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: www.wantedtobeadad.com

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

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 nextavenue.com 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.

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

www.legacyfilmfestivalonaging.org

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. 

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?

Why Gerontology?

"I learned a long time ago the wisest thing I can do is be on my own side, be an advocate for myself and others like me." - Maya Angelou

At 4 years old in a kimono, posing with my neighbors.

There are many reasons that led to the decision to study gerontology including my experience as a caregiver and that I've always enjoyed the company of elders. Another reason became more clear recently and it has to do with my experiences with prejudice from childhood. Growing up as a minority, there were times I was excluded from activities because some children and their parents did not want to associate with Asian immigrants. While most were kind, some people held assumptions about me based on misleading stereotypes of Asians. As a child, I remember being teased about my physical appearance, especially my almond eyes, and other times when people imitated Asian mannerisms (very much like the Mr. Yunioshi character from the movie Breakfast at Tiffany's) as I walked by. Alternatively, some people were impressed with my ability to speak with no tell-tale "Asian" accent. Though well meaning, peoples' compliments on my English intensified feelings of being a perpetual foreigner. 

You may wonder how my experience relates to my interest in working with older adults? I believe being treated differently because of what I am has made me sensitive to the way we treat older adults. Ageism is ingrained from childhood and we're not always aware of the prejudicial attitudes we harbor and how it affects people on the receiving end. In the past, I have asked older friends whether they had ageist views in their younger years, and many said they did. One friend who is in her early 70's admitted that as a youth, she disliked older drivers as she often thought, "Get off the road! Get out of my way!" Today, she realizes the irony as younger persons say similar things to her on the road. 

It may seem that older adults are separate from us, but in a sense, they are our future selves. Most of us will eventually become old. The inclusion of older adults in all aspects of society, therefore, would benefit all of us as we learn to create new possibilities within intergenerational environments.

For the Sake of Love

As always, The Legacy Film Festival on Aging gives great food for thought on the multi-faceted nature of aging. This past festival was certainly no exception! Of the many thoughtful offerings, the documentary Mimi and Dona was the most unforgettable. The story is about Mimi, a devoted mother and lifelong caregiver to her 64-year old daughter Dona who had been born with an intellectual disability. At 92, caregiving was becoming too exhausting for Mimi and she had to make difficult choices to protect both herself and Dona. Filled with both heart-warming and heartbreaking moments, there were many teary-eyed viewers in the audience (myself included) who were deeply moved by the unshakable mother-daughter bond.

I continued to think about this story for days afterward, and it brought back many different memories of my dad, including the period before his physical and cognitive decline. Deeply worried about his unmarried daughter, Dad would give me money whenever I visited. I refused the handouts most of the time, but would eventually give in due to his insistence. When I found out that my parents had financial struggles, I scolded Dad for being irresponsible in giving me money. As I recall the hurt look on his face, I now realize Dad wanted to protect me even though he needed protection himself. 

In seeing Mimi's willingness to sacrifice her own wellbeing to care for Dona, I have greater appreciation for my dad's deep, genuine love. This recognition has been a powerful experience, and perhaps the reason why my eyes were flooded with tears during the viewing. I'm grateful to director Sophie Sartain for sharing the beautiful, personal story of her family, which is a universal love story transcending cultural barriers. Kudos to the Legacy Film Festival on Aging for hosting yet another unique, socially relevant event!

NOTE: Mimi and Dona is scheduled to air on public television in November, please check for listings!

Left: Me and my dad on my wedding day. Right: Chatting with Sophie after the viewing. (Photo: Phu Trang)

A Film Festival on Aging Inspires All Ages

"The Opening Night program begins at 5:30 PM, with several amusing short subjects and one touching and funny documentary film, The Age of Love, about 70- to 90-year-olds taking part in a speed-dating event. Heck, why not? It may sound funny, but it shouldn't. We all want the same things, no matter the age: love, warmth, caring."  - Sheila Malkind, Executive Director, LFFoA

Photos from LFFoA 2014. Clockwise from Top Left: Amy and Sheila of LFFoA; Audience members; Koko with Howard and Sheila of LFFoA; LFFoA 2014. Photo credit: Rachael Podlishevsky and Phu Trang.

The 5th Annual Legacy Film Festival on Aging (LFFoA) will take place September 18 - 20 in San Francisco! I've been a long-time fan of this fantastic event which features films and documentaries from the US and around the world showcasing the multi-faceted aspects of aging. LFFoA's Executive Director Sheila Malkind is an inspiration! Sheila and the LFFoA team work tirelessly to put together a thoughtful, enjoyable film festival each year. The efforts are paying off as LFFoA's popularity has been growing steadily and people of all ages are gaining interest in aging-related matters. 

I recently asked Sheila some questions about LFFoA. Kindly, she has taken time out of her busy schedule to respond. Here are her answers:

What inspired you to start the LFFoA?

I have been in the field of aging in one way or another since I was 25, and shortly will be 77. The life process, including the end of life, fascinates me. I can’t wait to see what 80 will be like! I was the director of a similar film festival on aging in Chicago – Silver Images Film Festival – but the board of directors felt we had gone as far as we could.

When I moved to San Francisco in 2003, I saw a need for an organization that would present the issues of aging through the medium of film. Our mission is to educate, entertain and inspire intergenerational audiences about the issues of aging.

What do you think is the biggest misconception about older adults or aging?
Interesting question. So many misconceptions, but I do think views of older adults are slowly becoming more positive, partly due to the growing aging population, living healthier, longer and more active lives, with higher education. Now 10,000 people are turning 65 every day, and there are fresher views of later life.

On the topic of ageism, we are showing THE WALL, a 3-minute film, on Opening Night (Sept 18), highlighting many of the words that have been negatively associated with older adults: Cranky, grumpy, ugly, feeble, ailing, demented, nursing home – and more! 

What is your vetting process for the films you choose?

That is one of the most labor-intensive parts of the festival, which to outsiders sounds like so much fun: watching films! And it is, if the film fits our requirements to be respectful of older adults, and not use stereotypes. And it must be entertaining! We have 5 or 6 people viewing the films we receive or solicit, writing reviews, and even then we will often have maybe’s!

What is the biggest joy in putting together the LFFoA? 

Nada: it's all work! :-) Actually, it's very satisfying to see the end result at the festival, and that our stated mission is being fulfilled. It's also great when people understand that through watching films about older adults life can continue to be meaningful, no matter the age, no matter the very real challenges of later life.

Are you planning on some rest & relaxation after the film fest?

I will take a vacation with my partner, perhaps in October. However, I have a feeling that we will almost immediately start looking for films – and grants and sponsorship. Despite all the hard work, I can’t help myself!

For more information about the event, visit the LFFoA website.

Legacy Film Festival on Aging

September 18-20, 2015

New People Cinema, Japantown
1746 Post Street, San Francisco

www.legacyfilmfestivalonaging.org

Resilience, Longevity & Moments of Joy

"The author Hermann Hesse writes that the more one matures, the younger one grows. There are many people who as they age become increasingly vigorous and energetic, more broad-minded and tolerant, living with a greater sense of freedom and assurance. It is important to remember that aging and growing old are not necessarily the same." - Daisaku Ikeda

Mom was born in 1928 in a small seaside village in the southernmost area of Japan. A middle child from a family of nine siblings, Mom is one of three still living (and thriving)! As I think about the challenges Mom faced throughout her life, I marvel at her ability to maintain a resilient spirit in the face of setbacks. Prior to the second World War, my grandfather passed away at the age of 39 while Mom was in elementary school. With many children to care for, grandmother had to go out and find work. Consequently, Mom left school to become a caregiver to her younger siblings. World War II brought about even greater challenges as food became scarce and rationing became the norm. 

In the course of her life, Mom has faced various hardships including losing her husband (my father) in 2010 and losing her closest friend late last year. Mom turned 87 this week, and I'm grateful that she is healthy, independent (still drives and is able to travel overseas on her own), and partakes in activities that are both meaningful and joyful.

Today there are many Internet articles offering theories and/or personal views on healthy aging, so I decided to list what I think may be Mom's "secrets": Singing without a care if anyone hears; Laughing heartily at jokes made by her favorite comedians; Walking everyday for exercise and for errands; Cooking lots of food and experimenting with new recipes; Not dwelling on trivial matter; Being open to learning something new.

Mom aspires to become a centenarian, and I'm beginning to realize that perhaps achieving a healthy, long life requires big heartedness and unwavering optimism. These are qualities that Mom seems to possess in abundance. Thank you for taking the time to read my post! 

My mom and family friend enjoying Japanese bento lunches in San Francisco

A Celebration! Mom blowing out the candle on her birthday dessert!  

Caregiving and Cultural Expectations

"I am in between. Trying to write to be understood by those who matter to me, yet also trying to push my mind with ideas beyond the everyday. It is another borderland I inhabit. Not quite here nor there. On good days I feel I am a bridge. On bad days I just feel alone."

-- Sergio Troncoso, Crossing Borders, Personal Essays

Recently, I had the unique opportunity to share a personal experience regarding sibling conflicts in caregiving on OurParents.com. This experience led to my reflecting on cultural differences and expectations regarding the care of aging parents. I grew up in an immigrant household where I assumed responsibilities for grown-up tasks from a fairly young age, including translating business documents and accompanying my parents to their medical appointments. I often felt overwhelmed by my role as a broker between the Japanese and American cultures as I had yet to master English. 

As a child, I didn’t think about cultural differences; I simply wanted to fit in with my American peers who seemed to have the freedom to explore their childhood. I now realize that my experience was not unusual, and that there were many other children from immigrant families who shared similar situations. We didn’t have discussions about our circumstances and therefore, I thought I was in the minority. Like myself, other children from immigrant families may have wanted to be accepted and to be seen as "normal" American youth.

For children of immigrants, challenges become greater in adulthood when aging parents require more care. Due to language barriers and cultural needs, immigrants have fewer relevant resources to rely upon as they age. Thus, it is not uncommon for adult children to provide care for aging parents while juggling careers and raising their own families. In large families, caregiving may seem less daunting because tasks can be divided. Even so, having siblings does not guarantee that the caregiving process would be easy as circumstances vary.

My family and relatives on a boat ride

In American society, there seems to be a growing awareness of caregivers’ needs and conversations about supporting a diverse aging population. Things are far from being perfect, but I am hopeful that sensible options can be created to respect the needs of aging immigrant parents and their adult children in the coming years. My mother is 87 years old, and we are fortunate that she still drives, exercises daily, and enjoys various activities with her friends. Nonetheless, I know that things may change and that I would eventually assume greater responsibility to assist her (willingly, of course)! Fortunately, studying gerontology and working with aging-related organizations will be useful, as I now have more knowledge and resources to support Mom in a culturally-sensitive, caring manner.

Thanks for reading this post. Would love to hear your ideas and experiences on this subject.

The Five-Year Mark.

"The experience of losing a loved one impels us toward a deeper understanding of life... by struggling to overcome the pain and sadness that accompanies death, we become sharply aware of the dignity and preciousness of life and develop the compassion to share the sufferings of others as our own." -- Daisaku Ikeda

Mealtime at the hospital.

January 15, 2015. This date marks five years since my father passed away. Even now, I think of my father everyday and the moments we shared together. Each year, November through January are difficult months as we celebrate the holidays without father. At times, I think that some of my sadness comes from not knowing the details of who my father was. There are many questions I wish I could ask: How were you like as a child? Who was your best friend? What was your favorite subject in school? What are the things that made you happiest as a young person? What are the things that made you sad? 

For a few years, I was unaware of the conflicted and complex feelings I had surrounding my father’s death. Through writing about my experiences, I uncovered my true feelings and was surprised to find the anger I held towards my father. He died a few minutes before I arrived at the ER, and I wasn't able to say goodbye. I had always imagined that I would be with him in his last moment, and I buried my disappointment because I didn’t want to taint the good memories.

Another discovery I made was the expectation I held for our relationship. For most of my life, I looked to my father whenever I needed any kind of support. He was the person who always made things better. Undergoing a series of strokes and developing vascular dementia, my father suffered tremendous loss to both his physical and mental abilities. For awhile, I was delusional and believed that father would recover from his illnesses because he was a "rock." Instead, my father became depressed and cried about feeling useless and confused. After he died, I realized that his suffering was not just about the obvious losses, but rather, what the losses had meant to him. My father lost the roles that defined who he was. With weakening health, he was no longer the man, the husband, and the father he had been. This experience must have been intolerably painful for my father, yet I failed to grasp the depth of his struggles when he was alive.

In being a caregiver for my father, I was able to grow beyond my narrow, self-centered concerns. The experience sparked my interest to study gerontology. Now with my degree, my goals are to contribute to a greater understanding of aging, to help create solutions to meet the needs of an aging population, and to support an intergenerational society that includes the visible presence and the voices of our elders. In midlife, I finally found my life's purpose. For this, I am forever grateful to my father. Thank you for reading my post. 

Dementia: An Early Experience.

It's been a very long time since my last post! I graduated from school last May, and life has kept me busy! Throughout the year, I had many different ideas on what to write about, but I haven't posted any of them (obviously). Nonetheless, writing and sharing are always on my mind, and lately I've been thinking about my early encounter with dementia as I witnessed my father's dramatic behavior changes. Here is my experience:

At the Beach: Father posed for the camera as I collected seashells.

Between 2005 through 2010, I was a caregiver for my late father who had multiple chronic health conditions. To complicate matters, my father was developing dementia, but I did not realize this. I had no knowledge of what dementia was, and could not understand why my father’s personality had changed so dramatically. Even though my mother lived with him, she was also struggling with her own health challenges. With each visit, I was beginning to notice changes in my parents’ living environment such as overdue billing statements, unused medications, burned pots and pans, and unlocked doors. These changes were worrisome and often kept me up at night. Thus I decided to step in and help my parents. The following paragraph describes my early experience in witnessing my father’s behavior, which I now recognize were symptoms of dementia.

In 2005, my father started to exhibit behavior that was very strange. When he wanted to go to sleep, he would ask my mother to help him. (He had multiple strokes over the course of 10+ years, so he needed assistance with getting into bed at night.) My mother would proceed to tuck him in, and go back to the family room to watch television. A few minutes later, my father would come back and ask my mother to help him to bed. She would repeat the same process, and then moments later, he would come back again to ask for help into bed. He would continue with this behavior repeatedly. It would continue for at least 2-3 hours, every single night! My mother, in frustration, would ask him why he keeps coming back to the family room only to ask to be put to bed again. In response, my father would just look at her with a slight grin on his face and say nothing. Then, he would continue the back-and-forth routine. Although irritated, my mother did not question why my father behaved this way. She simply thought it was another one of her husband’s quirks. When I observed this situation, I thought that there was something seriously wrong, but I couldn’t understand what it might be. My father’s behavior was so out of character that it made me feel uncomfortable. This situation lasted for several months, and it stopped when my father had another stroke. New behaviors (i.e., making inappropriate comments, having emotional outbursts), however, were beginning to emerge.

I have many old notes on my experiences as I struggled to help care for my father. I hope to share them now and again, and perhaps it could help spark meaningful conversations. I would love to hear from you about your thoughts and experiences. Thanks for visiting my blog! Have a wonderful, healthy holiday season! 

Exploring the Potential of Assistive Robots.

Frank: Can't you do that super fast?  Robot: Some things take time, Frank. -- Robot & Frank, 2012.

As you know, I've been researching and writing a paper on the topic of assistive robots for older adults living in their homes. The topic caught my interest as I pondered the caregiver shortage and possible solutions.  Well, I'm nearly finished with my paper and presented a poster on this topic last week. 

I learned so much from this process and here are some interesting findings:

• Older adults are open to the idea of robots performing practical tasks such as managing information, manipulating objects, and assisting with household chores. Most prefer human aid for personal care needs (Smarr et al., 2013). 
• Many expressed preferences for small, creative looking robots with combinations of human-like and machine-like traits. Humanoid robots were the least favored (Wu, Fassert, & Rigaud, 2012).
• For older adults, robots must fit seamlessly into living environments because home is a central, interconnected hub where people, products, and activities come together (Forlizzi, diSalvo, & Gemperle, 2004).
• Very few studies have considered socio-demographic variables on studies of robot acceptance and usage (Flandorfer, 2012).

Presenting my poster at a graduate studies showcase. (Photo on right: by D. Houlton)

Despite fear and hesitancy towards the idea of assistive robots, those who participated in user studies had mostly positive experiences, and many suggested that they would not mind having such devices in their homes. In a few studies, however, older adults stated that robot usage represents loneliness, frailty, and isolation. Thus they would not utilize robots. 

Presently, there are ethical concerns, cost of robots, and lack of availability. These are all important issues to consider. Furthermore, there is a general lack of user studies with older adults.  I believe that robots have potential to provide assistance, but I also believe that there are so many areas that need to be addressed in order to move forward.  On a positive note, there are many new technological products being created for older adults to live safely and independently in their homes.

Thank you for visiting my blog. If you have questions or comments, I would be interested in hearing from you. Less than one month until graduation! Woohoo!!!

Robots and Older Adults: Prevalence of Ageism.

"Age is an issue of mind over matter. If you don't mind, it doesn't matter." -- Mark Twain

Time flies when there's so much to do, and it's been awhile since my last post! I have been researching articles for my paper, and slogging away through the initial draft process. It's been a challenging experience, but I've been learning so much!

Although there are many articles in the area of assistive robots, they are either focused on technical aspects, or emphasize views of designers, technologists, and other parties who are not the intended end-users. I'm not suggesting that their views are unimportant, yet I think it's perplexing that the most relevant persons, namely older adults, have played only a minor part in the conceptualization and testing of products. Then, I read a few mind-opening articles: one written by Peine, Rollwagen, and Neven (2014), and the other written by Neven (2010).

Me, as a chubby-cheeked 3-year old, posing with relatives.

Peine et al. wrote about how stereotypical assumptions of older adults leads researchers and designers to create products that lack meaningfulness, thereby overpowering older adults' potential to be co-producers in creating innovative products. Moreover, Peine et al. call critical attention to the paternalistic view in gerontechnology where older adults are expected to be the passive recipients of products. 

Likewise, Neven found that older participants in robot user-studies saw themselves as test users, rather than old people that such products were designed for. Many in Neven's study viewed themselves as healthy and active, thus they felt they were assisting research to help others who were weak and socially isolated. The authors in both articles point to the negative ways of how assistive products are positioned -- as aides for older persons who need help due to age-related declines, rather than as useful devices for individuals who wish to enhance their independence.

These articles really made me think. If I were the intended recipient of such products, I would be offended by the ageist views that are assumed as fact concerning older persons, such as being tech-averse, ignorant, or slow and decrepit. It makes me understand one reason (out of many) for the discrepancy between the availability of robotics products and the lack of older users. There's still more I can say about this issue, but I have to get back to writing my draft! Thank you, as always, for visiting. I hope to post again within a few weeks, but please feel free to comment.

Robots as Caregivers: Is it Unethical?

“Our very lives depend on the ethics of strangers, and most of us are always strangers to other people.” -- Bill Moyers

As I had mentioned in an earlier post, I am exploring the idea of robots as caregivers for older adults and will be writing a literature review as part of my graduate thesis project. I became intrigued by the idea of assistive robots as I pondered the caregiver shortage coinciding with the growing numbers of older adults. Although I don’t think of myself as pro-robot, I don’t believe that the use of robots is completely unethical.

There are arguments suggesting that the use of assistive robots will further marginalize older adults who are disregarded by society. Some declare that robots cannot understand human emotions, and therefore cannot provide the sensitive touch of human caregivers. Others argue that reliance on robots would increase social isolation. These concerns are very important, but the reality is that there is a shortage of caregivers. Robot technology may be one option that can help fill in some of (though not all) the gaps. Robots may even provide respite and assistance to formal and informal caregivers because let’s face it –- caregiving is hard work!

At age 3: Trying to be a lady.

Undoubtedly, social isolation is common among older adults, particularly those with cognitive and physical challenges. I’ve even witnessed it among some older clients I work with. However, social isolation is not a new phenomena, and it has existed prior to technological advancements. Alternatively, it may be possible that robots can help enhance social interactions and connections with family and friends.

Furthermore, if we are truly concerned about social isolation, all of us can make efforts to support older persons. It’s easy to criticize the use of robots, but are we all willing to take steps (big and small) to reduce or eliminate the need for such devices? Are we willing to pay more to ensure fair compensation for caregivers?

Many loose ends exist at this point, and I’ve only begun my research. Personally, some of my issues regarding robots include cost and availability. As I’ve been combing through the literature, presently it seems that care robots are expensive and unavailable to the masses. But for now, I will conclude with one final thought -- perhaps asking older adults about their views and wishes on this subject matter would be an ethical consideration. Thank you for reading my post, and please share your thoughts and comments!

A Sense of Purpose.

"You are never too old to set another goal or to dream a new dream." -- C.S. Lewis

Recently, I saw the movie Nebraska, in which an older gentleman named Woody Grant receives a sweepstakes letter suggesting he might be a million dollar winner. Woody's family warns him that this is a scam; nevertheless, Woody determines to do whatever it takes to get to Nebraska to claim his prize (even if this means walking all the way from Montana).

Father, mother, brother & cousin.

Woody’s indomitable spirit made me think about the concept of ikigai, a Japanese word that roughly translates as something to live for, or reason for being. For Woody, whose aged body and mind reveal the long-term effects of alcohol abuse, getting to Nebraska wasn’t just about the prize. Rather, it was about striving towards a significant, larger-than-life goal. Getting to Nebraska represents Woody's ikigai.

Ikigai is integral to life satisfaction no matter what age you may be. Even so, it is more challenging for older persons when goals are besieged by a myriad of obstacles such as health issues, loss of loved ones, and financial difficulties. My own immigrant parents have had many dreams, and also experienced great disappointments due to illness, loss of income, and family discord. Despite hardships, my parents courageously pushed themselves to get up everyday and to move forward. 

My Buddhist mentor Daisaku Ikeda, who turned 86 this past January, states, “This lifetime will never come again…to live without regret, it is crucial for us to have a concrete purpose and continually set goals and challenges for ourselves…” Are we ever too old for dreams? For me, the answer is no, but I would be interested in hearing your thoughts and comments. Thank you for taking the time to visit my blog.