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February 2012

International Aging

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USC Leonard Davis School of Gerontology dean Gerald C. Davison, PhD and assistant clinical professor Aaron Hagedorn, PhD, were among the international experts chosen to pen a chapter for the World Economic Forum’s Global Agenda Council on Ageing Society’s newest publication, Global Population Ageing: Peril or Promise?

Containing 22 essays by authorities whose expertise spans the globe—from the United States to the United Kingdom to the Netherlands and Japan—the book examines the interplay between ageing and multiple facets of the modern world, including urbanization, equity, media portrayal, leadership, economic security and, in Davison and Hagedorn’s chapter, gerontechnology: the interdisciplinary study of the interaction of technology and the unique challenges and needs of older people.

“We discussed how current and emerging innovations in technology and design can improve quality of life and, for older adults, extend the time they can ‘age in place’ rather than be consigned to residential settings for elders,” said Hagedorn.

“Technology can help level the playing field across the generations, enabling higher productivity for mature people who may be able to contribute productively for a longer time,” Davison said. “Aging societies will need to adapt, finding new roles for older people and supporting the sense of self-worth and self-sufficiency that enable them to maximize their physical and mental potential.”

The scope of gerontechnology’s ability to revolutionize the way we age is virtually limitless, and both Hagedorn and Davison see possible applications for every facet of life over time.

Look at what technology has done to the job market and general communication in just a few years, for example. The timing of technological expansion into the lives of older adults is excellent, since population aging and medical inflation are straining our existing framework for health and social services,” Davison said. “Implementing technological solutions across the board could result in improved quality of life and potentially save an extraordinary amount of money. Gerontechnology is changing the face of what it means to age.”

“I hope this chapter gives insight into the network of scientists behind technology designed for older adults, and a sense of how the field has developed in recent years,” said Hagedorn. “Specific technologies are often out of date before they get fully adopted, but the concepts that are at the heart of the products often live on in a new form. Our chapter gives insight into the major concepts that form the basis for products that can support aging in place.”

The most universal of human experiences, aging has increasingly become a crucial topic of study, policy and practice in terms of the future of our planet. In fact, the World Health Organization (WHO) believes it to be of such vital importance that they selected aging as the theme of World Health Day 2012.

“I welcome this timely book, which deals with some of the many other perspectives of population ageing,” said Margaret Chan, Director-General of WHO. “The diverse chapters within it can help us invent the kind of society we might want to be part of in the 21st century.”

The full text of Global Population Ageing: Peril or Promise? is available online at the World Economic Forum’s website.

Aaron Hagedorn, PhD & Dean Gerald C. Davison, PhD

The Memory of Movies

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Whispers come from the hallway as Margaret Thatcher’s assistants speak about her deteriorating mental condition. As she peeks through a crack in the door, Thatcher eavesdrops and occasionally speaks with her husband, who is eating his breakfast. While she seems to be in fine mental health at first, audiences soon realize that the images of her husband are merely hallucinations.

Maryl Streep as Margaret Thatcher in Iron Lady

Starring Meryl Streep in an Oscar-nominated performance, the 2011 film The Iron Lady addresses former British Prime Minister Margaret Thatcher’s struggles with Alzheimer’s disease, which complicate her view of reality and send her on a journey through her own memories. Once one of the world’s most powerful political figures, the film’s Thatcher has diminished into a helpless woman who is unable to leave the house on her own without causing alarm-not even for a pint of milk.

“This film is unusual because Margaret Thatcher is still alive, and some people feel that she is being humiliated by being labeled as demented in her later years. To the contrary, though, I think this film has helped people feel more sympathetic to what she accomplished in her life and understand the struggle she has faced in recent years,” said Aaron Hagedorn, PhD, of the USC Leonard Davis School of Gerontology. “The stories of Margaret Thatcher and Ronald Reagan demonstrate to us that anyone can get this disease, and show us how difficult it is to see a highly accomplished life of hard work end in a quiet and disorienting way.”

The Iron Lady is one of the most recent films that address the aging population’s struggle with diseases like dementia and Alzheimer’s. Representing the truly global scope of these diseases, the last decade has seen several such films, includingPoetry (2010, South Korea), Away From Her (2006, Canada), The Notebook(2004),and Iris (2001, UK), depicting the challenges older adults-and the people who love and care for them-encounter while faced with a debilitating mental illness.

“Showing people with dementia in films to some extent perpetuates the stereotype that older people are forgetful or senile, but they also allow audiences to see the human side of the disease, to realize that anyone could be affected, and to discover that life goes on long after the disease is apparent,” Hagedorn said. “With 4.5 million people diagnosed with Alzheimer’s in the U.S., many millions more can relate to what it is like, and can relate to demented characters.”

In Poetry, a Korean grandmother, Yang Mija (Yoon Jeong-hee) must raise her grandson and work to support her family while being diagnosed with Alzheimer’s. As her disease progresses, she enrolls herself in a poetry class that allows her to find her voice even though she is in a mental decline and struggling with the terribly destructive actions of her grandson. Despite the considerable stressors and setbacks she faces, she is able to discover and focus on moments of true beauty.

“While it’s true that keeping one’s mind active is generally associated with reduced risk of showing signs of Alzheimer’s, we don’t really know whether it’s too late to see an effect of brain exercise after the disease is apparent,” Hagedorn said. “This film does, however, give us hope that being diagnosed with Alzheimer’s isn’t an immediate death sentence. We could have 10 or even 15 more years or so of potentially meaningful life left to live, to create and leave a legacy.”

As difficult and frightening as dementia may be for the older adult who receives the diagnosis, it also presents a major impact for his or her family and caregivers. Both Away From Her and Iris deal with husbands attempting to care for their wives whose mental faculties are declining. In Away From Her, Fiona (Julie Christie) experiences a moment of clarity and chooses to check herself into a nursing home, despite the fears of her husband Grant (Gordon Pinsent). Deteriorating quickly, Fiona begins to forget her husband and embarks on a romantic relationship with another, married patient.

Iris is based on the life of British author and philosopher Iris Murdoch (Kate Winslet and Judi Dench) and her relationship with John Bayley (Hugh Bonneville and Jim Broadbent, in an Oscar-winning performance). The frustration, hopelessness and isolation experienced by many caretakers is born out onscreen as John must care for his declining wife, increasingly losing control of her mind and body, as he seeks to reconcile his love and respect for the fiercely independent woman he married whom he is forced to watch slowly disappear.

Rachel McAdams and Ryan Gosling in The Notebook

More glossy and romantic than the other, more realistic films, the American-set The Notebook presents a similar story of a loving man, Noah (Ryan Gosling and James Garner), who sees the love of his life, Allie, (Rachel McAdams and Gena Rowlands) struggle with dementia and the loss of her memories. Telling her their love story is the only way Noah can rekindle their connection, before Allie’s brief moment of lucidity disappears.

“These films show how quickly the disease can progress, and how everything may eventually be forgotten, leaving behind people who truly care. This is very hurtful, but we must remember that it is not the demented person’s fault, and there is little anyone can do,” Hagedorn said. “These film tells us not to expect too much out of the demented. If you expect gratification you will likely be disappointed. If you simply live in the moment, just like the person with Alzheimer’s, expecting nothing in return, you can be grateful for life in the present and what you’ve shared together before.”

What unites each of these films is that, even though Alzheimer’s disease and dementia can rob an older adult of their past and personality, they still retain a core of humanity and as such deserve respect, care and dignity. It is devastating for The Iron Lady’s Margaret Thatcher when, at the end of the film, she is able to grasp that her husband is indeed dead, and must confront losing him and the reality of her reduced circumstances. Although her awareness is not a permanent state, in the moment the audience is reminded that, despite her failing health, Thatcher remains a strong, vibrant woman at heart, and for an instant, she feels some freedom from the illness that has trapped her.

“Films like these help us to relate to people with Alzheimer’s as real people who still have their emotional selves, even if they’ve lost their ability to express themselves verbally,” Hagedorn said. “They can show us what it’s like to rise up to a certain level in life, and then find yourself unsure what is real and what is not. They can teach us that there are resources caregivers can turn to, and that no one needs to face this alone. They can remind us that demented people have a very strong perception of emotion, and holding hands can mean the world to someone who has little to live for beyond the present.”

In other words, these films reflect a universal struggle to make sense of a devastating disease that does not discriminate in terms of nationality, gender or race, that continues to challenge caregiver, patient and scientist alike, and it is only through a compassionate focus on our shared humanity that we can-if only for a moment-escape its reach.

Spotlight on Safety

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The Part of a Lifetime

Marilyn Faber wrote the part of a lifetime for herself and four other actors — literally.

The Fall Prevention Coalition-Los Angeles (FPC-LA) commissioned Faber to write, direct and star in The Falling Monologues. With coordination by USC’s Fall Prevention Center of Excellence (FPCE), Faber created an innovative production with real-life stories and scenarios. These empowered older adults to face a very real danger-the risk of falls.

“It’s very serious when you fall-once you have a fracture, it’s bad news or worse,” Faber said. “Knowing I could help people really motivated me and gave me a tremendous sense of gratification.”

“The Monologues are important since they feature seniors talking about actual experiences that other seniors can relate to,” said Helen Davis of the City of Los Angeles Department of Aging. Davis produces the local public access program Aging Well in LA on Channel 35. “Falls are a major cause of serious injuries and hospitalization among the senior population, and it is important that we continue to seek fresh and innovative ways to disseminate fall prevention information and resources.”

The production also starred Richard Attwill, Shirley Dougherty, Marcia Kassan and Lois Liebhaber. These longtime actors found multiple reasons to count their participation as one of their favorite roles.

“It was so meaningful, especially to those of us who live alone,” Dougherty said. “We never think [a fall] will happen to us, so this was a much-needed project.”

“It’s an important subject for all seniors and the message is essential. I’m eager to do anything I can to assist people,” Attwill said. “I felt pretty unique as the only male in the cast, but being surrounded by women is always fun. I wish it were the case all the time.”

Positive Reviews

Inspired by their experience, each cast member made changes in their own lives. They installed grab-bars in the bathroom, secured all loose rugs with gripping tape, and held their dog’s leash with both hands on walks, hoping that viewers would take these pieces of advice to heart.

In fact, the Monologues touched the cast more closely than even they expected.

“I know people who have fallen and some were really hurt,” Faber said. “That just reiterated to me why it was so important to do this. There’s nothing funny about falling, but I tried to lighten the tone of the Monologues to make the medicine go down.”

That sense of vitality, warmth and empathy runs through the Monologues and provides comic relief for a serious topic as well as a great conversation starter for audiences, who may not be aware of these issues, or the resources available to them.

“Seniors conveying important messages to their peers is our most successful and powerful approach to keeping the aging population engaged, informed, happy and healthy,” said Davis. “With the nation’s largest senior population, L.A. has a wealth of high quality service providers, agencies, and organizations dedicated to assisting seniors and their family caregivers. Let’s use them so we don’t lose them.”

Check your local listings for upcoming viewings of The Falling Monologues on LA CityView (Channel 35) and view it on YouTube. For additional information about fall prevention, visit the Fall Prevention Center of Excellence’s website at www.stopfalls.org. For services and programs, contact the Department of Aging (aging.lacity.org or 213-252-4000).

Better Than Chocolate

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Funny how a little red slip of paper, sprinkled with glitter, can make someone cry.

The 175 residents of the Alexandria Care Center received a Valentine’s Day surprise. The USC Leonard Davis School’s Student Gerontology Association (SGA) and USC Panhellenic Council showered them with over 200 handmade cards.

Funny how a few cheerful words, written in pink marker and ringed by heart-shaped stickers, can remind someone they matter.

“Our wish for the residents of the Alexandria Care Center is that they have an amazing Valentine’s Day filled with love, laughter and joy,” said Ashley Phillips. Phillips, the SGA president, spearheaded the event. “We want them to know just how much we care about and appreciate them.”

In fact, students created so many Valentines that there were enough left over to deliver a batch to Children’s Hospital Los Angeles down the street. The full emotional impact of the day continued to resonate with students long afterwards. Out of construction paper and crayons, they crafted a Valentine’s memory better than chocolate, roses, and diamonds.

Funny how a little gesture, lovingly made, thoughtfully delivered, can become enormous.

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