[Music] tonight on front line Americans 85 and older are now the fastest growing segment of the population I remember being repulsed by wrinkles and gray hair and now they're just a part of life medical advances have enabled us to live longer but not always better another bypass surgery another transplant nobody's bothered to think about what the repercussions are of trying to keep people alive longer and longer with such a limited ability to function it's an economic as well as a human Demand on strap middle-aged and middle class families they're still caring for their children when they're also caring for Mom and Dad but this is really a story about confronting the inevitable I keep trying to fix things and even though my head says I can't your heart your heart wants to fix everything and coming face to face with our own hopes and fears about living old I like life I like it but that is not to me it's not enough I'm Estelle strongen I was born on May 30th 1911. which of my arithmetic still serves me makes me 94 and a half all right so who else has it who else has it I'm what was once called a stockbroker by 500 each today we have the rather elegant title of financial advisor all right by 500 holx for a2836 and I still even though I'm 94 I still have Ambitions and one of them is to do the job well I know we're chasing it but they missed it so we're gonna chase it I was never one of the people to be horrified as the decades passed except I have to admit that 90 was a little intimidating I thought 90 meant thee and and I'm a little surprised that it hasn't I'm 99 years old I'll be 100 in two and a half months how's that feel to almost be 100 . no never never did I think I'd live so long I couldn't even think about ever living so long I I you know a little frightened I don't know I don't know anybody who was handed is there a change is there change yet we're on the threshold of the first ever Mass geriatric society and it is in many respects really a wonderful time to be old because people are not only living longer but they're living healthier into their 70s 80s in some cases even into their 90s that's the good news the bad news is the price that many people are going to be paying for this extra decade of healthy longevity is up to another decade of anything but healthy longevity in fact more and more people are living long enough to suffer from the as yet incurable diseases of body and mind [Music] thank you I think the biggest issue facing the population of patients is loss of function you begin to learn that not everyone has cancer not everyone has Alzheimer's or Parkinson's but almost everyone loses function [Music] and by function I mean it could be something as simple as slowly worsening vision or really bad arthritis in one knee that makes it harder to get around people want to live longer but they want to live longer in the self that they have at that moment and so if there was a way that we could keep you in your 40 year old body until you were 100 and then you drop dead that would be a major medical advance but unfortunately as time goes on these chronic diseases take a toll on the body foreign gradual loss of one's bodily Powers really our preparation for some of these long-term conditions of enfieldment and Frailty I want you to just simply tell the truth it's it no one wishes that for oneself or for one's loved ones the question is it's here if it's not going to go away how can we still make something out of it [Music] okay I'm going around here over the next 30 Years the number of people over the age of 65 will actually double to the point that they're about 20 percent of our population about 70 million people that's Chiller yes ma'am excuse me years ago people died of pneumonia and flu and tuberculosis infectious diseases and we've become much better at treating these sorts of things and now people are dying of their chronic diseases things like high blood pressure hypertension heart failure stroke diabetes these are all things that require management over time now we're dealing with older folks who have multiple chronic illnesses but are still kind of able to maintain their status quo but any little something's going to tip them over you know it's that uh Frailty where anything happens on top of it you you expose all of the underlying disease and disorder that was kind of masked by the other systems that we're compensating for it is our system is set up to treat with procedures and it's not set up to treat chronic diseases and to take time to figure out what's going on where do you want me to go I want you to have a seat right over here oftentimes you can't get to the heart of the problem on until 15 minutes into your conversation and with the way Health Care is today you may only have 15 minutes for your entire visit you have terrible what do you read yes what's happening with the urine I didn't know I make wet okay you can't hold it in no how long has this been going on for for a while like a few months or just a couple weeks a few moments okay does it happen every day yeah yeah let me close um door no I run this see I got if I can't that's okay it's all right take your time it'll come up it'll come up don't worry don't forget to use your cane the number of geriatricians right now that are in a training program for geriatrics and a two-year program the number that are in their second year that started this year is about 50.
you know so it's nothing you know it's really nothing so one out of five people are going to be older adults and there's not really anyone trained to care for them [Music] with fewer doctors now available to care for the rising number of elderly many worry we're on the verge of a national crisis in care nobody's bothered to think about what the repercussions are of trying to keep people alive longer and longer another bypass surgery another transplant without anyone worrying about how do you get them Physical Therapy will they ever walk again can they swallow their food you know it's not a very thoughtful way I think of providing Health Care medicine has changed I think appropriately in terms of the technology that's become available and the fact that we can diagnose people and we can treat them and we can cure them in some instances the problem I think is that the pendulum swung too far and so the focus over time became predominantly diagnosed treat cure good morning how are you Drjanowitz even when there's nothing quote unquote medical to do you still need to be there for someone as more and more people are becoming too frail to leave their homes many doctors are once again making house calls good morning early today huh David Mueller one of the founders of Mount sinai's visiting doctors provides Medical Care to a growing number of the city's homebound elderly I was going to write in some notes I can at least say good morning for the past three years Henry genowicz has been wheelchair bound a former physician he is now nearly deaf and has severe arthritis okay yeah how about your knees pain here here no only here each of us whether we're in the baby boomer generation or not as parents and we watch our parents get a little bit older and even if they're relatively healthy and functional you sort of see the Slowdown and you anticipate you try to plan ahead for being able to be around and care for them and at the same time you've got a family of your own and kids and a job and career aspirations and so it's an unavoidable part of life and I haven't figured it out for myself either as far as my parents are concerned I'd like to believe that you know I'll be there and be available for them whatever they need and whenever they need it but I don't know if that's really going to be the case what are their expectations of you do you know have you had those conversations um we've had the beginnings of those conversations probably mostly because of the work that I do I think their expectations are very typical and very traditional none zero you know they don't have any expectations that they'll move in with us that don't have any expectations that we'll have to do anything extra for them they don't want to be a burden they'd like to stay independent Drjanowitz is a widower and his daughters live too far away to be involved in his daily care so he pays 150 000 a year for the 24-hour help that he now needs to stay home care has gone up because we have so many Medical procedures now and interventions that we didn't have before often they're you know really complex things going on that have to be done in the home hi good morning so it's become much more complex it's not just taking blood pressure and filling up medicine box how's she doing today that's good hi Mr Enoch how you doing I'm just doing okay I'm Lillian the nurse yes I came to check your blood pressure and do your dressing on your leg all right all right okay I just got to lift your leg a little Mr Enoch okay our goal is to make whatever time the person has left be the best and most comfortable that it can be because a lot of these things have been going on for years and years and years and they're never going to go away and everybody has the fantasy of dying you know by just going to sleep and everything you know not not feeling anything and everything's great you just don't wake up but it doesn't always happen that way sometimes people live a long time with serious serious problems ready okay baby nearly two years ago Ontario payaroso was sent home from the hospital with a tracheostomy and a feeding tube but even with the help of two homemades paid for by Medicaid his daughter Carmen still quit her job to care for him she gives him is really expert care I mean she's she hasn't had medical training but she's learned everything about his care to the nth degree so she knows how to take care of all of the equipment that he has she knows how to feed him she knows how to take care of his skin how to take care of his trachea time for food thank you I think about it I mean it's a one-to-one caregiver patient relationship 24 hours a day seven days a week you can't get that in any institution that he just never would have been taken care of that way okay all right okay baby huh tranquilo [Music] okay some people feel that their kids are their race in the hole they'll take care of them it's not always the case I don't have kids for instance [Music] I really seriously have to think about what's gonna happen to me when I get older and it's not it's it's kind of a scary scary question we all want to postpone it I know I do I don't really want to think about it right now but I'm faced with it every day because I see it in my work [Music] bye America is still a country which believes that the people who should care for the elderly are their members of their own family but that is now an increasingly difficult task for families people are having fewer children families are smaller less stable geographically spread out at the time of caregiving has gone from months before death to years and in some cases up to a decade or more where people simply are living longer in conditions that are deeply needy thank you one study of very very telling study shows that only those people who have three or more daughters or daughters in law have a better than 50 percent chance of not finishing their life in a nursing home or an institution a policeman told us how to go oh and you're smiling the whole world smiles with you when you're laughing What People Like Us need is is I wrote to the Maharaja and I printed it up in the page so they will see it out you don't have to worry I don't have to they don't even know it's me I just didn't give them my name yeah even though I'm a nurse I never imagined that I would be in a nursing home as a patient came in and fractured him the been here seven years now no sense in them crying over spilled milk years take things as they come frightened of what's ahead not afraid I'd I don't want to live forever I I hate to I I don't know I tell you my daughter that's all because he's 72 now but she's she's doing all right [Music] oh my gosh Trio whatever questions nearly 60 percent of those who live past 85 will go into a nursing home and if they stay longer than six months the vast majority will never leave one person I visit on a regular basis in the nursing home calls it you know just the waiting room and and she views it as you know this is where we all come to wait to die in you know some perspective she's right I mean that's uh what happens you know um other folks I've seen people you know who Thrive there you know I've had patients that were at home and then went to a nursing home and they're much better off the socialization you know the participating in groups having all these people around for meals is tremendous and they live off of it and Thrive from it so it's not always you know a downturn for some people when I leave my home because I was lonely when I read 95 96. it was a little hard so I had a friend here so he said come over Clara come over it was all right she was on the seventh floor when I came I I said look you're not alone here they're not afraid they don't know how to be friends but they people they people and I have my I get beautiful magazines I get U.
