I attended the Colorado Alzheimer’s Symposium in Denver last week. I was humbled to see so many professionals learning, collaborating, and sharing their commitment to the well-being of people challenged with cognitive impairment. The Denver association is also involved in a unique collaboration with the Denver Broncos.  What a great way to get the message of help and hope to so many families affected by Alzheimer’s!  www.alz.org/co

Dr. Henry Emmons was the closing keynote speaker.  A psychiatrist who integrates mind, body, spirit and natural therapies, he has forged a distinguished career as an expert in resilience and living mindfully.   I’m looking forward to reading his books; The Chemistry of Joy, and the Chemistry of Calm.  You can learn more about his work at www.partnersinresilience.com



I just read the New York Times article about Bracing for Falls in an Aging Nation, published  November 2nd. http://www.nytimes.com/interactive/2014/11/03/health/bracing-for-the-falls-of-an-aging-nation.html?emc=eta1&_r=0   I cringe at the appalling ageist assumptions and paternalistic attitudes, but provide the link because it illustrates why we need a dramatic change in thinking towards aging and disability. We’ve gotten really good at celebrating “successful agers” who are downhill skiing at 90, but at some point we need to pull the thread of positive aging through all ages and all levels of functional ability.

Why is it that young people with disabilities are given tools, resources, and encouragement to overcome challenges and live life fully in spite of them, and elders are given tools to cope with challenges? The equivalent of “here’s your walker, and what you’re capable of now – good luck with that.” There’s a profound difference between the mindset of overcoming versus coping
– resulting in profoundly different outcomes.

It’s absolutely proven that loss of function can be prevented and even reversed with resistance training and other exercise interventions, but many people don’t take advantage of these proven programs. The article chalks it up to “denial of decline”.  I believe it’s something very different. 
Environments created to help elders with functional challenges often actively diminish rather than support resilience. And resilience is absolutely necessary to face challenges.

I’ve spent my career promoting lifelong vitality and have learned that great programs and equipment don’t motivate action until people, of any age, first believe in their ability to change their circumstances. They also have to be surrounded by others who focus on possibilities not disabilities. 

Start by taking age out of the equation -loss of leg function poses the same problems for a 20 year old and an 80 year old. View challenges through a lens of resilience. Environments must be co-created with elders that support self-efficacy, self-esteem, optimism, purpose, mastery and control – the building blocks of resilience. Embrace adaptive strategies to live fully in spite of challenges rather than coping strategies that create a smaller world.

Rejecting stereotypes and believing in possibilities will move us away from the – when in danger or in doubt, run in circles scream and shout approach to health challenges, and towards environments where people feel competent and compelled to live fully in spite of challenges.

Stories about care-giving in the November 2014 issue of Oprah magazine really saddened me; first for the obvious heartache these families expressed, and second for the less obvious but equally painful message that most of us should expect our parents to become frail and dependent, resulting in trauma and heartache.  Aging extremes are so prevalent in the media (frail/dependent vs. bungee jumping 90 year olds) that it’s easy to forget the vast majority of family aging experiences will lie somewhere between the extremes.

As a speaker I often ask audiences what % of adults over 65 will require nursing home care. Answers range from 40-75%. The correct answer is about 7%.  At age 85+ it climbs to 24%, which also means that 76% of adults 85+ do not require this level of care. 

To avoid unnecessary family conflict and suffering, consider a different response to changing health status of a loved one.

1) Take age out of the equation. Age is not the issue -circumstances and challenges are- and no age group is immune to those.  Start family conversations early that flow both ways, with adult children being as pro-active and forthcoming laying out their personal “emergency plans” as they are asking their parents to be. 

2) Build a plan of action around creating a culture of well-being rather than illness management. If allowed to, management needs like medication, appointments, and personal care can overwhelm the care environment and diminish an individual’s sense-of-self. This in turn actively diminishes resilience – the very thing a person needs most to live well in-spite of challenges.  

Take your cue from families with profoundly disabled children who build lives of well-being for the whole family. The challenges are undeniable but they aren’t the central focus of life.