"Elder Journal: Holistic Gerontology" January 2003

by Paul Takayanagi
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Aging is a social phenomenon with wide reaching variables, but it is still viewed by the average citizen, as primarily a health issue. The number of times that I have been introduced as “Dr.” (read M.D.) are countless just because I was talking to a group about aging issues.  Of course, I always correct the introduction by stating that I am not an M.D. and that I see aging as a social issue that affects persons of all ages. In my work, aging is a multi-faceted process that incorporates a person’s whole body, mind and spirit. While physical health and health care factors are important, they are by no means the only factors in the aging process. A person’s mental outlook combined with an enthusiastic spirit in a supportive environment can often make the difference in whether she or he is actually physically healthy at every age and most particularly, I have learned, when one is older.

In 2003, I will have been involved with the field of aging as a professional gerontologist for fifteen years. I am primarily a sociologically trained educator who provides education and training on gerontology related issues at institutions of higher learning, social service organizations and the general community. While senior social services have been the main venues of my work, I have also worked in clinical settings and with health care professionals at all levels.

There have been many changes in the field of aging since 1988 when I first entered the field. Primary among those changes is the whole notion of what is “healthy aging.” That was considered an oxymoron when I was trained as a gerontologist. While there was a few voices and some literature on the topic of what could possibly be a “healthy older adult,” aging was synonymous with frailty, decline and loss. That is beginning to change exponentially in many ways. The aging field often evolves in tangent with other fields including health care, psychology, sociology, biology and many others.

The field that most relates to the topic of this month’s column is Holistic Health. The holistic perspective of health has evolved hugely in the last decade with a growing interest in what has become to be known as Complementary and Alternative Medicine (CAM). The number of practitioners in a variety of CAM treatments and modalities have burgeoned during the 1990’s and into the 2000’s. There is more of a CAM influence on conventional medicine generally and geriatric medicine too. A White Conference on CAM was established during the Clinton administration and a report published this year (see resources list below).  There are currently over 34 million Americans who currently access alternative health care therapies annually in the United States.  The numbers of middle-aged and older people accessing these therapies may grow exponentially in coming decades as they seek more holistic ways to cope with and manage health and aging issues. These individuals along with a growing number of senior social providers in a variety of settings are interested in actively understanding what is lifelong wellness and how they can promote good health in holistic ways throughout their lives.

I recently gave a talk at a conference in San Francisco for older adults and senior social services providers on the topic of Wellness in Later Years. The group included 30 people between the ages of 35 and 90 years with the majority being aged 65 years and over.  When I asked the group how many had accessed some form of Complementary and Alternative Medicine, more than half the group raised their hands!   Upon further inquiry, the group had primarily accessed acupuncture, aromatherapy, massage therapy, Reiki and other healing touch modalities.  When asked for the kinds of reasons they had sought CAM treatments, they cited arthritic pain, general pain management, physical stress and emotional distress as the primary reasons.  A genuine curiosity in alternative, eastern and traditional (indigenous) medicine as distinct from allopathic (western) medicine was also given as a reason they sought CAM treatments (see glossary below). While they had accessed CAM, most agreed that these treatments should be in tangent with conventional medical treatments. The majority felt they had benefited greatly from the CAM treatments they had received and were interested in accessing more. In addition, persons in the group who had never experienced a CAM treatment were also interested in accessing CAM modalities sometime in the near future.

I welcome a growing interest in how to promote a holistic perspective of aging, health and wellness throughout life and especially in elder years.  There is more aging research focusing on the physical and psycho-sociological-spiritual processes of health called Integrative Medicine; more understanding of the major health issues affecting elders and their families today that are best managed from a holistic perspective; better applications of a holistic perspective of health and aging for lifelong wellness; and a growing influence of CAM on specialized issues including dementia care and long term care provision.  I believe in promoting a “holistic gerontology” as a lifelong process that is best managed across the entire life span through expanded self-awareness, self-regulation and deeper relationships across generations at school, work and in the community. If you are interested in this perspective as well, please stay tuned to future installments of this column. 

Glossary of terms related to this month’s column:

Allopathic Medicine; also known as Western Medicine; Conventional Medicine: All of these are terms for medical interventions practiced by practitioners with an MD (Medical Doctor) or related disciplines (nursing, physical and occupational therapy, etc.). Traditionally, these interventions have focused on disease control, drug treatments and other conventional methods of healing.

Complementary and Alternative Medicine (CAM): Includes those health care practices that are not currently an integral part of Allopathic or Western Medicine. The terms "complementary' and "alternative' originated to describe systems of care which are outside conventional medicine and not traditionally taught at western medical schools. Related terms include Preventative Medicine; Naturopathic Medicine; Holistic Medicine and others.

Eastern Medicine: Systems of care originating in Asia, particularly, Traditional Chinese Medicine, Ayurvedic Medicine (India) and other forms. May include acupuncture, acupressure, herbal treatments, Tai Chi, Yoga and more.

Geriatric Medicine: Conventional medical and health care systems focused on older adults.

Gerontology: The study of aging from a multi-disciplinary perspective including but not limited to medical, social, psychological and spiritual perspectives.

Holistic Health: A perspective of health incorporating ancient traditional, conventional medical and CAM health practices for a person's total being (mind, body and spirit).

Integrative Medicine: A new health care discipline being established in Western medical schools seeking to combine ideas and practices of Western and Complementary and Alternative Medicine. It may also refer to a combination of Western and CAM treatments for a specific person by a physician and CAM practitioners.

Traditional or Indigenous Medicine: Systems of health care practiced by indigenous populations in specific regions of the world. Examples include Ayurvedic Medicine (India); Chinese Medicine; Native American Medicine; and Tibetan Medicine. May include Shamanic traditions and systems of care. The term "traditional" is often confused with "conventional or Western" medicine.

Resources for a holistic gerontology:

Internet Resources

National Center for Complementary and Alternative Medicine
www.nccam.nih.gov 

Alternative Health News Online
www.altmedicine.com 

The White Conference on Complementary and Alternative Medicine\
www.whccamp.hhs.gov 

The American Society on Aging
www.asaging.org 

The San Francisco Ministry to Nursing Homes
www.sfmnh.org 

Alzheimer's Services of the East Bay
www.aseb.org
Email: info@aseb.org
Tel: (510) 644-8292 

Periodicals

Alternative Therapies Magazine
www.alternative-therapies.com 

Other: 

1.  Baltimore Longitudinal Study on Aging, Gerontology Research Center, Baltimore, MD 1-800-225-2572 

2.  Health Center of Integrated Therapies, Longmont Unified Hospital, 1840 West Mountain View Avenue, #3, Longmont, CO 80501, (303) 651-5188 

3.  Community Health & Wellness, LaPlanche Clinic, MidState Medical Center, 476 Murdock Avenue, Meriden, CT 06450, (203) 639-8030

Note: This is the first installment of Elder Journal for the ElderCare Online and ALZwell Caregiver Support web pages. I want to thank Richard O'Boyle for the opportunity to share my column and views with you. I look forward to your feedback and opinions on the variety of topics we will be exploring in Elder Journal. You can also contact me through my web page at www.livingoveraging.com.

About the Columnist:  Paul Takayanagi is on the faculty of the Gerontology Department at San Francisco State University.  He has also taught at the University of California, Berkeley; California State University, Hayward; Chabot Community College; and the Graduate Theological Union.  He is also the Education Director of Alzheimer’s Services of the East Bay in Berkeley, California.  He is a member of the American Society on Aging and currently is a Chairperson for their Summer Series on Aging.  He has presented nationally on “Holistic Gerontology” and other topics.  He resides in the San Francisco Bay Area.

Available from ElderCare Online™             www.ec-online.net             2003 Paul Takayanagi