Monday, October 10, 2016

On the Topic of Robots at The Legacy Film Festival on Aging

Left: Robot Dog. Right: Alice Cares.
As a graduate student, I conducted a literature review on the subject of robots as caregivers for older adults. A few professors thought this topic was controversial and would not support my paper. Even with the proliferation of robotics technology, the idea of using robots to augment the caregiver shortage is often met with ambivalence. On this subject, two robot-themed films were featured in the 6th Annual Legacy Film Festival on Aging (LFFoA): Robot Dog, directed by Drea Cooper and Zackary Canepari, about an aging (presumably childless) Japanese couple and their beloved robotic dogs, and Alice Cares, directed by Sander Burger, on a Dutch pilot study pairing Alice, a social 'care-bot', with older women who lived alone. In both films, robots provided companionship and helped decrease feelings of loneliness. In addition, Alice encouraged healthy behaviors and inspired social interactions between its users and other people.

After the screening, I co-facilitated a discussion and Q&A with Victor Wang, an MIT-trained roboticist and researcher. The interactions between the subjects and robots in the films were mainly positive, and many LFFoA audience members found the films and discussion interesting and educational. A few, however, expressed concerns, and even disapproval of the idea of robots as caregivers. I was not surprised that some people would find the idea distressing, as I found similar opinions among professors and classmates regarding my literature review topic on robots and caregiving.

Concerns often revolve around fears that reliance on robots would lead to elder neglect, or that robots would gain too much control over people. Robot technology is far from being perfect, but it's fair to say that having human caregivers does not guarantee that older adults would always receive the best care. Geriatrician Dr. Louise Aronson states many caregivers are overworked, and supplementing care with robots may reduce neglect and abuse. From a logistical standpoint, Johan Hoorn, the researcher from the Alice robot study, states that there won't be enough people to provide care for the global aging population. Utilizing robots, therefore, may become a necessity.

Left: Alice Cares. Right: Audience discussion with Victor & Koko. 

Many of our beliefs are shaped by our cultural environments, and until recently, caregiving was provided solely by people. It's no wonder that many older adults are uncomfortable with the idea of receiving assistance from robots. In contrast, the Japanese are enthusiastic towards the use of personal robots. Author Christopher Mims suggests that Japanese share the cultural belief that everything has a soul, which was also mentioned in Robot Dog. This may partially explain why older Japanese do not seem as distressed over the use of caregiving robots. Personally, I see myself utilizing robots in older age and wonder if my attitudes stem from my Japanese heritage and from growing up in a technology-dependent environment? In addition to receiving practical assistance, a robot's cool impartiality appeals to me as I imagine it would not care how old I am, what I look like, or be irritated by my personality quirks. It would not lose patience if I become forgetful due to memory changes, and it would not take things personally if I'm in a foul mood and should utter unkind words.

Quite possibly, robots may help fill the caregiver shortage in the coming years. Nevertheless, it is always critical to include older adults in the entire process of creating robotic products so they can be active participants rather than passive recipients of technology. In looking back at the LFFoA, the films on robots and older adults stimulated honest conversations about ways to support our aging family members and to think of our own needs as we age. As always, I applaud LFFoA for featuring thought-provoking, socially relevant films on aging. I'm grateful for having had the opportunity to be part of this unique event!

Sunday, September 4, 2016

Adventures with The Legacy Film Festival on Aging

The Legacy Film Festival on Aging emphasizes that aging can be a great adventure. So come and see for yourselves! -- Sheila Malkind, executive director, LFFoA

What a difference a year makes! Around this time last year, I posted an interview with Legacy Film Festival on Aging's (LFFoA) Sheila Malkind about the 2015 film festival. This year, I've had the pleasure of participating as a board member with the organization. Though I've volunteered with LFFoA in the past, being on the board requires greater commitment. As Sheila mentioned before, it's hard work to put together a film festival! Nonetheless, I have no complaints as it's been a labor of love. 

As a board member, I have been involved with a multitude of tasks and gained greater appreciation for the behind-the-scenes efforts that go into the making of LFFoA. Being a small nonprofit, board members and volunteers pitch in wherever there is a need, ranging from social media postings, sponsorship requests, reviewing films, etc. It was sheer joy to dive right in and to find creative ways to connect with people and organizations to promote the film fest. With less than 2 weeks until the event, we even created a quick iPhone video PSA to be aired on a local public TV station -- my 'directorial debut!' :-)
Left: Scene from the LFFoA PSA with Sheila & Phu. Right: Howard, Phu, Koko & Sheila selfie.

All of this comes at a pivotal time in my life. I recently turned 50 and have determined to focus on projects that are both meaningful and enjoyable. Through the experience of working with LFFoA, I've been able to tap into my creativity and social media skills to contribute to a truly unique film festival. I'm grateful to Sheila and LFFoA for inviting me to participate as it truly has been an 'adventure.' 

The Legacy Film Festival on Aging is around the corner and it's going to be an enjoyable, thought-provoking event. Hope to see you there! Here's the LFFoA PSA VIDEO.

Legacy Film Festival on Aging
September 16-18, 2016
New People Cinema, Japantown
1746 Post Street, San Francisco

Sunday, August 21, 2016

Aging & Involuntary Childlessness: Does It Affect Men?

I think it is important that the myth that men don't feel sad is busted. It is so damaging for everyone and society as a whole. - Robin Hadley, PhD

Articles and research on the effects of involuntary childlessness often focus on women. Interestingly, we seldom read or hear about childless older men's experiences and whether they feel sadness in not having children. As a Master's student, Dr. Robin Hadley sought to investigate the experiences of childless men as there was little information available. The research culminated in Dr. Hadley's PhD dissertation, Life Without Fatherhood: A Qualitative Study of Older Involuntarily Childless Men. Recently, I had the opportunity to ask Dr. Hadley some questions in his area of expertise to which he provided insightful responses:

Dr. Robin Hadley (© Paul Tonge)
How did you develop an interest on the subject of involuntary childlessness in older men?
I was looking for a subject for my Masters dissertation in Counseling and in discussion with my supervisor, Liz, I just said, "I was really broody in my 30's". She replied she'd not heard anything about that subject and so that is how it started. I then found there was very little about the male experience of childlessness and that has spurred me on. I think it is important that the myth that men don't feel sad is busted. It is so damaging for everyone and society as a whole.

Do you think there is a stigma around older men without children? 
Yes I believe there is a stigma about older men without children. In fact it is a double taboo as both older people generally are subject to ageism and the childless are seen as 'different' and suspect. The men in my recent study all reported a fear of being seen a paedophile and the view of men as a threat is reported widely in the media.

Are older men without children at a greater disadvantage as they grow older? If so, in what ways? 
It rather depends on their circumstances. However, men tend to have smaller social networks than women and when men exit work, their social network also tends to reduce. If they have a partner, they may come to rely on their partners’ social network. If the men's partner dies, their social network can again reduce. European research shows that there is no difference between the older childless and similar people with children. The difference occurs if something negative happens to the childless person. For example, if they fall ill, formal care is accessed earlier and they are more likely to be taken in to a care facility earlier and for longer compared to people with adult children. Adult children are often advocates in their parents’ dealings with health and care service providers. In the UK, there have been a number of high profile cases of poor care/abuse of older people in health and care facilities. The majority of these cases were highlighted by adult children.   

Was there anything that you found in your research that surprised you?
There are three things that surprised me: firstly, that the men very easily talked about their thoughts and feelings to a complete stranger. Many of them said this was the first time they had spoken about their feelings and thoughts about childlessness. Secondly, the fear that they all expressed about being viewed a paedophile - it is such a shame that all men are portrayed as a threat whatever their age. Thirdly, four of the men I spoke to had a role of 'grandfather'. The benefit they showed in those relationships was a joy to see.

What advice would you give to men who wished to be fathers but are childless and having regrets? 
Do something! Either talk with someone you trust or with a counselor. All the men I have spoken to considered becoming a father as natural. Not achieving it was a loss that was not possible to talk about - as men aren't 'supposed' to care! Therefore, the impact of non-fatherhood is not recognised in society and that loss does need to be acknowledged. Keeping it in and not being able to appreciate your feelings may adversely affect thoughts, feelings and behaviour. I would also consider looking at what connections you have that may give you the chance to have a role as an active uncle, grandfather, mentor or advisor. For example, in the UK many schools encourage older people to become involved in reading to children who would benefit from person-to-person learning.

Prior to learning about Dr. Hadley's studies, I had not considered how involuntary childlessness affects older men and appreciate learning about this issue. An important takeaway from this interview is that men experience sadness and regret as women do in these circumstances. Despite assumptions that men do not like to talk, they are, in fact, open to sharing their experiences. Therefore, it's vital to create opportunities for honest conversations and to truly listen. Thank you for this interview, Dr. Hadley. Additional details on Dr. Hadley's research:

Left: Graduating from Keele University, 2015. Right: Final Thesis

Sunday, August 14, 2016

Enough of Shaming, Let's Create Community

The number one thing caregivers can do for other caregivers is to say 'you are not alone.' -- Alexandra Drane

Earlier this week, I read an article on titled, When You Are Shamed for Moving a Parent into a Care Center. Author and gerontologist Rachael Wonderlin wrote of caregivers being harshly criticized for placing loved ones into long-term care communities. This article resonated with me because I was a caregiver for my late father and also made the difficult choice of moving him into a care home. I had hoped relatives and friends would be supportive of my decision. Instead, they were outraged and accused me of being an unfilial daughter. 
Together with the staff, we wished Dad a happy birthday.

At first, I tried to care for Dad at home, but his dementia worsened and he became debilitated due to multiple strokes. As Dad's care needs increased, many challenges arose including these examples:
  • Dad lost mobility in his legs yet he would often jump out of bed and land on the floor at night. Incidentally, putting rails on the side of the bed did not work.
  • We then placed a mattress on the floor, but he would wiggle off and bang his head on the wall or furniture as he attempted to maneuver his body. 
  • Dad developed difficulties with swallowing but would refuse to eat soft, pureed foods and often threw plates on the floor in anger while blaming Mom for his situation. 
  • Dad became agitated every night and would yell and bang on the walls until daylight. Me, Mom and Phu, my husband, took turns through the night to stay with Dad to soothe him.
I developed chronic insomnia, Mom had fainting spells due to blood-pressure spikes, and Phu sometimes fell asleep at the wheel during his 40-minute commute to work. We hired caregivers to assist Dad, but we could not afford round-the-clock care. Needless to say, I opted to find a long-term care home as Dad's safety became the biggest concern.

As we moved Dad into a care home, we were shunned by family friends. Even so, I continued to do my best to ensure that Dad's quality of life would not be compromised. It was by no means a perfect situation, but Dad's condition stabilized as he ate balanced meals and received the support he needed from a warm, caring staff. In addition, my parents' relationship improved as Dad began to express appreciation for Mom for the first time in over 40 years of marriage. I had also become closer to Dad, as I visited him daily to keep him company.

Say Cheese!
Since Dad's passing in 2010, I've earned a Master's in gerontology and learned about resources and information available for family caregivers. As I reflect on my experience, I firmly believe that caregivers need understanding, encouragement, and a caring community of friends and family. Guilt and worry come second-nature to many of us, so please stop the shaming and offer a helping hand or a shoulder to lean on!

On the subject of long-term care facilities, I recently had an opportunity to share my tip for family caregivers on the Association for Long Term Care Planning (ALTCP) website. ALTCP is a nonprofit organization providing free information, resources and expert advice on planning for long-term care -- what a great service! Here is the blog post: 20 Experts Talk: DOs and DONTs When Visiting Mom and Dad at the Long Term Care Facility. It was an honor to be included among caregiving experts I trust and respect. Together, we are all part of a wider community supporting caregivers who unselfishly look after their loved ones everyday.

Sunday, July 31, 2016

On Internalized Ageism and Turning 50

"In fact, looking back, it seems to me that I was clueless until I was about 50-years-old." -- Nora Ephron

Hello, it's been a very long time since my last post. This year has been difficult as I have been going through painful personal challenges and trying to resolve deep-seated conflicts with my aging mother. Even so, I've had some incredibly wonderful experiences, including reconnecting with old friends and being asked to be on the board for the Legacy Film Festival on Aging (LFFoA) in San Francisco. 

Adding to the positive, I celebrated my 50th birthday last week in Norway, which is an amazingly beautiful country. Reaching this milestone makes me hopeful towards new possibilities. Ironically, even with a master's degree in gerontology, trying to accept aging had not been easy as I agonized over age-related changes in midlife. I often wondered whether I had ageist attitudes towards myself, and if so, where did this come from?

Celebrating my birthday in Oslo. Right: Bergen waterfront (Photos: P. Trang / K. Kawasaki 2016)

Thoughts about ageism resurfaced as I began promoting LFFoA to friends and colleagues. Some people thought the word "aging" should be removed from the festival title as it might turn people off. I asked for clarification, and one person said that aging represents loss, decrepitude, and going downhill. Witnessing ageist attitudes made it clear, however, that including "aging" in the title is important as there is nothing wrong with aging. Furthermore, omitting the word does not change the fact that aging happens. Dr. Becca Levy, a Yale researcher on aging, states that while we think of ageism as "...attitudes and actions directed toward older individuals by younger individuals..," we are exposed to culture's ageist attitudes throughout our lives and in turn, direct such attitudes towards ourselves in old age. (From Dr. Levy's article: Eradication of Ageism Requires Addressing the Enemy Within.)

Suffice to say, being part of LFFoA gives me a sense of mission in helping to confront ageist attitudes (mine included) which are commonplace. LFFoA executive director Sheila Malkind, age 78, stated that she began the film festival on aging to ...motivate younger people to see the potential of their later years.”  In Your Call, a show on KALW public radio, Sheila and a few filmmakers from LFFoA discussed the topic, "What does it mean to be an elder today?" In growing older, Sheila stated that she was surprised when her body began to manifest aging-related changes (i.e., cataracts, hearing loss). Nevertheless, she emphasized the importance of making life meaningful amidst the various challenges that are part of growing older. (Listen to the full discussion HERE.)

While aging may invariably bring challenges, Sheila believes there are many positives to growing older and that we should be proud of our age. She says she is more excited about life today than when she was a teenager! Likewise, Dr. Laura Carstensen, director for the Stanford Center on Longevity, states that contrary to negative assumptions, older people are generally happier than younger people. As people age, they are better able to manage emotions and become compassionate towards others. Listening to Sheila and Dr. Carstensen's favorable views makes me look forward to my next 50 years! 

Save the Date: The 6th Annual Legacy Film Festival on Aging is coming to San Francisco in September. 

Legacy Film Festival on Aging
September 16-18, 2016
New People Cinema, Japantown
1746 Post Street, San Francisco

Monday, December 28, 2015

In the Blink of an Eye

"Don’t cry because it’s over, smile because it happened."  -- Dr. Seuss

A little over a year ago, my mom's best friend Mrs. Y unexpectedly passed away. It was a sad loss for all of us as Mrs. Y had been an important part of Mom's life (and mine) for over four decades. Mom and Mrs. Y saw each other every week, spending countless hours talking, eating, laughing and going for walks. When they weren't together, they talked on the phone and even had plans for traveling together in the near future.

Me (with chocolate on my face) and my childhood BFF.
Knowing her dear friend was no longer here, Mom was lonely. She was also saddened by not having had the chance to say goodbye. Though I was concerned, Mom impressed me with her inner strength as she kept up with her daily walks, her cooking and sewing, and socializing with others. Still, there were times when Mom spent most of the day alone, and my heart ached for her as she was clearly missing Mrs. Y. As the year progressed, Mom started going for lunches and walks with her other friends who began calling and visiting more often. Thanks to her friendships, Mom seems much brighter and jollier these days.

At age 87, Mom has lost many people including Dad, six out of eight siblings, relatives, and countless friends. Her resilience is admirable. In an article written by Paula Span in the New York Times titled, Tougher Than They Look, scientists suggest that resilience is learned through adversities in early life and people scoring high on the resilience scale are better able to bounce back from difficulties. The article states that even in late life, resilience can be acquired. This is hopeful news!

Mom's experience made me reflect on the finitude of life, and has given me greater awareness that every single day matters. Taking this to heart, I feel gratitude for life, including its challenging aspects, and all the people contained within it. Would love to learn about your thoughts and experiences. Has adversity made you more resilient? Thank you for taking the time to read this post. 

Monday, December 14, 2015

Is Independence Overrated?

Mom as a young lady.
Have realistic expectations for the kind of help you are seeking
Express your needs simply and clearly
Let others know you are there to help them as well
Praise your pals for their assistance and pat yourself for asking for help
-- Acronym for HELP by Dr. Deborah Serani

Recently, my husband and I returned from a short vacation and found Mom to be in a very grumpy mood. She stated that she pressed the wrong button on her remote so she could not get the television to work. In addition, the heater wasn't strong enough to keep her living room warm so she was freezing. All in all, Mom said she had a miserable week.

I asked her why she didn't call her friends, many of whom live within walking distance, to help figure out her television and heating dilemmas? Many of her friends also have children who live close by, within 5-10 minutes, who could resolve her issues in a pinch. Mom quietly uttered that she didn't want to be a burden to anyone. Though I wasn't entirely surprised by her comment, it made me wonder why Mom might choose to be miserable when her friends would be happy to help her.

This episode made me recall an earlier experience of Mom's friend who refused to accept help from friends and family as she faced cancer. Struggling physically and financially, she didn't want to be a burden and thought she could manage on her own. Sadly, the situation did not end well. Both Mom and her friend's experiences made me ponder why it's so hard to ask for help. There seems to be an element of shame involved in admitting we need help, but why?

Psychologist Dr. Deborah Serani discusses various myths that keep people from asking for help, and one particular myth that stood out is that asking for help makes us look vulnerable. There is also the stereotype of the frail elder that exists in society, which combined with the myths of needing help, that might make some older adults hesitant in asking for assistance. Mom's situation might also include some cultural expectations she has for me as her daughter (but we'll save this topic for another time).

In light of this situation, I try not to be too harsh with Mom. Having been raised to not be a burden to others, I may also face similar dilemmas in the not-so-far future. Rather than wondering why other people don't ask for help, however, I think I will muster up the courage to start asking for help more often. Knowing that most people enjoy supporting others, I resolve to be open to receiving help when I need it. I welcome your views on this topic. Do you think independence is overrated?