With the prevalence of Alzheimer’s disease expected to impact 16 million individuals by 2050, younger generations will increasingly assume caregiving responsibilities. More than a third of today’s caregivers are employed full-time. As millennials take on informal caregiving responsibilities, public and workplace policies must consider financial assistance or other support (e.g., family leave or allocated time off). This report explores the economic impact of the shift to millennial caregivers and the higher rate of incidence of Alzheimer’s disease in minority groups. The report concludes with a discussion of strategies at the organizational-and system-level to support millennial caregivers.
Calls for Action
Define public policy in supporting family caregivers in providing care.
Address how universities can better support student caregivers.
Companies and employers take the lead in supporting working caregivers.
Caregiver supports begin in communities.
Figure 1. U.S. population 65+ (in millions)
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As the global population ages, it is important to start designing strategies to address quality of life among older adults. The World Health Organization defines health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” Designing programs and policies to encourage quality of life across the age spectrum should not focus solely on addressing health issues as they arise, but rather promoting positive ways of living that can impact health in all realms – physical, mental, and social – throughout one’s life.
Strategies for healthy aging should include promoting activities that foster both individual growth and community participation. One such option is participation in the arts, which has shown to have a positive impact on both the individual and society.
Studies have shown that participating in visual arts, music, dance, drama, storytelling, etc. can improve mental and physical well-being, provide increased opportunities for friendship and meaningful social contact, foster a sense of social cohesion between different age groups, and break down stigmas associated with aging.
In Australia, several initiatives have been put in place to encourage “creative ageing,” which is defined as “the utilisation of the arts to excite imagination and support older people to age well.” For example, creative ageing was included in the Eastern Australian state of New South Wales’ Ageing Strategy, where community-based organizations such as the Creative Ageing Centre and Institute for Creative Health were established to encourage older adults to engage in the arts.
Results from the 2014 report titled Arts in Daily Life: Australian Participation in the Arts showed that participation in the arts increased from 41 percent to 48 percent since community arts centers became part of health policy. Among adults aged 55-64, participation increased from 36 percent to 44 percent.
The number of Australians aged 65 and over is expected to increase to 6.2 million by 2042, up from an estimated 3.4 million in 2014. Australia’s population is ageing. Now, more than ever, is the time to think creatively about aging and how these innovative strategies can have positive effects beyond for both the individual as well as society as a whole.
Diana Kingsbury is a doctoral student and graduate assistant in prevention science at Kent State University College of Public Health.
Much like elsewhere in the Western world, the population in New Zealand is aging; the number of people over 65 has doubled since 1980, and is expected to double once again by 2036. This increase in the aging population is largely the result of a rising life expectancy, as it is estimated that the average individual in New Zealand now lives up to 81.16 years of age – an increase from 78.64 years since 2000.
It is therefore important, now more than ever before, to promote strategies that improve quality of life among the aging. Creating policies that promote health across the life-span can enhance the physical, social, and functional mobility of the aging, and could have far-reaching positive impact.
One such strategy, as described by the Centers for Disease Control and Prevention, is Aging in Place, which refers to “the ability to live in one’s own home or community safely, independently and comfortably, regardless of age, income or ability level.” Research shows that aging in place is linked to health and emotional benefits, and the opportunity for families, governments, and health systems to make considerable cost savings, as compared to placing older people in traditional institutional care.
In an attempt to support these strategies, the Ministry of Social Development in New Zealand created the New Zealand Positive Ageing Strategy in 2001, which seeks to promote “a society where people can age positively, where older people are highly valued, and where they are recognized as an integral part of families and communities.” The Positive Ageing Strategy promotes ten goals to improve the quality of life of older adults, including:
Improved Health: Promoting equitable, timely, affordable, and accessible health services for older people.
Aging in the Community: Ensuring older people feel safe and secure, and can age in the community.
Opportunities for Growth: Increasing opportunities for personal growth and community participation for older adults.
According to a 2015 annual report about the Positive Ageing Strategy, there have been many successes in implementing this policy. These include an increase in the number of senior health programs as well as movement toward increasing the number of health care workers available and trained to care for the aging.
There has been additional success in providing elder abuse and neglect prevention services, providing support to those who serve as caregivers for the elderly through the New Zealand Carers’ Strategy Action Plan, and presenting local solutions to combat social isolation.
Finally, strides have been made to connect older and younger people to promote understanding between age groups; implement positive aging strategies in local communities; and provide opportunities for older people to advocate for their needs and well-being within the government.
With a projected rise in the aging population over the next couple of decades in New Zealand, promoting policies that support aging in place can have a significant positive impact on the quality of life of the aging.
Diana Kingsbury is a PhD student and graduate assistant in prevention science at Kent State University College of Public Health.
Old age homes are no longer a taboo! The waiting lists of nursing homes in Korea are at three times their capacity and the number of elder care homes in Nanjing, China has increased from 27 in 1990 and 52 in 2000 to 148 in 2009!
In Asia, people are seeing a shift in the traditional roles for elderly care. Changes in family structure, urbanization, and other factors of contemporary lifestyles often compel older members to seek care outside of the family. Elderly residential facilities, such as old age homes, retirement villages, and other forms of institutionalized care for the elderly, have become increasingly popular in Asia. Given the high demand for such facilities, there is a need to monitor its growth and the quality of care provided.
Thailand, Malaysia, and Sri Lanka are among the Asian countries that offer renewable visas to older expatriates. Private companies and developers in India and Malaysia are investing in senior citizen villages and assisted living infrastructure such as temples, spas and golf courses to attract the wealthy older population. There are some financially well-off older adults who choose to retire in such elderly villages. However, not many can afford this kind of lifestyle.
Two cross-sectional studies from India surveyed elderly residents of old-age homes to understand their reasons for opting to live in one. It is interesting to note that poor health was not cited as a reason explicitly. The cross-sectional study in Madhya Pradesh, India reported that the top reasons for the elderly to opt for old age homes are because there was no one to look after them (68.2 percent), they did not have a place to live (56.4 percent) and to meet like-minded people (53.8 percent). The other cross-sectional study in Uttar Pradesh, India found that the two most common reasons were misbehavior by son and/or daughter-in-law (29.8 percent) and poverty (29.3 percent). This survey data hints that moving to an old age home was more a necessity than a voluntary life choice.
In addition to lifestyle changes, the surge in dementia and other health conditions among the elderly is driving the need for high quality care. Caring for such long-term conditions places huge emotional, physical and financial burdens on families. For instance, the symptoms of dementia can include hallucinations and depression which require swift and expert medical care. Many institutions are hence better able and equipped to provide timely care and rehabilitation.
Asian countries can learn a lot from studying trends in elderly residential facilities in developed nations of the Western world. A study in the UK reported that the overall standard of care in both nursing and residential homes was highly deficient when judging against quality indicators. This study serves as a warning to the rapidly aging countries in Asia: Provide adequate regulation to ensure a high standard of quality care in elderly residential facilities.
Namratha Rao recently graduated with a MSPH in Social and Behavioral Interventions from the Johns Hopkins University Bloomberg School of Public Health.
“Laughter is a form of internal jogging. It moves your internal organs around. It enhances respiration. It is an igniter of great expectations. So let us laugh our way into good health, into happiness, and a brighter day.” Norman Cousins
Addis Ababa, Ethiopia – The old saying, ‘Laughter is the best medicine’, has withstood the test of time. Laughter is good for one’s health and soul. In fact, holistic interpretations of health and wellness would agree that people may well hold the key to good health.
Over the past 20 years, an international movement has erupted in the holistic wellness sphere – Laughter Yoga. Laughter yoga is a simple yet effective technique that combines laughter with yogic breathing techniques to improve quality of life. This revolution is no laughing matter, (pun intended!) and is currently practiced in more than sixty countries with thousands of laughter clubs across the globe.
The benefits of laughter yoga go beyond just emotional and mental health; scientific research indicates that the human body can also benefit from this exercise. A Vanderbilt University study reported that 10-15 minutes of laughter a day can burn up to 40 calories. Another study from Loma Linda University showed that a sense of humor can protect against heart disease. According to Dr. Madan Kataria, founder of Laughter Yoga University and the laughter yoga movement, some other benefits of the practice include:
Good Mood and More Laughter: Laughter yoga helps to change your mood within minutes by releasing positive endorphins, which will keep you cheerful throughout the day and make you laugh more than you normally do.
Healthy Exercise to Beat Stress: Laughter yoga is like a cardio workout that brings more oxygen to the body and brain, making one feel more energized and relaxed.
Health Benefits: Laughter yoga reduces stress and strengthens the immune system. You will not fall sick easily, and if you suffer from chronic health conditions you will heal faster.
Quality of Life: Laughter fosters positive energy, which improves relationships. If you laugh more, your vitality will invite more people into your life.
Positive Attitude in Challenging Times: Laughter creates a positive mental state that gives hope and optimism to cope with difficult times.
Many countries have picked up on this international trend, including Ethiopia where laughter yoga has achieved such popularity that October 31 is declared National Ethiopian Laughter Day. Laughter yoga was first introduced to the Ethiopian health and wellness space in 2002 by world laughter master Belachew Girma. Girma opened the first laughter yoga school in Addis Ababa called Laughter for All Association -Ethiopia. The school provides laughter yoga trainings in “Indigenous Laughter”, which focus on helping people hone their innate, natural laughter through Team Bonding, Stress Management, Positive Thinking, and Peace Building exercises. In addition to traveling around the world sharing his message, Girma visits old age homes in Ethiopia with professional laughter therapists as part of the school’s mission is to improve the quality of life for the elderly through laughter.
While the laughter yoga movement has been greatly successful across borders, it has had a unique impact in the African context. Health care accessibility in most African countries has seen significant improvements over the past ten years although mental health has not received enough attention. According to a study published in International Journal of Mental Health Systems, 79 percent of African countries spent less than one percent of their total health budget to mental health. Therefore, alternative self-treatments like laughter yoga can provide essential support in fighting mental illness.
Although the absence of laughter is not the root cause of all health issues, laughter yoga is a potential solution to the ailments of an increasingly sedentary and isolating lifestyle. The Social Care Institute for Excellence in the UK states that “The range of interventions for alleviating loneliness and social isolation can be grouped into one-to-one interventions, group services and wider community engagement. Those that look most effective include befriending, social group schemes and Community Navigators”. To sum up, social interaction is key to dealing with mental and physiological illnesses that stem from loneliness, and laughter yoga is a tool that facilitates such interaction.
Andria Reta is a Gerontologist and Health Administration Professor.
Montessori in Aged Care is a fairly new concept that is picking up momentum in Australia. It revolves around the idea of maintaining independence rather than creating excess disability. Excess disability simply means to increase the dependence of the individual when they can independently complete the activity or task. For example, if an elderly woman can brush her hair, often a staff worker will do it for them with the impression that they are helping, when in actuality they are taking away the resident’s independence. Imagine living in a nursing home away from the comfort of your own home and not being allowed to do the things you enjoy.
Montessori in Dementia Care enables individuals to maintain that independence, make choices and boost their self-esteem. It also empowers people to make important contributions and have a meaningful place in their community. The impact of dementia affects the resident in various ways including perception, attention, planning, insight, language, emotions, apathy, behavior, physical function and memory.
Therefore, the Montessori Method offers more choices and opportunities that promote self-determination and individuality to provide the best quality care for all. Here are strategies to provide relevant activities for people with dementia:
Take advantage of the known and remembered and use it to create meaningful activities for residents.
Offer more social interaction opportunities with people of all ages.
Provide more physical activity to keep residents, even those in wheelchair, active such as indoor bowling or ball games.
Provide mental stimulation for residents such as crosswords, word games, etc.
Utilize music therapy to play familiar music and trigger well-preserved memories and improve quality of life.
Delegate roles for different residents, if possible. Responsibility gives residents a sense of purpose.
Prepare resources ready to be used to minimize noise and distractions.
Know the residents individually: This involves personal history, employment, hobbies, interests and culture.
Always have a plan B, C, D, E, F, G because things never go as planned.
In conclusion, I think this new concept of dementia care focuses on the strengths and abilities of people with dementia rather than their condition. Montessori programs provide individuals the opportunity to engage the five senses, such as touch, sight, smell, taste and sound, and stimulate their minds. As success is easily achieved, people are encouraged to focus on tasks at hand. This creates a sense of security and high self-esteem, which contributes to the attainment of a life full of purpose and meaning.
Hazel Dompreh is currently a Diversional/Recreational Therapist at a nursing home in New South Wales, Australia.
As the world gets busier day by day, many Americans fail to get enough quality sleep. In fact, lots of people are ready to sacrifice bedtime to catch up on daily tasks. The problem of insufficient sleep has become a huge concern and the Centers for Disease Control and Prevention (CDC) now considers it an epidemic along with obesity. Approximately 50-70 million U.S. adults have sleep problems, according to the CDC. Gallup supports this data stating that 40 percent of U.S. adults sleep less than seven to nine hours as recommended by the National Sleep Foundation. Only 59 percent of U.S. adults meet that benchmark.
Lack of sleep is viewed as the cause of major disasters that have claimed and destroyed many lives. Less than the ideal sleep duration leads to difficulty concentrating, poor memory and other cognitive problems. These reduce productivity and result in accidents and man-made calamities. Lack of sleep also leads to a host of life-threatening diseases such as diabetes, hypertension, obesity and cancer. According to a paper presented at ENDO 2015, the Endocrine Society Annual Meeting in San Diego, sleeping 30 minutes less than the ideal on weekdays can boost diabetes and obesity.
Effects To Skin
Insufficient sleep is a major factor that speeds up the body’s aging process. As such, it can lead to many skin-related problems like dull skin, premature wrinkles and bags under the eyes. Sleep experts say that deep sleep allows the body to do two essential processes to produce healthy and glowing skin: cell repair and release of growth hormones. Decreased cell repair function can boost the body’s inflammatory response, causing more acne and increased skin sensitivity. In addition, more inflammatory cells in the body mean further breakdown of collagen and hyaluronic acid, the chemicals that give bounce, glow, and translucency to the skin.
Sleep deprivation disrupts hormone balance in the body. Therefore, sleeping less prompts the body to secrete more cortisol, the stress hormone. Excessive cortisol in the body can destroy skin collagen, the protein responsible for a smooth and elastic skin. Sleep loss also lessens human growth hormones that help thicken skin, increase body mass, and strengthen the bones. Moreover, lack of sleep leads to poor water balance, resulting in dull and dry skin. In addition, poor water balance in the body causes bags under the eyes and premature wrinkles.
Post-menopausal Sleep Problems
Adults, across all age groups, need eight hours of sleep on average. But elderly people are having a more difficult time falling asleep. Compared to their younger days, they have more trouble staying asleep. Approximately 50 percent of seniors have no problem sleeping. Seniors are light sleepers and their sleep efficiency – amount of time spent in bed as opposed to the number or hours spent in sleeping – falls at a rate of three percent per decade after they reach the age of 60. Lower sleep efficiency means shortened time in deep sleep.
For senior women, the effects of post-menopause contribute to sleep deprivation. The National Sleep Foundation states that postmenopausal women are less satisfied with their sleep and as many as 61 percent of them have symptoms of insomnia. Doctors cite hormone problems in women as the reason for lesser sleep satisfaction. Their fluctuating estrogen levels produce hot flashes and night sweats that disturb the sleep cycle. Drop in estrogen levels may also lead to sleep apnea, a condition that interferes with breathing during the night. Moreover, lowered progesterone levels in postmenopausal women are linked to insomnia.
During post-menopause, disruptions in women’s psychological condition results in sleep problems. The changes in their bodies before and during menopause may bring anxiety, depression, and stress that hinders the body to relax.
Tips for Better Sleep
To maintain a daily dose of sound sleep, do the following tips:
Engage in more physical activities. A daily exercise routine is a great way to induce deep sleep. Just make sure it is done less than an hour before going to bed.
Make relaxation methods a part of life. Stress and anxiety often make sleep difficult for most people, especially the elderly. Meditation, yoga, proper breathing, and other relaxation activities calm the muscles and nerves, and cues the body to release the sleep hormone melatonin.
Make the bed and bedroom a place only for sleep and sex. Almost a third of the day should be devoted to sleep. Thus, the bedroom should be comfortable and free from distractions. Make sure the bed and mattress are also comfortable for a restful sleep.
Get enough exposure to sunlight. Daylight exposure regulates the sleep-wake cycle or circadian rhythm. Sunlight cues the body to increase production of serotonin and melatonin. Serotonin is a molecule in the body that regulates sleep and melatonin keeps the body’s circadian rhythm in check. Be careful about getting too much sun exposure as it will triggerage spots. Using sunscreen can prevent current age spots from multiplying or enlarging in size.
Put daily activities in order as this can greatly reduce stress and anxiety.
Set a sleep schedule and stick to it even during weekends. Going to bed and waking up at a specific time every day will keep the circadian cycle in order.
Avoid eating a heavy meal, smoking as well as drinking alcohol and caffeine a few hours before bedtime. While these activities may satisfy the appetite, they can wreak havoc on the sleeping pattern.
Consult a doctor. Always discuss sleep problems with a doctor because there are some health conditions and medications that can disturb the sleeping pattern. A hormone imbalance during post-menopause also causes serious inconveniences including much-needed sleep. A doctor may prescribe hormone replacement therapy to restore the decreased estrogen and progesterone levels.
There is no alternative to daily quality sleep to improve health and beauty. A restful sleep not only retains health in postmenopausal life, but it also revitalizes skin to regain a healthy glow.
George Shanlikian MD is the medical director of Genemedics Health Institute. He is a national leader in the field of bioidentical hormone replacement therapy (BHRT) and preventative medicine.
Getting adequate sleep is a very common recommendation for achieving and maintaining good health. Insufficient sleep has been linked to a variety of chronic diseases (such as diabetes and heart disease) as well as unintentional injuries (such as motor vehicle accidents and workplace injuries). Poor sleep quality can also contribute to other issues that affect quality of life such as irritability, depressive symptoms, and inability to focus and stay on task.
The global adult population in general experiences a high prevalence of insufficient sleep, with some variation in terms of age, gender, and socioeconomic status. Among the elderly, however, the prevalence and subsequent effects can be especially pronounced. While it is not clear if this increase in prevalence of disrupted sleep and sleep disorders is due to aging itself or co-morbid conditions associated with aging (i.e, chronic pain, dementia), it is important to consider the impact such conditions have on the elderly.
It has been noted that common sleep disruptions among the elderly include trouble falling asleep, snoring, sleep apnea, insufficient time spent in deep sleep, rising early, and achieving fewer hours of sleep each night. The implications for sleep disruptions within this demographic can include a 2 to 3 times increased risk of stroke and mortality.
In considering the impact of sleep disorders among the elderly in the Americas, a study conducted in the Dominican Republic, Peru, Venezuela and Mexico found that 23-31% of older adults aged 65 to 80+ years experienced sleep disruptions. The prevalence appeared higher among women than men. In comparison to previous studies, it was found that among individuals aged 40 and older in Uruguay, Chile, and Venezuela, 34.7% reported trouble falling asleep. Previous findings have also included reports that 25% of individuals aged 18-77 years old in Buenos Aires, Sao Paulo, and Mexico City reported being moderately or severely impacted by sleep problems, with severity increasing with age.
To address sleep disruption among the elderly, it is important that health care providers, community support systems, and social support systems work with the aged to ensure they are experiencing the best quality of life possible. This includes working with the elderly to achieve optimal sleep.
Diana Kingsbury is a PhD student and graduate assistant in prevention science at the Kent State University College of Public Health.
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.
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.
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.
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.
