Why Do Old People Get Mean? – The Caring Generation®
The Caring Generation® – Episode 101 September 1, 2021. On this caregiving program, expert Pamela D Wilson helps caregivers gain insights into changes and frustrations experienced by aging parents to answer the question Why Do Old People Get Mean? Guest. Dr. Jennifer Frontera, professor of neurology at NYU Langone shares research about the short and long-term effects of COVID.
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Why Do Old People Get Mean?
0:00:04.0 Announcer: Caregiving can sometimes feel like an impossible struggle. Caregivers may be torn between taking care of loved ones and trying to maintain balance in life. The good news is that it doesn’t have to be that way. The Caring Generation, with host Pamela D. Wilson, is here to focus on the conversation of caring. You’re not alone. In fact, you’re in exactly the right place to share stories and learn tips and resources to help you and your loved ones. So now, please welcome the host of The Caring Generation, Pamela D. Wilson.
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0:00:36:86 Pamela D Wilson: This is Pamela D. Wilson, caregiving expert, speaker, consultant, and guardian of The Caring Generation. The Caring Generation focuses on the conversation of caring. Giving us permission to talk about aging, the challenges of caregiving, and everything in between. It’s no surprise that needing care or becoming a caregiver changes everything. The Caring Generation is here to guide you along the journey to let you know that you’re not alone.
0:01:03:31 Pamela D Wilson: You’re in exactly the right place to share stories, learn about caregiving programs and resources to help you and your loved ones plan for what’s ahead. Invite your aging parents, spouses, family, and friends to listen to the show. If you have a question or an idea for a future program share your idea with me by responding to my social media posts on Facebook, Instagram, Twitter, or Linked In.
0:01:32:28 Pamela D Wilson: The focus of this show is to answer the question, why do old people get mean? I’ll share five areas to offer insights for young adults who may not be able to imagine what it’s like to be old, insights for caregivers in all walks of life—family and professional), and for middle-aged and older-aged adults who are experiencing some of these concerns and perhaps feeling a bit misunderstood or ignored.
0:02:07:08 Pamela D Wilson: On a topic that is frequently misunderstood. Our guest is Dr. Jennifer Frontera, who offers factual information about her research at New York’s Langone Medical Center about COVID-19 patients. Dr. Frontera is a professor of neurology at NYU Grossman School of Medicine and specializes in neurocritical care and stroke. She graduated from Johns Hopkins School of Medicine and later completed neurology residency as well as stroke and neurocritical care fellowships at Columbia Presbyterian Hospital in New York.
0:02:48:44 Pamela D Wilson: Her research has centered on epidemiology and outcomes among patients with brain hemorrhages, with a recent focus on the neurological impact of COVID-19. She has authored over 25 articles related to SARS-CoV-2 and receives funding from NIH/NINDS, NHLBI, and NIA for her COVID-related projects. Dr. Frontera also sits on the WHO Brain Health task force for neurological complications of COVID-19.
0:03:24:09 Pamela D Wilson: Why do old people get mean? The first reason that many are now understanding about the pandemic related to isolation and loneliness. How has being alone more often affected you from a mental and physical perspective? Think back to the beginning of the pandemic in early 2020 when social distancing was mandatory. Stay-at-home orders were in place in many parts of the world.
0:03:58:86 Pamela D Wilson: Non-essential stores were closed, as well as and gyms, beauty shops, restaurants, hotels, and many of the other service providers. Leaving home was a rare event. Today the world has opened up again, but you might look at going out and doing all of the things you used to do from a much different perspective. Do you remember the anxiety or anger you felt when life turned topsy-turvy, and you could no longer do all of the things you enjoyed or found to be routine?
0:04:35:08 Pamela D Wilson: How would you feel if this situation were permanent and you could never return to doing everything you love? Think about that for a moment. Would you feel upset, angry, frustrated, feel like giving up, unmotivated, or that life isn’t worth living if you can’t have life be more of your way? Hold onto that thought. That is precisely how aging and older adults feel who are homebound or isolated. Elderly who have health concerns and can’t easily leave their home.
0:05:16:03 Pamela D Wilson: Older adults who have lost friends due to a lack of social contact or an inability to get in the car and drive to a friend’s home, or a restaurant, or some other activity. For many aging adults, the changes brought about by the pandemic were not new. They were already living under these constraints without the added fear of catching a virus. So, a few answers specific to isolation for why do old people get mean is that people they love and activities they enjoy are taken away from them because of circumstances like illness, an inability to drive a car, hearing loss, vision problems, or mobility problems.
0:06:07:41 Pamela D Wilson: Never think that this can’t happen to you when you are older. If you are over 30 years old—whether you realize it or not—parts of your body have already begun to age. You may not be as healthy as you were when you were younger. If you are a caregiver, you probably go to a grandparent’s home or to a parent’s home to help. Or you may be a spousal caregiver providing care to a sick spouse in your home.
0:06:36:72 Pamela D Wilson: Besides your caregiving activity, what else do you do that brings you into contact with other people? For example, if you have a job, you talk and work with other people. If you go to school, you have classmates and teachers to interact with, or you may have children. You may connect with friends on the phone, text messaging, emails, or social groups on the Internet. On average, how many people do you interact with every week versus your care receiver?
0:07:11:83 Pamela D Wilson: Some caregivers I know are as isolated as the persons they care for, which links the question of why do old people get mean to the answer – being around my caregiver and no one else. The same applies to primary caregivers who rarely get out of the house to take a break. Isolation can be as much a factor for being in a bad mood all the time as being with the same person all the time for days, weeks, and months on end.
0:07:47:39 Pamela D Wilson: While you love grandma, mom or dad, or your spouse, being together 24/7 all of the time is not good for either of you. If you are isolated and in this situation, what can or will you do to find one or more outlets so that you can interact with others. If you are young and tech-savvy, you have your I-phone or Apple watch, your android, or a computer.
0:08:14:00 Pamela D Wilson: Your aging parent or grandparent may not be tech-savvy, which lessens the options for outside contact without leaving home. In this case, how can you support technology use? One bright spot of the pandemic is that video calls are now as common as the rising and setting sun if one has access to a cellphone, tablet, or computer. How can you help connect your loved one to others in the family or friends across the country?
0:08:47:82 Pamela D Wilson: If you are an older adult living alone, computer people can come to your home to set up virtual access. But let’s say that you are isolated, live alone, can’t get out, and have lost most of your friends. What then? The answer is that it depends on the level of your interest and motivation to become involved in solo, 1:1, or group activities over the Internet.
0:09:19:14 Pamela D Wilson: There are plenty of opportunities for persons over age 50 to become life-long learners and participate in activities. Get out a pen and a piece of paper and get ready to write some information down, or you visit the page for this show Why Do Old People Get Mean on my website. Click on the Media tab, then the Caring Generation, and then the title of this show at PamelaDWilson.com. I will place links to the sites I’m about to mention in the show transcript.
0:09:52:61 Pamela D Wilson: The first option for everybody to investigate is the Bernard Osher Foundation online. Depending on where you live, there may be a Lifelong Learning Institute at a variety of locations. There are over 120 OLLIs, Osher Livelong Learning Institutes across the United States operating in all 50 states and the District of Columbia. You can download the list of Lifelong Learning locations from this show transcript. I live in Colorado. There there are 8 locations here.
0:10:28:15 Pamela D Wilson: Now, let’s talk about ways to meet new people and make friends. Volunteering in person or virtually is good for the mind, body, and soul. Research confirms that volunteering has positive effects for the volunteer and the people and causes helped through volunteer efforts. In addition to contacting local volunteer organizations you might be aware of, search for opportunities on the United Way and AARP websites.
0:10:59:009 Pamela D Wilson: If virtual volunteering is your goal, the source for this is VolunteerMatch. In your efforts to reduce isolation and increase socialization be open to all opportunities, in-person and virtual. You never know, the next person you meet could become a future best friend. Up next, more on Why Do Old People Get Mean? We will talk about health and how having health concerns can turn into a full-time job depending on the diagnosis.
0:11:34:20 Pamela D Wilson: You know this if you are a caregiver taking an elderly parent to doctor appointments. If you are looking for help with decision-making about care for elderly parents or making a care plan for yourself, I can help. Visit my website PamelaDWilson.com and schedule an eldercare consultation. Click on How I Help, next Family Caregivers, and next Eldercare Consultation. This is Pamela Wilson, caregiving expert, author, and speaker on The Caring Generation. Stay with me; I’ll be right back.
0:12:37:53 Pamela D Wilson: This is Pamela Wilson on The Caring Generation. You can help others who may be dealing with health, aging, or caregiving issues by sharing information about this show. The Caring Generation is available worldwide on your favorite podcast and music apps, including Apple, Google, I Heart Radio, JioSaavn, Spreaker, Amazon Music, Breaker, Deezer, Listen Notes, Pandora, Player FM,
0:13:01:55 Pamela D Wilson: Pocket Casts, Podcast Addict, Podchaser, Stitcher, Spotify, Tune In, and Vurbl. In the first part of the program, we talked about isolation as the first factor to answer the question from caregivers for why do old people get mean. Number two in the list—limitations imposed by health concerns. While health issues can occur because of genetics, your lifestyle is the most significant factor to prevent health concerns.
0:13:34:99 Pamela D Wilson: Actions like exercise, eating healthy foods, maintaining a healthy weight, and not smoking. Diabetes and heart disease are two common chronic diseases that can affect daily life. Persons with type 1 diabetes are insulin-dependent. Having type 1 diabetes means daily monitoring of blood sugar levels and insulin injections or using a continuous glucose monitoring system along with an insulin pump.
0:14:04:48 Pamela D Wilson: Persons with type 2 diabetes are not usually medication dependent on insulin but still should be attentive to similar lifestyle changes as persons with type 1 diabetes and take the medications recommended by your doctor. Women going through menopause can experience hormone changes that can result in a diagnosis of type 1 or type 2 diabetes. Heart disease can result in diet changes that means you want to look at lowering cholesterol or triglyceride levels, monitoring leg or ankle swelling,
0:14:41:07 Pamela D Wilson: taking daily blood pressure or experiencing feelings of anxiety. Diabetes and heart disease are two frequently undiagnosed conditions that can be diagnosed earlier if you see a doctor annually for check-ups and bloodwork testing. By the time you become a caregiver for a parent or grandparent, they have likely had health or physical concerns for some time. Isolation, as we discussed previously, has a direct
0:15:11:81 Pamela D Wilson: negative correlation to health conditions. Older adults who are isolated or homebound—as discussed on last week’s program with Dr. Claire Ankuda—have a higher mortality rate than adults who are physically and socially active. Isolated adults are more likely to have chronic diseases like diabetes, heart disease, COPD, and other health concerns. So all of these limitations imposed by health concerns answer that question, why do old people get mean. Isolated older adults are more likely to have chronic diseases.
0:15:52:42 Pamela D Wilson: Like diabetes, heart disease, COPD, other health concerns. Chronic inflammation in the body from these diseases results in weaker immune system function. It makes adults with chronic diseases more susceptible to viruses like COVID. Homebound or isolated adults with health concerns are more likely to be hospitalized or have nursing home stays. Bouncing back and forth between hospitals and nursing homes can permanently lead to residing in a nursing home.
0:16:28:41 Pamela D Wilson: Having health issues and feeling uncertain about the future answers the question why do old people get mean. As a caregiver, you probably experience worry about an aging parent’s health conditions. You may wonder what’s going to happen today, next week, or next month? Maybe your phone rings at all times of night or day. Parents call for help or tell you about something that happened that will require more of your time.
0:16:57:93 Pamela D Wilson: Much of the uncertainty for sick persons and their caregivers results from a lack of education about health conditions. You may not realize that it’s up to you to ask doctors for the information you should know. Why do old people get mean? Constant worry about health conditions or constantly feeling bad because you don’t know what you should be doing to manage a health condition. Feeling sick all the time is enough to make anyone feel cranky.
0:17:31:73 Pamela D Wilson: If an aging parent has various health conditions, going to multiple doctor appointments or seeing several specialists can be time-consuming. It’s one thing if your parent can drive him or herself to these appointments and remember what happened. It’s very different if your parent goes to the doctor and can’t remember any of the recommendations or the follow-ups.
0:17:58:95 Pamela D Wilson: Older adults who live alone, those who don’t have a friend or an advocate to help with health issues fare worse than older adults who have a consistent caregiver. When health issues exist, good organizational, planning, and follow-up skills result in better care. If you don’t have a system to track your health or medical care, this is a project to add to your to-do list or ask someone to help you organize.
0:18:33:68 Pamela D Wilson: Learn everything you can about managing your healthcare and what it takes to stay in the home. Information to help aging parents and loved ones stay at home is in my online caregiver webinar course that you can watch. It’s called Taking Care of Elderly Parents Stay at Home and Beyond. Being shuffled between doctor’s offices, hospitals, nursing homes can make anyone feel unsettled. Number three for why do old people get mean is worry about money worry about having help, worry about where they will live, and more.
0:19:09:31 Pamela D Wilson: All of these worries are valid. The aspect that I want to talk about related to why do old people get mean that can be of significant help to you today if you are young or are the caregiver for a parent are the concepts of having a positive attitude and being happy. While having money to pay for care is always helpful. Trust me, am not de-emphasizing the importance of saving money for retirement so you can pay for care.
0:19:38:68 Pamela D Wilson: Care. You want to make this a part of life planning. However, when the money runs out for aging parents, the worst-case scenario is using the state Medicaid benefit to pay for care. An aspect that counterbalances worry and can help avoid poor health in a major way is maintaining a positive attitude. Research confirms the effects of being positive on health and well-being. Understanding and making use Of research about happiness can reduce the financial investment you might make paying for care when older—if you work to change your general mood from unhappy to happy before you have health issues.
0:20:23:76 Pamela D Wilson: According to Veenhoven, the effect of happiness on longevity in healthy populations is remarkably strong, comparable to the effects on the body of smoking or not. Happiness does not cure illness. It does protect bodies from becoming physically ill. To make this easier to understand, think of being negative or unhappy as constantly feeling on edge or reacting to stressful or scary events.
0:20:56:98 Pamela D Wilson: If you are a caregiver, you can probably relate to the idea of feeling constantly on edge, constantly waiting for another phone call from an elderly parent. Feelings that are not good for your health constantly stick in your brain. Feeling on edge, stressed or scared are times when the body’s adrenaline kicks in. You might feel your heart pounding in your chest. Stress can raise your blood pressure and make other systems of your body go into high alert.
0:21:30:47 Pamela D Wilson: Stress, if ongoing, lowers your immune system, and as a result, you may be sick more often and don’t recover as quickly. To learn more about the effect of stress on the immune systems of caregivers, listen to my podcast interview with Dr. Christopher Fagundes from Rice University. It’s on the show Eldercare Workplace Solutions and Eldercare Programs.
0:21:56:65 Pamela D Wilson: On the other hand, let’s look at happiness. Happier people are more likely to be healthier, participate in sports, be more active, watch their weight. Happy people are less likely to binge eat or drink when something bad happens. Part of being negative or being in a bad mood is that bad moods increase unhealthy thoughts behaviors like smoking, drinking in excess, or using drugs.
0:18:00:00 Pamela D Wilson: Why do old people get mean? It’s because they are negative or in bad moods much of the time. The same applies to caregivers who feel short-tempered, angry, and resentful. These situations aren’t good for anyone. Let’s look at happiness and negativity in another way. When you are happy, you are more likely to be more open to ideas and problem-solving. As a result, you make better choices, and you’re less likely to feel distressed.
0:23:03:67 Pamela D Wilson: When you are negative, it’s more challenging to motivate yourself to do anything. You’d rather hang around in your pajamas all day in bed eating cookies or a bag of chips watching soap operas, talk, or reality shows. You get to choose. Happy or sad. Optimistic or gloomy. Feeling depressed is another apparent reason for why do old people get mean. Depression is a medical condition.
0:23:34:11 Pamela D Wilson: If you or an aging parent is feeling sad or moody, not sleeping, overeating, not having an appetite, see your doctor to discuss the situation. We’re off to a break. Thanks to all of the caregivers who follow and communicate with me on social media to ask questions and provide questions and topics for this podcast.
0:23:56:70 Pamela D Wilson: You can also complete the caregiver survey on my website to offer thoughts, suggestions, and information you’d like more of. Follow me on Facebook, join my Facebook online caregiver support group, The Caregiving Trap, it’s named after my book. Follow me on Instagram, Twitter, and Linked In. Up next, learn more about the short- and long-term effects of being diagnosed with COVID-19.
0:24:22:35 Pamela D Wilson: Dr. Jennifer Frontera joins us to share research from her article, Hospitalized Patients With COVID-19 in New York City. I’m Pamela D Wilson, on The Caring Generation. Stay with me. I’ll be right back.
0:25:00:00 Pamela D Wilson: This is Pamela D Wilson on The Caring Generation. If you’re frustrated by all of the crazy news that you’re hearing day to day about COVID-19. What to do and what not to do, and the risks. We are back to talk about the short and long-term effects for persons hospitalized with COVID. I’d like you to meet Dr. Jennifer Frontera.
0:25:28:41 Pamela D Wilson: Dr. Frontera, thank you so much for joining me today.
0:25:32:35 Dr. Jennifer Frontera: Thanks for having me.
0:25:34:41 Pamela D Wilson: So your research is specific to hospitalized patients diagnosed with COVID in New York. The presence of a neurological disorder was one criterion for inclusion in the study. What neurological conditions or other measures were necessary for study inclusion?
0:25:51:26 Dr. Jennifer Frontera: So we were looking at patients that developed a new neurological issue during hospitalization for COVID. So, effectively, we did this prospectively, so we screened the patients who were seen by a neurology service and were diagnosed by a neurologist with a specific condition. Most commonly toxic metabolic encephalopathy was most frequently seen, but we also saw patients that had strokes, seizures, hypoxic brain injury, neuropathy, and so on. The other criteria were, we were looking at adults. We weren’t really looking at a pediatric population. And we were looking at the first admission for COVID as opposed to readmissions for different types of issues. Though a lot of these patients did have neurological diagnoses at baseline preadmission. We’re looking at new symptoms, not reproduces of old symptoms from a prior neurological disorder.
0:26:52:25 Pamela D Wilson: What commonalities or chronic diseases among patients were more likely to lead to a neurological disorder after the admission for COVID or the diagnosis of neurological disorders after hospitalization?
0:27:05:51 Dr. Jennifer Frontera: Similar to what risk factors are for hospitalization with COVID, at least with this initial type of COVID that we’re seeing in New York. So older patients, male patients, those that had higher BMI body mass index, histories of hypertension and diabetes sort of was predisposing factors for folks to develop neurologic complications. And then, of course, patients that had a history of a neurological issue were more at risk for developing a new neurological complication during hospitalization.
0:27:42:77 Pamela D Wilson: How did the combination of the COVID diagnosis and a neurological disorder affect in-hospital deaths or the possibility of someone being able to return home?
0:27:53:89 Dr. Jennifer Frontera: If a patient had a neurological complication, their chances of dying in the hospital were significantly higher than if they did not. So 35% of patients that had a hospital complication, had a neurological complication died in the hospital versus 19% who did not have a neurologic complication. So these are very high numbers. You sort of have to take into account that during this was the first surge in New York, and we really were under-resourced, and hospital systems were overwhelmed. So mortality rates were higher than what you would see in a properly resourced setting in the United States. Even after adjusting for other factors that contribute to mortality in the hospital, having a neurologic complication was a significant factor amongst those who died versus those who did not.
0:28:46:87 Pamela D Wilson: A couple of questions. So, there’s a lot of talk out there about the idea of brain fog. So what percentage of the population that’s been hospitalized is likely to have neurological conditions associated with COVID that continue when they go home?
0:29:04:96 Dr. Jennifer Frontera: We looked at six-month outcomes in this cohort, and we’re looking at our one-year outcomes now. And half of, 50% of the patients that we were able to test at six months, and by that, I mean we had these patients undergo a telephone MOCA which is the Montreal Cognitive Assessment. Which is kind of a very standard screening assessment for cognitive impairment. And half of the patients that we interviewed had abnormal scores on this metric. That included patients that had neurologic complications during hospitalization and those that did not. In fact, they were equally at risk those two groups at six months. So this is a relatively high number. Higher than what we necessarily would have expected. You know that it’s not that it’s due to COVID itself.
0:29:53:24 Dr. Jennifer Frontera: We have not definitively shown that, but it’s likely due to the secondary effects of having COVID. Meaning low oxygen levels for protracted periods of time, low blood pressures from covid related sepsis, abnormal electrolytes. Other various things that go with being critically ill in a hospitalized setting or just sick enough to be hospitalized from COVID. The direct neurological effects of the virus are probably frequently discussed but probably not the main driving factor for most of these sequelae (a condition which is the consequence of a prior disease diagnosis). So I think we’re still trying to understand the mechanisms underpinning cognitive impairments after COVID hospitalization. But certainly, there’s something concerning going on there.
0:30:45:38 Pamela D Wilson: And so you’re following some of these patients. So what do we know about short and long-term cognitive effects? Does it get–can it get better, does it get better, or is it likely to remain the same or get worse?
0:30:57:96 Dr. Jennifer Frontera: So that’s exactly what we’re looking at with our one-year trajectory data. We really want to understand, was this a static result? Meaning that maybe they had low oxygen levels for the period of the acute illness. It’s over with, so now they’re going to regain cognitive function or stay the same. Or is this a progressive neurodegenerative issue where these patients might get worse over time which would be the scenario that you really kind of dread? So you know, I think with our six-month or one-year data, we’ll have a little better understanding of what trajectories these patients are taking. And it might be variable. You know, not everybody with cognitive impairment six months later has that for the same reason. So certainly, if you have a stroke or an intracranial hemorrhage during your hospitalization, one might imagine that you’re going to have some cognitive impairment deficits six months or one year out. If you did not, and you still have cognitive deficits, then there’s another factor at play that we really need to try to understand better.
0:32:00:67 Pamela D Wilson: Well, you made me think of another question. So, I want to kind of give our listeners a little bit of hope here. It’s just not COVID to your point that causes these cognitive issues. It’s the lack of oxygen to the brain, it’s other issues. So if you would set COVID aside, really anybody that has any of those other issues they also could have cognitive impairment that’s not even related to COVID, correct?
0:32:29:88 Dr. Jennifer Frontera: Yes, that’s right. So in large cohorts of patients with ARDS, so acute respiratory distress syndrome, which basically means patients that have very low oxygen levels from a variety of factors but most often severe pneumonia, like these COVID patients. You know 50% of these patients traditionally will have cognitive outcomes that are abnormal when you study them. And so, you know, certainly in that case, it’s related to prolonged hypoxia, being on a ventilator for a long period of time, etcetera, and all the things that go with being critically ill. So it’s possible that we’re just really seeing similar mechanisms. But I will say that we’re not just looking at intubated patients with ARDS in these studies. We’re looking at a spectrum of patients that had been hospitalized. Many of whom had never been on a mechanical ventilator.
0:30:57:96 Dr. Jennifer Frontera: So you know, although the commonality amongst these COVID folks is that they’re almost always hypoxic to some extent. Although, the population we’re looking at certainly some of them may have been less symptomatic from the COVID and more symptomatic from another reason that brought them into the hospital. The degree of hypoxia ranges across the spectrum. So I hesitate to say that the cognitive impairment is strictly due to hypoxia. That’s probably one element amongst others. You know, perhaps the cytokine storm and the hyper-inflammatory response that’s happening with patients plays some kind of a role. You know, I think we’re still trying to dig into this and figure it out.
0:34:10:15 Pamela D Wilson: Thank you for explaining that. So I saw another highlight from the article that stated, “impaired cognition occurred in 50% of COVID 19 patients and 47% were unable to return to work at six months.” Can you share more insight into those statistics?
0:34:26:40 Dr. Jennifer Frontera: Yes. So this was our six-month outcome paper. And you know we looked at patients who had been working before they were hospitalized. We didn’t look at patients who were retired, or who were students, or whatever. So we were looking strictly at people in the workforce and how many were able to return versus not return. You know, so a significant portion were unable to return to work for a variety of reasons. But it’s concerning because I think the potential economic impact of having a lot of people out of the workforce because of post-hospitalization, post COVID hospitalization sequalae is substantial. I think we are tracking this over time to see if some of these folks were able to get back to work by 12 months. Understanding that the kind of economic situation that we were in, you know, 6, 9 months ago may be different now and that maybe there’s more job availability. But you know, I’m hoping that number goes down, but we’ll find out.
0:35:34:25 Pamela D Wilson: Let’s say I’m a person listening to this, and I realize—and I had COVID, and I was hospitalized—and I’m thinking oh my gosh, I have some of this brain fog or some of these neurological conditions. What are the recommendations for people who are in this situation?
0:35:49:33 Dr. Jennifer Frontera: So it really does depend on your specific symptoms. So there are things like cognitive rehab where you can work on domains that are a particular weakness. It, of course, would require some cognitive testing beforehand to find out what domains really need to be focused in on. Whether it’s executive function, language, attention, so forth. There is, you know, for people who are fatigued and feel their brain fog might be fatigue-related there’s stimulants like Modapanil or Ritalin that some people have tried with success that sort of improved. Largely because, either their sleep quality is affected or just post-viral fatigue.
0:36:41:42 Dr. Jennifer Frontera: We, you know NYU has, is the clinical science coordinating center for the large recovery grants. So that’s a one billion dollar grant that was appropriated by Congress really to look at post-acute sequelae of COVID, and there will be multiple sites collecting information on people that are really suffering with these post COVID sequelae that’s limiting their ability to function to perform at their normal baseline. And this effort is really, I think is going to give us a lot of information about therapeutic opportunities. The scope and magnitude of the situation and hopefully give us more mechanistic information so that we can really target interventions for people like this to help mitigate what they might be dealing with in terms of cognitive impairment or brain fog. Once we also understand whether this is a static incident or progressive would also change, kind of our ability to target therapeutics as well.
0:37:55:04 Pamela D Wilson: Is there anything else that you’d like to share on this topic?
0:30:58:28 Dr. Jennifer Frontera: I think that there are a lot of things unfolding. And that we’re going to have more data over the next few months, I think. Because people are really moving very quickly with research in this arena. As with all things, we like to remind people to please get vaccinated. It really is your best protection against some of these long-term sequelae. That it’s not just a one-and-done illness. Some people are really suffering for months and at this point years, after, more than a year after their initial infection. So vaccination is really the best preventative strategy at this point. And I’m sincerely hoping that we have more therapeutic options available for folks in the near future.
0:38:47:57 Pamela D Wilson: And then one more question. So, I read a lot about COVID, and it’s like, you never know what’s accurate or not, but, so some of the studies I’ve been seeing say that if somebody is vaccinated, they’re less likely to be hospitalized. Is that, is there any truth in that?
0:39:01:99 Dr. Jennifer Frontera: Oh yeah, that’s definitely true.
0:39:04:32 Pamela D Wilson: Ok.
0:39:05:32 Dr. Jennifer Frontera: You know, if you’re vaccinated, and you get COVID, it’s much less severe. So still, 90, 90-95 plus percent of people that are hospitalized with COVID are unvaccinated. Those who are vaccinated and hospitalized with COVID tend to be immunosuppressed. So, I hope that the booster shot for some of these folks might mitigate that issue for them. Because there certainly could be waning immunity if you are at baseline immune suppressed. But a healthy person that’s been vaccinated their chances of getting hospitalized are vanishingly small.
0:39:41:80 Pamela D Wilson: Dr. Frontera, I thank you so much for joining me.
0:39:45:21 Dr. Jennifer Frontera: Thank you so much, Pam.
0:39:47:60 Pamela D Wilson:The Caring Generation is not limited by time zone or location—caregivers worldwide can listen any time of day. The show and the transcript that you can read to find links to research and caregiver support tips I mention during the program are on my website at pameladwilson.com. Click on the Media Tab and then The Caring Generation to find the show transcript. This is Pamela D Wilson on The Caring Generation. Stay with me. I’ll be right back.
0:40:40:09 Pamela D Wilson: This is Pamela D Wilson, caregiving speaker, expert, and advocate on The Caring Generation program for caregivers and aging adults. Whether you are twenty or 100 years old, you’re in exactly the right place to learn about caregiver support programs to help you and your loved ones plan for what’s ahead. If you’re not sure how to talk to your children about caregiving issues or if you’ve tried to talk to your aging parents.
0:41:05:55 Pamela D Wilson: Let me start the conversation for you. If you are looking for information and tips about caregiving, visit the Caring for Aging Parents blog on my website pameladwilson.com. I want to follow up on my conversation with Dr. Jennifer Frontera to put making decisions about vaccines or making any decision as an aging adult or a caregiver to put this into perspective. When people contact me for an
0:41:36:88 Pamela D Wilson: eldercare consultation it’s usually because they are seeking information or wanting assistance in making a plan for care or in making decisions. I will give you ten questions to ask to help you decide about getting the COVID vaccine or not. Upfront, I want to make it clear that it’s 100% up to you to vaccinate or not. I can’t tell you what to do. What I can do is ask you ten questions that you should ask yourself or your family members.
42:10:86 Pamela D Wilson: Making uncomfortable decisions is another factor that answers the question of why do old people get mean. People feel pressured to make a decision and may feel that they don’t have enough information. On the subject of do I? Do I not get a vaccine? Let’s begin with family health history and hereditary diseases. Question one. In your family, what chronic diseases exist with grandparents and parents? If anyone in the family has died, what did they die from?
0:42:46:83 Pamela D Wilson: A chronic disease is something like heart disease, high blood pressure, diabetes, arthritis, breathing disorders, kidney disease, dementia, cancer, and others. Question two. Do you have any of these chronic diseases? Question three. How do you know if you have a chronic disease? When was your last annual medical check-up and bloodwork? High blood pressure and diabetes are two highly undiagnosed chronic diseases. You can have them and not know.
0:39:30:00 Pamela D Wilson: Question four. Why is knowing if you have a chronic disease important specific to COVID? Statistics indicate persons with chronic diseases are more susceptible to COVID and can require hospitalization. Question five. Many people don’t think they need a COVID vaccine because they believe they are healthy? How do you know what it means to be healthy? I’ll give you a personal example from my own life. In my early 20’s I decided to join a gym because I wanted to be healthy.
0:43:56:53 Pamela D Wilson: By looking at me back then, you’d think I was healthy. No obvious issues. I was at a good weight. Wore size six clothes. I went to my first beginner aerobic class, and I barely made it through the class. I was out of breath. My heart was beating a million miles an hour. I was physically exhausted by the end of the class. You might be wondering why I went in the first place.
0:44:21:57 Pamela D Wilson: My mother was sick all the time with cardiac issues. High blood pressure, threats of aneurism, mini-strokes. I did not want to be or live like her. So if you are healthy, the question to ask yourself is. Are you defining health by your own definition and what you know—the limits of what you know. Or are you defining it by what the healthcare system identifies as being in good health?
0:44:53:19 Pamela D Wilson: Can you walk up a flight of stairs, walk a mile, carry groceries in from the car without becoming out of breath? If activity takes your breath away—what do you think happens when you have COVID that causes problems with your ability to breathe? How much physical activity do you get every day or every week? Are you within a normal weight?
0:45:19:99 Pamela D Wilson: Can you stand from a chair without holding onto the arms, or do you have balance issues that make you a fall risk? How much weight can you lift? Do you eat healthy foods, processed foods, or junk food? The easy way to tell between healthy or processed is the foods that come in a box versus foods that don’t come in a box or package. Those are the healthier ones. Asking yourself all of these questions will help you identify risk factors for COVID.
0:45:51:70 Pamela D Wilson: We’ve covered family health history, chronic diseases, and the definition of what people think is healthy that may not mean you are really healthy. Now let’s talk about assessing risk. Question six. What is the level of responsibility you have to support yourself or a family? This question relates to your ability to work and care for yourself if you get sick. Do you have children who rely on you or a spouse?
0:46:22:96 Pamela D Wilson: If you are not healthy and you have a chronic disease, or you are a stressed-out caregiver, research confirms you may have a weakened immune system that makes you more susceptible to viruses of all types: colds, the flu, and COVID. Question seven. Worst case scenario, you are hospitalized from COVID. You heard the statistics provided by Dr. Frontera. Persons hospitalized for COVID usually don’t come home healthier than they were before going into the hospital.
0:46:59:31 Pamela D Wilson: Many come home with neurological and cognitive issues similar to having Alzheimer’s or dementia. Many can’t return to work. If you can’t work, how do you financially support yourself and your family? Question eight. If you get COVID and you have more health issues after COVID, and you can’t work, and you need care. Who will be your caregiver? Is it your young children? Is it your spouse?
0:43:00:00 Pamela D Wilson: Nine. If you are healthy and people in your family have chronic diseases or are older, what happens if you bring COVID into the home and give it to a parent or grandparent? Number ten. How much of the information about COVID do you get from the news versus doing your own research to get the facts? And last, if you wrote down answers to these questions on paper, what do those look like? What risks are you willing to take? What else should you know when making the decision to vaccinate or not?
0:48:11:86 Pamela D Wilson: As you can see, making decisions about health and aging can be way more complicated than you think. Which is why old people and their caregivers get mean when you don’t understand available information, and the answers seem to keep changing every day. Returning to the list of why do old people get mean, number four is that the caregiver assumes that parents know what they know. Caregivers see parents as more experienced, older, and wiser. But are your parents as educated as you? Do they have the same life experiences? Are they exposed to the same information?
0:48:56:69 Pamela D Wilson: When you talk to your parents, do you confirm understanding and agreement, or are you like a steamroller who rolls in and tells your parents what to do? Here’s a very simple example. You have an interest in health and take vitamins. You tell mom and dad that they should take vitamins. Mom and dad refuse. They don’t understand the benefit and think vitamins are one more thing that spends their money.
0:49:22:73 Pamela D Wilson: How might you explain the short and long-term benefits of taking vitamins and the broader positive of the effects on health to your parents? If you’re looking for answers about that, check out my online caregiver course Taking Care of Elderly Parents: Stay at Home. There’s a lot of facts and research in that course. Poor communication and making assumptions about health and care issues is another response for why do old people get mean. Just as caregivers can talk over aging parents, the healthcare system does the same.
0:50:01:89 Pamela D Wilson: Doctors and healthcare professionals use big words or what I call “medical speak.” These words come easy to them. But the general public doesn’t understand. So what happens? Recommendations fall on deaf ears. You don’t understand why this information is important. This is why I am here because I can distill a lot of this complicated information in terms that may make sense to you. We’re off to a break.
0:50:33:20 Pamela D Wilson: Another thing I do understand is that caregivers and aging adults seek information about caregiving programs and support in ways that make sense to you. Listening to podcasts may be your go-to source for information. For others, videos, reading articles or blog posts, giving opinions by participating in the caregiver survey on my website, reading a book, watching a webinar, taking an online caregiver course, or joining an online support group may be your go-to choice. No caregiving situation is the same. In whatever way you prefer to receive information—you’ll find all of these options on my website at pameladwilson.com. This is Pamela D Wilson. Stay with me. I’ll be right back.
0:51:46:30 Pamela D Wilson: This is Pamela D. Wilson, caregiving expert, speaker, and consultant on The Caring Generation. If you are an aging adult or a caregiver not sure what to do or how to plan for care, my website PamelaDWilson.com offers resources for caregivers. Check out my caregiving library, my Caring for Aging Parents blog, listen to all of The Caring Generation podcasts, read the show transcripts, watch videos, check out caregiver courses online, and introduce your parents, siblings, friends, and people in your workplace to my YouTube Channel, featuring hundreds of caregiver videos.
0:52:22:77 Pamela D Wilson: There’s something for everyone at PamelaDWilson.com. We’re back to talk about the number five response for why do old people get mean? This happens when caregivers, adult children, doctors, and others pressure parents to make decisions without providing enough information or understanding the amount of loss related to making the decision. Losses related to decision-making can be experienced at all ages. This is the idea of knowing what to leave behind so that you can move ahead.
0:52:59:67 Pamela D Wilson: How many people live in the past and dream about the way things were. Because of COVID, thoughts of the way things were are more prevalent. Many people are stuck in the dream of wanting to return to a normal life instead of looking ahead adapting to the way things are or will be in the future. Making choices or trade-offs in life can be so uncomfortable that most people avoid change. This is the same with aging parents who used to be healthy and active and now have such a long list of health problems that going out of the house may take major effort.
0:53:39:71 Pamela D Wilson: Many think that the decision to hire a paid caregiver means that children will no longer show up to offer help. While this may be true, what might the benefits of having someone who sees 100% of their job as being helpful, versus a family member who is splitting time between work, family, going to school, caring for aging parents, caring for themselves? Splitting attention between multiple tasks can result in making poor decisions when people get physically or mentally exhausted.
0:54:17:24 Pamela D Wilson: Think of this as the idea of closing one door to open another door. The answer to why do old people get mean can mean that they feel stuck like they’re in limbo. Unable to decide between A and B or not really knowing what the options are. Imagine how scary that is. You have a problem, and you don’t even know what to do to solve it. So doing nothing, not making a choice, can drag on for weeks, months, or years all while the situation continues to get worse.
0:54:47:22 Pamela D Wilson: The choices that aging parents have to make often have major consequences. The same challenges in decision-making exist for caregivers. Making decisions to please others may ultimately result in an aging parent or the caregivers feeling resentful, angry, or mean. While it’s nice to keep all options on the table so that there is a degree of flexibility, you can create decision points to move projects forward. For example, when mom or dad is no longer safe at home as evidenced by multiple falls, leaving the burners on the stove turned on, multiple car accidents, then it’s time to consider bringing paid caregivers into the home, possibly day care, or moving mom or dad to assisted living.
0:55:33:64 Pamela D Wilson: Realize that care choices can be progressive if you ask yourself all the right questions, gather information, know your options, and develop a plan that you can use. You’ll reduce stress, sleep better at night and eliminate many of the reasons for why do aging parents and old people get mean. The process of talking about options and investigating information can be stressful. Tradeoffs may have to be made. All of those “memories” in your parent’s attic may have to be donated to family members or given to Goodwill.
0:56:08:82 Pamela D Wilson: It’s easy to become prisoners of our past when all we think about is the way things used to be or about the decisions we should have made. What we focus our attention on affects the result in our present life, and it can hold us back or move us to a future that may be better. It’s possible that your parents may be dwelling on all of the things they wanted to do in life but did not when they appear mean or disagreeable.
0:56:39:51 Pamela D Wilson: How many of us replay an event in our life that brings back the same emotions we felt when originally experiencing the event? Remembering negative events only makes the memory more vivid, and it doesn’t allow us to move forward. If you are a caregiver wondering why a parent or old people get mean, gain a better understanding of the isolation, the changes and limits of health and abilities, and the difficult choices that have to be made. Plus, the effect of being negative or positive.
0:57:13:99 Pamela D Wilson: Work to help your parents focus on the future by asking the question, what would I do if I had no memory of feeling indecisive or isolated, or how healthy I used to be? Would this move me ahead to focus on the future and dwell less on the emotional attachments I have to the past? The more we allow our brains and our emotions to take us off track from making decisions about our future, the more we dwell with unpleasant memories.
0:57:52:90 Pamela D Wilson: Think about this. Aging parents who spend hours alone every day have nothing to do but think. Which can be good if thoughts are positive and bad if thoughts are negative. Distractions, like we talked about earlier, becoming more engaged socially, taking classes—becoming a lifelong learner, considering volunteering, and finding positive people to connect to can eliminate even having to ask why do old people get mean.
0:54:30:00 Pamela D Wilson: Why not ask instead, why not wake up every day asking how many amazing opportunities are ahead? Try waking up every morning for the next 7 to 14 days believing that amazing opportunities are ahead every day for you. How might your life change for the better? I’d be interested in knowing that. This is Pamela D Wilson, caregiving expert, speaker, and eldercare consultant. If you’d like to learn more about the experiences and interests of other caregivers, follow me on social media. My posts respond to caregivers who complete the caregiver survey on my website and communicate with me on social
0:54:30:00 Pamela D Wilson: media on Facebook, on Instagram, on Twitter, on Linked In. Thank you for joining me on The Caring Generation – the only program of its kind connecting caregivers and aging adults worldwide to talk about caregiving, well-being, health, and everything in between. Invite your family and friends to listen to this and all of the past shows on your favorite podcast and music apps. This is Pamela D. Wilson, caregiving expert, advocate, and speaker. I look forward to being with you again soon. God bless you all. Sleep well tonight. Have a fabulous day tomorrow with many positive thoughts and pleasant journeys until we are here together again.
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