Search for tag: "geriatric"

Interviewer: Sheltering in place because of COVID-19 can increase anxiety and also the feelings of isolation, which are already a threat to older adults.

Gerontologist Dr. Mark Supiano is the Chief, Division of Geriatrics at U of U Health. And if you have a loved one that's 65 or older, that's at high risk, they've been staying at home, how can you keep engaged with them and make sure that they remain mentally healthy? We think about the physical aspects. We don't always think about the mental aspects. Explain what you mean by that.

Dr. Supiano: So, Scot, we're very concerned about the deleterious effects of sheltering in place, particularly for people that were alone already. So this is only heightening their sense of loneliness. We know that loneliness itself is a risk factor for bad outcomes for health. So if you're not able to feel connected with other people because of the physical restraints or physical restrictions that were now imposed on people, those risks could really further escalate.

So in terms of anxiety levels, so what we can do to try to lower these risks or make people feel more connected, making sure that those connections still happen even without physical connections, whether you can do that virtually through a simple telephone call, through a video chat with some platform, but maintaining your connections with family, with friends. Have a daily call. Make sure that you're connecting with someone on a daily basis, that someone is checking in with you.

Interviewer: Being a grandparent is a joy for many, many people that has been kind of taken away, right? You're not able to interact with the grandkids as much, which would also lead to the things we're talking about. Do you have any tips for how that could take place in a safe way?

Dr. Supiano: So I'm in that same boat actually. So my grandchildren are in various parts of the country, and I have not seen them for months. And unfortunately, it will be several months more before we'll have that opportunity.

So maintaining video or, you know, telephone, video chat, we're living on FaceTime and those connections are very important. For people that have the families closer to them, there are still ways that you can interact with your family members while adhering to the recommendations about maintaining physical distance. So it's time and density and protective equipment. Minimizing the time of that interaction, maximizing the distance, so the density, make sure that there are a few people, that you're keeping at least six feet apart, and wearing a mask and making sure that everyone is masked to minimize those risks.

So those types of interactions can still happen, but you need to be careful that the restrictions that we've talked about are still in place and also that your family members, your children or the grandchildren have not been lax about their protective measures. So if they've been out in a group, if they've been out at a party, or with, you know, a group of their friends and there were 100 people there, they're potentially a carrier, and I'm not sure I would want that person, that family member getting close to me.

Interviewer: Which brings up a great point, right? There's a lot of . . . we're learning more and more that asymptomatic carriers, there's a lot more of those out there. So you might not be experiencing any symptoms at all, but you could be spreading it and that would be . . .

Dr. Supiano: Exactly. So if you've had a potential exposure, you should stay away from your older family member.

Interviewer: Yeah. So part of it comes from me realizing what my situation and being honest about that, and part of it is also implementing these protective things. What could I tell somebody in my life who is an older adult? You gave us some ideas of I could, you know, maybe make a phone call, do a video chat. Are there some other pieces of advice that I could give, like a parent or a grandparent, as to how to stay mentally healthy?

Dr. Supiano: So great question, Scot. I think the first point, and this comes from our mental health experts who have been careful to point out, for all of us to hear, that right now it's okay not to be okay and just recognizing that as a fact that everyone's in this together. We'll get through it together. And if you're not okay right now in terms of heightening anxiety and stress, everyone else is experiencing this too, and right now, it's okay not to be okay.

Interviewer: And especially your loved one, if they express that feeling, I think it's normal for us to say, "Oh, it's not going to be that bad," and dismiss it. Probably not do that right now.

Dr. Supiano: I think it is that bad right now. We need to acknowledge that and kind of give people that ability to be open about those feelings. With that, though, there are some tips that have been promoted to try to minimize the anxiety and stress.

One of them is, although we want people to be informed, minimizing the constant stream of bad news and anxiety-inducing news that you may be seeing on your television, through your social media, and other means. Take some stress breaks. Take care and attend to your wellness, which is another factor. And making sure that you're getting exercise. It's hard to do if you're sheltering in place at home, but getting some regular exercise every day, ideally now that the weather's improved to be outside, you're away from other people, getting sunshine, fresh air, but more importantly getting that exercise is a very important stress reducer and can really go a long way in helping with anxiety.

Make sure you're getting enough sleep. So sleep deprivation related to anxiety is going to feed on this even more. So making sure that you're getting restorative sleep. Relax, doing other activities that you enjoy, maybe not watching TV right before bed as an example, and then maintaining those connections with others are the things that would be recommended.

Interviewer: Yeah. You gave me some great ideas there of some questions next time I talk to people in my life. Just to make sure they're sleeping okay and make sure that they're getting their needs met and make sure that they're getting out and getting some exercise. So that's a great list. I love to ask the experts, you know, at the end of the interview. You're the expert, so like what's the one thing you would want somebody to take away after listening to us talk today?

Dr. Supiano: So I'll take two.

Interviewer: All right, you can.

Dr. Supiano: Just I'll do them quickly. So first, if you're over age 65, you're at high risk and be extremely vigilant about these precaution measures. Secondly, social distancing is not physical distancing. So maintain your physical distance but don't be socially isolated. And make sure to maintain those connections.

Interviewer: Going to learn more about a brand new book called Autism Spectrum Disorder in Mid and Later Life. That's next on The Scope.

Announcer: Health tips, medical news, research and more for a happier, healthier life. From University of Utah Health Sciences, this is The Scope.

Interviewer: Scott Wright is a researcher at University of Utah and also the editor of the book Autism Spectrum Disorder in Mid and Later Life. Tell me about this book. Why did you decide the world needed this book?

Scott: I do think the world needs this book. My interest into autism issues with the aging intersect, the gerontological connection, came about when I was involved in a research project where I saw grandparents, grandparents as being very involved in the care of children, young adults on the autism spectrum, and realized that okay, here you go. Here's the grandparents yet again showing the kind of support and that safety net to help out their grandchildren. But think about this, their grandchild that has special needs and the grandparents were there providing that care. Well, from there, I realized that grandparent issues are also aging parent issues. Are there aging parents that are still supporting their adult child with disabilities, in this case perhaps with autism spectrum disorder, autism conditions? And yes, there are. In my discovery of the literature and the research, aging parents very much have this very, in a way, very concerned futuristic look about what is going to happen to their son or daughter who's an adult in their 30s, 40s, and 50s. What's going to happen to them when the aging parents, when they die? And then from there I came to appreciate that the amount of research, literature looking at this topic, it simply wasn't there. There was just this huge gap in looking at autism issues and aging, which literally stopped at adolescence and then picked up again a little bit in the geriatric years but nothing in between.

Interviewer: So kind of like a dumbbell. There's a lot young, a lot old, but mid to later life, nothing.

Scott: That's a great image to think about, very much like this barbell effect where you have a lot of interest, activity, services, programs, just general thinking that autism is a childhood issue and then it just goes away. Or that we're not paying attention to it once individuals transition, the transition years to adulthood. What happens then? Because autism is a life-long condition. What happens after adolescence? This is what this book does.

Interviewer: Is this book accessible for the lay public? I'm noticing a lot of references and I don't even know what these are called, oh, they're called references. At the end of the chapter it looks like an academic kind of book.

Scott: The original intent of this book was to create a publication of the latest evidence-based research. And indeed it has, I would say a good part of the book is academic and written for other professionals. But really this book is for a variety of different audiences - grandparents, aging parents, adults on the autism spectrum that are aging themselves. So this book has this great feel of being accessible to so many different groups and I think it's been accomplished. That goal has been accomplished with the final outcome.

Interviewer: It sounds like, so when you first brought up what interested you in it, I guess I just automatically assumed that parents with, somebody with a child that has autism are probably just going to be essentially parents their whole life. And that's what you're seeing is actually going on, but maybe that's not the best way.

Scott: That is a great question because for many parents, their son or daughter will reach adulthood and the programs and services that were there in the K-12 years, which are federally mandated, suddenly it appears that once their son or daughter reaches adulthood there is such a lack and a huge gap in services and programs. Parents become, in effect, the support system. When we look at individuals with autism, role models like Temple Grandin, she has some very interesting advice. And what she would say is a key issue during the transition years to adulthood, work. Work. Employment is such a big factor for a hallmark indicator of adulthood. But it would be my guess that the listening audience may not even know this statistic: 90% of individuals on the autism spectrum, they have the highest unemployment rate of any disability group. We're talking about 85-95% of this population with autism are unemployed. This is unacceptable in our society. Why is this happening? Work is a hallmark for adulthood and yet unemployment is a huge challenge. We need to address this.

Interviewer: So what were some of the things that you found out in the process of editing this book? And I will say that you did tell me that there were a lot of contributors to it. International contributors, not only people with MDs and PhDs but people on the spectrum as well. So what did you learn? What are some of the things that can be done in mid and later life that isn't being done?

Scott: What to glean from this book, with you're right, international authors, individuals, adults on the spectrum who are contributing the chapters, I think the two big themes that emerge out of the book that are important issues actually relate to the general population, to you or me and to everybody. That is when you think about to love and to work are two key factors to well-being and quality of life. For individuals on the autism spectrum, to work, which we would think of as almost like an automatic factor of being involved in our society, is a huge challenge for all sorts of different reasons. And then to love would be the issue of establishing relationships. More importantly, social networks and I think of this term social capital in terms of to love and having connections and social support. And then work to have a productive contribution to society and in return the rewards of that, this is what needs to be worked on, addressed for autism issues into adulthood and then into later life.

Interviewer: And what are they answers? Are they within the covers of this?

Scott: I think that the authors, yes. The authors that have been collected here, brought together in this book, they've done a great job with indicating what the answers are. I'm proud to say that, again, the researchers that are involved in this are talking about the data that they have collected but more importantly are the contributors who are adults on the autism spectrum, they have shared their story. And their story says we have learned a lot, we'd like to share it with everybody else, the right steps to live a fulfilling life.

Interviewer: And it sounds like it might offer some new perspective and new thoughts, too. Just even the perspective of, boy, a job is really important. Inclusion is really important but yet also is autonomy. That's important as well.

Scott: It is, so think about . . .

Interviewer: And these are all relatively new concepts to the thinking of the condition, is that correct?

Scott: It would be because, again, think about how we view autism, it used to be primarily a childhood/adolescent context. Now the context is when you're an adult on the autism spectrum the issue of community inclusion is huge. How can I sustain an independent living circumstance? Which to maybe many other people that's going to be an automatic transition, for individuals on the spectrum it's fraught with a variety of different challenges. So community inclusion is big. And then the employment issue, again, I can't think of one issue that would help so much in the lives of individuals on the autism spectrum and their families and our communities and our society would be meaningful work, and the opportunity to engage in and interact with meaningful work is one of the key issues in the landscape of autism today.

Interviewer: So it sounds like it's really kind of perhaps a guide into some uncharted waters.

Scott: I think that's really the best way to describe that. This book is pioneering, I think, in opening up new understanding of autism and aging issues.

Interviewer: What would you hope if a parent or a grandparent that had somebody with autism in their life purchased it? What would hope that they would be able to do after they have read it?

Scott: I think the key here is to realize that services, programs are becoming available in our society and in our communities are rapidly increasing. That's the good news. And that for the individuals who would read this book is that they should not, please, feel like that they're all alone, isolated in this particular context. That there is an increasing amount of services and programs in our communities. The key is to build the bridge between the individuals who need it and the individuals who can provide it. That's going to be the key factor.

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