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Archive for September, 2011

Celebrating the triumph of living a longer life

There’s a huge demographic change afoot in the world. We’re living longer: worldwide, there are about 600 million folks over 60 and by 2025, that number will double, skyrocketing to almost two billion by 2050. The vast majority of these people—80%—are in the developing world.

People over 60 are an essential part of our world: through paid work and volunteering; caregiving for family members; and passing on insights and wisdom acquired through their experience. People over 60 are often vibrant, energetic, active folks with major contributions to make to societies the world around.

We’re here to celebrate all this today on International Day of the Older Person. Established by the United Nations in 1990, this day aims to bring appreciation to the contributions and challenges of this demographic. Population aging is a profound triumph, but also a huge challenge.

People over 60 sometimes face obstacles to living full, meaningful lives. During last year’s event, U.N. Secretary-General Ban Ki-moon called on governments to do more to address the needs of older persons. “The key interventions are well-known: granting universal access to social services; increasing the number and worth of pension plans; and creating laws and policies that prevent age and gender discrimination in the workplace,” he said.

Older persons make major contributions to societies around the world. This is particularly true in Africa, where young and middle-aged AIDS patients are cared for by their parents. And upon the AIDS patients’ deaths, their orphaned children are left to be raised by grandparents. Right now, that number is a staggering 14 million under the age of 15 in African countries alone.

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World Alzheimer’s month

I regularly visit with patients who have Alzheimer’s disease and it’s a bittersweet experience. We celebrate the health that they do have, but grieve the changes in personality and behavior that alter our friends.

The disease traps people inside of their physical bodies. But even at the final stages, when the disease is at its worst, sometimes there are moments of clarity for these folks and a small window opens for us to see who they really are. I cherish those moments.

This is World Alzheimer’s Month, a time to bring awareness to this devastating disease. Although we see much progress in treatment, it’s still progressive and incurable. I’m wearing purple today to show solidarity with others in recognizing this month. Take some time to learn more about this disease that will likely affect one in 85 people globally by 2050.

Alzheimer’s 101

Some memory loss is normal as we age (link to previous blog post on memory loss), but when it’s serious enough to interfere with daily life, we call it dementia. Alzheimer’s is the most common form of dementia, accounting for 50 to 80 percent of the cases.

Age is the greatest risk factor—most people with Alzheimer’s are older than 65. But up to five percent are actually in their 40s or 50s. This is known as younger-onset Alzheimer’s.

We’re still learning about the cause and progression of Alzheimer’s disease. Many scientists and researchers believe that it has something to do with amyloid plaques and neurofibrillary tangles in the brain. Amyloid plaques are protein fragments that accumulate between the nerve cells of the brain and neurofibrillary tangles are insoluble twisted fibers found inside the brain’s cells.

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The role of a hospice nurse

Caring is the essence of nursing and that is particularly true in hospice, where nurses are present to help patients and families navigate the end-of-life journey.

This is a time when patients have stopped life-prolonging medical treatments and have begun pain management and other comfort measures and have started the process of closure. A hospice nurse is frequently asked to fill several vital roles, from medication supervision to emotional support. It can be difficult to care for patients with terminal illnesses, but more often, I see it become a meaningful journey for patients, families and those who work with them.

I have tremendous respect for the men and women who choose hospice nursing as their calling — and I believe it is a calling to be present with others as they prepare to die. As a culture, we often avoid thinking about or talking about death, but in hospice the philosophy is different. Because the end of life is imminent — usually a patient is admitted to hospice within the last six months of life — the patient and family can prepare themselves, say what needs to be said, and perhaps have long-wanted experiences.

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