and cats with willing and able senior citizens. Since older dogs are usually house-broken, trained, and come with a fully developed personality, they can serve as great companions to the elderly.Several animal welfare organizations such as SAVE, Paws and the North Shore Animal League America successfully run such a program, often providing financial and other support to senior adopters. Pets for the Elderly Foundation, is a non-profit solely focused to this cause. It provides financial support to adoption centers around the United States that place dogs and cats with senior citizens.

Animal therapy, in all its forms, is a burgeoning field of study in geriatric care. There are only a handful of scientific studies documenting the efficacy of AAT on loneliness, but current research shows positive trends. Despite the challenges of working with animals, the therapeutic role companion animals can play in fighting loneliness is promising.

Namratha Rao is currently pursuing her MSPH in International Health in Social and Behavioral Interventions at the Johns Hopkins University Bloomberg School of Public Health.

The Threat of Food Insecurity Among the Elderly in the U.S. and Beyond

In 2012, 1.1 million (9.1 percent) U.S. senior citizens living independently were considered food insecure. This number is expected to increase by 50 percent in 2025 as the U.S. population continues to age. Data reported by American Association of Retired Persons (AARP) described increases in the number of older adults experiencing food insecurity since 2007. It was shown that food insecurity rose by 25 percent among individuals aged 60 and older between 2007-2009. According to AARP, individuals were more likely to report food insecurity if they were non-white, Hispanic, renters, widowed, divorced or separated, high school dropouts, unemployed and with a disability, had an income below the federal poverty line, and those with grandchildren living in the household.

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Defined as “limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways”, food insecurity is directly related to a household’s ability to acquire the foods that are necessary for daily living. Among vulnerable and dependent populations such as the elderly, food insecurity can be particularly pronounced.

Individuals who are considered food insecure are at risk for experiencing poor health due to malnutrition. Health risks of particular relevance to the elderly include impaired cognition, diminished immune function, and the potential decrease in life expectancy. In addition to physical health concerns, mental health risks may also accompany malnutrition including feelings of powerlessness and isolation as well as stress and anxiety. Among the elderly, feelings of anxiety related to food insecurity are more pronounced than among young people. For the elderly living with chronic diseases (a number that has grown exponentially worldwide) such as cancer, heart disease, and diabetes, having access to a nutritious diet is a key factor in their ability to manage their condition.

While food insecurity is closely tied to having the financial resources necessary to purchase food, among the elderly, additional barriers may impact their access. In a series of interviews conducted with 46 elderly households in New York state, additional barriers to food access that participants reported were: transportation limitations, mobility limitations, lack of motivation/ability to prepare meals, financial compromises (purchasing food vs. other expenses), and food compromises (quality vs. quantity).

From a global perspective, ensuring that the aging population has adequate access to the resources necessary for healthy living (including safe, nutritious, and affordable food options) should be a priority. Advocating for such resources requires concerted efforts locally, regionally, and nationally. This is particularly important as our global society continues to confront multidimensional problems that threaten environmental, economic, and social stability.

Diana Kingsbury
is a PhD student and graduate assistant in prevention science at Kent State University College of Public Health.

A Comparative View of Elder Abuse in Israel and the United States

Photo Credit: Hamed Masoumi

I spend every Tuesday morning visiting a dear friend at a local nursing home. My friend is a Holocaust survivor and at 90 years old, her mind is sharp since she easily recounts the story of her life – from the horrors of the camps to the beauty of Israel and finally to the hard work, freedom, and challenges of America. As I am ready to leave her and return to school each week, a look of loneliness washes over the smile on her face and I am reminded that her only other visitors are nurses and her daughter who can visit once a week.

The elderly comprise a significant amount of the U.S. population and statistics indicate that 10,000 baby boomers will turn 65 each day for the next 15 years. As the U.S. population ages, older adults are often viewed in a negative light, and hence a target group for all kinds of abuse: physical, sexual, verbal and financial exploitation. It is estimated that a shocking 500,000 older adults are abused each year in the United States, with family members as the overwhelming majority of abusers (mainly partners and children of the individual). Most of these cases go unreported because the victim does not have the physical capability or mental capacity to inform an official of the mistreatment.

Elder abuse is a major issue currently plaguing Israel as well. A report by the University of Haifa indicated that 18 percent of elderly participants were subject to some form of abuse. The most common form is verbal abuse, indicating a potential problem in interpersonal relationships as people age. Verbal abuse may also be used as a method to instill terror and power in a relationship, lending the way to more types of abuse.

Many religions teach people to respect and revere the elderly. In short, an individual’s exterior does not properly convey the depth of its contents. My dear friend appears to be a frail old woman with a failing body but her mind is very active. The elderly are people above all else and they deserve to be treated as such.

It is impossible to ignore the fact that everyone will grow old one day. With this in mind, I urge you to take some time and think about giving back by volunteering with a senior in your area. You may be the only contact the person has with the outside world beside the caregiver, and can advocate on their behalf if you suspect abuse. For U.S. residents, visit Give Back to Seniors to search for volunteer opportunities in your community.

Linda Nakagawa is a rising senior at Brandeis University. She is a double major in Psychology and Politics with a minor in Social Justice Social Policy. Linda is originally from Newburgh, New York and is a member of Temple Beth Jacob. As a Machon Kaplan participant, Linda was a public policy intern at the National Association of States United for Aging and Disability.