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Chronic Insomnia, Stress, Depression, Sleep Apnea: Why Has Getting a Great Night’s Sleep Become an Elusive Dream for Baby Boomers? And What Can You Do to Help Yourself?

September 25, 2008 by  
Filed under Blog, Health & Fitness, Sleep Apnea, Wellness

Can You Get a Restful Night Sleep?

Remember how much you played when you were a kid? Likely you had so much energy you played outside after school, and maybe even headed outdoors again after dinner; coming in only after your parents repeatedly hollered for you to come home. And didn’t they usually have to holler at least three times — because you pretended not to hear them?

Perhaps your favorite games were: “Tag,” “Red Rover,” “Kick the Can,” “Hide and Seek.” Or maybe kickball or softball in someone’s back yard. Then again, maybe you played that slightly more strategic and mentally challenging game, “Mother, May I?”

No matter what games you preferred, chances are:

  • Once you got home, you fell asleep as soon as your head hit the pillow, totally spent.
  • When you woke up in the morning you were alert, refreshed, and ready to get right back into it.
  • Nobody gave any thought to having problems with sleep.

Could Playing “Mother, May I?” Have Anything to Do with Sleep?

Maybe not, but let’s give the question some thought.

In that game, in case you forgot, one kid was the “mother” and the other kids were her “children.” The game started out with the kids all an equal distance away from mother, with their goal being to gain access to her. The first to reach her became the new “mother” and won the game. The “mother’s” goal, therefore, was to maintain her role by allowing some forward motion, while preventing any kid from totally reaching her. The rules, went something like this:

  • Each kid took turns asking “mother” if he or she could take a certain number of steps toward her.
  • It could be something as small as five baby steps, or as large as three giant steps. Your more creative friends might have even jazzed things up by suggesting more unusual options like ballet, backward or bunny steps.
  • The “mother,” in her infinite wisdom, would reply, “Yes, you may,” or “No, you may not.”
  • You and your friends found infinite fun in figuring out the type of steps that might get you across the finish line, but your biggest challenge was in remembering to ask the all-important question, “Mother, May I?
  • If you forgot to ask permission, Mother would force you to go back to the starting line and you had to start all over again.
  • Forgetting to ask permission felt sort of like drawing the “Jail” card in the more sedentary game of Monopoly” (“Go back to the beginning. Do not pass go, do not collect $200”) in that you were highly unlikely to win the game at that point… Take about extreme frustration. Starting over was the worst!

The Games You Play These Days Are Different – And As an Adult, Your Most Extreme Frustration Doesn’t Come From Forgetting to Ask Permission, But Might Possibly Result From Failing to Get a Good Night’s Sleep!

First of all, we all sleep less than we used to, according to a recent Japanese study. The research showed that in 1970 we slept an average of 7.5 to 8 hours a night. In 1990, we slept an average of 7 to 7.5 hours a night.

Nobody knows why this is so, but if you had to hazard a guess, it’d probably be due to our faster-paced “24/7” lifestyle, which offers you less time for play, and in which you have to juggle so many more responsibilities.

But if you want to know how all-pervasive insomnia has become, try gathering together two or three Baby Boomer-aged couples and challenging them to a game of “Truth or Dare.” Or, less dramatically, just mention your recent sleep problems and ask your friends if they have any advice or suggestions.

  • Don’t be surprised if the flood gates open, and you find out that most of your friends are also sleep deprived. Sort of surprising, since you all once thought your sleepless nights would end once your kids were old enough to sleep through the night!
  • The fact is, most Boomers either regularly experience personal trouble sleeping or they know someone who does. Many will even tell you about couples they know who’ve resorted to sleeping in separate bedrooms due to sleep problems
  • If you aren’t bold enough to ask your friends directly, all you have to do is watch TV commercials for a few hours, and you realize you’re not alone when it comes to being challenged to get a good night’s sleep
  • The reasons your friends are losing sleep are many and varied: Everything from snoring to restless legs syndrome, narcolepsy, teeth grinding, night sweats, sleep walking or talking, nightmares, stress, depression and reaction to meds
  • Of course, the pharmaceutical companies suggest all sorts of solutions, but you’re not sure if that’s right for you.
  • And don’t get people started on their fears about sleep apnea and having to wear a mask unless you’ve got a whole evening! That’s a major conversation (Though if wearing a sleep mask can keep you or your spouse from dying of a heart attack or losing your brain function due to oxygen deprivation, isn’t the mask a no-brainer (easy) solution?)

It’s not possible to return to your carefree childhood days when sleep came easily. But, it is possible for you to get a better night’s sleep. And as with your old “Mother, May I?” game, there are dozens of ways you can successfully get yourself to the goal line to win yourself that bliss and energy that comes from experiencing fantastic sleep. Guess it turns out that Mother really did know best…

The first thing your mother would advise you would be to try non-pill solutions first, since all medications have some potential for side-effects. So just like you did with the game, now is when you need to look at the more creative – and successful sleep inducing – steps you can take…

If You Asked “Mother, May I Get Better Rest?” She’d Suggest You First Take These Baby Steps to Improve Your “Sleep Game:” Minor Lifestyle and Environmental Changes

  • Prepare yourself for sleep
  • Follow a sleep schedule, and
  • Get the “sleep vampires” out of your bedroom!

These are solutions that can be extremely effective, and are a great place to start solving your sleepless equation. Here’s how to start:

Take Action to Prepare Yourself for a Better Sleep

Just as your mother had you follow pre-bedtime routine (remember, it probably went something like this: take a bath or wash up, get into your PJs, brush your teeth, story time and prayers, kiss goodnight and lights out) you can still get your mind and body into “sleep mode” with a regular routine that send a message to your brain that it’s time to wind down. Here’s the grown up version:

  • Find ways to relax your body: First, avoid physical exertion just before bedtime. Your goal is to reduce any muscle tension you may have acquired over the day. Try relaxation techniques such as massage, meditation, progressive relaxation, or even taking a warm bath or shower.
  • Unwind mentally: About a half hour before going to bed, stop whatever else you’ve been doing – including watching late night TV – and replace it with an enjoyable low-key activity, such as reading or listening to music. There are even some sleep promoting recordings available, which you might find effective.
  • Drink a glass of warm milk before bed: It turns out there’s a scientific basis for your mother’s old-fashioned remedy. Milk contains tryptophan, a chemical that may promote sleep in some people. And if a solution actually pops into your head while you’re relaxing, make a point to get up and write enough of it down so you’ll remember it tomorrow, then return to bed
  • If you’re hungry at bedtime, try a high-carb snack: It’s harder to sleep if you’re either hungry or overly full. But if you are hungry, select a light snack that is high in carbohydrates, such as a crackers, pretzels or a plain bagel
  • Avoid eating heavy, spicy, or high-sugar foods late in the evening, they activate your digestive system, which keeps you from relaxing into sleep
  • Stop drinking caffeinated beverages after noon: Amazingly, caffeine can interfere with your sleep for up to twenty hours after you consume it. Caffeine is also present in colas, chocolate bars, and cocoa. Even headache remedies and diet pills contain caffeine. Instead try drinking herbal teas or to other energy boosters like ginseng, ginger, and licorice. At night, use calming herbs like valerian, hops, and passion-flower
  • Reduce your alcohol consumption: Alcohol temporarily depresses your nervous system making you sleepy, but it’s rapidly metabolized, which creates a rebound effect just a few hours later, waking you up with a start. So that nightcap you’ve taken for better sleep is actually not a good idea
  • Cut out your cigarette usage: Nicotine alters your energy patterns, locking you into a pattern of stimulation. Perhaps worse, cigarette smoke contains high amounts of carbon monoxide, which replaces the needed oxygen in your body. Both cigarettes and caffeine, can leave you “wired but tired”
  • Consider adjusting your prescription drugs: Many prescriptions, like steroids, asthma medications, thyroid hormone, and decongestants containing stimulants, cause sleeplessness as a side effect. Also, some long-term meds can cause nutritional deficiencies that result in sleep problems. If you adjust the dosage or the time of day these drugs are taken, sleep will often return naturally
  • Don’t get in bed until you feel tired enough to go to sleep: If you find that you’re still awake after lying in bed for 20 minutes, go into another room and do something relaxing, such as reading a book. Return to bed only when you’re sleepy
  • And finally, once you’re in bed, try not to spend time worrying: Don’t allow your mind to dwell on problems – or challenge it to find solutions for them – while you’re in bed. Instead, before going to bed, make a list of problems and “next steps” for the following day

Follow a Regular Schedule

Again, Mother had it right when she tried to keep you on a daily schedule:

  • You’ll find it’s worthwhile to work at going to bed and getting up at the same time every day — even on weekends.
  • Once you make a habit of regular bedtimes and wake-up times, you’ll find that your mind and body become conditioned to expecting to go to sleep at “bedtime.”
  • Once you achieve some success with this strategy you’ll find keeping to a schedule doesn’t seem too confining.
  • Also, plan for regular times to exercise. Ideally, exercise in the morning or afternoon, but avoid exercise in the final four hours before bedtime. (Yeah, getting to sleep’s a lot harder now than when you were a kid!)

Check Your Bedroom for “Sleep Vampires”

When you were a kid, your parents may have helped you eliminate any bogeymen, ogres or monsters who were hiding in your closet or under the bed. These days you can make your bedroom more sleep-friendly by eliminating the “sleep vampires” that are robbing you of your “daily eight.” For example:

  • Block out noise:. Or better yet, eliminate it. Even if you fall back to sleep after noise wakes you, the quality of your sleep is compromised because you need time to get back to sleep. Don’t play radios, televisions, or stereos in the bedroom while you’re trying to sleep, and if sounds “bleed through” your bedroom walls from other parts of the house, silence them as well. If you can’t control the noise, try earplugs or use some sort of white noise emitter to block the sound. This can be as simple as running a fan in your room, or try a white noise machine, which creates a consistent, smooth humming designed to mask other noises
  • Reduce the light in your bedroom: The issue isn’t merely how light affects your eyes. Light also affects the way your brain produces hormones that regulate your sleep cycle. Even a tiny amount of light can disrupt your sleep. Possible solutions: Ask your sleep partner to read in another room; wear a “sleep mask”; use blackout shades or other window treatments to make the room very dark. More on this later in the post…
  • Adjust the room temperature: If you’re physically uncomfortable, you won’t sleep as soundly as you might. Correct the temperature by adjusting the thermostat, your sleepwear, or bedding. Or install a ceiling fan, open or close a window.
  • Hide the clock: If you have insomnia, looking at the clock can make you anxious. Try keeping it out of your line of sight
  • Try banning pets (and children) from your bed: If your dog or cat sleeps in your bed, your chances for sound sleep are jeopardized. Try having your pets sleep on the floor, giving them their own bed in your room, or keeping them in another room. As for any young children or grandchildren who may have wandered in due to their own anxieties, work at getting them to stay in their own beds
  • Don’t talk about problems or challenges you’re facing either at home or work while you’re in your bedroom. Your goal is to get your brain to understand that the bedroom is where you go when you are ready to sleep
  • Don’t use your bedroom for an office or project area: As tempting as it might be to set up your bedroom for multi-tasking, it’s not a good idea. When you use your bedroom for a home office or hobby room, your mind is confused as to the purpose of the bedroom. If space is tight and you MUST allow the bedroom to do double-time, try visually separating your work or task areas from your sleep areas with a partition of some sort
  • Beyond what you do in the room, pay attention to what you do – or don’t do – in or on your bed: Ideally, you don’t want use your bed to watch TV, pay bills, work or read. That way, when you actually get into your bed your body knows it is time to sleep. Sex, of course, is an acceptable exception
  • Finally recognize the impact of your partner’s sleep problems. A bed partner who snores, tosses and turns a lot, talks while sleeping, or gets up often can affect your sleep, even if the activity doesn’t totally awaken you. As mentioned above, earplugs or “white noise” can help. If your partner gets up a lot, make sure he or she sleeps closest to the door. If your partner tosses and turns frequently, consider a larger bed, or even resort to separate beds or bedrooms

You Need to Realize That Your Sleep Problems Are More Than Just a Nagging Frustration, They Are Actually a Health Issue.

When you don’t sleep well, it affects how well you function, how you feel emotionally, and may even affect how well your immune system fights off disease.

Besides that, your health may be affected simply because more accidents happen at night, when our innate circadian sleep patterns would prefer that we are sleeping. Take a look:

  • Every nuclear accident reported so far anywhere in the world has occurred on the night shift, when people are tired
  • Most highway accidents take place between midnight and 6:00 am and are fatigue-related. Their rate is nearly triple that of accidents occurring at noon or 6:00 pm
  • People who suffer from severe sleep apnea have more than twice as many car accidents as the general population
  • Fifty thousand car accidents a year occur because drivers fall asleep at the wheel
  • About 25 percent of American workers have work shifts that are not nine-to-five
  • The most difficult schedule for the body to adapt to is a “swing shift,” the work shift that cycles between the various day-parts. This challenge is similar to “jet lag,” the difficulty the body experiences during travel

Even if you aren’t flying off to Asia or working the night shift, it’s possible that you may have a profound sleep disorder called Circadian Rhythm Insomnia, simply because you live in the city or the suburbs. Why? Urban living there forces you to live and work under artificial light. As a result of unavoidably being exposed to so much light at night, you may actually suffer the same disrupted rhythms and light deprivation that a night worker suffers from. That’s because the natural cycle of the body seems to be about twenty-five hours. (Which is why you get a boost in the fall when we set the clocks back one hour.)

What Can You Do If You Think You Might Be Experiencing Circadian Rhythm Insomnia?

  • Try to work by day under natural light, in an office with windows. If you are an urban dweller, make sure your shades blot out the city lights at night. This will allow your brain the peace of total darkness
  • If you are a shift worker, try to change to an earlier shift. If that’s not possible, try to work regular hours
  • Consider taking melatonin extracts at night. Studies show this may help regulate your body clock. One study of individuals flying to Europe found that of you take melatonin for several days before your flight you can eliminate much of the impact of jet lag. However, not all medical professionals are convinced.
  • A newer treatment for circadian shift problems is simple, safe, and effective: Exposure to light that simulates sunlight. This is the same treatment commonly used to treat seasonal affective disorder (SAD). We’ve now learned that your inner body clock can be selectively manipulated by using bright light

Do You Need to See a Sleep Specialist?

OK, if you’ve removed your sleep robbing activities, put yourself on a sleep-promoting schedule, rid your bedroom of sleep vampires and STILL can’t sleep, you probably realize it’s time to take bigger steps.

Your first step will be to recognize that the sleep problems you or your partner are experiencing could be symptoms of an underlying illness or a complication created by medications you might currently be taking. So if you’re still playing the “Mother May I?” game, you’ll want to call your primary healthcare provider and make an appointment to discuss your situation.

You’ve probably heard that in recent years health-care professionals have become increasingly aware of the importance of sleep. So much so that professionals from a wide range of disciplines — including neurology, pulmonology (lungs), psychiatry, psychology, and otorhinolaryngology (ears/nose/throat) — have developed secondary specializations in the area of sleep. But trying to take a giant step there directly will get you nowhere.

Most certified sleep specialists require referrals from your primary care physician, so that’s why your best plan of action is to see your regular healthcare provider first. If he or she suspects a serious sleep disorder or feels testing would be beneficial, you will be referred to a specialist. And depending on the symptoms you report, that referral can happen lightening fast, so don’t try to bypass the referral step!

You’ve probably realized that some sleep specialists operate free-standing sleep centers sleep centers or sleep labs designed to diagnose sleep disorders while others work from hospitals or clinics. Maybe you’ve even heard that some testing can be done in the comfort of your home.

Where you end up will depend on what sort of issues you’re experiencing. Some centers are geared toward assessing breathing-related sleep problems, such as sleep apnea while other centers address a broader range of sleep disorders, including problems related to

  • Snoring
  • Restless legs syndrome
  • Narcolepsy
  • Teeth grinding
  • Night sweats
  • Sleep talking
  • Sleepwalking
  • Nightmares
  • Stress
  • Depression
  • Medications or other health issues which can impact your sleep

So To Sum It All Up, Here’s the Final Way Sleep Problems Are Related to That Old “Mother, May I?” Game:

There are a lot of ways to get to the goal line – once again getting a good night’s sleep. But your first step, once you’ve tried the suggestions listed above, needs to be to contact your primary care practitioner, and get a referral — the ol’ “Mother May I?” permission — to see a sleep specialist.

And if the worst case happens? If for example, it turns out you have sleep apnea and you’re advised that you ought to wear a sleep mask to bed every night? Here’s the great thing about that: Your neurologist will explain that if you wear the mask, you’re instantly and completely cured.

Which means you’ll have a lot more energy to go out and play with your friends! How wonderful is that!

Newly Diagnosed with Type 2 Diabetes: Wondering if You’ll Ever Be Able to Enjoy Treats Like Chocolate, Ice Cream, or Granola Again?

September 6, 2008 by  
Filed under Anne Holmes, Blog, Diabetes, Food & Recipes, Wellness

Can You Still Eat Treats With Type 2 Diabetes?

If you’re like most Baby Boomers who’ve suddenly found themselves with newly-acquired Type 2 diabetes, you were probably totally shocked when routine blood work during your annual check-up revealed your blood glucose numbers were “out of whack.” (Sorry, Highly Technical Term)

It Seems Baby Boomers Are More Likely to Develop Type 2 Diabetes

The typical Type 2 Diabetic profile includes:

  • Over 40
  • Sedentary and overweight, especially with excess weight around the middle (“Apple” body type)
  • Hispanic, Black, Native American, or Asian background

The Good News is You Can Handle It – Even the “Healthy Eating” Part!

Here are some helpful tips to get you started on the road to glycemic control:

  • Set goals for controlling your diabetes with your doctor
  • Arrange for some training in how to handle your new challenge. (Many hospitals and clinics now have diabetes education offerings, and many insurance programs cover this)
  • Check out web sites designed to help you manage your diabetes, too. All have great tips and recipes. Here are several good ones:

Be Honest About Your Eating Habits

When you meet with the dietician during your diabetes training sessions, it’s tempting to try to put a “good face” on your eating habits, but best to tell the truth… Your goal is to find out what changes you need to make in your diet in order to keep your blood glucose numbers in control.

  • Don’t worry, most likely you will still be able to enjoy eating many of your favorite foods – but now you’ll learn to use healthy moderation
  • Your dietician will show you that you don’t have to settle for boring food; in fact, you’ll still be able to enjoy loads of foods with ethnic and regional flavors
  • Realistically some foods may have to be prepared differently
  • But amazingly, many of your old favorite treats, like ice cream, chocolate or granola will probably still fit into your healthy new regimen.
  • Apparently it’s not so much about the sugar, as it is about something called the “glycemic index” which measures how fast a food is likely to raise your blood sugar.

Your Dietician Can Best Advise You on Your Situation

Everyone’s specific situation is different, and diabetes is not to be ignored, so this post does not attempt to provide medical advice. But just to prove that you probably will be able to enjoy some of your old favorite foods – in appropriate moderation, of course – here are a handful of diabetic diet-approved recipes for granola. For help with your dietary calculations, all of them come complete with nutritional information.

Remember, Granola isn’t Just for Breakfast (or Hippies) Anymore… Never Was, Actually

You can also enjoy it as an appetizer, a snack, or pack it with you on a hike. The hiking-take-along concept is important; since you’ll most certainly be looking for ways to get more exercise, and a brisk hike accented at the end with a snack like one of these crunchy and naturally sweet granolas can be extremely satisfying!

What a Delicious Way to Reward Yourself for Working Up a Healthy Sweat!

  • Granny’s Old Fashioned Apple Granola
  • Eight Great Recipes for Low Fat Homemade granola

Why not plan to enjoy one of these delicious and nutritional recipes today!

The Shocking Truth About Hip Hop Dancing: Who Knew It’s Actually A Hellaciously Fun, Heart-Healthy Workout That Also Benefits Your Brain?

September 4, 2008 by  
Filed under Anne Holmes, Blog, Health & Fitness, Memory Loss, Wellness

If you’re like many Baby Boomers, you’re always planning to get to the gym “next week” when you life won’t be quite so busy. (Yeah, right.) You probably already know that what you really need to do is to find an exercise program that is so much fun you can’t wait to get back to it. (And of course, it’d be even better if you could do it wherever you find yourself – at home, at work or on the road – without having to buy any expensive equipment). Otherwise, with your “busy-busy-busy” lifestyle, fitting in a trip to the gym falls to the bottom of your to-do list

Maybe the Beijing Olympics Inspired You a Bit?

No doubt watching 42-year old Dara Torres anchor the U.S. women’s 4×100-meter freestyle relay to a silver medal finish encouraged you to find time to get back into a fitness routine. Dara’s certainly a testament to dedication, passion and willpower. Doubtless she motivated millions of Boomers who’ve slipped away from the health benefits of a regular exercise routine.  But for fitness-challenged Boomers, Dara may not have been the most inspirational presence at the recent Beijing Olympics. Nor were the 20 other older Olympians – motivational as they were — who represented other sports, including:

  • John Dane, a 58 year old sailor, whose pursuit for an Olympic berth began 40 years ago in 1968. Dane has teamed with his son-in-law to make the team in the Star event.
  • Libby Callahan, 56 year old pistol shooter and retired Washington, DC police officer, who competed in her fourth Games.
  • Hiroshi Hoketsu, Beijing’s oldest Olympian at 67, who competed on the Japanese equestrian team.

No, For Pure Fitness Inspiration, Nothing Could Possibly Beat Beijing’s “Hip Hop Grannies” – Who Weren’t Even IOC-Sanctioned Olympians!

Did catch the Hip Hop Dancing exhibition led by Wu Ying, a 70 year old Chinese grandmother from Beijing? Her troupe, the Hip-Hop Grannies,” performed on set of the Today show, and were truly amazing. Check it out for true inspiration!!

For The Hip-Hop Grannies, Dancing Proves “50 Is the New 30”

Wu Ying is from a generation that lived through some of modern China’s most tumultuous decades, including the stifling Cultural Revolution era, when western cultural thought and influences were banned. She probably never heard of the Boomer slogan “50 is the new 30,” but she does know the benefits she’s gained from her fun exercise program that she can practice anywhere. And she plans to dance for as long as she physically can, noting:

“I think that dancing hip-hop has made me younger, happier, [and] improved my memory.”

Dancing Also Benefits Mental Health

The physical health payoff from dancing might appear obvious, but there’s more: Regular physical exercise also staves off dementia and improves mental acuity. Just ask the “Grannies:”

  • Liu Jian Zhu, a 59-year-old former pharmacist with the Chinese air force, said dancing hip-hop has been “a breakthrough” for her. “Since I was in the military, my life had been required to be serious and intense,” Liu explained. “It has really changed my life and personality.”
  • Wen Di, 55, used to work as a railroad construction technician, but after retiring just last year she wanted to find something to fill what she called the emptiness in her life. “I saw Wu’s dancing on TV and thought that it was very inspiring.”
  • Says Wu: “We represent a new image, a new fashion for Chinese grandmothers. We develop with time and connect with the world. We don’t just learn our own Chinese culture. We learn cultures from other countries to enrich ourselves and our lives to lead a more colorful and high-quality life.”

How the Chinese Dancing Grannies Got Started

Wu Ying began performing hip-hop routines in 2003, after catching the first National Hip-Hop Dancing Competition on Chinese television:

  • “The competitors were all young people, wearing headscarves, headdresses, hats, and various clothes,” recounted Wu, a retired accountant who was 66 at the time. “I thought that was very fresh.”
  • Inspired by “the look they had in their eyes, the way they moved their fingers, heads and bodies,” Wu thought hip-hop dancing would be perfect for herself and China’s aged and infirm.
  • Wu set out to learn hip-hop dancing at a local gym.
  • She also began looking to put together a five-member troupe to promote hip-hop dancing by touring the country and by performing on Chinese TV.

The Hip-Hop Granny Dance Team soon formed and the Grannies – whose average age was 60 – made their debut in August of 2004 at the Beijing qualifier for the National Hip-Hop Dancing Competition.

  • They faced off against people several decades younger.
  • “They (the younger competition) were professionals.”
  • “We seniors didn’t know much so we were very nervous.”

But their daily rehearsal routines paid off; the women walked off with third prize.

So Now It’s Your Turn to Get Up Off Your Couch and Started Dancing!

Here’s how to start hip-hop dancing in your neighborhood!

  • Download your free Hip Hop Radio toolbar, and start dancing to the hip hop beat from the comfort of your home.
  • Find out if there’s a dance studio near you offering adult hip-hop and sign up. Do it now. Don’t let the grass grow under your feet! (They really wanna be dancing!)
  • Check out this great list of hip hop dancing videos which you can order online and start learning in the comfort of your own home.

And one last parting thought: Wu Ying says the next dance she plans to tackle is break dancing! Think you can keep up with this spry septuagenarian Chinese grandmother?

Love, Romance May Still Flourish in the Nursing Home, But Can An Advance Directive Give Residents the Right to a Sex Life?

August 9, 2008 by  
Filed under Anne Holmes, Blog, Health & Fitness

I just read a thought-provoking article which begins, “She was 82. He was 95. They had dementia. They fell in love. And then they started having sex…”

Written by Slate’s Melinda Henneberger, it’s a modern day Romeo and Juliet tragedy titled “An Affair to Remember,” which is somewhat of an ironic title, since it deals with Alzheimer’s and loss. In the article, we read that perhaps a document which doesn’t yet exist — a sexual power of attorney — might have eased the pain all around.

I agree, and I’m all for it. But as it doesn’t yet exist, I’m suggesting that at minimum, Dororthy and Bob could have been protected by an Advance Directive, especially if when issuing it, each had had a frank discussion about their wishes with their Power of Attorney-designee. But that would have involved having some REALLY frank discussions…something few of us might be up to talking about with our parents — or our children.

When Dorothy Met Bob…

This is the true story of Dorothy and Bob (not their real names) who met in their assisted living community. As backstory we learn that:

  • Dorothy, a widow of sixteen years, had married her childhood sweetheart upon his return from WWII, and together they’d raised four children, built a business and traveled the world. She lapsed into dementia following his death.
  • Meanwhile, Bob had been married three times, and prior to meeting Dorothy, had been quite a player within the nursing home, inviting different ladies to dinner nightly.

But once the two met, it’d clearly been love, and according to Henneberger, their relationship had been beneficial for both of them.

“Whenever Bob caught sight of Dorothy, he lit up “like a young stud seeing his lady for the first time.” Even at 95, he’d pop out of his chair and straighten his clothes when she walked into the room. She would sit, and then he would sit. And both of them began taking far greater pride in their appearance.

Dorothy went from wearing the same ratty yellow dress all the time to appearing for breakfast every morning in a different outfit, accessorized with pearls and hair combs.”

The two often spent time at the piano, Dorothy playing while Bob sang. Never mind that he always sang the same song, no matter what Dorothy played, it was clear to all observers that they were happy together.

Bob’s Son Puts a Stop to the Relationship

However, Bob’s son, who had been appointed Bob’s guardian, decided to put a stop to the relationship after walking in on his father and his new girlfriend having sex in Bob’s room.

After getting over his initial sputtering shock, he asked the facility’s staff to ensure that they were never left alone together, then a month later, moved Bob to another nursing home without first notifying either Bob or Dorothy.

We read that Bob was hustled out in greatly confused distress, while Dorothy looked on, perplexed.

Now here’s where the story really began horrifying me:

  • Once Bob was gone, Dorothy stopped eating.
  • She lost 21 pounds, was treated for depression, and hospitalized for dehydration.
  • She sat in the window for weeks waiting for Bob’s return.
  • She doesn’t do that anymore, though: “Her Alzheimer’s is protecting her at this point,” says her doctor, who thinks the loss might have killed her if its memory hadn’t faded so mercifully fast.

Sexual Power of Attorney

In the article, Dorothy’s daughter, who is an attorney, comments (maybe facetiously) that a Sexual Power of Attorney might allow the elderly to control their own sexual experiences when they reach a point of dementia.

I’m not sure how this sort of power of attorney would work or how anyone might go about designating a person to oversee his or her sexual future. The concept however, is very interesting.

Shouldn’t someone have protected the couple’s right to privacy—their right to have a sex life? As the facility manager reminds us in the article, “We were in uncharted territory.”

Certainly there are many questions:

  • Can someone with dementia give informed consent?
  • How do we protect against what might actually be “date rape?”
  • How do caregivers balance safety and privacy concerns?
  • When families object to a demented person being sexually active, are nursing homes responsible for chaperoning?

Manager Say It Was Her “Worst Professional Experience”

  • In all of her years of working with elderly people, this was not only her worst professional experience but was the only one that left her feeling she had failed her patients.
  • She had a particularly hard time staying neutral and detached, she said, because she kept thinking that “if that was my mom or dad, I’d be grateful they’d found somebody to spend the rest of their lives with.”
  • In fact, as a result of the whole experience, the manager, who is 50, had a different version of “the talk” with her 25-year-old daughter, instructing her never, ever to let such a thing happen to her or her husband:
  • “I hope I get another shot at it when I’m 90 years old.”

Dorothy’s doctor also took this experience personally.

  • “Can you imagine as a clinician, treating a woman who’s finally found happiness and then suddenly she’s not eating because she couldn’t see her loved one? This was a 21st-century Romeo and Juliet.
  • And let’s be honest, because this man was very elderly, I got intrigued; my respects to the gentleman.” His patient was happier than he could ever remember; she was playing the piano again, and even her memory had improved.
  • But after the trauma of losing Bob, Dorothy’s doctor came close to losing his patient, he said, adding that most people her age would not have survived the simultaneous resulting insults of depression, malnutrition, and dehydration.
  • “We can’t afford the luxury of treating people like this. … But we don’t want to know what our parents do in bed.”

Henneberger notes the conflicted feelings, writing:“We’re squeamish about the sex lives of the elderly—and even more so when those elderly are senile and are our parents. But as the baby boom generation ages, there are going to be many more Dorothys and Bobs—who may no longer quite recall the Summer of Love but are unlikely to accept parietal rules in the nursing home. Gerontologists highly recommend sex for the elderly because it improves mood and even overall physical function, but the legal issues are enormously complicated, as Daniel Engber explored in his 2007 article “Naughty Nursing Homes.”

At Minimum, WE ALL NEED a Signed Advance Directive

  • I believe that we all need to designate someone to whom we would trust our life to be our attorney-in-fact or proxy.
  • We need to trust this person to not only keep us alive should we find ourselves in a vegetative state or to pay our health care bills when we’re incapacitated
  • We also need to know that this person’s values and beliefs are in line with our own – including our beliefs on sexuality and sexual behavior
  • We need to be able to trust this person to make the same decisions we would make, or at least follow our intent and look out for our best interest

In the case of Bob and Dorothy, I don’t feel that Bob’s son was truly looking out for his father’s best interest. I have the feeling he might have been trying to safe-guard his inheritance or to keep his father “alive-but-lifeless” to satisfy his own need to keep his father around.

Which Leads Me to My Closing Thoughts:

  • First, perhaps immediate family members are not always the best people to designate for such important roles. Certainly this sadly botched love affair shows the incredible intensity and human cost of an issue that, as Dorothy’s doctor says, “We can’t afford to go on ignoring.”
  • And finally, as much as I know that my two adult children don’t want to think their parents or grandparents actually have sex lives, I’m going to send this post to them, and suggest that it’s time we have “the new talk.”
  • And finally, what do you think about this? I hope you’ll make time to talk about this within your families, too.

Meanwhile,

  • As Baby Boomers we need to recognize that Advance Directives are not just for our parents in the nursing home, they’re for all adults.
  • They’re designed to spell out what kind of treatment we would want if we were to experience a stroke, a heart attack, an auto accident, or some other situation which leaves us suddenly incapacitated, and can protect us at any age.
  • If you or your parents don’t already have a signed advance directive – preferably both a living will and a healthcare power of attorney – in force, you need to take care of this immediately.

Send for my free report on these crucial topics. Just fill in your name and email address in the box below, and click the button that says, “Send me information on protecting myself and my family with an Advance Directive.” Please do it now! None of usknow what tomorrow will bring…

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