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Friday, January 13, 2017

“An Improved Profile” Ageism – 1

© Imelda Maurer, cdp  

There is a TV commercial that I have seen several times promoting treatment for “moderate to severe fat below the chin.” There’s a catchy story line to the ad, ending with the promise that this procedure will result in “leaving an improved profile.”

Ageism pure and simple!  The assumption is that the absence of fat below the chin, the absence of that double chin that sometimes appears as one ages, is better, more acceptable.  This thinking says that the appearance of physical youthfulness is better than that appearance can only happen with physical maturity and an increase in years.

Ageism is pernicious.  Its effects have great potential for impacting the self-image of every single adult who has or at least has the potential of being blessed with a long life.  We cannot address this bias toward age and aging until we recognize it. 

Can you name an instance within the last few days where you saw ageism in the press, on TV, in cartoons, -- or even in your own unexamined thoughts?

Ageism is the last ‘ism’ to be conquered.  Interestingly enough, it is also the only ‘ism’, the only prejudice, to which every single person is subject to.  That is, if one is blessed with the gift of years.


Thursday, January 12, 2017

Yesterday's error corrected

A reader notified me that the link I used yesterday is not functional.  I apologize.  I corrected the information in that post and include it here also.


Beth's article with accompanying pictures can be read here here


Wednesday, January 11, 2017

"Rebooting the Nursing Home"


Beth Baker is the author of several books. One, which I consider a classic is OLD AGE IN A NEW AGE. It was written almost ten years ago, but it is still so relevant.  It tells the story of several nursing homes in their transition from a hospital-like INSTITUTION to HOME. I consider it a must read.

Beth continues to write about this culture shift in nursing homes and has just this morning posted an article from Politico titled "Rebooting the Nursing Home."  Future consumers of nursing home services as well as present advocates of present nursing home residents must begin to imagine nursing homes in a new way and demand that environment and philosophy.  We must be able to imagine it if we are to make it happen.

Beth's article with accompanying pictures can be read here .

Wednesday, January 4, 2017

Loneliness Can Be Deadly


© Imelda Maurer, cdp   January 4, 2017

The title above is taken from today's post of "The New Old Age" in the New York Times.  Tragically, the word 'deadly' is not merely a figurative description of loneliness among elders. Research shows several negative outcomes - cognitive, emotional, and physical -- among older adults who are isolated and older adults who report feelings of loneliness.

In fact, self-reports of loneliness are a prediction of moving into a nursing home because, researchers theorize that loneliness is a precipitant to poor physical and mental health. That is, loneliness is followed by a rapid decline in physical and mental health.

Relationships are at the heart of life.  Life. Period. Not just youth or young adulthood, but LIFE.  Is is possible that in our well-intentioned work to provide "good care" to those elders under our charge, we focus on the physical, and are not mindful of the interpersonal, relational needs all of us share?

How does the environment, "activities" and "the schedule" (!) enable and encourage relationships and friendships among residents and between residents and persons who were a part of their lives before they came to live with us?

The article in the New York Times is well worth reading and  includes several useful related links.  You can read it here .

Wednesday, December 7, 2016

How can you be Providence to the world if you are not Providence to each other?

On October 25, 1866, two Sisters of Divine Providence touched Texas soil after several months crossing the ocean from their motherhouse in France Over the past twelve months, my Congregation, the Sisters of Divine Providence, has experienced a year of profound grace, joy and gratitude.  We have been remembering, celebrating and ritualizing this event that occurred 150 years ago, and we are committing ourselves to honor that legacy by living it into the future.

We end this year with a retreat together at our motherhouse in San Antonio on December 31st.  One of the Sisters on the committee responsible for preparing the prayer for this retreat just sent me a draft of part of our retreat day together.  Part of the prayer is a “dialogue” with Mother St. Andrew, one of those two original Sisters of Divine Providence who came to Texas 150 years ago, and who led this fledgling Congregation until she was persecuted and ostracized by the then presiding Bishop of Texas.

In the dialogue, Mother St. Andrew, a heroine to all of us Texas CDPs, asks this simple question, “How can you be Providence to the world, if you are not Providence to each other?” I could not and cannot read this question without tears.  It resonates with a profound conviction I have had for many years about the ministry of service we offer to our own frail, elder Sisters.  We Sisters have been schooled to serving “the other” in a totally selfless manner.  We have also wholeheartedly accepted the mandate, operative since the days of the Sister Formation Conference, that we should be fully prepared for the ministries to which we are assigned, or to which we feel called.  However, until we Sisters make that shift of consciousness – that the ministry of service to our own members is  on a par with and is as sacred and as Gospel-driven as any other ministry “to others” – we will miss the mark. 


For me, as a Sister of Divine Providence, I live out our Congregational charism when I am “being Providence”, when I am reflecting the abundance of God’s loving care for all of creation.  I cannot, my congregation cannot, restrict living the charism only to “the other”. The charism must also be lived in the way I see my frail, elder Sisters and in the manner in which my congregation sees and executes its ministry of service to their own members.

For women religious following this blog, what is your Congregation's charism?  When you ponder that in terms of the aging of your own members and the aging services they need, what do you see in a new light?

Wednesday, November 2, 2016

Who is Responsible for Furthering the Mission?

© Imelda Maurer, cdp
Several years ago I participated in a marvelous workshop entitled “Choreography of Culture Change”. One of the questions I brought with me was the role of  Human Resources in this whole marvelous shift of culture.  I think I didn’t know how to pose my concerns well, but concerns I had, because I saw in a particular Sisters’ nursing home community that HR was hiring persons that met HR’s paper qualifications period. In my estimation the consequences were chaotic oftentimes for both other staff and the residents. And of course turnover in more than one department was a major problem.
There is a new HR Director in that aging services community now and she wrote about how she sees her job. I share it with her permission:
“I look forward to partnering with you as we move forward together to further our Mission and Vision. Please know that I am here to serve all of the Sisters and employees. My main focus is to foster a work environment that embraces our core values which ultimately will create the pleasant home environment that all the Sisters deserve.”
With this focus, this HR Director will, I know, be evaluating potential employees on much more than academic, professional, certification or licensure requirements. She will be looking for candidates who are capable of and desirous of fostering “a work environment that embraces our core values”.  And in creating that “pleasant home environment”, employees will also be working in a happier, more contented, more professional environment.  THAT’s Culture Change!
Who’s responsible for furthering the mission? Everyone who walks through the door of the community. And HR is a vital link in enabling that to happen!




 

Thursday, September 1, 2016

Just a Thought

© Imelda Maurer, cdp  September 1, 2016

Earlier today a Sister friend posted on our Congregational e-bulletin board Pope Francis' "A  Prayer for our Earth" on this day which has been marked by Francis as the World Day of Prayer for the Care of Creation".  Here is just the very first part of that prayer:

"All-powerful God, you are present in the whole universe
and in the smallest of your creatures.
You embrace with your tenderness all that exists."

I stopped after reading/praying just that much with this thought flooding my heart:  Wouldn't it be a tender gift if every frail elder living in a nursing home or a convent infirmary could lay her head on her pillow at night knowing and feeling that during the day she had experienced that embrace of God's tenderness --- in the face and actions of those who by assignment or appointment are there to meet her needs.  Wouldn't that be wonderful!  Wouldn't that be in total alignment with Congregational documents, Chapter statements and mission statement!

Just a thought.

Tuesday, August 23, 2016

"Can the Environment Hold the Vision?"

©  Imelda  Maurer, cdp  August 23, 2016
One of my Facebook friends posted the following poem this morning.  

You Start Dying Slowly by Pablo Neruda

You start dying slowly
if you do not travel,
if you do not read,
If you do not listen to the sounds of life,
If you do not appreciate yourself.
You start dying slowly
When you kill your self-esteem;
When you do not let others help you.
You start dying slowly
If you become a slave of your habits,
Walking everyday on the same paths…
If you do not change your routine,
If you do not wear different colours
Or you do not speak to those you don’t know.
You start dying slowly
If you avoid to feel passion
And their turbulent emotions;
Those which make your eyes glisten
And your heart beat fast.
You start dying slowly
If you do not change your life when you are not satisfied with your job, or with your love,
If you do not risk what is safe for the uncertain,
If you do not go after a dream,
If you do not allow yourself,
At least once in your lifetime,

How true all of this is. I read it through the lens of any older adult.  That passion, that purpose and meaning is so vital to being fully alive as long as we have breath.

There are two necessary factors necessary for living with purpose and meaning: the initiative required on one's part to live  precisely with that passion, and the environment in which one finds oneself.  If elders are to find purpose and meaning, there must be possibilities within their environment for that to be present, facilitated and nurtured. I am reminded once again of the statement repeated again and again in a presentation I heard on a totally different topic two years ago:  "Can the environment hold the vision?" This question should be posed and studied and returned to often by any individuals or teams responsible for providing aging services -- in any setting!

Wednesday, August 17, 2016

I Can't Abide It!

© Imelda Maurer, cdp   

I'm in a "red hat" mood as I write this morning -- the 'red hat' indicating that part of my personality that instinctively reacts with strong emotion to issues/events I consider valuable or important.

The issue is about how aging is too, too often presented to Sisters.  As a gerontologist, I studied the aging process and the various theories of personality development.  What I know about aging is rooted in a solidly grounded knowledge base, affirmed by my own experiences as a woman in her eighth decade of life.

The women in whose circle I am so honored to be a part are characterized by their life of selfless service to others.  They want to do good; they want to be good.  If and when they are given directives on how to be good -- and I refer specifically to the issues around aging -- if the words come from another Sister, those words, validly or not, are empowered with a special credibility by the audience.

My most recent exposure to such a presentation to elder women and men religious held the same familiar pessimistic view of aging only as an experience of loss and decline.  The spirituality suggested is that of "letting go".

We experience loss throughout the life cycle. Losses are not experienced for the first time when we leave "active ministry".  We do not have to learn -- for the first time -- how to deal with loss when we are in our later years. This concept and lived reality merits its own chapter!

Aging does not always bring physical or cognitive disability. Additionally, how we age is uniquely individualized. When we generalize otherwise, we are guilty of ageism.

I groan for my Sisters when I become aware of common presentations on "aging and spirituality" because
---  "letting go" is only half the story
---   "letting go" is not an experience unique to our later years; and
---    because spiritualizing myths and negative biases about aging does not provide a solid foundation of spirituality,
---   this false foundation does not reflect the God of Mercy, Compassion and Abundant Providence who planned the whole of life for those so cherished by the very action of creation.

As I listened to the address I'm referring to, I had to take a break and view something that shows an entirely different picture of aging.  I've had this clip on my blog before, but I think it is so affirming of the other half of "letting go" that I  share it again.  It is an ad for women's health, but it is so marvelous in presenting so many qualities of life in our later years.

Treat yourself to this one minute clip here

Tuesday, August 16, 2016

"I have found my tribe"

At a Pioneer Network Conference some years ago, Karen Schoeneman who directed the nursing home regulatory section at CMS talked about her initial experience with the Pioneer Network. Actually Karen was present as a co-founder of this wonderful organization, the Pioneer Network.  Karen expressed her strong identification with these other co-founders, persons who believed that residents in long term care settings should be in the drivers seat this way:  "I felt that finally I had found my tribe."

Those are strong and profound words from a  person who might have become just another bureaucrat in Washington DC writing nursing home regulations, but who instead maintained her integrity as a passionate advocate for changing the culture of aging and aging services.

That spirit within this pioneer network continues and it was deeply sensed and acknowledged by certified nursing assistants who attended this year's annual conference held in New Orleans.  One of those CNAs wrote of his experience at this gathering in New Orleans in the blog at CNA EDGE.  You can access that blog here entitled "Among Kindred Spirits" here . I encourage  you to read it.

Monday, August 8, 2016

If You Are a Family Member BE AN ADVOCATE

©  Imelda Maurer, cdp
If you are a family member or a friend of someone who is receiving aging services in any environment -- home, assisted living or nursing home setting -- it is so imperative for the well-being of that person or those persons with whom you have this relationship that you see your role as an advocate for that person or those persons.

Acting as an advocate is a work of Mercy. Pope Francis has reminded us during this Holy Year of Mercy that true mercy is not practiced by words only, but by actions.

My suggestions here do not imply that staff is not maintaining clinical standards, or that things in the aging services organization or not what they should be.  Rather, I urge a healthy collaboration with the interdisciplinary team, providing a second pair of ears and eyes as well as a loving heart. What I suggest and urge are three aspects of advocacy for your family member

1)  Informed consent. Never take the direction or interpretation of any healthcare provider as the final word without an adequate explanation. If a new medication or therapy is prescribed, or if a change  in either is recommended, an advocate should have sufficient information to either consent to or to refuse the recommendations. It goes without saying, of course, that if a family member is capable of making decisions, then s/he should receive the information necessary to make such an informed decision to accept or to refuse treatment. In such circumstances, the advocate can best serve by listening to the desires and needs of the family member and by helping to answer his/her questions if there are any.I

2)  Know the standards of care. To be an effective advocate, you must know the standards of care. You cannot advocate for another if you don't know "what the rules are."

I'll give an example from my early days as an advocate, embarrassing as it is to reveal!  I was in my beginning weeks as an ombudsman. The daughter of a nursing home resident told me that her mother complained that on mornings when she needed to use a bedpan, if she were eating her breakfast (from her tray on an overbed table) no staff member would bring her a bedpan, telling her she had to wait until after breakfast.  When I approached the administrator about this, she told me with great confidence, authority and good humor why no bedpan was offered under the circumstances at hand: "If the CDC got wind that we were doing that, we'd be fined like you wouldn't believe!"

I remember being puzzled, but I didn't know what to do with the answer I had received.  This administrator, one with a great lack of integrity in this instance, got one over on the advocate -- because I couldn't answer her explanation.  I wouldn't have had to quote a regulation, I would only have to say that this nursing home resident has a right to have her needs accommodated -- whenever they arise.

3.  Be that second pair of eyes and ears.  As a family member you visit often and take time to sit and listen to your family member.  Because you really know that person you pick up nuances of mood, physical and/or mental changes.  You may well become aware of issues that even good staff may miss merely because you know the person so much better.  So discuss these observations with the charge nurse, or with the home health nurse that comes in.

I saw a chart that is recommended for nurse aides to use for this very purpose.  I offer it here  for your use as a guide, not to be checked and handed in, but to be used as a guide and as talking points if you detect changes in your family member.

(When you click on the link, you may get a warning about viruses.  The site is safe.)

Friday, August 5, 2016

Making Connections

©  Imelda Maurer, cdp

As I write this, it was two days ago to the hour that we gathered for the final session of the Pioneer Network Conference, our luncheon and its stirring program.  Since my return, I've been doing the mundane tasks of getting back into my routine as well as addressing some issues with short deadlines. 

At the same time, I'm aware that I have several business cards here on my desk, indications of new connections  I made at the Conference.  I'll do more than just adding this data to Outlook.  I'll be in touch with these new-found common-visioned colleagues.  I've also been  mulling over my experiences at the Conference and, as at every conference, I came home with ideas about how to implement some of my "what if", some of my "why can't . . . " visions.  There are two projects I will work to implement this coming year.

A CNA who was at the Conference has already reflected on one experience that provided a clear connection between what she heard at the Conference and how it applies to her work every day as a CNA.  The following is the core of what Yang writes in reflecting on a conference experience:

This really is “what it’s all about.” A person centered environment means that as we approach and respond to our elders, we pick up on the cues that provide us with an awareness of how they as individuals are perceiving the situation and use this as the context for our interaction with them. An unhurried and indirect approach with a light touch creates an atmosphere of cooperation and reassures our elders that they are in control.

The full entry can be accessed here.

The investment of time and money involved in participating in a national conference is totally wasted if new ideas learned are not put into practice back at home.  Does your organization  have and implement a policy about staff bringing back conference ideas and insights?  Is there an expectation that these ideas will be shared with staff and stakeholders?  Fiscally, it is just being responsible. Ethically, I believe we are morally impelled to act on what we know helps to move from INSTITUTION, even if it is a "loving institution", to HOME.






Wednesday, July 13, 2016

“Her mind is shot – resign.”

© Imelda Maurer, cdp
July 13, 2016

The title of this post is a tweet from Donald Trump sent late last night responding to Judge Ruth Bader Ginsburg’s comments about his competency to hold the office of President of the United States. It is the most recent example of ageism being 'alive and well' in the field of politics and throughout our society.

Such statements are blatantly ageist, blatantly prejudicial. Ageism – with all of its negative effects for older adults, and future older adults – will continue to flourish until us as a society name this prejudice that permeates our society. And the journey of a thousand miles begins with a single step.  Which brings me to the question posed in yesterday’s post:  “What are the challenges?” I offer two here.

On a personal level:
We must challenge ageist statements whether they are directed to us personally, or if they are general prejudicial statements. When a sales clerk calls me “young woman”, I refute it nicely and graciously but firmly.  After all, the basis for anyone calling a woman in her 70’s a young woman is because our society sees youth as a more acceptable state than age. This bias must be acknowledged and addressed. 

We must monitor our immediate responses to events and persons that may reflect that we are drawing a conclusion based on chronological age. This practice will lead to a greater consciousness about the degree of ageist attitudes that heretofore have been present but unacknowledged, and therefore not attended to.

On an organizational level:
For those of us whose work involves services for older adults, the previous suggestion of checking immediate responses to persons and events holds true also.  Do we automatically believe that this person or that cannot accomplish a certain task because of his/her age or state of presumed disability?

A second aspect is to assure that all policies related to aging services are free of a negative ageist bias.  An easy test of that is to see if any policies are age-based:  “When a Sister reaches the age of 75 ----.”    If Sisters are required to have their driving skills tested ONLY because they have reached a certain age that is ageism being practiced openly and blatantly.  Insult is added to injury when the driving skills test is done not by an occupational therapist specialist but by a representative of an insurance company! Clearly, the concern of the insurance company is its bottom line.  Period.


I have had participants in workshops argue the previous point with me.  I stand on solid gerontological principles in this regard however. If we want a convenient, orderly organization, the ageist policies may be the way to go.  If we want an organization where every member is encouraged to continue to develop and live life as fully as possible, we will do away with “when a Sister reaches the age of 75 ------”. It may be a little messier and require a little more time with individuals and/or situations, but it is the more honorable way to facilitate life in an organization.  It honors the dignity of the older adult who is seen and judged as a whole person, not someone categorized because of her chronological age.

Tuesday, July 12, 2016

Ageism Snakes its Way into Politics

This political election cycle h as been crazy, as so many pundits have reminded us.  Indeed it has been a strange and unpredictable period of political history. However, even in the midst of this unpredictability, examples of ageism are front and center. Its presence proves that our culture is soaked in the prejudice of ageism.

Four years ago an 84-year-old Clint Eastwood spoke to an empty chair during the Republican Convention.  It did not go over well.  The most common ‘analysis’ by pundits was age-related:  “What were they thinking, asking an 84-year-old-man?”

Two years ago Chuck Todd interviewed Nancy Pelosi in the context of national elections possibly resulting in the Democrats regaining control of the house.  Chuck wondered if Former Speaker, Nancy Pelosi, would seek that position once again, asking her if she didn’t think that perhaps she was too old for that position. 

Last month there was much chatter about the unfortunate decision of Bill Clinton to visit Attorney General Loretta Lynch while their planes were on the tarmac in Atlanta.  One commentator mused that he wondered if perhaps Bill Clinton is “not at the top of his game” any longer.  In other words, Bill Clinton, at age 69 – in making what many consider a very unwise decision – made that decision because he’s slipping, because, after all, he’s 69.  What else can you expect?

To date, no one in the public area has come back to denounce any of these instances as ageist, as negatively prejudicial.  Had Chuck Todd suggested that Pelosi is unqualified as Speaker because she is a woman, he would have lost his job at NBC.  Sexism – not acceptable.  Had someone suggested that Clint Eastwood’s flop performance was due to his Irish ancestry, the outcry would be to denounce ethnic prejudices.  Racism -- not acceptable.

But  ageism? No one speaks up against blatantly ageist remarks.  Why? A major reason is because collectively, as a society, we do not recognize this bias. Ageism is so ingrained in our culture that we don’t sense its presence. We too soak it up without realizing it.

And what’s the challenge:  There are two.  See this space tomorrow.

Saturday, July 2, 2016

What does our Gracious God Who is Rich and Merciful desire for us in our later years?

The Communications Director of our Congregation extended an invitation to all the Sisters to share a reflection on how our specific ministry reflects the spirit of this Holy Year of Mercy. I submitted mine to her today and share it here with you, my blog readers.

-----     -----     -----

It was a cold December evening in Charleston, WV, 1988, as I was making an unannounced after-hours visit to a nursing home in my role as ombudsman. After about an hour visiting residents, I was retracing my steps down the hallway toward the front exit.   Although it was only 7:30, many of the rooms were already darkened and their occupants in bed for the night.  From such one darkened room I heard a resident call out from his bed.  I was nearing his doorway, and though I could not yet see into his room, I remembered having talked with him earlier. He was a WWII veteran; his right arm had been amputated at the shoulder.  I asked from the hallway, “Can I help you?”   The answer was quick and strong:  “A hug.”  I walked into this man’s room and gave him a simple hug; he settled back onto his pillow and I made my way home.

A simple response to a vulnerable elder’s expressed heartfelt need.  I hope there was some message of his being loved eternally and unconditionally.

Francis tells us in “The Name of God is Mercy” that “Mercy is deeply connected with God’s faithfulness.” Francis also says clearly that true mercy is not words alone, that active love and compassion must find voice in action.

My current efforts – through writing, workshops, presentations, visits to motherhouses and provincialates, and consultative services – are to stir a new consciousness among those who, by election or by appointment, are called to serve those elderly Sisters who need supportive aging services. This new consciousness calls for transforming the institutional culture of retirement centers to places where life is still lived to the fullest. Transforming the culture, the operative philosophy, opens doors to heretofore unimagined scenarios of life in the midst of frailty and illness.

Life blossoms each day with:
          ♦ Knowledge that one’s dignity is being recognized and honored.
          ♦ Experiencing purpose and meaning in one’s day and life.
          ♦ Richness of meaningful relationships.
          ♦ The exercise of choice about every possible event of their day.
The Sister is no longer living in an institution, she is living at HOME!

Our God, Gracious, Kind and Merciful, Rich in Mercy -- as the psalmists tell us-- wants this quality of life for each of us, wants us to have what fulfills us and enables us to live more fully.  My efforts in ministry to make such life possible for Sisters across the country are surely a work of mercy.



Wednesday, June 29, 2016

Our Legacy of Preparation for Ministry

Sister Jane Behlmann, CSJ, is the archivist here at the St. Louis provincial house. She often posts information about their Sisters’ history. With her entries, Sister Jane usually includes pictures related to whom or to what she is writing about.

Yesterday's post included the following quotation taken from the CSJ Annual, 1936, a annual reporting of events within the province over the preceding year:

“Regular classes for the sisters in the St. Louis missions were held at the Provincial House [Our Lady of good Council Convent, Cass Avenue] every Saturday during the scholastic year. The summer session, which is always held at Fontbonne College, opened on June 28 and continued until August 3. Each day chartered busses took fifty-two sisters to and from Fontbonne. Nothing but a love of obedience and zeal for souls could have sustained the sisters in this daily routine of labor in the acquisition of knowledge, spiritual, cultural, and intellectual, to be used later in promoting the interests of God and Community.”

Posted is the following picture of Sisters (from several different Congregations) attending classes during the summer of 1946. Such realities of multitudes of nuns spending their summers advancing their education  were not uncommon as the Sister Formation Conference took hold.



This aspect of our history as women religious in the United States is clear: there was an intentional effort from our beginnings to send Sisters to study --  to acquire the knowledge, ”spiritual, cultural and intellectual” necessary to effectively “promote the interests of God and Community.”

The challenge today is to be convinced in the depths of our souls that the ministry of service to our own elder members is the same as any and all works of mercy – another definition of apostolic ministry – that have characterized all our ministries to others.

When that conviction becomes part of our collective consciousness, we will also see and act on its implications, only one of which is to continue our legacy of adequate, competent professional and spiritual preparation for ministry to our own

Tuesday, June 7, 2016

Scalloped Potatoes Brought to you by Betty Crocker and Corporate Food Processors

What follows is the list of ingredients taken directly from the box of Betty Crocker Scalloped Potatoes.  There are brief explanations for some of the 40 ingredients in this "food".

1.  Dried Potatoes

2.  Wheat flour

3.  Niacin – a vitamin – Vitamins and minerals found naturally in foods are lost under food processing conditions. Therefore manufacturers add back synthetic or natural forms of these substances to maintain the nutritional value.

4.  Iron – a mineral

5.  Thiamin Mononitrate – a synthetic form of the vitamin, Thiamine, Vitamin B-1

6.  Riboflavin – a vitamin

7.  Folic Acid – a vitamin

8.  Maltodextrin – polysaccharide that is used as a food additive. It is produced from starch by partial hydrolysis.

9.  Corn Starch

10.  Salt

11.  Potassium Phosphate –Phosphates are used to enhance the characteristics, cooking performance, and value of the foods in which they are used.”
         
 From a page linked to the National Institutes of Health: "the public should be informed that added phosphate is damaging to health.

12.  Monosodium Glutamate – Also known as MSG, this chemical is used as a flavor enhancer.  The Food and Drug Administration (FDA) has classified MSG as a food ingredient that's "generally recognized as safe," but its use remains controversial. For this reason, when MSG is added to food, the FDA requires that it be listed on the label.

 13.  Canola and/or partially hydrogenated soybean oil – Partially hydrogenated fat molecules have Trans fats, and they may be the worst type of fat you can consume. These trans fats are also present in margarine and ‘butter spreads’.

14.  Potassium Chloride – Used as a flavor enhancer, as a replacement for the potassium lost due to processing, and to provide flavor without increasing the amount of sodium in the food.

15.       Sugar

16.  Natural Flavor – The definition of natural flavor under the Code of Federal Regulations is: “the essential oil, oleoresin, essence or extractive, protein hydrolysate, distillate, or any product of roasting, heating or enzymolysis, which contains the flavoring constituents derived from a spice, fruit or fruit juice, vegetable or vegetable juice, edible yeast, herb, bark, bud, root, leaf or similar plant material, meat, seafood, poultry, eggs, dairy products, or fermentation products thereof, whose significant function in food is flavoring rather than nutritional”   (21CFR101.22).

17.  Paprika

18.  Whey

19.  Dried Celery

20.  Dried Onion

21.  Wheat Starch

22.  Mono and Diglycerides – Mono- and diglycerides of fatty acids (E471) refers to a food additive composed of diglycerides and monoglycerides which is used as an emulsifier. This mixture is also sometimes referred to as partial glycerides.

23.  Soy flour

24.  Nonfat Powdered Milk

25.  Lactic Acid

26.  Yeast Extract –Yeast extract is the common name for various forms of processed yeast products made by extracting the cell contents (removing the cell walls).

27.  Enzyme Modified Cheddar Cheese (milk, cheese cultures, salt, enzymes) – Enzyme-modified cheese (EMC) is cheese curd which has been treated with enzymes to produce a concentrated cheese flavor ingredient.

28.  Calcium Lactate – Calcium lactate is a black or white crystalline salt made by the action of lactic acid on calcium carbonate.

29.  Spice

30.  Enzyme Modified Cream – From Cargill’s website:  Through natural processes enzymes and cultures act on the proteins, fat, and carbohydrates of fresh dairy products to develop highly flavorful compounds. During this process of enzymolysis and fermentation, the dairy product is transformed into a highly concentrated, intensely flavored ingredient. The process is controlled to inactivate enzymatic activity and ensure proper flavor development. The ingredients will not change in flavor profile or texture over the span of their shelf life.

31.     Silicon Dioxide (anticaking agent) – This is also known as silica.  It is a major component of quartz. I  do not know what function it has in processed food.

32.  Yellow Lake 5 Food Coloring – Yellow No. 5 is an azo dye that imparts a lemon-yellow color to foods, drugs and    cosmetics.

33.     Yellow Lake 6 Food Coloring FD&C Yellow No. 6 Lake is a color additive used for drug dosage forms such as tablets and capsules. It is also approved for use in foods and cosmetics.

FD&C Yellow No. 6 Lake imparts a reddish-yellow color to medicinal dosage forms.
FDA performs regulatory review for color additives used in foods, drugs, cosmetics, and medical devices.
FD&C specifies the color is approved for use in food, drugs and cosmetics. FD&C Yellow No. 6 Lake may be safely used as a color additive when following FDA specifications.
To form lake colors, straight dyes (such as FD&C Yellow No. 6) are mixed with precipitants and salts. Aluminum may be a component.
34.  Artificial Color – from the website of the American Chemical Society: “Why bother with artificial, or synthetic, food colorings? Aren’t there enough natural colors to go around? A big reason to go artificial is cost. Synthetic dyes can be mass-produced at a fraction of the cost of gathering and processing the materials used to make natural colorings.”

For more information go to

35.  Dried Blue Cheese (milk, salt, cheese cultures, enzymes)

36.  Enzyme modified Blue Cheese (milk, cheese cultures, salt, enzymes) – Enzyme-modified cheese (EMC) is cheese curd which has been treated with enzymes to produce a concentrated cheese flavor ingredient.

37.  Soy

38.  Lecithin – Lecithin is used in many foods as an emulsifying agent (emulsifiers help keep the fat from separating).

39.  Sodium Phosphate – Sodium phosphates are often used as emulsifiers, thickening agents, and leavening agents for baked goods. They are also used to control pH of processed foods. They are also used in medicine for constipation and to prepare the bowel for medical procedures.

40.  Freshness preserved by Sodium Bisulfite – (Seriously, this is taken directly from the ingredient list! I don’t think Big Agriculture sees it as oh so ironic!)

LOOK!!

If you want home cooked, cooked-from-scratch, scalloped potatoes, here is the ingredient list for that recipe from the Betty Crocker Cookbook:
1. Potatoes
2.  Milk
3.  Onion
4.  Butter
5.  Flour
6.  Salt
7.  Pepper

More tomorrow on how this relates to this blog’s articulated focus on aging and aging services.


Monday, June 6, 2016

"Eat Food"

Michael Pollan, in his book, “In Defense of Food” says there are three simple rules for eating for health:
1.       Eat food.
2.       Mostly plants
3.       Not too much

Let’s look at that first rule of Pollan’s:   “Eat food.”  This ‘food’ is in contrast to processed foods that might more accurately be labeled “food-like”. Yesterday I stopped at a Panera’s Bakery for a bagel and coffee breakfast on the way home from a very long trip to and from Texas.  I noticed a poster entitled “The No No List”. It is a long, long list of chemicals and additives that Panera has already eliminated or will eliminate from all its products within the next six months. I'm going to try to post that list on this blog.

When I arrived home, a neighbor had dropped off two boxes of food:  Archway Oatmeal Raisin Cookies (a Target product I believe) and Betty Crocker Scalloped Potatoes

These are the ingredients listed for the cookies.  Ingredients are always listed in descending order of predominance by weight.  Those ingredients in bold font are ingredients found in a typical oatmeal raisin cookie recipe.

Bleached and unbleached wheat flour
Niacin
Reduced Iron
Thiamine Mononitrate
Riboflavin
Folic Acid
Raisins
Sugar
One or more of the following:
Canola oil, corn oil, palm oil, soybean oil
Rolled oats
High fructose corn syrup
Glycerin
Corn syrup
Modified corn starch
Baking soda
Nonfat dry milk
Whole eggs
Cinnamon
Salt
Potassium Sorbate (preservative)
Natural and artificial flavor
Soy
Lecithin

Which cookie do you think is less costly to prepare? An oatmeal raisin cookie from a box or one from the oven?


Which one tastes better?  Which one is a healthier choice?

We'll tackle the ingredients in  the box of scalloped potatoes later.

Saturday, May 21, 2016

We First Eat with Our Eyes Part II

Continuing with the thoughts in my last post here, I share  a couple of pictures that were taken in two different convent retirement settings.

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This was the table setting for Easter.  Pleasant to the eye!  The food service line is separated from the dining area by an attractive, curved glass-brick type barrier.  Attractive in itself, and only about five feet high, it has the effect of adding grace to meal time.

The Sisters' custom here is to seat only four at each table. The decision was deliberate.  It is easier for each to hear the other with just four chairs, and, it was explained, if there is a Sister with any cognitive impairment the four per table seating facilitates greater participation in the conversation. This operational activity is an example of aligning practice with mission, of making sure that the environment supports the vision.


The following photographs depict "presentation".  In this provincial house setting, the Sisters are served restaurant style.  In my visits there, service has always been warm and gracious.  There is never a long wait for a Sister's meal to arrive --- and to arrive with such art and grace!


This was the menu for Chinese New Year's: Egg drop soup, cashew chicken and steamed rice, homemade egg rolls and fruit. All made 'from scratch'!




This portrays a typical weekday evening meal.


The woman who directs the kitchen is a person with a passion for what she does.  In correspondence with  Rosanne, she responded to a resource I thought she would appreciate: "I find that the more information I have, the better care through food, I can provide to the Sisters."

"Care through food"!  What a great and valid concept!  Every person serving elders is a care giver!  Every person so engaged is offering the ministry of service! Thank you, Rosanne, and all the Rosannes in our retirement settings!


Thursday, May 19, 2016

We First Eat with Our Eyes

One of my favorite times each Wednesday is reaching for the Food Section of the daily newspaper. I always enjoy looking at the recipes and deciding if this one or that one is one that I want to try soon or perhaps just add to my collection of recipes for another day.  The food editor always has an interesting column elaborating on the theme of what recipes and/or restaurants are featured.

This week’s column started out with this:  “They say we first eat with our eyes. . . . The visual appearance of food is part of the experience of eating it.  Often the better it looks, the better it tastes.”  Just a few days earlier I had seen a short video addressing the high risks of older adults being malnourished. There are many factors involved in older adult malnutrition, but let us never underestimate the role of visual and olfactory stimulus in good nutrition.

With that, let us not neglect the role of what I call grace in our daily life. 

Meals can be a task necessary to assuage hunger and to maintain bodily health.  Or meals can be a time of grace: an experience of sharing nutritional, attractively presented food, cooked with purpose and care for those being served. 

Meals can be served in an environment that focuses only on task, or the table and the dining room can be an environment honoring the reality that our meals are experiences of nurturing body AND spirit.

Meals can be experienced as a continuation of our Eucharistic meal.

Providing an environment that supports this vision of and experience of food for soul and for the body does not add a single penny to the operating budget! 

What awaits in the dining room for you and those you serve?



Thursday, May 12, 2016

Expensive Dementia Drugs --- Ineffective? Harmful?

If you are age 60  or over, or if you have any degree of concern or responsibility for anyone over age 60, you should know about the book "Worst Pills, Best Pills" and use it frequently as a reference. The information contained in both this published volume and in the monthly companion newsletters reflect the highest degree of academic excellence  and integrity in research. The material is directed to "older adults" -- meaning over 60.

The May issue of the newsletter, Worst Pills, Best Pills News, was in my mailbox today. Page three features an article entitled "Memantine:  Still a Poor Choice For Alzheimer's Disease".

The trade name for memantine is Namenda. We've all seen the direct-to-consumer TV commercials advertising this drug, as well as similar ads for Aricept. As a matter of fact, the ads tell us that the two drugs used in combination are more effective than either drug taken alone.

Though the ads appeal to the compassion, devotion and sense of protection that a family member feels for someone living with dementia, the true story of the effectiveness of these drugs is quite different. In fact, Public Citizen's Health Research Group, the official name of the organization that publishes this newsletter I'm quoting from, categorizes this drug as a "Do Not Use" drug. They cite as the reason that there is no  persuasive evidence that it is effective, "making the drugs known risks unacceptable."

The risks refer to common side effects which are these:  dizziness (a risk factor for falls in older adults), headache, constipation, difficulty breathing, hallucinations and confusion.

Rare side effects include inflammation of the pancreas, kidney failure, bone marrow failure, heart failure, liver failure --- the list continues.

And what does the Federal Drug Administration (FDA) report to the public regarding the drug's effectiveness in the face of these side effects?  The newsletter quotes an FDA medical officer: "Only a small minority of patients treated with memantine showed even a minimal or moderate improvement, with no patients showing a marked improvement, and the most common response being no change."

The authors of a study done in 2011 concluded "… evidence is lacking for the benefit of memantine in mild Alzheimer's disease, and there is meager evidence for its efficacy in moderate Alzheimer's disease."

Most telling is the drug' s product labeling which, according to this article, states: "At this time, there is no evidence that memantine prevents or slows neurodegeneration in patients with Alzheimer's disease.

So let's look at what Big Pharma, even in the eyes of the FDA, is pushing:
A drug that is very expensive, a drug that has common, serious side effects, a drug that shows "meager evidence for its efficacy."

As far back as twenty years ago, I heard respected geriatricians tell their audiences the same thing that I have written here.  One doctor put more of a face on it, telling us, "If you have an aunt who has been diagnosed with Alzheimer's, forget Aricept and Namenda.  Take the money that you would have spent on those prescriptions and take her to her favorite fancy restaurant every month or more often.  It won't cost nearly as much and it will do her more good than the drugs."

That advice is still good.  Now to update my Advance Directives Form:  if I am diagnosed with dementia, I do not want to be given Aricept or Namenda.  I refuse that treatment.

And another update to my directives:  I do not want to be put on thickened liquids.  We haven't talked about those studies have we?  "Watch this space."