Sunday, May 28, 2017

Ageing at Home

A growing trend among retirees is the desire to remain in one's home as long as possible. In fact, a recent study quoted by AARP shows 87% of those 65+ want to age in place for as long as it is safe. Even among those 10 years younger, 71% would opt to stay put. Familiarity and community ties are the biggest draws.

In BC 93% of seniors live independently, with 80% owning their own homes and 20% renting. The three biggest challenges to senior homeowners are:
  • Taxes and utilities increasing faster than inflation
  • Maintenance costs
  • Major repairs may force a move
  • Home equity becomes difficult to assess.

The biggest challenges to senior rentals are
  • Affordability
  • Availability
  • Appropriateness

 The following chart from the office of the Senior Advocate of BC shows how in BC senior renters and homeowners are in trouble:

Homeowners and renters Living expenses 2016
Metro Vancouver
Home Owner
After Tax Income
Total Homeowner Expense

Basic Cost of Living

Remaining Funds

Average Rent 1 Bedroom

Basic Living Costs

Safer Subsidy*

Remaining Funds

*Shelter Aid for Elderly Renters

So We want people to age in place, but we make it almost economically impossible to do this, so we have to advocate the government to give more consideration to this particular aspect of ageing. 

The research shows that if more seniors end up in homes than the health care costs will go very much higher. This issue is not just an issue for us in BC, but it is an issue in almost every jurisdiction. Allowing seniors to age in place reduces costs to society, and makes ageing a more pleasant experience.

Saturday, May 27, 2017

Licencing Issues for Seniors

One of the workshops I give is on Licencing Issues for Seniors. In BC when a person reaches 80, they have to go in for a medical assessment to see if they are still able to drive.  As one ages, specific functions related to driving skills may be impaired. These functions include vision, hearing, sensation, and cognitive and motor abilities. For example, a decline in peripheral vision may affect the ability to pass approaching vehicles safely, and the decreased range of motion in an older person's neck may impair the ability to look behind when backing up. In addition, reaction time decreases by almost 40 percent on average from age 35 to 65. 

The aging process may also affect cognitive skills. Short-term memory loss, for instance, can impair driving skills by interfering with a person's ability to process information efficiently when merging with traffic or changing lanes. Such difficulties are magnified when the older driver performs these driving skills under stressful conditions. The higher incidence of cognitive impairment, particularly dementia, among older adults produces an increased risk of accident involvement. 

As a group, persons age 65 and older are relatively safe drivers. Although they represent 14 percent of all licensed drivers, they are involved in only 8 percent of police-reported crashes and 11 percent of fatal crashes. This can be compared to drivers age 16 to 24, who are involved in 26 percent of police-reported crashes and 26 percent of fatal crashes, but represent only 14 percent of licensed drivers.

In fact, drivers age 65 and older have a lower rate of crash involvement per 1,000 licensed drivers than any other age group. They also drive fewer miles on average than any other age group.

When drivers over 65 are involved in crashes, the situations and reasons are generally different from those associated with crashes involving younger drivers. For older drivers, the situations in which crashes occur most frequently are when they are turning left, whereas for younger drivers, crashes occur most often while they are driving on a straight road or highway. The errors most often involved in older driver crashes are failing to yield right of way or not responding properly to stop signs and traffic lights. By comparison, the errors most frequently made by younger drivers are related to speed or to following too close.

Among all drivers age 65 and older, it is the oldest drivers who pose more risk to themselves and to public safety. For all adults age 25 to 64, and for adults age 65 to 69, the rate of crashes per miles driven is relatively constant. The rate begins to rise at age 70, and increases rapidly at age 80.

Older persons may also regulate their own driving behavior. They may stop driving or limit driving to accommodate their individual declining capabilities. On average, persons age 65 and older drive substantially fewer miles than drivers in any younger age group.

In addition, older drivers often adopt different travel patterns, driving shorter distances, driving less at night, and avoiding rush hours, major highways, and bad weather conditions.

Ode to Forgetfulness

This post is for my friend Larry. Larry is a little forgetful, and he worries about it. We keep telling him that people at all ages forget things. In this wonderful song by Mack Dryden, he references the "Threshold Syndrome" which affects all ages. More videos by Mack Dryden can be found here

Thursday, May 25, 2017

Is it harder to hear as you age? Short answer yes

I have worn a hearing aid for about three years, and I have found it to be a wonderful tool. However, many of my friends do not even though I think they are having trouble hearing. The issue is that many of us as we age, suffer hearing loss.

Age-related hearing loss (presbycusis) is the loss of hearing that gradually occurs in most of us as we grow older. It is one of the most common conditions affecting older and elderly adults.

Approximately one in three people in the United States between the ages of 65 and 74 has hearing loss, and nearly half of those older than 75 have difficulty hearing. Having trouble hearing can make it hard to understand and follow a doctor’s advice, respond to warnings, and hear phones, doorbells, and smoke alarms. Hearing loss can also make it hard to enjoy talking with family and friends, leading to feelings of isolation.

Age-related hearing loss most often occurs in both ears, affecting them equally. Because the loss is gradual, if you have age-related hearing loss you may not realise that you’ve lost some of your ability to hear.

There are many causes of age-related hearing loss. Most commonly, it arises from changes in the inner ear as we age, but it can also result from changes in the middle ear, or from complex changes along the nerve pathways from the ear to the brain. Certain medical conditions and medications may also play a role.

Why do we lose our hearing as we get older?
Noise-induced hearing loss is caused by long-term exposure to sounds that are either too loud or last too long. This kind of noise exposure can damage the sensory hair cells in your ear that allow you to hear. Once these hair cells are damaged, they do not grow back and your ability to hear is diminished. Many factors can contribute to hearing loss as you get older. It can be difficult to distinguish age-related hearing loss from hearing loss that can occur for other reasons, such as long-term exposure to noise.

Conditions that are more common in older people, such as high blood pressure or diabetes, can contribute to hearing loss. Medications that are toxic to the sensory cells in your ears (for example, some chemotherapy drugs) can also cause hearing loss.
Rarely, age-related hearing loss can be caused by abnormalities of the outer ear or middle ear. Such abnormalities may include a reduced function of the tympanic membrane (the eardrum) or reduced function of the three tiny bones in the middle ear that carry sound waves from the tympanic membrane to the inner ear.

Most older people who experience hearing loss have a combination of both age-related hearing loss and noise-induced hearing loss.

At this time, scientists don’t know how to prevent age-related hearing loss. However, you can protect yourself from noise-induced hearing loss by protecting your ears from sounds that are too loud and last too long. 

It’s important to be aware of potential sources of damaging noises, such as loud music, firearms, snowmobiles, lawn mowers, and leaf blowers. Avoiding loud noises, reducing the amount of time you’re exposed to loud noise, and protecting your ears with ear plugs or ear muffs are easy things you can do to protect your hearing and limit the amount of hearing you might lose as you get older.

The most important thing you can do if you think you have a hearing problem is to seek advice from a health care provider. There are several types of professionals who can help you. You might want to start with your primary care physician, an otolaryngologist, an audiologist, or a hearing aid specialist. Each has a different type of training and expertise.