Welcome.

And thank you for joining us for Aging Answers, where we seek to explore the challenges of aging, provide valuable insights and destigmatize the natural act of aging.

I'm your host, Paula Cunningham, and I will be joined today by our experts here to talk about the importance of mental fitness.

We have Dr. Jed Magen.

Dr. Magen is associate professor and chair of the Department of Psychiatry at the Michigan State University Colleges of Osteopathic and Human Medicine.

And Michelle Traill-Crosser, who is director of sales and marketing at Burcham Hills Retirement Facility.

Thank you both for joining us today.

This is going to be an exciting conversation and we're going to start with you, Michelle.

Let's talk about aging.

At what point should we start talking about aging?

That's a big question.

I would say start talking about it today.

Start talking about it right now because you're always in the process of aging.

My experience is that for some reason, people plan up until retirement and then they stop planning.

They might obviously plan where they're going to go to college, where they're going to buy a home, if they're going to have a family, where they're going to go to work, what age they want to retire.

They have a good 401k and a pension.

And then they seem to think that's it.

They're done.

There's a lot of life that comes after retirement.

Paula: Absolutely.

It's better to have a plan and not need it than to have no plan.

It's almost inevitable your mobility is going to decline.

Your health is going to decline.

You don't want to be stuck in that crisis mode trying to figure out what you're going to do.

You want to have something in place.

So when you talk about health declining, people sometimes, like you said, they plan for retirement, they plan for post retirement, but they don't take care plan for their own health and their mental wellness and what's going to happen to them.

So what are some of the things that people should be mindful of as they age?

And we talked about the, you know, the 401k, we talked about those things.

What else should they be mindful of in terms of their self and their health?

Well.

From from my standpoint, from looking for where you might want to live at that point, I think it's important to look for some place that has many, many options because you don't know what the future is going to bring.

We have people I move people in in their nineties who you'd swear were 72.

They're very active.

They're very cognitively sharp.

I have people who might move in in their sixties who are very compromised cognitively and physically.

So I think when you're planning, you want to make sure that you are looking at something that provides you with a lot of options where you can change your plan as needed.

And we talk a little bit about aging in place and what that means, but also exercise.

And I know that you have some knowledge about taking care of yourself.

Ira Which one of you want to respond to how important exercise is as you age and to continue to exercise and stay active?

Well, Dr. Magen, maybe you can contribute to that, but.

Well, exercise, you know, these things start really early.

So if you're in your teens or twenties, that's a great time to start, right?

It's not it's good, but it's not great to start when you're in sixties, you're in the sixties or seventies.

So exercise does a whole bunch of things.

Obviously, it's great for cardiovascular health, but it's also anti-inflammatory.

As we get older, we get more inflamed, unfortunately.

And so exercise, that anti-inflammatory piece is really as important as the cardiovascular fitness piece.

So start early and keep doing it.

And it does something mentally for you as well as I.

Absolutely.

Talk about that.

So exercise is a great stress reliever.

We think it's probably implicated in preventing a whole bunch of psychiatric disorders, mental illnesses, among them Alzheimer's.

Again, probably because of that anti-inflammatory piece.

You know, there are we talk about care people who are transitioning, but there are caregivers also who are taking care of their loved ones and I have seen we've all seen where something happens to a person and they need a caregiver either I think it was Rosalynn Carter, said that you're going to be one You're going to need one or you are one.

A caregiver.

What do they need to do?

What do people need to do to make certain that they're not dependent on someone else?

You talked about planning, but what else needs to happen in someone's life as they begin to age and they can't take care of themselves?

Well, I think people need to realize that there's a lot of options.

You can have caregivers come to your home.

You can have you can move into a community that provides care for you.

But I think and this is very difficult, you need to be willing to accept the help when you need it.

And as a caregiver standpoint, you need to be able to know when you're at your limits.

I think I tell people all the time, at some point you need to allow yourself to go from being the caregiver back to being the spouse and let somebody else take over as a caregiver.

We see a lot of caregivers whose health declines quicker than the person that they're caring for because they're not taking care of themselves.

Right.

How how much of our health is genetic?

I mean, some people will say, you know, my mom had this, my dad had this or that.

Well, you know, so you you can't pick your parents.

You can't pick your genes, but it helps to have good genes.

So absolutely.

And you see these people who are in their eighties and nineties.

You say, well, how did you do that?

And say, well, I had bacon and eggs every morning.

That's probably genes, but a whole big chunk, maybe more, probably more is really environmental and, and, and individual kinds of issues.

So again, if you exercise, if you eat well like a mediterranean diet, if you have a good outlook on life, if you're optimistic, family support, you know, and social support are incredibly important.

So all those things are probably more important than your genetic endowment.

Wow.

So you mentioned the social life, the social isolation was a major, major factor during COVID and still can be a major factor for folks.

When you say social.

I'm taking the keys from someone.

Okay, so how do I get around?

What do I do to stay connected?

To stay involved?

I don't want to be dependent on someone else.

Any tips or suggestions for people?

Well, I talked to a lot of people who hesitate to move into a senior community because they tell me they're going to lose their independence.

And I usually turn that around and I just ask them, what do you do typically for your day?

And a lot of times their day is spent alone.

They might wake up in the morning, have some toast, watched TV, maybe go for a walk, maybe wait till my daughter stops by on her way home from work and then watch TV and go to bed.

I usually say to them, Well, how independent is that, really?

Are you going out?

Are you able to go out?

Can you go down the hall and have dinner with your friends?

Can you sign up to go for an outing?

And then when they think about it, they really can't.

So what I encourage and again, I'm coming from a senior retirement community viewpoint.

Think about how much you can be isolated in your home if you're just striving for independence.

Or do you want to be truly independent?

Meet with people, talk with people.

You mentioned that social isolation during COVID The news was full of articles about senior living communities.

My mother was living by herself, so I would drop things off in the garage.

She only saw me or my family.

She was in her eighties.

I think that was much more detrimental than those people living in senior communities.

They saw their neighbors.

They saw the caregivers.

They saw the hospitality staff.

They saw the housekeepers.

So I think I don't know if there's ever been any study done at this point with our senior community in how that social isolation impacted them compared to yeah, there might have been a little bit more risk of contracting COVID if you lived in a community setting.

But how does that compare to the social isolation?

Everybody can't afford a community that type of facility, right?

I mean, so you've done AARP's, done studies, and 89, 90% of people want to age in place.

They want to age in their own home.

They want home and community based services people to come in to help them in their own home.

Go ahead.

You know, you can't you really can't overemphasize the social connectedness issue enough, really.

You know, humans are social animals.

And we see many, many, many people, usually women, because they tend to outlive men.

And the exact scenario that you point out, they're living at home, they don't really have a lot of connectedness.

They get depressed, they don't have stimulation.

So, you know, and acknowledging that people don't have financial means, often there's the Internet, so you can stay connected via social media.

You know, if your grandkids are in California, if you can stay connected with them and you can actually see them.

So there are those kinds of things.

You've got to also try to take advantage of whatever resources are out there.

In East Lansing, you got the Hannah community center, you know, and other sorts of places.

And in part, I think it's a responsibility of the medical care team to kind of help these people connect with those kinds of things as possible.

Absolutely.

And people don't know where to go.

Navigating through a system can be very challenging.

And we already have some medical conditions going on.

I mean, things like crossword puzzles and being online with different groups.

I know an older woman, she's 93 and she plays bridge three times a week.

You know, those are the types of things that you don't want to stop.

One of my friends used to say she was an emergency room nurse and she said, Honey, whatever you're doing at the age of 20, 30, 40, 50, just keep doing it.

If you're jogging and you can't jog, then walk.

You know, you're standing, you can't stand and then sit, but just keep doing it.

So it's so important to stay active and stay involved.

What do you see?

I mean, you've been in this profession for how many years?

Oh, 40 plus.

So what do you see?

What is the number one?

Number one or two?

You're aging.

And look, we're all aging.

That's a good thing.

The alternative meets the alternative, right?

Right.

So in your 40 years, what are the top two or three aging issues that you've seen that you can tell people will help them if they do X?

Well, I think one is the social isolation.

I think second is chronic diseases.

So people really develop all these chronic diseases.

It begins to limit them in terms of mobility, in terms of, you know, having chronic disease begins to take time, lots of doctor's visits and that sort of thing.

So you got to really take care of those chronic diseases.

And sometimes you have to find those alternative kinds of methods of doing the things that are in interest.

Interested in interesting to you can again keep you vital crossword puzzles.

You know, you don't have to have a lot of mobility to play crossword puzzles.

And I think thirdly, you know, there's a lot of denial as you get older and in I think as you were alluding to, You've really got to be realistic about what you can do and what you can take on as you get older.

If you can't live independently, then you've got to be realistic about that.

Paula: Same question.

Well, I see a lot of people who have and I agree they have been a little bit in denial about what their needs are.

And I, from both the standpoint of the individual and then maybe the adult child, sometimes the adult child has to be a little bit creative in their suggestions.

I was talking to a friend who said, my father refuses to use a cane and I'm worried he's going to fall.

And I said, Have you ever thought about using a walking stick?

Sometimes just the word cane as opposed to a walking stick makes a big difference.

So what I notice is, you know, people in their their desire to stay in their home sometimes sell themselves a little bit short and what they could be enjoying in their life.

This generation, in my observation, seems to put a lot of priority on their home, almost more than themselves.

Like so I think sometimes they need to step back and say, You're sacrificing a lot to maintain this 200 or 2000 square foot home.

How about if you had a 300 square foot studio apartment and your focus was on yourself?

Yeah, that's you know, housing is an affordable housing, particularly for older adults, is a major, major issue right now.

And even people who want to downsize as we talk about aging and aging answers, they can't find that 2000 square foot home from their former four or 5000 square foot home anymore.

And so home community based services having more services available too for people, that's another option, right, for people to come in, you know, to help with the meals or to help with the cleaning or the washing, so that when you do come home and you talk about the caregivers have to having to take care of themselves.

So when you do come home, you don't have to worry.

You can be mentally stressed over all the other things that you have to do.

Plus taking care of a loved one.

And I often tell people, just make one phone call.

And a lot of times that one phone call will they will provide other resources.

If you just call tri county office on aging, they're going to give you other resources.

If people just call me.

A lot of times I'll talk to them.

They don't really need the services of Burcham Hills.

Maybe they can afford the services of Burcham Hills.

I'll give them places to call.

Yeah.

So if you're feeling overwhelmed, just make one phone call.

You know, Tri-County Office on Aging is a great resource.

There's a resource called PACE, which is really for medical care, and it will really fulfill a lot of your needs.

You know, I can't help but reflecting my mother, bless her heart, you know, lived in this big house and we were afraid we'd find her at the bottom of the stairs one day, you know, and kept saying, you know, no, I don't want to you know, you have this intergenerational conflict.

But eventually she moved to Burcham, you know, which was which was perfect.

And then she really went through the continuum of Burcham.

And it was, you know, was incredibly helpful.

And people don't like you're saying people don't often understand the alternatives that they have.

They're so wedded with that house, you know, that's that they want to stay in their own home.

They want to stay there.

And there are ways that you can do that.

I mean, because, again, everybody can't afford to move in to another facility.

There are ways that you can do that.

Tri-County Office on Aging can help you whatever you want to do whatever your desire is to help you.

And there are some resources on AARP, Michigan forward slash care in terms of resources where you can go if you need someone to turn, you know, you've got a husband that you need to turn two or three times a day or you've got meals that you want to be brought in there, resources out there that people can go to.

We're living longer.

Michigan has one of the fastest aging states in the nation.

I think we're the third or fourth fast, fastest aging state in the nation as a state as infrastructure and policies.

What do we need to be paying attention to?

What do we need to advocate for?

For older adults?

Well, I think right now.

So the big issue right now is going to be Medicaid.

So, so many older individuals now, you know, older individuals who got Social Security, they're eligible for Medicare, a certain proportion are eligible for Medicaid.

And Medicaid provides a lot of services.

The kind of cuts that the federal government is talking about now can be really devastating to a lot of services.

People don't realize that Medicaid is not just insurance for people who are lower income.

Medicaid supports big programs within the state.

And as those get cut, those programs begin to go away.

So that's a really critical issue right now.

I would agree.

And I think that there's a big, big gap.

If you qualify for Medicaid, wonderful.

If you are financially capable to afford some place like Burcham Hills, great.

There's a lot of people that are in that middle ground.

They they have worked hard all their life.

They have Social Security.

They might have a 401k, There's still a financial gap.

And as a society we really need to address that.

I mean, I don't have the answers to that.

I don't have the solutions, but I see the problem every day I don't have the solutions, but I see the problem every day where people look at me and say, How can we afford this?

Yeah, yeah.

Yeah, yeah.

And it's prescription drugs is another one in the affordability for prescription drugs.

We know that there was some legislation passed that reduced the price of insulin that capped it at $35 per month.

And you know, you only have to pay like... $3,000 a year for your prescriptions drugs.

That's another major issue as people begin to age.

And I think about Michigan in particular, do we have enough housing?

Is there enough sufficient housing is for people to for older adults, affordable housing so they can downsize and also look at meals and, you know, go through Wayne County or some of the eastern parts of the state, east side of the state.

And people are still hungry.

I mean, they can't find the kind of they can't afford the meals, you know, that they need, the kind of nutrition that they need.

How important is nutrition and food and toward, as you age?

I mean, you can't eat the same things.

I can't eat the same things I used to eat.

Of course, it's incredibly important.

And again, you know, you may think you're immortal at age 20, but what you do at age 20 actually has consequences for what you look like at age 70 80 and hopefully beyond that.

for what you look like at age 70 80 and hopefully beyond that.

So actually, there's a big study that just came out recently and it looks like the Mediterranean diet and the Dash diet, which is which was developed for hypertension, really are the two healthiest diets and really help you prevent the development of chronic diseases as you get older, highly processed foods, on the other hand, red meat, those kinds of things not so great for you.

Now, problem is, of course, you know, fresh fruits and vegetables, those kinds of things can be more expensive.

And so you get back into the into the income issues, ultra processed foods, cheaper, easier to make and so on.

So what do we need to do to make certain that as we age and we're all aging, that young people are more conscious of what they put in their system?

Because right now, you know, the school you know, the school lunches have gotten a little better, I understand.

But it's still what they put in their system.

If you watch at a basketball or football game.

If you watch at a basketball or football game.

It's it's of so it's part of it.

We got to get rid of food deserts.

That's that's a huge problem in cities particularly.

But even in even in rural areas you may have to drive 20 miles to a grocery store.

So I think those kinds of things, you know, educating people helps.

Education doesn't change behavior a whole lot.

Unfortunately.

You got to get to families and you got to get to parents.

And how do you do that?

I think some of that's education, some of it's you know, we as physicians ought to be talking more about diet.

Do you have classes on diet as you go through med school, on nutrition?

Not much.

That's what I personally.

We spend a lot of time with.

But there's a lot of information out there.

There's a lot of information.

And you talk about the Dash diet.

Yeah.

Tell us about that.

Dash diet is another it's a Mediterranean like diet.

It emphasizes fruits and vegetables and, you know, higher protein kind of foods, fish, those kinds of things, less red meat, that sort of thing.

It's not a lot of salt.

Is it true that you are what you eat?

You know, kind of I mean, I mean, it just has all these behaviors that you engage in early in life really do have these tremendous implications for what happens later in life.

And that's what we need to be more cognizant of, right?

It absolutely is.

What happens later in life.

What have you seen?

And you've been doing this work for how long Michelle?

I've been working with seniors for about ten years.

Okay.

So in a ten year span, what have you seen The most egregious thing that we don't do that we should be doing?

Is in planning?

Is it What is it?

Well, planning is a big part of it.

I think.

And this might be kind of touchy.

Family involvement is a big part of it.

You know, we don't all have a daughter or a son that live in the area.

And if you don't, you know, try to connect with somebody that's going to check in on you periodically.

Prior to working at Burcham Hills, I had a franchise that helped people downsize.

And the number of times that we went into someone's home, maybe after they passed away, I went in there.

Then the children came in and hired me to clean it out and they were astonished about the conditions that their loved one had been living in.

I felt bad for them.

I wasn't judging them.

But, you know, their their visits were kind of surface visits.

So I think that that's the thing that may makes me feel bad, is that sometimes there's nobody checking in on our senior citizens, maybe knocking on the door and delivering Meals on Wheels, but not walking in and seeing how people are actually living.

A big part of aging is memory loss.

We haven't talked a lot about that.

What are some of the signs that we should look for?

People should look for when it comes to memory loss in Alzheimer's or dementia and what can be done.

If you misplace your car keys?

Don't worry too much about it.

So everybody does that.

Yeah, more significant memory loss if you have trouble going to the store and figuring out how to get there, if you begin to have trouble with calculation, that sort of thing.

The problem with Alzheimer's usually is learning new information.

So if if I asked you, you know, where did you live 20 years ago, you could tell me.

But it was something new that you encountered a day or two ago, or you just moved someplace having trouble retrieving that information or the kinds of things some of the things we begin to look for.

And more and more people are suffering some type of memory loss, it seems like.

I don't know what the reason behind that is.

If you think that your loved one is suffering from some type of dementia, what is one thing you should do?

You got to get a medical evaluation and and look at that.

So it could be your family physician.

Often people get sent to neurologists for those sorts of things, geriatricians or geriatric psychiatrists.

I always tell people to and don't be ashamed, you know, they want to hide someone when they're not fully functional and not have them be social anymore.

I think that's a big mistake.

Yes.

Yeah.

So you get some kind of diagnosis to make certain that they are actually suffering.

From getting evaluation to figure out what's going on.

We've got about a minute left I'd like for each of you to give our audience one tip on, something they should do today to begin that aging process, that aging answer today.

One thing.

Get information and then decide what's the one kind of healthier thing you're going to do.

Paula: Nice.

Very nice.

I would agree.

Get information.

I've had people come in.

They've talked to me when they're 55 and said it's a long time down the road, but what can you do?

Thank you for that.

Thank you so much.

You all are awesome.

Appreciate you.

We're out of time for today, but thank you so much to my guests, Michelle Traill-Crosser and also Dr. Jed Magen, I'm Paula Cunningham and thank you for joining us for Magen, I'm Paula Cunningham and thank you for joining us for aging answers.

Thank you.

Thank you.