Seniors say they hesitate to mix healthcare and matters of faith

Published in RINewsToday on December 26, 2022

When it comes to matters of one’s personal beliefs, most seniors choose to keep their health care and their spiritual or religious lives separate, a new University of Michigan poll finds. But they do see a role for their health care providers in assisting them to cope with illness by looking for meaning or hope.

The National Poll on Healthy Aging (NPHA) is based at the U-M Institute for Healthcare Policy and Innovation (IHPI) and supported by AARP and Michigan Medicine, U-M’s academic medical center.

For this new NPHA report, the poll team worked with Adam Marks, M.D., M.P.H., a hospice and palliative care physician at Michigan Medicine, and L.J. Brazier, M.Div., a chaplain at Michigan Medicine’s Department of Spiritual Care.

The poll report is based on findings from a nationally representative survey conducted by NORC at the University of Chicago for IHPI and administered online and via phone in July 2022 among 2,163 adults, aged 50 to 80. The sample was subsequently weighted to reflect the U.S. population. 

Religious and Spiritual Beliefs and Health Care Decisions

According to new data from the National Poll on Healthy Aging (NPHA), released on Dec. 12, 84% of people between the ages of 50 and 80 say that they have religious and/or spiritual beliefs that are somewhat, or very important to them, including 71% who cited religious beliefs and 80% who cited spiritual beliefs.  About 40% of these older adults say those beliefs have gotten more important to them as they grow older. 

NPHA’s poll findings indicate that women were more likely than men (63% vs. 46%) to report that religious or spiritual believes were important, as those living in the South and Midwest (61% and 59%) compared to those in the West and Northeast (51% and 43%).

In addition, the researchers found that older adults with lower levels of education were also more likely to report religious and spiritual believes as being very important (61% high school or less, 56% some college, 47% bachelor’s degree or higher), as were those with annual household incomes less than $100,000 compared to those with $100,000 or more (59% vs. 43%).

Among older adults with religious or spiritual beliefs that are important to them, 19% say their beliefs have influenced their health care decisions, and 28% say they want health care providers to ask them about their beliefs, note the researchers.

Meanwhile, 77% of all older adults, regardless of beliefs, say health care providers should keep their own personal beliefs separate from how they deliver care.

“While 45% of older adults say their religious beliefs are very important to them, and 50% say that about their spiritual beliefs, even this group largely wants to keep this aspect of their lives separate from their health care,” says Marks, an associate professor of geriatric and palliative medicine, in a Dec. 12 statement announcing the poll’s findings.

“But a sizable majority of all older adults – whether or not they say belief is important to them – reported that they’d turn to health care workers to help them find deeper meaning in their illness, and 78% believe health care workers will help them find hope when they’re having a health-related challenge,” he adds.

According to Brazier, many health care systems have a way to record the religious affiliation of patients in their electronic medical records, and that medical students and others training for health professions are told to ask their patients about any beliefs that might affect their future care.  Having this information available can help providers ensure that patients with strongly held beliefs or specific religious affiliations receive everything from appropriate hospital food to visits with chaplains of a specific faith tradition when they’re having a health crisis or nearing the end of life. 

But for those who do not follow a faith tradition or have strongly held beliefs, having that information available to health providers can also be helpful, says Brazier.

“Being a religious or spiritual person, or not following a faith tradition or spiritual practices, is a highly personal matter,” notes poll director Jeffrey Kullgren, M.D., M.P.H., M.S., an associate professor of internal medicine at Michigan Medicine and physician and researcher at the VA Ann Arbor Healthcare System. “So perhaps it’s not surprising that only about a quarter of all people in this age range say they’ve talked about their beliefs with a health care provider, though this rose to about one-third of those who say their religious or spiritual beliefs are very important to them.”  In all, 70% of those who say their beliefs are somewhat or very important to them reported feeling comfortable discussing their beliefs with their health care providers, he says.

Researchers say that even if patients don’t want to discuss their beliefs with their health providers at a typical appointment, it’s important for providers to know if patients with significant health needs, or those experiencing a health crisis, are connected to a faith community that can help provide support. 

In all, 65% of the older adults whose religious or spiritual beliefs are important to them said they belong to a community of people who share their beliefs. 

My Say…

Kathryne Fassbender, Founder and Executive Director of the Hem of Christ: A Dementia Care Ministry, notes that she has never met anyone in her 15 years of work in the field of aging who has wanted to keep their health care and spiritual/religious life separate as the NPHA study states. “What I have found is hesitancy to bring up faith with health care professionals both in physical and mental health care,” she says.

“As Catholics, our health care is woven into how we live our faith, and we wish to have the care we receive be in line with the teachings of the Church. In all honesty, it is increasingly difficult to find doctors who will respect that wish, which opens up a much broader topic of discussion,” she notes. “This hesitancy is across generations, so even care partners for older adults are not always as forthcoming with information regarding faith and health for fear of losing a current healthcare team,” Fassbender observes.

“While the number of doctors who would dismiss someone as a patient because of one’s wishes to keep with the teachings of the Catholic faith in the care they receive is small, the fear is there and it does happen,” says Fassbender, noting that the current medical and social landscape magnifies this fear. “The hostility toward religion and in particular the Catholic Church has a greater impact than I think we understand sometimes,” she warns.

Fassbender says that while it can be helpful to know the personal beliefs of our care providers, it is more important that the doctor, nurse, and therapist, respect our faith. “I know some great care providers who are deeply atheist, yet when they work with their clients of deep faith, they don’t allow their personal beliefs to influence care in any way. They instead assist their client in living out their faith traditions,” she says, stressing that this is what we all seek.

“While I may question some of the findings of this research, I see the findings as a call for care providers to increase seeking to help people of all ages, and all beliefs to live their purpose until their final breath,” says Fassbender.

Fassbender adds: “We must never dismiss one’s faith, regardless of their physical or neuro-cognitive abilities, and most certainly one’s age. I see this study as an invitation to crack open this conversation and allow the hostility, misunderstandings, and fears regarding faith and health to be overcome by the pursuit of care for the human person, fully who they are, what they seek, and how they wish to live life until the final breath.”  

The Hem of Christ started when the time was taken to pause and hear that still, small voice. After years of witnessing how a person’s faith can be diminished simply because of a dementia diagnosis or because someone put their life on hold to care for a loved one, Kate decided that it was time to formalize the small ministry work she had been doing for almost a decade.  Kate answered the call to formalize and set a path for others to walk down, reaching for the hem of Christ. 

NPHA Poll Puts Spotlight on Health Care and Aging Issues

The National Poll on Healthy Aging (NPHA) is a recurring, nationally representative household survey. By understanding the perspectives of older adults, the NPHA provides information to the public, health care providers, policymakers, and aging advocates on issues related to health, health care and health policy affecting U.S. adults ages 50 to 80 and their families.

Launched in spring 2017, the NPHA grew out of a strong interest in aging-related issues among members of the U-M Institute for Healthcare Policy and Innovation (IHPI) bringing together more than 600 faculty members  who study health, health care and the impacts of health policy. In addition to IHPI, the poll receives support from AARP and Michigan Medicine, AARP and U-M’s academic medical center.

The NPHA results can put a spotlight on future research needs and to create an informed national dialogue on poll issues examined. 

Psychologist Elaine Rodino’s Tips on those Holiday Blues

Published in RINewsToday.com on December 19, 2022

It is a visible sign of the approach of Christmas.  Houses are decorated with colorful Christmas lights with wreaths with red ribbons hung on the front doors of homes throughout the community. But planned gatherings next weekend with family and friends may not bring the joyful feelings and closeness you might expect, rather. isolation and loneliness. 

Increased demands of family obligations during the upcoming holidays, from last minute shopping trips for gifts, baking and cooking, cleaning, to hosting parties, getting your Christmas cards in the mail, and even unrealistic expectations can oftentimes produce extra stresses, feelings of anxiety, isolation and depression.  

During her 43-year career as a licensed practicing psychologist in Los Angeles and at State College, Pennsylvania, Elaine Rodino, Ph.D., a fellow and former president of the American of the American Psychological Association’s division of psychologists in independent practice, has had a longstanding interest in the holiday blues and has helped many of her patients cope with this issue over the years. 

No formal condition but it’s a “real” condition

During an interview on Speaking of Psychology, the flagship podcast of the American Psychological Association (APA), Psychologist Dr. Elaine Rodino noted that there’s no formal diagnosis of holiday blues, but it is a real condition. “It’s a condition that usually appears around the holidays and then fades away sometime in January,” she says.

According to Rodino, feelings can vary. To some people it’s a feeling of malaise, tiredness and they just can’t get to things. For others it’s the “traditional bah-humbug attitude,” she said, noting that “they hate the holidays and just can’t wait until they are over.”   

In counseling sessions during holidays, Rodino says conversations always come up as to how the patient will “get through the holidays, what they’re doing, what the stresses are, and how they’re going to deal with getting together with the family.”

Rodino, who has been quoted on the topic over the years by the LA TimesChicago TribuneNew York TimesBoston GlobeWebMD, and many magazines, offers these tips to cope with the stresses and anxiety triggered by the upcoming holidays.

Be conscious of your spending especially this year with soaring inflation and high interest rates. “Especially large families where each person usually gives to every other person there can be a plan to have a grab-bag of names and buy only for the person whose name you pick out of the bag. I have heard of this plan working well in a number of families and groups,” says Rodino.

Rodino suggests that if you know of a person who had a loss this year or has recently become single, it’s good to invite them to join you and your family for any holiday events or dinners. “People who are alone can take the initiative to create a gathering of others and have a potluck party.  This can be planned for Christmas or New Year’s, too,” she says.

“COVID is not totally gone and this year the flu and RSV are creating illnesses and hospitals are near capacity in many places. Continue to take precautions,” adds Rodino.  “I suggest that people get their immunizations for COVID and flu.  It may not prevent you from getting sick, but it will most likely be a milder case,” she notes.

“Don’t be intimated if you want to wear a mask. Just because you may feel like the only person wearing a mask, if that’s what you feel is safe, wear that mask,” recommends Rodino. “I’ve known people who say they knew they should have kept their mask on, but no one else was wearing one,” she says.

Don’t talk politics if everyone’s not on the same political page

Rodino warns that in family gatherings unless everyone is on the same page, politically, try not to bring up politics or issues that are politically split. “The slightest mention of one of these topics could seem okay at first, but then can slowly escalate to high levels of debate and arguments,” she says.

It is important to be very aware that some people may be recently sober, says Rodino. “If someone declines a drink of eggnog, etc. do not insist.  Likewise, if you are newly sober you may want to party with other sober friends,” she suggests. 

“Some people may also have eating disorders and may also be triggered by insistence that they try a certain dessert, or have seconds,” adds Rodino. 

Take care of your self-care during this time of year. “Consider taking time for yourself.  Take a break from shopping and all things related to the holidays. A walk, a warm bath, a massage, or even just reading a book can do wonders to renew your energy,” she notes.

Become aware of your own expectations and that of others as to what you “should” be doing for the holidays. “Take time to figure out what you really want to do, who you want to spend time with, what you want to buy. You don’t need to follow traditions that no longer have meaning for you. You can start your new ways of celebrating the holidays. That may even include leaving town and going on a vacation,” she says.   

Rodino says, “Why not spend some time reviewing your plans for the holidays, and make wise decisions now, so you can really have Happy Holidays.”

To listen to APA’s Blog with Dr. Elaine Rodino speaking about holiday blues, go to https://www.apa.org/news/podcasts/speaking-of-psychology/holiday-blues.

Don’t Drop Your Guard Against COVID, Flu, and RSV

Published in RINewsToday on December 12, 2022

COVID 19 cases across the nation are fewer in number than this time last year. But health care experts say that the Covid-19 is here to stay.

A new poll released by the Washington, DC-based American Psychiatric Association (APA), the nation’s oldest medical association, shows that while nearly a third of Americans report that while they anticipate being more stressed out this holiday season than last year, they are less worried about spreading or contracting COVID at a festive family gathering. Researchers say the findings, reported in the Dec. 2022 Healthy Minds Monthly Poll, reported they were more worried about affording holiday gifts. The APA’s study was conducted online by Morning Consult from Nov. 9-14, 2022, among 2,209 U.S. adults, with a margin of error of plus or minus 2 percentage points.

Holiday Worries, Less Concern about COVID Pandemic  

According to the poll’s findings, 31% of adults say they expect to feel more stressed this upcoming holiday season compared to last. This is an increase of 9 percentage points since 2021. Potential drivers of holiday stress include worries like affording holiday gifts (50%) and meals (39%) and finding and securing holiday gifts (37%). Younger adults and those making less than $50,000 are more likely to worry about affording the holidays, say the researchers.

Compared to 2021, adults are less worried this holiday season about spreading (35% in 2021 versus 25% in 2022) or contracting (38% in 2021 versus 26% in 2022) COVID-19 at a holiday gathering, noted the researchers. Adults are also less worried about spending time with family who have different views about COVID-19 (30% in 2021 versus 18% in 2022),” they say.

“This is a busy time of year for many people, and it’s common to put a lot of expectations on ourselves during the holidays,” said APA President Rebecca W. Brendel, M.D., J.D in a Dec. 1st statement announcing the study’s findings. “We can all benefit by enjoying moments that bring meaning and belonging, but those times are different for each of us. It’s also okay to opt out of some or all events if they bring more stress or distress than joy. There is no one right way to spend the holiday time of year,” she said.

On the positive side, the researchers added, “the plurality of adults (47%) say they are most looking forward to seeing family and friends this holiday season, of the options tested. That varied by age: Older adults (45-64: 50%, 65+: 63%) are more likely than younger adults (18-34: 37%, 35-44: 36%) to say so. A fifth of American adults (21%) said they were most looking forward to eating good food.”

The researchers noted that parents (39%) are more likely than non-parents (27%) to say they anticipate experiencing more stress this holiday season compared to last year. “Young adults and Democrats are more likely to worry about discussing politics and spending time with family with different viewpoints about COVID-19 during the holidays,” they say.

“While Americans are looking forward to seeing family this year, it’s important to remain vigilant about COVID-19, the flu and RSV,” warns APA CEO and Medical Director Saul Levin, M.D., M.P.A. “We are in a different situation than in 2020 or even 2021, but it’s still important to take precautions and stay home if you are sick,” she said.

Beware of the “Tripledemic”  

 With the Christmas holidays just weeks away, older adults must now not let their guard down about protecting themselves against a “tripledemic” of COVID, flu and RSV, says Nick Landekic, a retired scientist and biotechnology entrepreneur who is a contributor to RINewsToday. 

“COVID is now a pandemic of older people,” warns Landekic in a Dec. 9 article in the state-wide news blog. “With the year-end holidays upon us and infection rates rising across the country, the stark new reality is COVID is now a pandemic of older people,” he says.

“Right now, is a particularly risky time with a ‘tripledemic’ of COVID, flu, and RSV, with almost the entire country at ‘high’ or ‘very high’ levels of infection. Hospitalizations and deaths are both up sharply over the past two weeks, with deaths increasing as well,” says Landekic.

According to Landekic, the most accurate predictor of ending up hospitalized or dying from COVID is age. “Older people are thousands of times more likely to die of infection than younger persons,” he says, noting that the statistics bear this out. “Ninety percent of COVID deaths are now among those over 65. Over 300 Americans continue to die of COVID every day, and nearly 1,000 just on December 7 – a rate of over 100,000 a year – and most of them are over 65,” he says.

(COVID is now a pandemic of older people – Nick Landekic: https://rinewstoday.com/covid-is-now-a-pandemic-of-older-people-nick-landekic)

“You don’t want to get sick from one of these viral  infections and miss visiting with family and friends during the Christmas and New Year holidays, says Michael Fine, MD, author and chief health strategist for the City of Central Falls, adding that  “we’re in a “tripledemic” of COVID, flu and RSV (filling the nation’s pediatric hospitals). “It’s the worst flu year we’ve seen in recent memory,” he says, noting that “it has come early and hit hard.”

Dodging the Bullet 

During the upcoming holidays, Fine says it is easy to protect yourself against the “tripledemic” to prevent infection.  He recommends the importance of getting a bivalent COVID booster  if you haven’t had a booster during the last four months.

“You want to be extra careful two weeks before attending holiday gatherings,” says Fine, a family physician who contributes on health and medical issues (as well as short stories) for RINewsToday and is the former Director of the Rhode Island Department of Health.  Specifically, wear masks in stores and avoid restaurants and bars for about two weeks before a gathering or planned travel. “I don’t think many are eating outside at this point,” he quips.

“Wearing a mask in an airport terminal is important when traveling to family gatherings,” says Fine.  While there is good air infiltration in the air, it is not so in terminals, he adds.

When attending a holiday gathering with multiple households, it is a very good idea for everyone attending to take a COVID 19 home test. “It is not perfect but better than nothing,” says Fine.

“Those who have not been vaccinated yet, you still have time to do so before attending those holiday gatherings,” says Fine

Fine believes that people who haven’t yet been vaccinated can take comfort from the last two years and our now extensive experience with the vaccine. “We have two years of experience with the vaccine with billions being vaccinated.  We haven’t seen any substantial programs. It’s now the best tested vaccine in history,” notes Fine.