This Is Getting Old: Moving Towards an Age-Friendly World Podcast with Dr. MELISSA BATCHELOR

Latest Episodes:

EP117: Funeral Industry Oct 18, 2022

Show notes

Death, dying and the funeral business are all inevitable parts of life that we will all deal with at some point - either for ourselves or someone we love.

I had a fascinating conversation a few months ago with someone who had been training to become a mortician. As someone who has helped families navigate end-of-life care for nearly my entire career, I hadn't really ever thought about what happened when my job ended. Much of what this person shared with me bothered me but was also eye-opening – so I wanted to share some of that information with you.

Thousands of people have dealt with funeral costs in light of the pandemic, and today I'll share some things I learned about the funeral industry in this week's episode of This is Getting Old: Moving Towards an Age-Friendly World.

Key points covered in this episode:

✔️ The Funeral Industry Pulls In Big Bucks

The costs for burial and cremation are skyrocketing. Most funeral homes are privately owned, but large corporations are starting to own more and more funeral homes. Here's a fun fact…funeral homes pull in $20 billion dollars a year in the United States. Yes, BILLION. The largest death-care corporation in the country, Service Corporation International, has nearly 2,000 locations. In 2018 alone, they brought in $3B in revenue. The second largest funeral company, StoneMor Partners, pulled in $316M in the same year. We also have a growing monopoly on our hands due to fewer large, corporate parent companies. These large corporations have bought up the trusted, well-known family-owned businesses. They typically keep the name of the original business but bring in new staff and salespeople, and often increase prices. These large corporations can do this because there isn't a lot of competition. This means fewer wealthy and powerful corporations manage this industry. ✔️ The Funeral Industry Is Poorly Regulated

This big, wealthy industry has been largely left to regulate itself. Businesses in the industry have a history of committing widespread deceptive practices that limit a consumers' ability to make informed decisions Some attempts have been made to fix this, starting in 1984 when the Funeral Rule was introduced. The Federal Trade Commission established this rule to protect vulnerable families from exploitation by licensed funeral homes. Funeral homes can be fined up to $40K each if they violate this rule. The problem is there's a loophole. Suppose a funeral home is found to be in violation of the Funeral Rule. In that case, they can opt into the Funeral Rule Offenders Program – a training program run by the industry's largest trade association and lobbying group – the National Funeral Directors Association (NFDA). This organization then is responsible for "policing" and penalizing offending businesses and is ultimately able to conceal violations from public knowledge. ✔️ Profit-Seeking + Poor Regulation = Predatory Practices

Since 1970, we have known that funeral homes have used predatory practices to increase profits. When you need a funeral home, the consumer is often not in the right frame of mind to handle the logistics of a funeral, burial, or cremation. Funeral homes have been known to prey on the emotionality of bereaved family members making funeral decisions by offering "up charges" for products or services that give the appearance of a higher quality funeral or burial.

When we as individuals do this type of planning for our families in advance, we are giving them a huge blessing when we die. Leaving your funeral planning to loved ones can evoke a lot of intense emotions; and the multiple decisions that have to be made may have conflicting answers within a family that causes unnecessary stress during an already stressful time.

✔️ Historically, Price Transparency Non-Existent In The Funeral Industry One thing that isn't transparent is the price tag associated with funeral and burial or cremation – the price for the same service can range from a few thousand dollars to over ten thousand.

The Funeral Rule doesn't require funeral homes to provide prices upfront or online, which means the general public has a hard time protecting itself from predatory pricing practices. NFDA disclosed in 2021 that the average cost of a funeral with a viewing and burial is nearly $8,000, while a funeral with cremation costs only about $1,000 less. However, these costs don't include costs associated with the cemetery, monument, marker, or other miscellaneous costs, such as flowers. These added expenses often increase the cost of full funeral services by $2,000 or $3,000. And this really shocked me! Caskets are often marked up 300 to 500%!

Caskets from a wholesaler cost about $325, but a funeral home sells it to you for about $1300!! Other markups are crazy and predatory – for example, selling people a premium sealed casket for $800 when it only means adding an $8 rubber seal to the lid (I mean, why does a casket need a seal anyways?!).

And here's a fun fact – the Funeral Rule allows YOU to provide your casket for a funeral – and the funeral home is not allowed to charge an extra fee if you do! You can literally buy your casket from a wholesaler or make your own. (Talk about a DIY project I've never heard of before!) ✔️ Funerals Are Bad for The Environment

This information was also interesting. Some in the funeral industry are "going green". Why? Because according to National Geographic, funerals put over 800K gallons of formaldehyde into the earth – equivalent to one and a quarter Olympic-sized swimming pools yearly.

And cremation, while touted as being the "greener" alternative to burial, generates an estimated 534.6 pounds of carbon dioxide – per person.

There was a lot more information online about planning a "green funeral" that I didn't go into in this episode. It has given me reason to pause and reconsider my own advance directive about wanting to be cremated. If you have already explored this option, drop a comment below or on social media. I'm interested in learning more! ✔️ Where To Find Help With Your Funeral Option?

Funeralocity is a platform to find and compare all funeral homes and cremation services near you. AARP names the service provider as its latest funeral planning recommendation.

If you have questions, comments, or need help, please feel free to drop a one-minute audio or video clip and email it to me at melissabphd@gmail.com, and I will get back to you by recording an answer to your question.

-----------------------------------------------------------------

About Melissa Batchelor, PhD, RN, FNP, FGSA, FAAN:

I earned my Bachelor of Science in Nursing ('96) and Master of Science in Nursing ('00) as a Family Nurse Practitioner (FNP) from the University of North Carolina Wilmington (UNCW) School of Nursing (SON). I genuinely enjoy working with the complex medical needs of older adults. I worked full-time for five years as FNP in geriatric primary care across many long-term care settings (skilled nursing homes, assisted living, home, and office visits), then transitioned into academic nursing in 2005, joining the faculty at UNCW SON as a lecturer. I obtained my PhD in Nursing and a post-master's Certificate in Nursing Education from the Medical University of South Carolina College of Nursing ('11). I then joined the faculty at Duke University School of Nursing as an Assistant Professor. My family moved to northern Virginia in 2015 which led to me joining the George Washington University (GW) School of Nursing faculty in 2018 as a (tenured) Associate Professor. I am also the Director of the GW Center for Aging, Health, and Humanities.

Please find out more about her work at https://melissabphd.com/.

EP116: Difference Between Hospice and Palliative Care Oct 11, 2022

Show notes

A lot of people don't want to talk about death and dying. Yet, talking about death doesn't mean it's going to happen, and it's usually better to talk about it before it happens – for everyone involved.

Death and dying are something that a lot of people don't have a lot of experience dealing with. That's because, over the past several decades, as a society, we have moved death out of the home and into institutions.

For some, the information I share in this podcast may be an intellectual conversation/ information) – for others, it may hit the heart. It's one thing to listen to information about death and dying when you're not right in the middle of it; compared to being in the middle of it and trying to learn more. Listening to and learning about death and dying can be harder when your heart is hurting.

Many of the most important things tend to range from education around what to expect, preparing by getting their finances straight, and getting advanced directives in order. There are many things to think about when preparing for the end of life— if you're lucky enough to have time to do so.

In my experience, some people have the luxury of this time, and some don't. Those whose loved one dies unexpectantly are upset because they didn't have time to resolve unfinished business or get to a place of acceptance ~ compared to those families whose loved ones take months to weeks to ultimately die being upset that it's taking so long for death to come, because it's emotionally exhausting.

In this episode of This is Getting Old: Moving Towards an Age-Friendly World, we will discuss end-of-life care— two different types of care; as well as the providers involved and the type of care provided.

Key points covered in this episode:

✔️ What is the difference between End-Of-Life Care, Palliative Care, and Hospice Care? It can be very stressful when you or someone you love is diagnosed with a life-threatening, serious illness. For most people who go through this experience, it is helpful to understand what type of care and resources are available. This information will help you navigate the system to get answers to the questions you have – or will have - and help you manage the uncertainty of what to expect next. End-of-Life Care End-of-life care is an umbrella term that refers to the process of addressing all the issues that come into play from medical care, social and emotional support, and the spiritual care that you may need either as the person dying or as a family member.

Palliative Care

Palliative care begins early during the course of treatment for a life-threatening, serious illness, and it can be delivered at several points of care across the continuum of healthcare settings. This type of end-of-life care includes institutional long-term care settings (nursing homes and assisted living); home health, acute care facilities, and outpatient clinics. Palliative care has limited funding, and most palliative care programs need alternative funding.

Hospice Care

Hospice care is comfort care when you reach the point in the disease trajectory where aggressive care or therapies are no longer a viable option. It's a service delivery system that provides interdisciplinary care for people with limited life expectancy—typically when you're given six months or less to live. Hospice care also includes comprehensive biomedical, psychosocial and spiritual support as you enter the terminal phase of an illness or condition. Hospice care also supports you, your family member(s) understand what to expect as death nears. Luckily for people 65 and over or those with a disability, Hospice care is funded by Medicare's Hospice Benefit. ✔️ What Type of Healthcare Providers Provide Palliative Care?

Basic Palliative Care

Basic palliative care is delivered by health care professionals who are not palliative care specialists—they are not "certified" in palliative care by a credentialing organization.

Basic palliative care providers can be primary care providers and disease-oriented specialists, such as cardiologists or oncologists; nurses; social workers; chaplains; and other providers (such as physical, occupational, and/or speech therapists).

Specialty Palliative Care

Specialty palliative care providers are all those same provider types (interdisciplinary team), except they are certified in palliative care by a credentialing organization.

I look back on my career, Hospice was certainly part of the standard of care when I graduated as a nurse practitioner in 2000; but Palliative care was just coming into practice at that time in my area. I was lucky enough to work with a geriatrician who trained us to provide high-quality palliative care. Technically, that made me a basic palliative care provider because I didn't have a certification in that specialty.

✔️ What Type of Care Does Palliative Care Provide?

Physical: Physical care has to do with your physical symptoms of either respiratory distress, pain, difficulty breathing, or anything physically that occurs along the disease trajectory and/ or at the end of life.
Psychological and Psychiatric: Psychological or psychiatric aspects are the emotional support helping you deal with the reality of the situation and any other psychiatric things that might come into play—if you have a longstanding psychiatric illness and/or end up experiencing delirium.
Spiritual, Religious, and Existential: Everyone has a different way that they connect to their spirituality. The hospice and palliative care team is there to help ensure that all of those needs are met for you.

Cultural: Many cultural things come into death and dying from needing to open a window at the moment of death, mourning family and friends around, compared to not wanting anyone to see you. The person dying and their family need to communicate these cultural customs to the team, so they can ensure those needs are met.
Ethical and Legal: These ranges from advance care planning, deciding on a surrogate decision maker, to making sure that all advance care planning wishes are in writing. If ethical issues come up along the way, the patient and the family's autonomy is supported.
Care of the Imminently Dying: This care involves making sure that all symptoms are managed when death is imminent. This includes making sure the person is pain-free, doing what we can do to help with breathing, and talking to the family about what to expect and what changes to anticipate during the final days and weeks of life.

Bereavement: Bereavement happens after death. This service is to support your family member(s) in dealing with the different complex consequences that a death in the family can cause; and helping support you duing the process of grief and grieving for up to one year after the person dies.

✔️ Help Is Always Available

If you or someone you love are going through end-of-life experiences—help is always available.

How to find a hospice and palliative care provider?

National Hospice and Palliative Care Organization.

The National Hospice and Palliative Care Organization is a national organization that can connect you to palliative care providers. You can visit their website, enter your zip code or the type of provider that you're looking for, and you can connect with healthcare providers in your area.

Medicare.gov

Check out the Medicare website and in the Provider Type section, select "Hospice Care". Enter your zip code, and then it will tell you what providers are available in your area.

About Melissa Batchelor, PhD, RN, FNP, FGSA, FAAN:

EP115: Top Car Consideration for Older Drivers: Age-Friendly Technologies/Age-Friendly Cars Sep 27, 2022

Show notes

In today's world, there are advances in many age-friendly products and services — meaning that when things are age-friendly, they are friendly for everyone.

Another term I've learned for designing age-friendly products is "universal design". Universal design means products that are accessible for all people — regardless of age, disability or other factors.

Over the years, I've noticed many advances in the automotive industry that I consider to be age-friendly, so I wanted to do a podcast focused on age-friendly cars. Many of the technology features in newer vehicles help drivers of ALL ages.

However, when I googled "best cars for older drivers", most of what came up had to do with seating comfort, how easy it was to get in and out of the vehicle, safety ratings, reliability and/or warranties. It was more difficult to find articles focusing on technologies that could make us all safer drivers, particularly as we get older.

Contrary to popular belief, as we age, some of us may prefer to drive cars with all of the technology — but some older adults don't like all the new bells and whistles — the technology they are used to is what they like. My parents are two great examples — my Dad loves technology, and my Mom wants to keep it simple. You may have gleaned from that statement that I'm more like my Dad, but some of the technology I'll share also keeps it simple.

With a new driver in my own family I've had to learn to use these technologies as a passenger, and have promised my kids that I would try not to "freak out if the car wasn't," with all of its sensors and warning capabilities.

Tune in to this episode of This Is Getting Old: Top Car Consideration for Older Drivers: Age-Friendly Technologies/Age-Friendly Cars, to learn about a few of the age-friendly technologies in cars and how they help drivers of all ages.

Key points covered in this episode:

✔️ Blind Spot Information Systems with Cross-Traffic Alert

Blind spot information systems with cross-traffic alerts are great for older drivers and those with reduced mobility–or if you're the passenger in the vehicle with a newly-licensed driver (like my 16-year-old!). This feature uses sensors to alert drivers, and displays a warning light in the side mirror (and/or make a sounds, depending on your vehicle) when a car is in your blind spot.

✔️ Front 180-Degree Camera with Split View

The front 180-degree camera helps see small children, pets, or other obstacles that may be too close to your car when trying to pull out, with limited visibility for oncoming traffic. A split-view camera can also show you what's on the front of your car's left and right sides.

I decided this was a good feature when I inadvertently pulled out of a grass parking lot that I thought was level on all four sides, only to drive right into the only ditch. Said ditch was the length of the front of my car, and my older children had a field day laughing at my error while we waited for the tow truck to pull me out. My next vehicle had the front camera, which has proven handy for several intersections in my town and when I drive in Washington, DC.

✔️ Park Assist System for Parallel Parking

Park assist systems are another helpful feature for drivers of all ages. This feature helps you with traditional parallel parking (and some vehicles also assist with perpendicular parking). Parallel parking assist systems are very useful in urban areas where there may not be much room between cars. And while I love this feature, my 16-year-old son enjoys using this feature and has been quite proud of himself for successfully parallel parking. What he may not realize is that he needs to pay attention to the angles the car uses to parallel park so he can park without this feature — because the chances that his first car will self-park are pretty slim.

✔️ Adaptive Cruise Control with Stop-and-Go

Adaptive cruise control with stop-and-go allows you to set your cruise control to a certain speed, and if you have a car driving slower in front of you, the car auto-adjusts to the slower speed. You can set this feature to follow one, two, or three car-lengths behind, depending on your comfort level.

✔️ Perimeter and Rear Parking Sensors

Perimeter and rear sensors emit a high-frequency sound that bounces off nearby objects. If you're backing up to park in a garage, these sensors can emit a sound that lets you know if you're getting too close to a wall or another car. These sensors can be helpful for all drivers; the trick is to make sure you use them.

In the video version of the podcast, you can see that I didn't listen to my perimeter sensors when I was in a parking deck recently, and my car, Foxy, ended up in the "hospital" for repairs.

✔️ Infotainment Touch Screen Systems: Apple Play

The Infotainment Touch Screen System is a great feature that simplifies things when transitioning from car to car. I've found this "universal" technology to be particularly helpful when I travel and have to use a rental car. Through your smartphone, you can use apps you are already familiar with from car to car, such as Waze or Google Maps for navigation, which might be easier than the vehicle's built-in GPS that you may not be familiar with.

Apple Play can also let you connect your phone to your car's speakers to listen to music or podcasts through the car's audio system. This feature also allows you to use voice activation hands-free, using the same technology on your phone.

✔️ Lane Keeping System

I've found this feature to calm my nerves when riding with a less-experienced driver. There have been times that I felt like we weren't in the middle of our lane when my son was driving, and to verify where we were, I could look over and see the lane-keeping system. I could do this without stressing my son out and relax, and/or the car would let him know by correcting him into the lane without any verbal prompting from me. All parents riding with new drivers benefit from this technology!

✔️ CarFit Program

The most important thing is that the car we drive at any age fits us — for maximum safety and comfort.

The AAA, AARP, and the American Occupational Therapy Association, partnered in 2006 to offer a new program called CarFit — a community-based program designed to keep older drivers safe while driving by focusing attention on comfort, fit, and security in their vehicles. The program is designed to help older drivers find out how well they fit into their current vehicle, identify actions they can take to improve their fit, and talk about driver safety — for themselves and others on the road. They have an in-person event and offer virtual workshops. You can volunteer to help keep the roads safer for everyone.

You can find more information at Car-Fit.org — the link is below in the description if you're watching on YouTube, but can also be found on my website, MelissaBPhD.com, in the blog for this episode.

—————————————————————————————

About Melissa Batchelor, PhD, RN, FNP, FGSA, FAAN:

EP114: Social Media in Healthcare with Dr. Mona Shattell and Rebecca Darmoc Sep 13, 2022

Show notes

Social media has developed into a valuable resource for knowledge in the healthcare arena. A poll found that 76% of participants used social media "at least a bit" to research COVID-19, but the majority of those respondents (63.6%) indicated they were reluctant to check with a health expert about the accuracy of that information.

Healthcare professionals can use social media to educate the public and contribute to halting the spread of false information while using social media.

Do you want to be on social media but don't know how to get started?

Tune in to this episode of This Is Getting Old: Moving Towards an Age-Friendly World - Social Media in Healthcare. If you are a health-care professional or a leader in a healthcare organization, this information could help you get started in using social media. In this episode, we are joined by Dr. Mona Shattell, PhD, RN, FAAN and Rebecca Darmoc, MS.

✔️ Why Should Healthcare Professionals Use Social Media?

There are so many things healthcare professionals can do on and through social media. For example:

Networking
Sharing information with their colleagues.
Expanding their practice.
Disseminating research.
Get information out to the public.

Healthcare professionals are experts in their specialty, and misinformation is spread on social media. The public and even reporters trust healthcare professionals to give the most accurate information. A social media presence is an opportunity for healthcare professionals to go outside of their practice and the walls of their institutions and reach people on an exponential level.

✔️ Tips For Branding Professionally On Social Media

Social media in the healthcare industry may be challenging to navigate. The first thing to remember is: YOU ARE YOUR BRAND. Use your name when you're signing up for social media as your username if possible. Using your first and last name helps potential followers to find you. You don't want to use slang terms or phrases—be as professional as possible.

Number two is to highlight your expertise. Brag a little by sharing some of the accolades and things you've done professionally in your profile. People will know you're an expert when they can see what you've done, and when they can see a few aspects of your professional experience. Furthermore, it's how people will learn from you and trust what you have to say on social media.

✔️ Three Levels For Joining The Conversation Using Social Media: Consume, Contribute, And Create

It can be overwhelming to start up a new social media platform. Healthcare professionals should think about gaining social media experience as a developmental process.

First, CONSUME. This step involves just reading and scrolling through a variety of social media platforms. Get comfortable with how to use each one, follow your colleagues, look up people's names in your specialty area, see what others are doing, and see how (and what) they are posting. Getting used to the platform at this level is the most critical step to beginning your journey.

Then once you're comfortable with being a consumer, you can move on to the second level and CONTRIBUTE to the online conversation. When you see something that someone says, you can like it and retweet it (e.g., on Twitter). When you retweet and add a comment, you are contributing to the conversation.

The highest level in using social media is to CREATE. This is when you create content from scratch, and begin to move into being a thought leader. Creating means putting your specialized knowledge and expertise out there for your specific audience based on your goals.

✔️ Where to Find Help With Kickstarting Your Social Media Presence?

Dr. Mona Shattell, PhD, RN, FAAN, Rebecca Darmoc, MS, and Melissa Batchelor, PhD, RN, FNP, FGSA, FAAN, released a book a couple of weeks ago called '#SocialMedia and #HealthCare: A Guide to Creating Your Professional Digital Presence.' The book is a guide to helping professionals use social media to educate the public and specific patient communities, make connections with industry leaders and peers, and enhance their professional reputation online.

Grab a copy of the book through AMAZON; or through the publisher Slack Incorporated, and receive 20% OFF and FREE SHIPPING of the print book with promo code AU20.

—————————————————————————————

Mona Shattell, PhD, RN, FAAN, is a professor, and Hugh F. and Jeannette G. McKean Endowed Chair and Department Chair at the University of Central Florida College of Nursing in Orlando. She is also the editor of the Journal of Psychosocial Nursing and Mental Health Services. Mona got into social media about 10 or 12 years ago when she did a fellowship with the Op-Ed project.

—————————————————————————————

Rebecca Darmoc, MS, is a marketing strategist for a technology consulting company. For about 10 years before that, she was director of marketing and communications for an academic health system in Chicago. She got into social media for her job as a marketing professional.

—————————————————————————————

About Melissa Batchelor, PhD, RN, FNP, FGSA, FAAN:

EP113: Five Symptoms of Alzheimer's Disease Aug 30, 2022

Show notes

Alzheimer's disease is a syndrome that impacts a person's ability to think, problem-solve, and function every day. It can influence a person's memory, language, behavior, decision-making, visual and spatial skills, and ability to pay attention.

It happens slowly, over time, so often it may take family and friends – and even the person experiencing the disease – years to recognize these problems. In fact, dementia isn't usually diagnosed until these problems are to the point that they interfere with the person's ability to work, take care of their affairs, and manage their household.

Tune in to this episode of This Is Getting Old: Moving Towards an Age-Friendly World to learn about five symptoms of Alzheimer's. This information could help you or a loved one identify the early warning symptoms and get earlier treatment.

Key points covered in this episode:

✔️ #1: Difficulty Understanding Spatial Relationships

If your loved one has difficulty understanding how to get from place to place, it could be a symptom of dementia. This can manifest in several ways, such as getting lost in familiar places, being unable to follow directions, or misjudging distances.

If you notice your loved one having difficulty figuring how things fit together, understanding maps, wandering, or getting lost, or changes in depth perception – trips, slips, falls, or a car accident, it could be an early symptom of a memory problem.

✔️ #2: Aphasia—Difficulties with Language Use

Aphasia—not to be confused with dysphagia (trouble swallowing)—is difficulty with understanding or using words. It can make it hard to read, write, or say what you want to. Aphasia may also make it hard to follow or carry on a conversation.

If you notice your loved one having trouble following conversations, finding the right word, substituting made-up words; writing that is hard to understand; or slurred speech, it could be an early symptom of dementia.

✔️ #3: Trouble Paying Attention

Staying focused becomes more difficult; repeating questions; losing or misplacing things; errors in managing finances. The person may lose their train of thought when talking to you or have trouble following a conversation.

✔️ # 4: Difficulty Managing Time and Effort

Trouble with time management is another common symptom of dementia. This can manifest as forgetting what day it is, losing track of time, or inability to follow a schedule. In more severe cases, people with dementia may have difficulty planning and carrying out tasks that require multiple steps.

This can manifest as forgetting to take medications, having trouble cooking meals, having difficulty driving, taking longer to complete normal daily activities, and having trouble organizing themselves to get out of the house.

✔️ # 5: Amnesia and Agnosia—Memory Loss and Trouble Recognizing Familiar Objects or People

One of the classic symptoms of dementia is memory loss. This can manifest as forgetting recent events, conversations, or appointments. In more severe cases, people with dementia may forget who their loved ones are.

Memory loss is often accompanied by agnosia, difficulty recognizing familiar objects or people. This can manifest as the inability to identify everyday household items, not knowing how to use ordinary things, or not recognizing close friends or family members.

Watch the NOSH: Nurses Optimizing Supportive Handfeeding video to learn more about how to manage mealtimes for persons with Alzheimer's disease. You can use the three different hand hand-feeding techniques with other activities of daily living.

Knowing that Alzheimer's Disease is Not A Normal Part of Aging Could Help You Live Longer.

Aging doesn't have to equate to decay and decline.

Alzheimer's disease is not a normal part of aging. You should know that as a young person because what you think about aging impacts how well you age and how long you live.

Learn all you can about what is NORMAL with aging, not what you may think is expected or believing the negative stereotypes accompanying aging in American culture. The negative stereotype of aging is called ageism, and it can decrease your life expectancy by almost 8 years. In fact, most older adults in the US are still vibrant and engaged in life. Strive to be that type of older adult – I know I am.

About Melissa Batchelor, PhD, RN, FNP, FGSA, FAAN:

EP112: Six Things To Do After an Alzheimer's Diagnosis Aug 09, 2022

Show notes

In 2022, it is estimated that 6.5 million Americans are living with Alzheimer's disease.

The number of people per 100,000 newly diagnosed with Alzheimer's disease per year (incident rate) appears to be declining, the number of people with Alzheimer's disease (prevalence) is expected to continue to grow (2022 Alzheimer's Disease Facts and Figures Report, p. 19).

If you are or someone you love have been newly diagnosed with Alzheimer's, this episode will give you 6 things to do because many people do not know where to start.

Many people feel that everything has changed after learning that a loved one has Alzheimer's disease or a related dementia. There are many myths and misperceptions about Alzheimer's disease (stigma) – this episode will give you resources to learn more about the reality of disease progression and steps to take.

First of all, remember that you're not alone. There is help available, and there are resources to connect you to people who understand what you've been through and what you're going to go through.

These six things presented in this podcast will help you after getting a diagnosis like Alzheimer's disease; tips on what to get organized, permission to make healthy living a priority, and ensuring important things are taken care of.

Key points covered in this episode:

✔️ #1. Educate Yourself (And Others) About The Disease.

Being stigmatized by others is often a primary concern of people living with Alzheimer's and their care partners. Stigma is a negative label identifying a person with an illness or disability. Stigma around Alzheimer's disease typically happens because people don't understand it or know what to expect.

Learn as much as possible about this disease and encourage care partners to do the same. You can learn about the condition from the Alzheimer's Association website.

✔️ #2. Coming To Terms With Your Diagnosis And Sharing The Diagnosis With Others

You may or may not be able to come to terms with your diagnosis before you tell others. You may not want to wait until you've had time to come to terms with it, or you may want to wait; but either way, as the disease progresses, you will need help and support from others who know and understand you. You can decide who to tell and when to tell and when you do, this is an excellent time to educate them, too.

✔️ #3. Be An Active Participant In Your Financial, Legal, And Long-Term Care Planning.

This will likely be the best gift you can give your loved ones. If you don't provide information about your wishes and your legal documents accessible, the burden of making these decisions will fall on your loved ones. I recommend getting a copy of Cameron Huddleston's book "Mom & Dad, We Need to Talk" and filling out the "In Case of Emergency Organizer" available on her website for free.

✔️ #4. Reevaluate Your Priorities.

Set goals for the things you still want to accomplish. Life is not over yet – so dust off that bucket list and start planning to do as much of it as possible while you're still able. This is the same thing that many people do after receiving a terminal diagnosis.

You know yourself best and what's most important to you in the time you have left – which by the way, could be 20 more years. While you are able, make decisions about how you want the rest of your life to look and share that vision with those who love you.

✔️ #5. Take An Active Role In Managing Your Disease And Build Your Care Team.

Start now and begin to build your care team. This includes you, your family and friends, neighbors, and healthcare professionals with expertise in Alzheimer's care.

Learn more about Dementia Friendly Communities. These are communities that provide supportive options that foster quality of life. If you don't have one yet, you may want to look into starting one.

Additionally, find out if there is a Village in your area, join it and start volunteering. The Village Model is "neighbors caring for neighbors" – a nonprofit, grassroots, community-based organization of volunteers that reflects the needs of its members and communities.

✔️ #6. Discuss Alternative Treatments, Supplements, And Medications With Your Healthcare Team.

Although current medications cannot cure Alzheimer's, some drugs may help lessen symptoms, such as memory loss and confusion, for a limited time. Other medicines change disease progression, with benefits to cognition and function.

Look into FDA-approved drugs, alternative treatments and supplements, and consider participating in clinical trials.

About Melissa Batchelor, PhD, RN, FNP, FGSA, FAAN:

EP111: Six Things People Living with Alzheimer's Disease Want You To Know Aug 02, 2022

Show notes

Alzheimer's disease is becoming more common in the United States. All ages combined, more than 6 million Americans struggle with Alzheimer's, and according to studies, that number will reach about 13 million by 2050.

A diagnosis like Alzheimer's disease often leaves everyone involved at a loss about what to say or how to act when they hear the news. Many people do not understand Alzheimer's disease or how it progresses, so they may not know how to interact with you – most likely worried that they may say or do the wrong thing. Hence, for those with Alzheimer's disease and their families, combating and getting past stigmas and preconceptions can be a big problem.

The Alzheimer's Association recognizes that there's a lot of work to do to reduce the stigma around dementia. In response to the challenge, they released information they collected from people living with early-stage dementia—The Six Things People Living with Alzheimer's Disease Want You To Know.

Tune in to This Is Getting Old: Moving Towards An Age-Friendly World to learn valuable ways to help—in big and small ways— a person with Alzheimer's or those who care for them.

Key points covered in this episode:

✔️ Six Things People Living with Alzheimer's Disease Want You To Know

People with early-stage Alzheimer's disease and other forms of dementia were recently asked by the Alzheimer's Association what they wanted others to know. The following six things are shared by those with a diagnosis:

#1. My Alzheimer's Diagnosis Doesn't Define Me

While a diagnosis like Alzheimer's disease at any age is life-changing, the diagnosis itself doesn't change who the person is – just as a diagnosis of diabetes or high blood pressure doesn't change who that person is. Alzheimer's disease may be a progressive disease, but it doesn't happen overnight. It may take years or decades before the person can no longer do all the things they once did. The best thing to do is to take each day as it comes and continue to do all of the things you have always done and enjoyed for as long as possible.

#2. If You Want To Know How I'm Doing, Just Ask Me

Changing how you communicate with someone recently diagnosed is frustrating to the person living with Alzheimer's. Continue to interact with the person as you always have and be sure that you don't talk around them. If the person is sitting right there or nearby, ask them how they're doing rather than asking their spouse or care partner. Doing so only makes them feel more alone and isolated.

#3. Yes! Younger People Can Have Dementia, Too

While most people who are diagnosed with Alzheimer's disease are aged 65 or older, people as young as 30, 40, or 50 can be diagnosed. When the person is that young, they may have an even more difficult time getting an accurate diagnosis when the disease-related symptoms are similar to younger- and older-onset forms of the disease. They may also have more challenges in the aftermath with juggling family and work demands and may have to stop working earlier than they planned to.

#4. Please Don't Debate My Diagnosis—Don't Tell Me I Don't Look Like I Have Alzheimer's

Dismissing an Alzheimer's diagnosis can be offensive. It was already hard enough for them to share the diagnosis with family and friends, don't make them have to defend it, too. Remember that Alzheimer's disease is a diagnosis of exclusion – which means everything else had to be ruled out, and it has been a difficult, frustrating, and anxiety-provoking journey. The person isn't going to look any different on the outside, and you can't see their illness, but they are living it every day.

#5. Understand That Sometimes My Words And Actions Are Not Me—It's My Disease

As Alzheimer's disease progresses, the person may experience a wide range of disease-related emotions and behaviors, from confusion and anxiety to aggressive or inappropriate behaviors that may change daily and moment-to-moment. Be patient if they say something unexpected or out of character. They will have good days and bad days.

#6. Remember That An Alzheimer's Diagnosis Doesn't Mean That My Life Is Over

The fact that the person's Alzheimer's disease was detected and diagnosed earlier doesn't mean that they will die tomorrow or be shriveled up and living in a nursing home next year. Those are negative stereotypes and myths perpetuated by a society that doesn't want to think or learn about Alzheimer's disease until it affects them personally. Being diagnosed at an earlier age – and quite frankly, being diagnosed earlier in the disease trajectory – can be a blessing. It gives the person and everyone who loves them the time to prioritize what's most important to them and begin to plan their futures.

✔️ Ways to Help People Living with Alzheimer's

The stigma surrounding Alzheimer's and other dementia is due in a large part to a lack of public awareness and understanding of the disease. If you're looking to support those with Alzheimer's and those who care for them. Here are the things you can do;

Learn more about Alzheimer's disease and the challenges faced by those living with the disease. This is the single best way to reduce stigma and correct myths and misperceptions.
Check out the Alzheimer's Association website (alz.org) to learn more about every stage of the disease.
Subscribe to the Alzheimer's Association's Live Well Series—an online resource that gives tips to help those diagnosed with this disease live their best lives.
You can also learn more by checking out This Is Getting Old's Alzheimer's-related episodes, ranging from 10 Warning Signs of Alzheimer's Disease to How Alzheimer's Disease is Diagnosed.
Other ways you can get involved to help #EndALZ is by volunteering, advocating, being a partner or sponsor, participating in events and/or making a donation to support work.

✔️ A Call For Everyone!

The stigma surrounding Alzheimer's and other dementia is due in a large part to a lack of public awareness and understanding of the disease. By shining a light on stigmas and misconceptions surrounding Alzheimer's and other dementia, we can help people be more supportive of individuals and families affected by this devastating disease.

About Melissa Batchelor, PhD, RN, FNP-BC, FGSA, FAAN:

EP110: Colon Cancer And When To Get Your Colonoscopy Jul 26, 2022

Show notes

The American Cancer Society (ACS) reports that colon cancer, after skin malignancies, is the third most prevalent cancer diagnosed in the United States. Last year alone, the ACS reported that 104,270 Americans were diagnosed with colon cancer.

While it's true that colon cancer typically affects older adults, it can happen at any age. Statistically, the rates of colon cancer have been increasing in younger people, with a 2% per year increase among people under 50. There was also a drop in the colon cancer survival rate among younger adults.

Hence, healthcare professionals strongly advise regular colorectal cancer screenings for those aged 45 to 75.

Watch today's episode, This Is Getting Old: Moving Towards An Age-Friendly World, where we'll look at colon cancer's signs and symptoms, causes, and prevention measures.

Key points covered in this episode:

✔️ What is Colorectal (Colon) Cancer?

Colon cancer is a type of cancer that begins in the colon (large intestine)—the last part of your digestive system. This type of cancer is sometimes called colorectal cancer, which is a term that combines the colon and the rectum, but cancer begins in the rectum. The disease typically starts as a small, non-cancerous or benign polyp—a clump of cells forming inside the colon. But over time, these polyps can become colon cancers.

✔️ Symptoms and Early Warning Signs of Colon Cancer

So you should see a doctor if you have any of these symptoms,

If you have a persistent change in your bowel habits
A change in the consistency of your stool
Rectal bleeding, or blood in your stool
Persistent abdominal discomfort (gas cramps or pain)

A feeling that you're bowel isn't emptying all the way.
Experiencing weakness or fatigue
Unexplained weight loss

✔️ Even Black Panther Didn't Escape Colon Cancer

You may remember Chadwick Boseman, who played the role of the superhero Black Panther. He died at age 43 of colon cancer. While most people think colon cancer is just a diagnosis for older adults, the rates of colorectal cancer have been falling for older adults, but are rising for younger adults.

✔️Did You Know That Race And Ethnicity Have Something To Do With Colon Cancer?

African-Americans are 20% more likely to get colorectal cancer, but they're also 40% likely to die from it compared to any other racial group. If you are an African-American and in a high-risk category, please talk to your health care provider because they may recommend starting your colon cancer screening earlier—even as early as your thirties.

✔️Is Colon Cancer Hereditary?

1 out of 3 people who get colorectal cancer have a family member who have also had the disease or polyps. Having a first-degree relative's (parent, sibling, or child) history of colorectal cancer does increase your risk. If any of your blood relatives has had colon cancer, you're at greater risk, so you should start screening earlier.

✔️The Role of Diet in Colorectal Cancer Incidence

It is believed that the typical low-fiber, high-fat Western diet increases your chances of colon cancer, but research studies have had mixed results. Some studies have found an increased risk of cancer in people who eat diets high in red meat and processed meats. This is why France has now called for a ban on the nitrate additive for ham and charcuterie.

✔️The Link Between Alcohol, Smoking, and Colon Cancer

Smoking tobacco has been linked to all types of cancers for a long time, including colon cancer. While it is known that moderate to heavy alcohol drinking increases your risk, but even light to moderate alcohol intake has been associated with some risk increase.

✔️ When and How Often Should You Get a Colonoscopy?

Colon cancer screening can be a stool-based test (visual exam) done in your doctors office annually, but the gold standard screening is the colonoscopy. This test is crucial because you may not have any symptoms of colon cancer, but if polyps are found during the colonoscopy, they can be removed before they turn into cancer.

✔️ 45 is the new 50

For an average-risk person, you should start screening at age 45 and continue every ten years as long as you're in good health and have a life expectancy of more than ten years. You should get colonoscopies until you're at least 75 years old. Then from 75 to 85, you can decide if you want to be screened based on your overall health, life expectancy, and prior screening history. When you reach the age of 85, screening is no longer recommended.

✔️How To Avoid Colon Cancer?

Move It!

Not being active increases your risk. So you've got to move it—10,000 steps a day should be your goal.

Maintain Healthy Weight

Being overweight also increases your risk. A healthy BMI is a BMI of less than 25. A BMI of 25 to 29.9 is considered overweight, but over 30 is considered obese. So make sure we keep our weight where it needs to be. Use this tool to calculate your BMI.

Stop Smoking

It's never too late to quit smoking so talk to your health care provider about ways to quit.

Drink Alcohol in Moderation

For ladies, this means one drink a day; and men, you get two.

Stick to a Plant-based Diet

Foods that come from their original wrapper are the types of foods that you want to eat. You can never go wrong with including a variety of whole grains, vegetables, fruits, and nuts in your diet.

About Melissa Batchelor, PhD, RN, FNP, FGSA, FAAN

EP109: Smell, Memory, and Alzheimer's Disease Jun 21, 2022

Show notes

One American researcher discovered that older adults (approximately 3000 older adults aged 57-85) with reduced smell (hyposmia) had more than 50% risk of acquiring dementia within five years, regardless of other risk factors. Those who had the worst smell loss (full anosmia) were the ones who would be most likely to acquire dementia within five years.

Furthermore, the severity of dementia was linked to the degree of olfactory loss, which means minor smell loss correlates to moderate cognitive impairment compared and a massive smell loss associated with severe Alzheimer's.

Have you ever smelled anything that took you right back to a memory? A smell can bring on a wide range of feelings and memories.

For older adults, the loss of smell may significantly influence one's quality of life. In Alzheimer's disease, smell is impacted and for both groups of people, loss of smell often results in a loss of appetite, poor nutrition, and subsequent weight loss.

Understand how smell, memory and Alzheimer's disease are intertwined in another valuable of This Is Getting Old: Moving Towards an Age-Friendly World. Tune in to Episode 109: Smell, Memory, and Alzheimer's Disease, and walk-through ways to provide better care for older adults with Alzheimer's.

Key points covered in this episode: ✔️ How Does Smell Work?

We have smell neurons or receptors in our noses that connect to a very short nerve (about two inches long) called the olfactory nerve. It runs along from the back of our nose to a structure called the amygdala.

The amygdala triggers emotions and feelings and is the "emotional spark plug" of the brain. Since smell neurons send a message to the amygdala first, we may not be able to identify what exactly the smell is before we have a feeling about it. That's why many smells are remembered as a feeling.

✔️Does Alzheimer's Disease Impact Smell?

Losing your sense of smell has been linked to early changes in brain health and mild cognitive impairment - which may or may not turn into Alzheimer's disease. A study in 2013 found that not being able to smell peanut butter could be an indicator of Alzheimer's disease—it may in fact be an early warning sign. This is likely due to the brain shrinkage that happens in Alzheimer's disease on the left side of the brain where the temporal lobe degenerates first. However, a study the following year wasn't able to replicate the same results…so this is not a definitive way to know if you have Alzheimer's disease or if you will get it.

✔️ Why Smell Triggers Memories?

The movie "Cleaner" with Samuel L. Jackson is an example of how smell can trigger memories. In the film, his wife died, and in one scene, he sprayed her perfume in the air during a moment he wanted to remember her.

Perfumes and colognes often remind us of certain people when we smell them. I've worn the same perfume for the past 17 years. My friends and children associate that scent with me. A few years ago, I bought a different perfume. One whiff and my daughter asked me what that smell was…I told her it was a new perfume, and she told me, "No. That doesn't smell like you." So I guess me and Chanel's Coco Mademoiselle are in it for the long haul.

✔️Associating Smell with Your Memories?

The next time you have a meaningful life experience, like relaxing on the beach or being in a noisy stadium with a hot dog stand, take a moment to inhale the smells around you. Take a few minutes to appreciate the qualities of those scents and use these scents to reminisce the memory. You can use scents to travel back to pleasant memories, help you relax and unwind at the end of the day, or recall any other special event in your life.

✔️What To Do When You're Experiencing Changes In Your Sense Of Smell?

If you are experiencing changes in your sense of smell, please work with your primary care provider and get it checked out.

About Melissa Batchelor, PhD, RN, FNP, FGSA, FAAN:

I earned my Bachelor of Science in Nursing ('96) and Master of Science in Nursing ('00) as a Family Nurse Practitioner (FNP) from the University of North Carolina Wilmington (UNCW) School of Nursing (SON). I genuinely enjoy working with the complex medical needs of older adults. I worked full-time for five years as FNP in geriatric primary care across many long-term care settings (skilled nursing homes, assisted living, home, and office visits), then transitioned into academic nursing in 2005, joining the faculty at UNCW SON as a lecturer. I obtained my Ph.D. in Nursing and a post-master's Certificate in Nursing Education from the Medical University of South Carolina College of Nursing ('11). I then joined the faculty at Duke University School of Nursing as an Assistant Professor. My family moved to northern Virginia in 2015 which led to me joining the George Washington University (GW) School of Nursing faculty in 2018 as a (tenured) Associate Professor. I am also the Director of the GW Center for Aging, Health, and Humanities. Please find out more about her work at https://melissabphd.com/.

EP108: Emotions, Memory, and Alzheimer's Disease Jun 14, 2022

Show notes

You may recall that Maya Angelou said something along the lines of "people will forget what you say, they will forget what you did, but they will never forget how you made them feel". Well, there's a reason for that and that's what I'm going to talk about today.

We can all use the concept of emotional memories to make new memories or to recall old ones. We can create moments that last a lifetime around positive feelings and boost our overall mental health – and if you are a caregiver for a person living with Alzheimer's disease, understanding how emotions can impact your interactions is key.

Take a deeper dive at how emotions, memory and Alzheimer's disease are interlinked in this another valuable of This Is Getting Old: Moving Towards An Age-Friendly World. Tune in to Episode 108: Emotions, Memory, and Alzheimer's Disease, and together let's strive to make this world a better place for older adults.

Key points covered in this episode: ✔️ Memories Attached to Emotions are Stronger

Emotions are tied to memories. In fact, memories tied to strong feelings, whether positive or negative, tend to last longer and don't fade as fast or disappear as quickly.

✔️ A Person with Advanced Alzheimer's Disease may Mimic the Emotions Of Those Around Them

In Alzheimer's disease, emotions remain intact. Hence, they will lose the ability to use and understand language, but our nonverbal behavior often communicates how we're feeling. As a result, even a person with very advanced Alzheimer's disease will be able to pick up on our emotional state. So whatever we feel as caregivers can be still be sensed by a person with advanced Alzheimer's disease, whether we wanted them to or not.

✔️ Maintain a Positive And Happy Emotional State When Caring For Older Adults

Whatever our emotional state is will be mirrored back to us by the person we're caring for. So as a caregiver, make sure that your emotional state is more on the positive side to having more positive interactions with the person you're caring for.

✔️ The Link Between Emotions and Memories

How you feel at any given moment impacts what you think about and vice versa. If you're in a positive mood, you're more likely to think about and recall positive memories. If we are in a negative mindset, we tend to recall and think about more negative things, and either of these tendencies can be self-perpetuating.

The good news is that you can control what you think about. If you find yourself in a bad mood, try thinking about fun or positive experience until your mood improves. Moreover, by focusing on feelings, you will have an easier time finding your way back to that memory later.

✔️Learn How to Tap into Music to Improve Your Emotional State

Music impacts our emotional state, and it has a powerful way of altering anybody's mood. Playing a person's favorite song is a great way to lighten their mood, and it also gives you another chance to interact positively. Who knows, maybe both of you will get up and dance!

About Melissa Batchelor, PhD, RN, FNP, FGSA, FAAN:

I earned my Bachelor of Science in Nursing ('96) and Master of Science in Nursing ('00) as a Family Nurse Practitioner (FNP) from the University of North Carolina Wilmington (UNCW) School of Nursing (SON). I genuinely enjoy working with the complex medical needs of older adults. I worked full-time for five years as FNP in geriatric primary care across many long-term care settings (skilled nursing homes, assisted living, home, and office visits), then transitioned into academic nursing in 2005, joining the faculty at UNCW SON as a lecturer. I obtained my Ph.D. in Nursing and a post-master's Certificate in Nursing Education from the Medical University of South Carolina College of Nursing ('11). I then joined the faculty at Duke University School of Nursing as an Assistant Professor. My family moved to northern Virginia in 2015 which led to me joining the George Washington University (GW) School of Nursing faculty in 2018 as a (tenured) Associate Professor. I am also the Director of the GW Center for Aging, Health, and Humanities. Please find out more about her work at https://melissabphd.com/.

Our TOPPODCAST Picks

Follow Us

Stay Connected

This Is Getting Old: Moving Towards an Age-Friendly World Podcast with Dr. MELISSA BATCHELOR

Related Podcasts

Links

Stay Connected