The New Old Age Blog: After Storm, 'Friends' Rescue a Caregiver

Tales of Hurricane Sandy survival will likely emerge for years — particularly about the sick and elderly who were trapped in their homes or forced to evacuate under harrowing circumstances. Many of those stories have happy endings, like this one of social media and neighborliness I recently heard.

It is about two ailing 90-year-olds who, because of social media, formal and informal, and the ingenuity of one of their daughters, were located amid the rubble of Long Beach, N.Y., after the storm’s initial fury, and in short order gained admission to one of the few elder care facilities in the region that could meet their divergent needs.

“The pluses of social networking really come into play in a situation like this,’’ said Alice, 66, the couple’s daughter, a social worker for senior services in the office of a New York State senator who found herself almost as flummoxed as a nonprofessional when she needed help for her own parents. “More people are willing to help others than we think, but nobody is going to help if we don’t ask.’’

Alice’s social media search, first to locate her parents and then to find them a new home, began on a Facebook page for missing persons, one of many that sprang up after the storm. Long Beach, one of the hardest-hit areas, had no phones or power and was, for the most part, inaccessible. A Facebook page, Long Beach NY Hurricane Information, was meant to help residents find free hot food, a mobile medical van, somewhere to do laundry, revised school bus routes, lists of open stores, suggestions for good contractors, warning of price-gougers and, increasingly, share tales of recovery.

“I put up a post and sure enough some wonderful man from Brooklyn got back to me,’’ Alice said (we tell Alice’s story using only her first name to protect her parents’ privacy). The man had braved the miles of dark back roads to get to his own mother, who happened to live in the same co-op building as Alice’s parents.

He volunteered to check on the old couple and their home health aide on the third floor. Alice’s father, who has dementia, is incontinent and cannot walk because of a neurological condition, and her mother, who is deaf, suffers from depression, but by comparison is the “well spouse.’’

Their personal belongings were not destroyed, although her mother’s medical records were lost when her doctor’s office was damaged. But the old building would be uninhabitable for an indeterminate time, surely too long for a pair of 90-year-olds to ever return. Still, the information that they were O.K., coming from a total stranger, “provided a night of sleep I otherwise never would have had,’’ Alice said.

The next morning, she and her younger sister, Sharon, were able to get to Long Beach and tell their mother that the evacuation would be permanent. They brought the couple to Alice’s home in Queens for a few days, then to a nearby hotel and finally to a borrowed apartment in a neighboring building.

“It is so painful for them to be uprooted all of a sudden, at this age,’’ Alice said. “But in a way this may be one of those blessings in disguise. The way they were living, it was only after we actually had them with us that we realized my mother’s description of how things were going were not exactly accurate.’’

This is the case with many elderly parents, getting by in their own apartment and putting the best face on it lest their children tell them it is time to leave. So in the short window before she and her husband left for Chicago, and Thanksgiving with their own children and grandchildren, Alice had to set in motion the next step.

Her sister and brother-in-law on Long Island would keep an eye on the old couple in the short term. But the long-term solution, Alice said, with the clear-eyes that came from seeing others in this situation day-after-day, was a senior community where her father could live in the skilled nursing section and her mother in the less restrictive assisted living area. They would see each other as often as they wished, but each would get the correct level of care.

So before leaving for Chicago, using a more informal kind of social media, Alice e-mailed 40 friends — from her synagogue, her social work circle, her Rolodex of elder care lawyers and Medicare advocates. The e-blast was a plea for help.

“Each of you on this email know me personally,’’ she wrote. “As you all know, many years of my professional life have been dedicated to helping seniors . . . . Now I find myself in the position of needing help for my mom and dad.’’ She told them the story of her parents evacuation and how “exhausted and completely stressed’’ she and her sister and both of their husbands were. Now her “biggest hurdle was to find a place that can accommodate each of their needs.’’

She essentially asked this group to put on their thinking caps, and they did. Alice and her husband left for the holiday on a Monday. That Wednesday, the day before Thanksgiving, she got a phone call from an admissions person from exactly the kind of facility she needed, who had been contacted by her friends. Alice was told what kind of records she would need for their application. A plan was made to reconvene by telephone the Monday after Thanksgiving.

On Friday, Nov. 30, Alice and her sister toured the place. In that same blur of a week, the sisters took turns going to Long Beach to deal with their parents’ possessions. Alice’s mother slowly moved from reconciled to relieved. When it was time to tell Alice’s father “he went from sad and crying to angry at my sister and I for not being able to take them to live with either of us.’’

Through it all, Alice kept her e-mail committee up to date. She had crowd-sourced one of the hardest problems she would ever face. She had tapped the viral nature of hastily created Facebook pages, where strangers literally “friend’’ each other, and sent e-mail blasts to the kind of friends who take no offense at receiving the same message as a bunch of people they may or may not know.

In the “new old age,” this is one of many ways of doing what nobody really knows how to do. And in all likelihood, with the paperwork almost complete, Alice’s parents will have a new home for Christmas.


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Chicago electric bills set to rise $1 a month









In the new year Chicago area residents can expect to pay about $1 more per month on average to have ComEd deliver electricity to their homes.

The new rates, approved Wednesday by the Illinois Commerce Commission, affect all 3.7 million residential electricity customers in ComEd's service territory, including those who have switched to other suppliers. ComEd, which owns the wires that flow into homes, delivers electricity and is responsible for fixing outages regardless of which company supplies the power.

The rate "update" is the second under a law enacted in 2011 that changed the way electricity delivery rates are determined. Rather than intensely debated court-like proceedings, electric rates are now set according to a fill-in-the blank formula. The formula devised by the ICC in May, however, has been controversial. ComEd has taken the regulators to court over 12 items that amount to $100 million per year for the utility.

For now, ComEd must use the formula.

Consumers saw lower bills through 2012 with thhe first electricity rates set under the law. Despite Wednesday's hike, customer bills remain lower than they were before the Energy Infrastructure and Modernization Act was passed. That law allows ComEd to charge customers to modernize the electric grid and recover those costs each year.

ComEd will file for another rate update in May to take effect in January 2014.

Separately, the ICC approved an electricity procurement plan by the Illinois Power Agency -- the government agency that procures electricity on behalf of ComEd and Ameren for  customers who continue to have their electricity both supplied and delivered by their legacy utility -- that has it not purchasing additional power in the New Year. The agency said that with about 1.5 million residential electricity customers recently fleeing for alternative electricity suppliers,  it has enough power on hand to serve the customers who remain.

At the same time, the plan helps a so-called clean coal plant slated for Morgan County, Ill. clear a major financial hurdle by requiring the state's electric utilities to purchase electricity from the power plant for 20 years. The federally-backed FutureGen project, long stalled, would mean retrofitting a coal plant in Merdosia in order to largely prevent carbon dioxide and other pollutants from entering the atmosphere. The plant is not expected to generate electricity until 2017 but its backers needed to prove the plant would have customers ready to purchase the electricity in order to receive government approval to move forward with preliminary design, pre-construction and engineering work.  

jwernau@tribune.com

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Document shows CPS had detailed school closing plans









An internal Chicago Public Schools document obtained by the Tribune shows for the first time that the Emanuel administration has weighed how many elementary and high schools to close in which neighborhoods and how to manage the public fallout.


Labeled a "working draft," the Sept. 10 document lays out the costs and benefits of specific scenarios — revealing that the administration has gone further down the path of determining what schools to target than it has disclosed.


While schools are not listed by name, one section of the document contains a breakdown for closing or consolidating 95 schools, most on the West and South sides, as well as targeting other schools to be phased out gradually or to share their facilities with privately run charter schools.





Mayor Rahm Emanuel and his top school leaders have said they are in the early stages of making difficult decisions and that the city cannot afford to keep operating deteriorating schools with dwindling student populations in the face of a billion-dollar budget deficit. The document goes well beyond what the administration has outlined to the public.


Amid a September teachers strike, the Tribune reported that the Emanuel administration was considering plans to close 80 to 120 schools, most in poor minority neighborhoods. Administration officials have repeatedly denied they have such a figure.


"Unless my staff has a hidden drawer somewhere where they've got numbers in there, we don't have a number," schools CEO Barbara Byrd-Bennett said in November.


But the internal document, prepared at a time when school leaders faced a December deadline to make their decisions public, lays out multiple scenarios for closing neighborhood schools and adding privately run charters — a key component of Emanuel's plans for improving public education. Chicago Teachers Union members, aldermen and other charter school critics have accused the administration of favoring the charters while depriving schools in poor neighborhoods of needed improvements.


The document discusses how to deal with public reaction to school closing decisions, with ideas ranging from establishing "a meaningful engagement process with community members" to building a "monitoring mechanism to ensure nimble response to opposition to proposed school actions."


It is unclear how closely the administration is following the ideas in the 3-month-old document; sources told the Tribune the school closing plans are being constantly updated and subsequent proposals have been kept under close wraps.


The detailed document obtained by the Tribune comes from a time when a Chicago teachers strike interrupted the beginning of the school year and Jean-Claude Brizard was still Emanuel's schools chief; the embattled Brizard quit soon after. Byrd-Bennett was a top education official at CPS under Brizard and was named by Emanuel to succeed him.


CPS spokeswoman Becky Carroll said Tuesday that "this plan was proposed by past leadership at CPS and is not supported by CEO Byrd-Bennett."


"In terms of whatever document you have, I don't care when it's dated, as of today there's no list and there's no plan," Carroll said. "Maybe there were multiple, different scenarios passed around at some point, I don't know, but there's no list of schools.


"When CEO Barbara Byrd-Bennett took this position, she made it very clear that we were going to do this differently than how it's been done in the past," which is why she appointed a commission to take public input on school closings, Carroll said.


But under Byrd-Bennett's tenure, at least one of the proposals outlined in the secret document has come to pass — the idea of a five-year moratorium on further school closings after this school year.


First mention: The September document raises the idea of a moratorium that would extend beyond Emanuel's first term in office as part of the rollout of school closings. But the mayor's first public mention of a moratorium came in November, when he offered it as a sweetener that helped persuade state lawmakers to extend the December deadline for announcing school closings to March.


Critics called the delay a ploy to give opponents less time to organize against the closings. But Emanuel said school officials needed the time to gather community input on the "tough choices" about school closings.


Byrd-Bennett said her decisions on what schools to close won't come until after she receives recommendations from the commission she created. The Tribune reported last week that the commission chairman doesn't plan on issuing recommendations until days before the March 31 deadline for announcing school closings — and even then, there are no plans for the commission to identify individual schools.


While CPS has not released a list of schools to close, it has made publicly available a breakdown of how much a building is used, performance levels per school and how expensive the facility is to keep open. School officials have said underenrollment is a key factor in school closing decisions this year. The school system recently released a list of about 300 "underutilized" schools — nearly half the district — that have dwindling student populations.


But the document obtained by the Tribune contains clues as to how the administration could make those decisions.


Closing breakdown: The most stark page in the document is a graphic that breaks down the 95 schools that could be closed in each of CPS' 19 elementary and high school networks.





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“Castle” star Nathan Fillion to preside over Writers Guild Awards show






LOS ANGELES (TheWrap.com) – Pretend writer Nathan Fillion will help honor real writers on February 17, when he hosts the Writers Guild Awards West Coast show, the Writers Guild of America, West said Monday.


Fillion, who plays a mystery novelist on ABC’s “Castle,” joked that he was “confused” when he was tapped for the hosting gig.






“When I first accepted the honor of hosting the Writers Guild Awards, I was confused and actually thought I was receiving one. Since I play a writer on TV, I felt perhaps someone was under the impression I deserved an award and I wasn’t about to correct them,” Fillion said. “However, now I’m in the perfect position to present myself with whichever award I choose. Who’s going to know?”


The Writers Guild Awards West Coast show will take place February 17, 2013 at the JW Marriott Los Angeles L.A. Live. The East Coast show will take place simultaneously at B.B. King Blues Club in New York City.


Writers Guild Awards executive producer Cort Casady praised Fillion’s multiple talents – along with his thriving Twitter account – in the announcement.


“Not only does he play a writer brilliantly on ‘Castle,’ but also, in addition to acting, he sings, dances, is a popular voice talent, and has a great gift for comedy,” Casady said. “And with over 1.5 million Twitter followers, Nathan brings a smart, enthusiastic audience to our celebration of writing.”


TV News Headlines – Yahoo! News





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The New Old Age Blog: Older People Become What They Think, Study Shows

All of us have beliefs — many of them subconscious, dating back to childhood — about what it means to get older. Psychologists call these “age stereotypes.” And, it turns out, they can have an important effect on seniors’ health.

When stereotypes are negative — when seniors are convinced becoming old means becoming useless, helpless or devalued — they are less likely to seek preventive medical care and die earlier, and more likely to suffer memory loss and poor physical functioning, a growing body of research shows.

When stereotypes are positive — when older adults view age as a time of wisdom, self-realization and satisfaction — results point in the other direction, toward a higher level of functioning. The latest report, in The Journal of the American Medical Association, suggests that seniors with this positive bias are 44 percent more likely to fully recover from a bout of disability.

For people who care about and interact with older people, the message is clear: your attitude counts because it can activate or potentially modify these deeply held age stereotypes.

The researcher who has done more than anyone else to advance our understanding of this is Becca Levy, an associate professor of epidemiology and psychology at Yale University.

In the mid-1990s, she began a series of experiments with older people in laboratory settings. The idea was to expose them subliminally to negative or positive stereotypes by flashing words associated with aging on a computer screen too fast for them to process consciously. Then these seniors were asked to perform a task.

Those exposed to negative words such as “decrepit” had poorer handwriting, slower walking speeds, higher levels of cardiovascular stress and a greater willingness to reject hypothetical medical interventions that could prolong their lives. Those primed with positive words such as “wisdom” did much better.

The experiments involved external stimuli, however, and Dr. Levy was interested in peoples’ subjective experience of older age. For that, she turned to a database of adults age 50 and older in Oxford, Ohio, who were followed for a period of 23 years, from 1975 to 1998.

Many had filled out questionnaires at the start of the study designed to elicit stereotypes about aging. This involved soliciting a “yes” or “no” answer to a series of statements like “things keep getting worse as I get older,” or “as you get older, you get less useful.”

When Dr. Levy looked at 660 participants, she found that those with positive age stereotypes lived 7.5 years longer than those with negative stereotypes. The research was published in The Journal of Personal and Social Psychology in 2002.

What might account for this finding? In her paper, Dr. Levy speculated that people with positive age stereotypes have a stronger will to live, and that this might affect their ability to adapt to the rigors of older age. Also, people with negative age stereotypes may have a heightened cardiovascular response to stress, with attendant ill health effects.

In other research using this data set, Dr. Levy established that people with positive age stereotypes were more likely to eat a balanced diet, exercise, limit their alcohol consumption, stop smoking and get regular physical exams, and that they had a higher level of physical functioning over time. Results were controlled for other factors like illness, gender, race and socioeconomic status.

In these papers, Dr. Levy hypothesized that positive age stereotypes are associated with a greater sense of control and that this enhanced seniors’ sense of self efficacy — their ability to remain captains of their own ship, as it were.

Her new findings about the impact of age stereotypes on older adults’ recovery from disability is an extension of this body of work. In this case, Dr. Levy and her co-authors followed 598 adults age 70 and older in New Haven, Conn., from 1998 to 2008. Disability was defined as needing help with basic activities of daily living like bathing, dressing and walking, and its onset was typically precipitated by an illness or injury.

Again, seniors with positive age stereotypes were much more likely to have good results and recover fully.

Dr. Marie Bernard, a geriatrician who serves as deputy director of the National Institute on Aging, said she found the report “quite intriguing” and that it confirmed her clinical observations in more than 30 years of medical practice. But she cautioned that it is a small study that needs to be replicated.

“What we really need to understand is the mechanism,” she said. “Is it something that is malleable and, if so, could we help people live longer, healthier lives?”

Researchers don’t have an answer to that yet. But many believe that part of the answer has to lie in tackling ageism – which is pervasive in our youth-oriented culture — early on, from earliest childhood.

“Even young kids have negative associations; they tell you that older adults are sick, slow, forgetful, no good,” said Dana Kotter-Gruehn, a visiting assistant professor in the department of psychology and neuroscience at Duke University.

Also generations need to be brought together so that “people can experience what it means to be an older person” and stereotypes can be dispelled, Dr. Kotter-Gruehn said. This has been shown to help change people’s stereotypes about race and homosexuality, she noted.

Closer to home, all of us who interact with older people can “think about how to reinforce the more positive aspects of aging,” Dr. Levy said.

“If all of us became a little more aware of the implications of our communications” — the tone of voice we use with seniors, the attitude we adopt, the use of loaded phrases or expressions, the extent to which we give older adults our full, undivided attention — “that would help quite a lot.”

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Property purchase near McCormick gets OK









Convention officials on Tuesday took a step toward acquiring properties north of McCormick Place for the potential development of hotels, restaurants and entertainment venues.


The Metropolitan Pier and Exposition Authority board approved the purchase of a parcel at 2101 S. Indiana Ave. for $5.1 million, with closing expected by year-end. A two-story building on the 23,126-square-foot property is now leased to operators of a methadone clinic.


The property is on the same block as a contested 1.23-acre parcel at 230 E. Cermak Rd., owned since 2005 by Olde Prairie Block Owner LLC. The company, led by developers Pamela Gleichman, Karl Norberg and Gunnar Falk, is fighting in U.S. Bankruptcy Court to retain that parcel as well as the entire block immediately to the east, at 330 E. Cermak, which it has owned since 1998 and hopes to develop as a convention hotel, a smaller boutique hotel and restaurants.





If Olde Prairie fails to show its plan is financially plausible at a hearing Dec. 27, Judge Jack Schmetterer has said he will dismiss it, opening the door for lender CenterPoint Properties Trust to take over the parcels and put them up for auction. Olde Prairie has been in default since early 2009.


Jim Reilly, CEO of the authority, the state-city agency that owns McCormick Place, declined to comment on whether the authority would pursue the Olde Prairie Block properties if they become available.


The authority, commonly known as McPier, has been in talks with DePaul University about the possibility of building an arena for men's basketball near McCormick Place, but Reilly said the purchase of the South Indiana parcel is an independent move aimed at ensuring the authority has room to develop such add-ons as more hotels, restaurants and entertainment venues. DePaul, whose Blue Demons play at the Allstate Arena in Rosemont, also has been in talks with the owners of the United Center.


Meanwhile, speculation has resurfaced about building a casino near McCormick Place, with questions about whether the Olde Prairie blocks would be considered. Reilly said he thinks they are too close to the exhibit halls. Convention officials have said a casino on the convention campus or its immediate vicinity could pull trade show attendees away from the show floor.


McPier's latest acquisition will add to a nearby parcel it already owns at 2100 S. Prairie Ave.


"Ultimately, our goal is to develop a more vibrant and interesting neighborhood for McCormick Place," Reilly said.


McPier will purchase the parcel on South Indiana from RZR Equities LLC, Noah LLC and Hinsdale 111 LLC.


A financial restructuring approved by the Illinois General Assembly in 2010 gave the authority additional borrowing capacity for expansion projects. McPier will use proceeds from expansion bonds to fund the purchase.


kbergen@tribune.com


Twitter @kathy_bergen





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22 face charges in NIU student's fraternity hazing death









Nearly two dozen members of a Northern Illinois University fraternity were charged with hazing crimes Monday after a student died following excessive drinking at a party last month.

On the night before his death, freshman David Bogenberger went from room to room in the Pi Kappa Alpha fraternity, answering a series of questions in exchange for vodka and other liquor over a two-hour period, authorities said.

It was a part of an annual ritual known as "parents' night," an alcohol-infused party in which senior members of the fraternity and associated sororities are assigned as mentors to new members. Bogenberger, a 19-year-old finance major from Palatine, had recently pledged the house in an effort to make friends at his father's alma mater.

"He wanted to be liked. He wanted to be accepted," said Peter R. Coladarci, the Bogenberger family attorney. "It's a classic case of a kid who just wants to fit in with the group."

Bogenberger's efforts to fit in proved fatal, as he was found dead in a fraternity house bed the next morning. Subsequent tests found his blood alcohol content was about five times the legal limit for driving of 0.08 percent at the time of his death, authorities said.

NIU regularly approves parents' night parties, but police say fraternity leaders intentionally kept the event a secret from campus officials so they could serve liquor without oversight. Registered gatherings typically include inspections to ensure that university rules are being followed.

The alleged deceit led to criminal charges against 22 members of the fraternity, which ceased operation shortly after Bogenberger's Nov. 2 death.

DeKalb County authorities have charged five fraternity leaders with felony hazing in connection with the incident, authorities said. Seventeen others face misdemeanor charges.

"They knowingly planned this event and did not seek to register it because of the kind of event they were going to provide, because of the amount of alcohol that was to be consumed," DeKalb Police Department Lt. Jason Leverton said.

Charged with felony hazing are the fraternity's president, Alexander M. Jandick, 21, of Naperville; its vice president, James P. Harvey, 21, of DeKalb; pledge adviser Omar Salameh, 21, of DeKalb; secretary Patrick W. Merrill, 19, of DeKalb; and event planner Steven A. Libert, 20, of Naperville, authorities said.

Felony hazing carries a possible prison sentence of one to three years, though probation is an option. The misdemeanor hazing charge carries a penalty of up to 364 days in jail, with probation as an option.

In a statement released through DeKalb authorities, Bogenberger's family it still was grappling with his death and a future without him. The family also acknowledged concern for the families of those charged Monday.

"We have no desire for revenge. Rather, we hope that some significant change will come from David's death," the statement read. "Alcohol poisoning claims far too many young, healthy lives. We must realize that young people can and do die in hazing rituals. Alcohol-involved hazing and initiation must end."

One of the fraternity officers called the Bogenberger family in Florida over the weekend to express his regret, Coladarci said. The student -- who Coladarci believes was among those charged -- gave his account of the evening and acknowledged errors in judgment, the attorney said.

The family believes the charges were necessary to prevent future hazing incidents, Coladarci said. He declined to discuss possible punishments, only saying the family is not seeking "an eye for an eye" and does not want to see any "harm" done to those charged.

"These kind of hazing incidents are commonplace on college campuses, and I think these kids don't understand that you can die from it," he said. "This is a national health epidemic, which must be addressed."

A spokesman for the Pi Kappa Alpha headquarters in Memphis, Tenn., did not respond to requests for comment.

NIU has placed temporary sanctions against the fraternity, meaning that it cannot operate as a student organization, NIU spokesman Paul Palian said. The fraternity faces disciplinary charges that could lead to permanent sanctions.

NIU also announced disciplinary charges Monday against 31 fraternity members. The charges stem from violations of the student code of conduct regarding hazing and alcohol consumption.

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$35 Raspberry Pi computer gets its own app store









Title Post: $35 Raspberry Pi computer gets its own app store
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Ricky Gervais in negotiations for “The Muppets” sequel






LOS ANGELES (TheWrap.com) – Ricky Gervais is in negotiations to star in “The Muppets” sequel at Disney, a representative for the actor told TheWrap.


Ty Burrell was cast in the film earlier this month after Christoph Waltz dropped out.






James Bobin, who directed the 2011 Muppets film, is directing the sequel, which he co-wrote with Nicholas Stoller.


Filming is expected to begin in Europe early next year.


The 2011 “Muppets” feature made $ 88 million at the U.S. box office.


David Hoberman and Todd Lieberman are producing the sequel.


Gervais’ recent credits include “Spy Kids: All the Time in the World in 4D.” His upcoming films include “The Wind in the Willows.”


He is represented by WME and United Agents.


Movies News Headlines – Yahoo! News





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The New Old Age Blog: In the Middle: Helping Unhappy Couples

A post on Monday discussed the forces that can make an older couple’s good marriage suddenly go bad — an array of subtle, and often-misunderstood, mental, physical and emotional factors that can upset the equilibrium of even the happiest marriages.

Now we have consulted marriage counselors and geriatricians to find out what caregivers — either the grown children of the couple, or one of the spouses involved– can do to help restore peace and balance to these relationships. The experts consulted uniformly agreed that even older people can at least take steps to reduce tensions and improve their relationship, even if they cannot actually change. (Really, who can, at any age?)

“Even though the situation may seem overwhelming, take heart,” said Dr. Gordon Herz, a psychologist in private practice in Madison, Wisc., who specializes in neuropsychology and rehabilitation psychology. “Couples who have been together for 60 years tend to have worked out ways to manage conflict – or they wouldn’t still be together.”

Retreat to a neutral corner

When grown children see their parents fight, many want to run and hide. But those who are assuming an increased caregiving role often feel impelled to jump in and “fix” the problem, as they do with the other caregiving issues.

If you are so inclined, experts speak with one loud voice to advise: Don’t!

Trying to act as emotional broker between your parents can backfire. (Now they tell me! Suffice it to say that after one such effort my sister said to me in not exactly the friendliest tone, “Well, that went well, didn’t it?”)

“It’s better if your parents can find somebody else to talk to than you,” said Dr. Nancy K. Schlossberg, professor emerita of counseling psychology at the University of Maryland and the author of “Overwhelmed: Coping With Life’s Ups and Downs.”

Don’t give up on marital therapy

“Marital therapy for individuals over 65 years of age is difficult, since habits of a lifetime are deeply ingrained,” stated a study in The Canadian Journal of Medicine, one of the few in the medical literature about marital therapy among older people.

“Yet, in a sense, marital therapy is more crucial for the elderly than for younger patients,” the study continued. “At a time when they are least adaptable and most vulnerable to stress and are entering perhaps the most difficult period of their lives, the elderly must learn new methods of relating and coping” because of the physical and mental changes described in our earlier post.

There’s another reason learning to cope with life changes as a couple is even more critical for older couples: Unlike younger couples, the elderly are rarely in a position to leave the marriage and start over.

Help at least one spouse get counseling

What if only half the couple is ready to seek counseling? Not a problem, therapists said. “You want to help the part of the couple that is suffering,” said Dr. Elaine Rodino, a therapist in private practice in State College, Penn. “The other person may still be the curmudgeon, but I think of it as the law of physics: When you change one aspect of the formula, things change in the total.”

When dementia affects one of the spouses, therapy can help the caregiving spouse learn coping techniques, “which can reduce the marital discord and stress that can make conditions, especially cognitive difficulties, worse,” said Dr. William Dale, chief of geriatrics at the University of Chicago Geriatrics Medicine.

Consider the general practitioner or internist

If the couple won’t see a marriage counselor or therapist, can a family doctor be of any use? The experts had mixed responses.

Many pointed out that general practitioners have neither the time nor the training to offer much relationship help, unless the origin of the problem is exclusively physical. Others thought they could be of use, if given a little direction from the family.

“I encourage the kids to talk to the doctor in advance and let him know something is going on – signs of depression or other problems the parents won’t talk about,” advised Dr. Dale, adding that a consultation with a geriatrician who is more familiar with problems of the aging might be even more productive. “Then the doctor can say, ‘Gee, you sound really frustrated or down — are there any reasons we can explore?’”

Don’t overlook the importance of intimacy

“Mutually stimulating sexual relationships need care and feeding by both partners at any age, but especially in the geriatric years,” according to a study on marital therapy for the elderly. “The need for physical contact, warmth and touching perhaps reaches a peak in this age of loneliness, decreased self-esteem and poor health.”

Forget the idea that elderly couples are too shy to talk about intimacy, insisted Dr. Rodino. “I saw a couple in their 80s, the husband was getting penile injections at the doctor’s office, and then they hurried home to have sex.”

But Dr. Rodino does concede that for older patients it is especially important to focus not only on sexual function and performance, but on “touching, and non-intercourse sexual relations; I help them rekindle the affection and emotional closeness,” Dr. Rodino said.

Address any neuropsychological issues.

To find out whether the sudden marital conflict may stem from early mental cognitive impairment (M.C.I.) —or to rule M.C.I. out and find the real source of trouble — make sure the spouse obtains a full neuropsychological evaluation. If it is M.C.I., “it convinces everybody that there is more than just abstinence, it’s not a personality problem — and they need to address it,” said Dr. Dale.

Don’t overlook simple solutions

“Sometimes a memory problem is something simple, like low Vitamin B12, that is easily fixed,” said Dr. Dale. “Or hypothyroidism, which is quite common, can affect memory.”

In that case, doctors administer synthroid, a thyroid hormone replacement that Dr. Dale said is “very safe, with almost no side effects.” Other changes in behavior can also be the result of a simple problem or be remedied by a change in medication. Don’t assume the worst.

Put an end to the blame game

Help reframe the problem. “Even if dementia is involved, let them know it’s not that their partner hates them, it’s that he is having cognitive changes,” said Dr. Linda Waite, director of the Center on Demography and Economics of Aging at NORC/University of Chicago.

“When you re-frame it like that, it’s easier for the spouse not to take it personally and not blame themselves and feel it’s something they did,” said Dr. Waite. “It can make a difference.”

A 2009 study in the journal Gerontologist supports this notion: “Care partners likely would benefit from strategies aimed at reducing self-blame, enhancing coping skills … and communicating effectively with the person with M.C.I and significant others.”

Separate the anxiety

Divide and conquer — time away improves time together.

“Older couples, especially those with disabilities, spend way too much time together,” said Dr. Lisa Gwyther, director of the Duke Center for Aging Family Support Program. “It would be a problem for any couple.”

Caregivers can best help by arranging for an activity or outing that each spouse can do separately so they can return to each other refreshed and more cheerful. “That can help a lot,” said Dr. Gwyther.

Dial down the tone

For spouse caregivers, it is important to watch not just what is said, but how it is said. In any relationship, tone influences our interpretation of what our partner says. Those with M.C.I. will especially react to tone, rather than the substance of the exchange, Dr. Dale said.

“Ratchet down the emotions, repeat things calmly,” Dr. Dale said. The person with cognitive problems doesn’t know he asked the same question five times — he only knows that you sound angry at him for no reason he can fathom. One spouse’s anger fuels the other’s, and pretty soon there is a fight or withdrawal.

Zero tolerance for violence

If a spouse becomes violent, “that’s an entirely different issue,” said Dr. Schlossberg. “Call in an expert on family violence” or the police.

Help them help others

Nobody likes feeling dependent and having to ask for help. Finding a way to have your loved one volunteer, help others and continue to feel useful can improve moods and marital interactions – even if M.C.I. is involved.

With one couple Dr. Gwyther saw, the wife was not only “driving her husband nuts because she was asking him the same questions over and over,” but she could no longer drive and deliver food in a mobile meals program as she used to. “So her husband agreed to be the driver — and she took the meals to the doors,” Dr. Gwyther recalled.”It made her feel good to continue to do that — and it made them feel good to do it together.”

Caregiver, heal thyself

You have heard it a million times here and elsewhere but, unlike us, this advice never gets old.

If you are exhausted from caregiving, you are bound to be cranky, and that will make everybody around you edgy and irritable, too — especially the spouse who requires your care. Taking the time to look after your own health and engage in activities that bring you pleasure can go a long way toward reducing stress and reestablishing a peaceful balance in a marriage.

How have you coped with tensions in your marriage — or in your elderly parents’ marriage, as you care for them in their old age? Share in the comments below.

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