Why Do Men Die First?

92016-why-men-die-first
by Janet Simpson Benvenuti

Women outlive men by six years. Heart disease in some men begins at 35. Like you, I never questioned why until I read Why Men Die First by Dr. Marianne Legato. Dr. Legato, professor of clinical medicine at Columbia University, has been studying the differences in health between the sexes for decades. Her research found several ways to help men avoid premature death, summarized by Don Fernandez at WebMD.

Here are five suggestions to lengthen the male lifespan.

1. Speak candidly with a physician. Although men are inherently more vulnerable than women genetically, their cultural conditioning encourages them to take risks, deny pain and show no weakness. Those social pressures make them reluctant to seek medical help and speak frankly to their physicians. Mothers, spouses, sisters and friends play an important role in helping men reach out for help before a medical condition worsens.

2. Men are biologically predisposed to infection. Boost the immune system with proper diet, exercise and sleep. Avoid infections by using condoms and keep immunizations, including tetanus shots, up to date.

3. Treat depression. Like in women, depression is a risk factor for heart disease and stroke, and older men are more likely than women to become suicidal and take their own lives.

4. Watch young adolescent males whose lifestyle make them vulnerable to injury or death.

5. Assess the risk for heart disease and take steps to lower risk factors. Some men, especially those in stressful jobs like firefighters and police officers, show evidence of heart disease as young as 35.

For more insights and guidance, listen to this 30-minute video posted by Second Opinion, an informative discussion about why men age more poorly than women.

Together, let’s help our sons and spouses, brothers and nephews lengthen their lifespan.

c Circle of Life Partners, LLC. All rights reserved.

BOOK REVIEW: The Heart of the Hereafter, Love Stories from the End of Life

by Janet Simpson Benvenuti

The Heart of the HereafterEach month I read dozens of books, articles and research reports about aging and healthcare, looking for tidbits of information that I can share with you, knowledge that will make your family life easier, healthier, more joyful. After 25 years in healthcare, it’s rare that I find a book that makes me pause and reconsider how we care for the dying. The Heart of the Hereafter, Love Stories from the End of Life, is one of those books.

Author Marcia Brennan, Ph.D., is a professor of Art History and Religious Studies at Rice University in Houston, Texas. She also is the Artist In Residence in palliative medicine at the renowned M.D. Anderson Cancer Center. Curious about her role, I anticipated that her book would describe anecdotally how art therapy can help a patient cope with their cancer diagnosis. Far from that, Dr. Brennan becomes our guide to life’s greatest transition – death – using art as the language to describe what words cannot.

Dr. Brennan briefly provides context about historical guides to the art of dying called the ars morendi, small printed books widely used in the 14th century to help people understand the dying process and acknowledge the moment between living and death, when an individual is suspended between worlds. “Sometimes when I visit people at the end of life,” she writes, “I get the sense that they are inhabiting multiple worlds at once…their physical appearance changes and they become extremely beautiful.” This state of grace, a moment of sustained peace and comfort, a convergence of the physical and spiritual, is captured through her stories about 10 patients, including a child, who are dying.

In “The Heart,” Dr. Brennan brilliantly demonstrates how she creates a complete summation of each patient’s life in a single poem, words that are transformed by a visual artist into a charcoal drawing. She places their reflection in the context of her deep knowledge about religion and art, centering each story around the different types of love that influence and transform a person’s life. The result is breathtaking, especially as each patient acknowledges the accuracy of her work, comforted by her understanding and a sense of accompaniment when facing the transition between worlds.

The news today is full of stories about how to navigate the last years of life. Housing choices, hospice care, insurance coverage and legal plans are mundane but necessary decisions that distract families from what truly matters: being present with loved ones in the last months and moments of their lives. Dr. Brennan, a stranger to the patients she meets, reminds us that our role is to listen and affirm, to remain open to whatever arises, to acknowledge that “the end of life is all about life itself and the many different types of love that we experience as human beings.” This book is a gift to us, one to re-read each time someone in your life approaches the end of their own.

HIGHLY RECOMMENDED. Click this link to purchase The Heart of the Hereafter: Love Stories from the End of Life

c2015 Circle of Life Partners, LLC. All rights reserved.

BOOK REVIEW: Being Mortal by Atul Gawande

by Janet Simpson Benvenuti

Let’s talk about death, or better yet, dying. Our guide is Dr. Atul Gawande, brilliant surgeon and best-selling author, who weaves a compelling narrative that informs, enlightens and challenges clinicians and senior housing leaders to improve the way our institutions of care impact lives. Unlike his previous books The Checklist Manifesto: How to Get Things Right, Complications: A Surgeon’s Notes on an Imperfect Science, and Better: A Surgeon’s Notes on Performance, Gawande gets personal in Being Mortal: Medicine and What Matters in the End, with a perspective enriched by his father’s end-of-life journey. “We are not ageless,” Gawande writes, pushing readers past the denial that afflicts both the physician and the patient. Our goal, he continues, is “not a good death, but a good life to the end.”

The challenge, of course, is how to achieve that goal when only three percent of medical students receive training in geriatrics. While Gawande and his colleagues at Ariadne Labs focus on physician education, Being Mortal provides insights that readers can use with their own families.

My favorite tip was his description of ODTAA Syndrome, the signature way to tell when a patient or loved one is nearing the end of their lives. ODTAA Syndrome is when one experiences “One Damn Thing After Another,” a sure sign that the body is weakening and starting to fail. While the medical community uses clinical markers and checklists for stages of dying, this intentionally amusing name most clearly describes what families experience.

Long before ODTAA syndrome begins, older people with medical concerns face three housing choices: aging in a home setting with assistance, moving to an assisted living community, or moving into a skilled nursing home. While each option has benefits and challenges, Gawande describes resources worthy of consideration.

1. The Eden Alternative – As a new medical director of Chase Memorial Nursing Home, Dr. Bill Thomas found that residents were suffering from boredom, loneliness and helplessness. His solution? Admitting 100 winged and six four-legged residents. Gawande shares this hilarious story about the founding of the Eden Alternative; you may find nursing home communities that subscribe to their philosophy here.

2. Assisted Living Communities – As a caution to families, Gawande reminds us that today only 11 percent of assisted living communities “offer both privacy and sufficient services to allow frail people to remain in residence,” the original intent of Dr. Keren Brown Wilson, the founder of the first community for assistance in Portland, Oregon. One of the model organizations recorded by Gawande is Sanborn Place, led by friend Jacquie Carson who provides the kind of passionate advocacy and skilled care all elders deserve.

3. Palliative and Hospice Care – Perhaps the most useful guidance in Being Mortal were the examples of how patients, including his father, weighed treatment options during the last few years of their lives. Highlighting the importance of palliative consultations and hospice care, Gawande used his father’s fear of becoming a quadriplegic to demonstrate those often difficult conversations about care options, conversations that are the focus of the 5 Wishes, The Conversation Project, and the popular card game My Gift of Grace.

Here is an excerpt of the questions a physician trained in palliative care might ask.

1. What do you understand your prognosis to be?
2. What are your concerns about what lies ahead?
3. I need to understand how much you are willing to go through to stay alive.
4. What are your goals if your condition worsens?
5. If time becomes short, what is most important to you?

Unfortunately, until more physicians and health care providers are trained in palliative care, it remains for family members, especially those who are designated as health care agents, to clarify their loved one’s wishes. Being Mortal gives families insight into how to have those conversations. Buy a copy and use it to start the conversation with those you love.

HIGHLY RECOMMENDED. You may purchase a copy here.Being Mortal: Medicine and What Matters in the End

c 2014 Circle of Life Partners, LLC. All rights reserved.