An Aging Society - Issues and Problems

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An Aging Society: Issues and Problems


Guest: Sally Smith – Author/Artist

Host: Dr. Layton McCurdy – Psychiatry & Behavioral Sciences

Sally Smith: Welcome to an MUSC Health Podcast. Welcome to Age to Age. I'm Sally Smith. Let's talk. Today, we're fortunate to have Dr. Layton McCurdy, Dean Emeritus of MUSC, with us, one of my favorite people to talk to about ideas and thinking through problems. He has been kind enough to join us when we want to look at the problems and issues of aging and caregiving in this crisis that we're in now, that only seems to be mushrooming. We've talked a little bit about what the situation is. Now we want to look at the problems that are going to have to be solved. What do you see as some of these problems that we're going to have to solve to get through this crisis and come up with better solutions?

Dr. Layton McCurdy: Well, for one thing, I'm very happy about the magnitude of research that's underway now to identify causes and treatments for, certainly, Alzheimer’s, and perhaps some of the other forms of dementia that come along with age. My goal and my hope is that there will be some treatments, some specific treatments. We have treatments now that have some evidence that they work, that they slow down the process of Alzheimer's. There's very little scientific knowledge that we can slow down the sort of so-called normal aging, dementia, forgetfulness, and so forth. I think the research is going to be incredibly important, that certainly is one thing. The other thing is, in this country, to figure out ways to manage better. I don't know if you have a long-term care insurance policy, but I do. And sometimes I wonder, is it worth it? But, I still have it, both my wife and I.

And I think that's an important thing. What if we couldn't afford it, where would we be? And we have a care system that's pretty good for acute care, regardless of your status in life. But, for the management of chronic illness, or chronic conditions, which I think dementia is, we don't have a good system. You may have noticed recently in our newspapers, in Charleston, and in other parts of South Carolina, there are full-page ads. There was one yesterday about the management of chronic illness. And there's an organization that's pushing the presidential candidates to take a position. It's a national organization but they're focusing on South Carolina and New Hampshire, for obvious reasons. And so far, we haven't lured any of the presidential candidates into taking a stance on the care of chronic illness. The argument is that chronic illness uses eighty-five percent of the healthcare dollar. I can't verify that number, but it's a lot, I do know that.

Sally Smith: I know that there are two issues pending, pending laws, one for increased research into all sorts under the umbrella of dementia, which would, of course, include Alzheimer's and many other forms of dementia. Another one is tax breaks for caregivers. I think the unseen issue here is so often the caregiver. We were talking earlier about the baby boomers and the see-saw effect. They just got finished taking care of the children, and now here they are taking care of the grandparents. One question I have, because I've met with all sorts of emotions from people in that situation, and sometimes they're quite angry, they love their parents.

Mr. Layton McCurdy: Anger's a perfectly natural response to adversity, I think. You know, it's a healthy response. And sometimes not being angry is probably less healthy than being angry. Obviously you have to manage it. Caregivers, there are many places and programs. I do know that there are opportunities for respite for people who give care, to take a day or two off and have someone step into the home. It helps a lot, you know. I think it gives people something to look forward to. But, for the caregiver, the person who's seriously committed, it's a demanding, constant, twenty-four-a-day job, very constant job.

Sally Smith: The one thing that was interesting, too, is the article I read, when it talked about the man hours lost through caregiving, where people leave a job, have to hurry to a neighboring city to take care of someone. There are all sorts of ways, obviously, that this could play out. But, a lot of people finally just give up their job. They can’t juggle it all. They can’t do it all. And that’s man power that, then, is lost. In small thing, that’s not so important, but in a big thing, when you look at the huge numbers of people that are caregiving, and yet we’re tied to it through our traditions.

One question I have: how tough is the psychological hit of being brought up to do what you can, not growing up on the old farm home place like we all traditionally did hundreds of years ago, moving way off, siblings spread all across the world, the United States, whatever, and then somebody’s got to step up to the plate and take care of Mother or Daddy back home, how taxing is this for family dynamics?

Dr. Layton McCurdy: Well, I think it’s very taxing, because if you’ve talked to siblings in a family about this, nobody’s doing their fair share in the minds of each sibling. It has only been a generation, I saw it in my own mother’s family, and I’ve known that in other families that, in a large family, with five of six children, one of them gets tagged as the caregiver. And, usually, it’s a woman. They often don’t married because it’s expected that they’re going to be the caregiver for Mother when the time comes. I don’t see that much anymore. I don’t think people gear their lives in that direction anymore. We’re much more prone to independence and pursuing our own destiny. But, I think it creates family dynamics a lot. I hadn’t thought about it just in those terms, but you do see that, you know, who’s doing their share of the job.

Sally Smith: One thing I’ve noticed with families, sometimes it’s an expectation financially. They say, look, I’m taking care of everybody, you know, you all ought to realize I get a little bigger piece of the pie when we divide it up. And there are just so many issues like that where people see things differently, and it can cause upset.

Dr. Layton McCurdy: That’s fascinating. I hadn’t thought about it just in that way, but it’s a very good point.

Sally Smith: Well, one thing that I was so amazed at was the illnesses, the amount of illness in the caregiver group, where you think, here’s the ill person, or the old, frail person, and he’s the one we’re all worried about, when so many times the anxiety and the angst, and the frustration, as you say, of taking care of someone that is not thinking straight is an incredibly grueling 24-hour-a-day job. A lot of times they fall ill. One of the key solutions that’s important to remember is other people stepping in, maybe that sibling that lives far away, and giving them the respite you mentioned. I think Hospice will do that as well.

Dr. Layton McCurdy: Yeah.

Sally Smith: Because it is so pivotal not to lose the caregiver. It’s the caregiver that keeps you from having the really huge costs of assisted living nursing.

Dr. Layton McCurdy: There are very pricey and costly care systems and, hopefully, more and more people will plan for that in their lives, with insurance or with other means. I have an anecdote, a story, actually. One of my colleagues, from many, many years, marvelous man, at about age 70, had an accident. This man was actually a marathon runner and wrote two or three text books on the brain; he was brilliant. He had an accident and had cardiac arrest for a short time, and wound up very demented.

His wife was determined to keep him at home. It was such a blow, and such a sudden blow. And, within the first six months or so, they would, you know, go to the grocery store. He sort of wandered away from her one day in a grocery store and got hit by a car, and had a terrible accident, broke a bunch of bones and things. And so, there are all kinds of unanticipated side things that can happen with a person that requires constant observation.

Sally Smith: Wow. Let’s move on. Let’s close this session out, because we’re going to talk about our dream scenario of how all these problems are going to magically go away and we’re going to come up with the utopian society for the elderly. Thank you, so much, Layton McCurdy, for talking with us today, and thanks to all of our listeners for joining us. We welcome your suggestions and always invite your comments on our website. This is Sally Smith, Age to Age, saying good-bye and wishing courage and joy on your journey. We are all connected.

If you enjoy listening to Sally Smith, you can buy her book, The Circle. It’s the story of how she personally responded to her mother’s journey with Alzheimer’s disease. It’s a wonderful gift of hope for anyone with a parent with dementia. Just click on Sally Smith’s name under the Health Professionals tab on the Podcast homepage. All profits support research at the Center on Aging. Thanks.

If you have any questions about the services or programs offered at the Medical University of South Carolina or if you would like to schedule an appointment with one of our physicians, please call MUSC Health Connection: (843) 792-1414.

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