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Healthy Aging Panel Discussion | Aging Matters | NPT Reports — Transcript

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0:00- Hello. I'm LaTonya Turner.
0:02As you've just seen, the definition of health
0:04may change as we age, but the goals for quality of life
0:07remain the same.
0:09To help us continue our exploration
0:11of health and well being, we've invited three professionals
0:14to share their perspectives and offer advice.
0:17First, Carol Orsborn whose most recent book is titled,
0:21The Spirituality of Age: A Seeker's Guide to Growing Older.
0:25Also, Dr. William Petrie, Director of the Geriatric
0:28Psychiatry Outpatient Program
0:30at Vanderbilt University Medical Center.
0:33Finally, I'm joined by Janet Jernigan,
0:35executive director of Fifty Forward,
0:37an organization providing pathways to health,
0:40well-being, and lifelong learning.
0:42Thanks all of you for joining us.
0:43- Thank you. - Welcome.
0:45- I wanted to start by asking each of you
0:48to define healthy aging.
0:50I know, from talking to you,
0:53and we've seen from the documentary,
0:54each of you have a little bit different perspective
0:56so let's start with you Carol.
0:58How do you define healthy aging
0:59when someone says that to you?
1:01- I have to start with a little story
1:03which is that my mom was a very powerful woman
1:07who was used to being in control,
1:09and when she went through the end of life processes,
1:12she became a victim of aging,
1:15and I realized that she had not been doing
1:19the kind of spiritual work and personal growth work
1:22that I've been doing all my life,
1:24and I determined at that point
1:26that there must be a better way to go through aging
1:31than how she did it, and so for me,
1:32successful aging has a very deep psychological
1:35and spiritual component to it.
1:38- And it's sound like maybe some of that involves
1:41being in control of the decisions that are made around that.
1:46- I suppose so, but for me, the emphasis is really
1:49how to live through the end of your life
1:54when things are out of your control.
1:56It has to do with acceptance, and it has to do with faith,
2:01a belief, a belief that there is something,
2:05some meaning and purpose in your life
2:06no matter what comes our way.
2:09- I have to ask, do you think we put too much emphasis
2:11on the physical aspects of aging
2:15and doing things
2:17physically different to impact the aging process?
2:20- Well, I think as long as you can be physical
2:23and as long as you wanna be physical
2:26and even if you don't want to (laughs),
2:28if you're capable, it's probably some role
2:30for discipline in that, but I do worry.
2:33I just saw the documentary, and I do worry about
2:37the man who is the champion runner at 63 or 64.
2:42What happens when his knee blows out?
2:44Because I think some people who place
2:47a tremendous emphasis on things that may spin
2:50out of their control are not, they don't have the time
2:54for the internal personal growth work
2:56that takes a lot of time, as much time I think
3:01to have a spiritual practice and to be asking yourself
3:03the big questions about ultimate concerns
3:07that are equally important to having physical practice.
3:11- Okay, well Dr. Petrie, I imagine you have to kinda
3:14reconcile both the mental, spiritual, and the physical part
3:18with some of your patients,
3:19so what do you tell people healthy aging is?
3:23How do you describe it?
3:24- Well, I think it has several components.
3:26I think the most important thing is adjustment
3:29to changing roles and changing circumstances
3:33that you're gonna encounter with aging
3:36whether it's 68 or 88.
3:40I think, secondly, it's crucially important
3:43to remain productive and active, to keep pedaling.
3:48It's what I tell most of my patients.
3:50"You can't coast, you've gotta keep pedaling."
3:52And I think the third important aspect of aging
3:55is to stay engaged with a social network
4:01and to have a social persona
4:04which interacts with a variety of other people.
4:08- Okay, well speaking of keeping pedaling
4:11or continuing to pedal, Janet certainly is a model for that.
4:16So when people ask you what is healthy aging,
4:19and not everybody can achieve the goals you have,
4:22but what do you say?
4:23- Well, I agree.
4:24There're just so many different components,
4:25and it means different things to different people
4:28in their lives, but I think starting out,
4:31it's just having very mutually supportive relationships,
4:34real good exercise and fitness and healthy nutrition,
4:39trying new things, have a very significant purpose in life,
4:46and just the courage and the perseverance
4:48to keep on keeping on, and when you experience setbacks
4:53and issues that you've not faced before,
4:56realizing there're people all over the community
4:59who have been through things that are very similar.
5:02So being able to reach out to other people,
5:04to take advantage of resources,
5:06just continuing to stay very active and very involved
5:09and then finally, just having a real positive
5:12outlook on life.
5:13I think the studies show that people who have
5:15a very positive outlook live, on average, 7 1/2 years longer
5:19than people who complain a lot and are more negative.
5:22- Okay, all good advice.
5:25I think one of the things that a lot of people want to know
5:29because I was talking with some of my coworkers
5:31about this is, and this relates to something that was said
5:35in the documentary about adapting to your limitations.
5:39So it would be great if there was some kind of little guide
5:42like there is when you have children
5:44and they say, "By six months, your child ought to
5:47"be doing this and by a year, they ought to be doing that."
5:49I don't know if that's possible, but can we expect certain
5:53things to sort of start becoming more limiting
5:58in a progression that people can then learn
6:01okay I need to adapt to this because my vision is changing--
6:04- Well the problem is that people age at different rates,
6:07and it doesn't start in the 60s.
6:09It actually starts in the 20s.
6:11Many people age in a very different,
6:15at a very different rate than others
6:18so that the number really doesn't make a whole lot of--
6:21- Maybe there're markers to look for.
6:23- Exactly.
6:24I think changes in work, changes in family relationships,
6:30changes in physical activity, obviously
6:32are gonna be very big, but we really don't know
6:37how well some people can age.
6:41We're stuck back in a situation
6:45where I think we don't expect enough
6:47from people who are aging.
6:49In ancient Rome, the life expectancy was 28.
6:55In 1900, it was 47.
6:57Now, it's gonna be over 80 now for women,
7:01slightly less than that for men,
7:03but we need to, I think, have a lot more
7:08emphasis on what people are capable of doing.
7:10As Janet's trying to operate, to get people physically
7:14active and intellectually active.
7:17- Okay, you know Carol, you talked in the documentary
7:20some about perceptions and attitudes about aging,
7:24just what Dr. Petrie has just touched on
7:26and sort of our culture around aging.
7:28Do you have any thoughts about that,
7:31and it definitely has evolved but I'm not sure
7:35you're completely happy still with how people perceive--
7:38- Well, I guess I'm gonna have to play devil's advocate
7:41just a little bit because we certainly don't want
7:45to marginalize older people and let them have
7:49that slow, sad decline into depression that I think,
7:54again that was my mother's expectation
7:56and I think a previous generation,
7:58but in some ways, I worry that we may have
8:02overcompensated with activity theory,
8:05this notion that we have to be busy and productive
8:07and reinventing ourselves all the time.
8:11So there's this new thing happening called
8:14the Conscious Aging Movement that my book and
8:18a number of us are sort of popping up talking about
8:21and that is, at least for the boomer generation,
8:23so many of us have had a contemplative practice for years.
8:27We've been trying to strip away our egos
8:29and be in the present moment
8:31and enjoy sitting by the riverbank or whatever,
8:34and we're finally, we've worked so hard for so long.
8:37Some of us would like to just have
8:40part of the definition of successful aging,
8:43the notion that we can, in addition to when we feel called
8:47to produce and to be active, that it's okay.
8:50We have the freedom also to enjoy the present moment.
8:54And especially, with the very aged,
8:57that woman on the park bench,
8:59we may have to call social services.
9:01She may be depressed, but she also may be having
9:03a transcendent experience,
9:06so I'm just trying to open it up just a little bit.
9:08- I wonder how much though might be cultural
9:11because I can remember growing up
9:12and seeing some of the elders.
9:15I grew up in the south, so people sat on their porches
9:17in the evening and that was a social thing.
9:20Sometimes, they would sit there,
9:22but there was also a different level of respect I think
9:26for those who did, and I remember my friends and I
9:29really engaging with some of those older people
9:32in a very respectful and healthy way.
9:35So some of this may be driven by how we
9:38see people who are growing older.
9:39Would you agree, Janet that
9:41it's that expectation in our western culture
9:46that you've got to still be busy and active
9:49and doing something as opposed to sitting on your porch?
9:53- When I was 20, I thought Lord if you were over 30,
9:55you were over the hill.
9:57And I was even trying to decide how I would go
9:59professionally, whether I would go into recreational and
10:02physical therapy kinds of things or whether I would go
10:06into psychology or some other field,
10:08and I just figured at the time,
10:09"Well probably my mind is gonna outlast my body."
10:12Somehow, I just had this feeling
10:14that boy, that body is really gonna decline,
10:16and I've just been so fortunate through experiences
10:19with the national Senior Olympics and really knowing people
10:22who are in their 90s and 100 years old
10:25who are still very active and physically capable,
10:28and I think it's something that Dr. Petrie said too.
10:31I think many people short sell themselves
10:34about what they can accomplish
10:36and as they have one setback, then they think,
10:39"Okay, well I can't do this any longer."
10:41And the world just becomes smaller and smaller
10:44and smaller until you have someone who's alone
10:48in a room and just needing all kinds of support.
10:52So if there are ways to help people realize,
10:55I know Peter Pressman who's president
10:57of the Nashville Striders always says,
10:59"It's not how far you fall but it's how you bounce back."
11:02And he's a 70 year old runner,
11:04a good friend of David's who was featured in the documentary
11:08but Carol, you had asked about David and saying
11:11concerned about the runner and what happens
11:14when he blows out his knee.
11:15I think if he's like most of the other people
11:18that I relate to, he'll figure out that he can swim
11:21or he can do other things or he can coach
11:24or there's some other thing that he can do
11:27to be worthwhile unless your self-esteem
11:31is totally tied up in that.
11:35Now, I know that most psychiatrists know this,
11:38that athletes are the hardest to treat
11:42when it comes to mental illness and depression
11:45because in a lot of people, depression can be managed
11:48with great exercise but sometimes, in athletes,
11:52so much of your self-esteem is tied up into winning
11:56and when you can't do it, it's a problem.
11:59- Dr. Petrie, you're gonna have to reconcile this.
12:01(laughs)
12:02You've got two different perspectives here.
12:04- Let me say this.
12:05Let me say this.
12:06I think the problem that I have is that we have
12:09an extremely sedentary lifestyle,
12:12and in America today, it's very unhealthy.
12:16You can't walk a lot of places.
12:18Most people fill up their days with television,
12:22and most people, as they have limitations in transportation
12:26or other issues, they become isolated in their home.
12:29So, you absolutely have to walk.
12:32I don't care what's the matter with your knees.
12:35You gotta walk about a mile a day.
12:37Everybody, and the reason is
12:40that's your nursing home insurance.
12:43That keeps you out of the nursing home.
12:44You can have a good quality of life
12:48even if you have memory impairment if you've got good legs
12:52but if you can't walk safely, then expect big problems.
12:57So I know, in my practice, I see how you don't want
13:00to end your life.
13:03And I think the issue is, you've got to retain
13:06some of that independence and I think
13:08we've got to come up with innovative ways
13:10of keeping people together, walking together,
13:15studying together, learning together, worshiping together
13:19because the trend that you see with older people
13:23is they get more isolated, quit going to church.
13:26I say to most of my patients,
13:29"I'll leave your religious beliefs up to you,
13:31"but the thing I like about church,
13:33"you gotta wake up, you gotta get dressed,
13:36"and you've got to say hello to a bunch of people."
13:40And you also gotta sing.
13:42(laughs)
13:43- There was one study, LaTonya
13:45that in regard to the walking that showed
13:47you can reduce the chance of getting Alzheimer's by 60%
13:51by practicing two health habits.
13:54One is a daily walk, and the other is eating
13:56a Mediterranean style diet.
13:58- And we saw at the end of the documentary,
14:01a little bit about that in terms of exercise,
14:04physical activity, actually being more beneficial
14:07than the brain games that we were talking about
14:10about some studies, but Carol, I'm not,
14:13I wanna just give you a chance to comment
14:14because I don't hear you saying that you're against
14:18physical activity and walking, but I think maybe
14:21what you're saying is, "Don't disregard the importance
14:26of those who choose to sit on their porch
14:29to use the analogy that I gave, at times
14:33and just enjoy where they are in life,
14:36but maybe I'm wrong.
14:37Tell me what you think about--
14:38- No, and I think you had a really good point.
14:41The really important point, and that is
14:44that if your identity is so tied up in who you've been
14:49in the past, you're both saying the same thing
14:52that when you experience the normal losses
14:56that are associated with age, that you let them stop you
15:00from getting enjoyment out of life.
15:02That is what I'm talking about.
15:04And I think in this anti-aging culture
15:07that is so youth dominated,
15:09there's a lot of people that get depressed
15:11unnecessarily soon and early when they have their
15:14first loss or disability because they think
15:17there's something wrong with them
15:18and they become isolated,
15:20and so I love what you were saying about get to church,
15:23but I think something else happens at church
15:25or synagogue or mosque, and I think that is
15:28that at every spiritual and mystical practice,
15:31they were always talking about loss of ego,
15:35transcending materialism, developing your inner life,
15:39not identifying with your ego.
15:41I mean, there's a lot of us that have a spent a lot of time
15:43meditating, doing yoga, things like that,
15:46reading spiritual literature, bible study for heaven's sake,
15:49and all of it.
15:50And the thing is is that when we get older,
15:52this happens organically.
15:54I mean, organically, all those things challenge us.
15:58And can we look at aging as a spiritual opportunity?
16:04Not just a panacea we throw at a problem,
16:06so I totally believe, I exercise,
16:09I'm a member of Fifty Forward. (laughs)
16:11Absolutely.
16:12And I'm telling you, the 80-year-olds
16:14give me a big runaround. (laughs)
16:17So, I mean, it's very inspiring to me,
16:20but I'm not doing it to stay young.
16:23I'm really doing it to have a balanced life
16:25in which I'm my best possible self whatever I'm facing.
16:29And I did have to get over my ego
16:30cause I'm in the cherry yoga class.
16:32I'm in the silver sneakers class.
16:33I'm not on the floor doing what the 20 year olds can do.
16:37And that was a big transition for me, of letting that go
16:41and saying, "Okay, I am at a level
16:43"with 70 and 80 year olds and I just have to accept that."
16:47And it works for me.
16:49- So much of the marketplace and the culture though
16:53seems to be about hanging on to youth,
16:56continuing to stay in a youthful sort of lifestyle,
17:01products geared toward making you look younger,
17:04making you feel younger, so there is that pushback--
17:09- They've got a bunch of pills
17:10- Exactly, and I wanna talk about that
17:13all the products - plastic surgery
17:14that are being pushed and the treatments
17:16and techniques and overwhelming amount,
17:19and I'd love to start with you, Dr. Petrie about
17:22because in some ways, that's the advertising industry
17:27catering to this new generation of folks who are aging
17:32but it's creating this dynamic that Carol is saying
17:35is out of line, it's out of kilter.
17:38- And I think, not just advertising but I think
17:40the medical profession has over promised.
17:44- How do you mean?
17:45- In terms of what they can do as people age,
17:49the illnesses that they can cure, we can do this,
17:52we can do that where the fact is that
17:57there's a whole lot that they cannot do so that
18:03- And you're not talking about the superficial
18:06cosmetic type things?
18:08- Yeah, well, I'm talking about that but I'm also talking
18:10about other illnesses: cancer, degenerative diseases.
18:15You look in the paper, there's a new cure
18:18for Alzheimer's disease every week.
18:19Well let me tell you this.
18:21We are a decade away from any substantial treatment
18:25that's gonna change that,
18:26so what we're gonna have to face is
18:28how do we deal with these people in our midst?
18:31How do we deal with our family members?
18:33And I think we've doctors have got to be more honest
18:37with what's gonna happen, and if you look,
18:39there's studies that show that if you look at physicians
18:43and if you ask, their patients says,
18:45"How long are we gonna live and so on?"
18:492/3 of the time, they are overly optimistic.
18:52- Well and let's talk about that, I mean, being honest.
18:55What are things that just are going to happen?
18:59And I'll mention vision because that's certainly something
19:02you start noticing.
19:03I've started noticing changes in my vision,
19:06but we know that eyes are gonna change
19:08or vision's gonna change,
19:10and that's a realistic expectation people should have.
19:12What else?
19:13I mean, we hear about arthritis.
19:15I used to hear people growing up talking about
19:16Arthur coming to visit, (laughs) meaning arthritis.
19:20- Yeah, arthritis and limitational lumen.
19:21You lose one percent of your bone mass
19:23and muscle mass every year after 50.
19:26One percent, that doesn't sound like much--
19:27- And that's just gonna happen naturally--
19:29- Well unless you do some contrary work
19:32like keep yourself active and do some resistance work,
19:35I mean, it doesn't sound like a lot for a year,
19:36but if you look at a decade,
19:38you lose 10% of your muscle mass from 50 to 60.
19:41That's big.
19:43- That is big.
19:44- Can I address the elephant in the room?
19:46- Please.
19:47- Because this is a society that doesn't
19:49wanna mention the d word.
19:51We die.
19:52I mean, that's the biggest.
19:55I had breast cancer 18 years ago,
19:57and I was able to stay positive about it
20:00and thought I'd made peace with mortality,
20:04but the thing is is that breast cancer was something
20:06I could hope to recover from.
20:08When I turned 63 a few years ago,
20:11I realized I am not gonna recover from aging.
20:14I mean, it really does raise the stakes.
20:16You have two choices.
20:17You can either come to terms, ask yourself the big questions
20:21about the meaning of life or you can be in denial.
20:26And I think some people who are in denial drink too much.
20:31Some of them go for too much plastic surgery.
20:33Some of them run too much.
20:35You know, it's like what we don't
20:37(laughs)
20:40- Thank you for time.
20:42- But I think what we're tying to do as a society
20:44is to actually get rid of aging
20:46and what we want to have is an extended midlife.
20:49So we try and obliterate the idea of it
20:52so that it does come as a shock to us
20:55when you encounter something you can't cure with a pill
20:59or something, and it's absolutely right about that.
21:01- And I think we're looking for that panacea
21:03and you're saying that in some ways,
21:04the medical community kinda caters to that a little bit.
21:09- [Dr. Petrie] More than a little bit.
21:10- Okay, more than a little bit.
21:12I want to also address something that you
21:14kinda hint at with that because aging is the journey
21:19toward the end of life and toward dying,
21:21and depression has come up in this conversation
21:24by each of you as being something to really address.
21:30Tell us or let's talk a little bit about how
21:34some of these things contribute to depression
21:36and why we are hearing experts say that
21:39by 20 years from now, 30 years from now,
21:42depression's gonna be the leading cause of disability
21:47as people grow older, and that is a figure,
21:50a fact that we've discussed in the documentary.
21:53- Yeah, and if you look at depression in older individuals,
21:57one of the things you see is that as they become
22:00more physically and firm and develop
22:02more medical illnesses, the rates of depression go up
22:05and are increased.
22:06Now, on the other hand, what are the things
22:07that help depression?
22:09You mentioned fitness for depression,
22:12social connection, talking, psychotherapy and--
22:17- Spirituality.
22:18- Spirituality. - Yes.
22:20- And of course, medicine too has a role in that.
22:23So it's a huge problem for older patients
22:28because it also spoils their quality of life,
22:31and it ruins their ability to enjoy and appreciate
22:34and even stay connected to their spiritual life.
22:38- And so, does it become this tug of war
22:43where there are lot of factors that are contributing
22:46to depression because of aging,
22:49but the things to do to combat that
22:53are hard to do when you're depressed?
22:55(laughs)
22:57- Yeah. Right.
22:58- So and then, I think we also should talk about
23:01medications because there was a very interesting part
23:03of the documentary where we heard about
23:05how medications can just pile up and pile up
23:08and pile up, and that can contribute to this as well.
23:11Janet, do you have any thoughts about
23:14the vicious cycle that kind of comes with depression,
23:19getting out of depression, and how to deal with that?
23:21- Well there's a really good book.
23:23It's called Spark by Dr. John Ratey,
23:25and it's all about the connection
23:27between brain function and exercise.
23:31And I just think that you've gotta start somewhere.
23:36You've gotta do something.
23:38If it's a daily walk, if it's just getting up out of the bed
23:44and a lot of times, people have to have professional help
23:46to be able to take those steps that they need to take.
23:51- Are there resources in our community that are needed
23:54to help with that?
23:57I think it was you, Dr. Petrie, that said you need to walk,
24:01but we don't really have the infrastructure
24:03for people to walk.
24:05We know there are transportation issues.
24:08Janet, I know Fifty Forward has been involved
24:10in trying to help people, help this community
24:13develop some of those resources.
24:14Where are we with that?
24:16- Well I think we're behind many many other communities,
24:18and transportation generally is the number one issue
24:22on any kind of community needs assessment
24:24for older adults and also for people with disabilities
24:27and even people who don't have disabilities.
24:30So that's a really important thing and of course though,
24:34the last mayor, and I think Mayor Barry
24:36had put a good emphasis on livable communities,
24:40and we just need to really really step up that effort
24:43so that we've got sidewalks and we have all the
24:46public parks, and we have people living
24:48where there's retail and other kinds of things
24:51so that you're not so separated
24:53and you don't have to depend on transportation
24:55all the time.
24:57- And Fifty Forward's doing a great job
24:59in helping with that.
25:01Let's start to wrap up our conversation
25:03and since you're talking Janet, just tell us one thing
25:05that we can do as a community or as individuals
25:10to pursue healthy aging.
25:12If you can just give me a brief comment about that
25:14and then we'll let each person do it.
25:15- I think one thing is that in most communities
25:17around the country, organizations similar to Fifty Forward
25:21have some local government support.
25:24Many of the senior centers throughout the country
25:27have pretty nice allocations from local government,
25:30and that has never happened in Nashville
25:33as far as that goes.
25:35In Williamson County, we have support
25:38from the city of Brentwood and also
25:39the Williamson County Commission, so right there,
25:42making an investment in Fifty Forward and the wonderful work
25:45that we do with about 20,000 older adults every year
25:48would be a great thing.
25:50- Well maybe there's some council folks watching (laughs)
25:53that will hear that.
25:54Dr. Petrie, pursuing healthy aging.
25:57- I think it's really helpful for most people
25:59to speak to their doctors about how they can take
26:03a substantial part in their medical care
26:07and not just that, but what they want the end of their lives
26:11to look like.
26:13To think about, do you wanna die at home?
26:18- Rather than how could I stay young
26:20Thinking about how do I age--
26:21- How do you age, and I think, to talk about the pills.
26:25Do I have to take all these pills?
26:28How can I eliminate three of these 12 pills
26:31that I have to take every day?
26:34And to engage personally with your physician,
26:37which is really important when you do have to
26:40encounter the problems of various types of illnesses
26:44and limitations.
26:46- Very good.
26:47Carol, can you just briefly tell us what your thoughts are?
26:50- Well, I think we've gotta get out of denial
26:54that we are gonna be forever young
26:56and start a spiritual practice, whatever it may be
27:00early enough in life so that when
27:04the things start piling on you, you have something
27:07inside of you and hopefully, some divine wisdom or power,
27:12something greater than yourself that you can also draw upon
27:16because it's not always going to be
27:18something that we can handle by something we do.
27:22Sometimes, it's gonna have to be some sort
27:24of internal shift that we make.
27:27- Okay, great advice from each of you.
27:30Very different perspectives but very helpful.
27:32Thank you for joining us, and we've run out of time.
27:35We thank you for tuning in to our discussion
27:37on healthy aging.
27:39If you'd like more information on this and future programs
27:42about aging in our community, go to wnpt.org/agingmatters.
27:48Thank you for watching.

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