Wow, it’s been such a strange couple of weeks! I just started the new school year completely online, and it’s been quite an adjustment. It feels like an awkward stage, between summer and school, because online school just doesn’t feel real. It was also like there was never closure to the previous school year because we ended online. Going through my blog, I know many of my recent posts have been about COVID-19, which I do believe is an important topic to explore, especially with respect to the elderly. However, further past these posts, I came across one about the different types of memories, and this sparked me to search for the opposite: the different types of memory loss.
Amnesia: “a partial or total loss of memory” (please note that this is different from causes of memory loss, which include dementia and Alzheimer’s disease)
Most of the time, amnesia is temporary. However, it is definitely a daunting concept to face. Clive Wearing, as mentioned in Musicophilia by Oliver Sacks, never ceases to inspire me. He’s a musician who, after a brain infection, suffered from devastating anterograde and retrograde amnesia. His memory span is only a few seconds, so he is constantly in a state of confusion about where he is, who he is, and what he’s doing. Every time I come across his story I am both amazed and haunted at the same time because I could never imagine how to live when every moment is like a new moment because I’ve forgotten that a few seconds ago even existed.
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Throughout the United States and across the world, a topic sparking much alarm and urgency is the disproportionate amount of COVID-19 cases in nursing homes and the even larger share of deaths. It breaks my heart to hear the news about these residences being devastated by COVID-19, so I looked into research trying to understand underlying reasons for this. I’ve learned that the inherent characteristics of nursing homes make them more vulnerable: residents likely have underlying medical conditions and the communal setting makes it easier for transmission. Previous research has confirmed that urban location and larger facility size of the nursing home are related to the nursing home having COVID-19 cases. After thinking, this intuitively makes sense: a higher population density makes it harder to social distance, and a larger facility means there’s more traffic of staff in and out of the nursing home. I also watched a webinar hosted by the NIA IMPACT Collaboratory, which affirmed that facilities with COVID-19 cases were likely to be larger, in urban areas, and in states with more cases.
After going through this existing research, I realized most studies are only on nursing homes. What about other types of long term care facilities? Less research has been done on the transmission of COVID-19 in other facilities and comparing the outbreaks to those in nursing homes, although there are many distinctions between the types of facilities, the main one being that nursing homes are more focused on providing medical care for residents. This sparked an idea: I wanted to visualize the different patterns of COVID-19 cases in nursing homes vs other facilities, so I created a map. The map consists of outbreaks in licensed nursing homes and residential care facilities for the elderly (RCFEs; encompass assisted living, memory care, and continuum of care communities) in Los Angeles County, and I also included layers to compare the cases within the racial composition and median income of the area they are located in. The COVID-19 cases are grouped by zip code in order to depict the outbreaks in a community as a whole.
Here is my first map of LA County (the case numbers are not being updated). The nursing home cases are displayed for all of California, while the RCFE cases are only displayed for LA County. To view the legend, click on the arrow button on the top left:
I also recently created a similar map for Austin, TX, with case numbers that are up to date. Here, the exact locations of long term care facilities with cases are displayed: A clear major difference between nursing homes and RCFEs is that there are fewer cases of COVID-19 in RCFEs. I think this could be due to the differences in care and living between nursing homes and RCFEs, like residents being more independent in RCFEs and staff providing less hands-on care. Furthermore, unlike nursing homes, residential care facilities are not federally regulated, but rather states set most regulations, so the quality can greatly vary between facilities. This also means that COVID-19 responses for these facilities can vary greatly between states— yet another factor that could contribute to the presence of COVID-19 cases. Therefore, there may be many more variables to consider with regards to COVID-19 cases in other long term care facilities than in nursing homes. As the extent of the spread of COVID-19 in a community contributes to its transmission into long term care facilities, it is everyone’s responsibility to protect the residents living in them. In order for us to understand this and take necessary precautions, we also need a clear picture of the COVID-19 situation of the long term care facilities in our own communities. Therefore, I believe it’s important to create visualizations of the long term care facility data that are easy and quick to understand and on a local level. This can help the general public to recognize where outbreaks occur, focus appropriate attention and resources, and consciously take action to lessen the spread of COVID-19 to those most vulnerable in the community. Sources
I can’t believe it’s already almost August! This summer has both flown by and seems like it’s lasted forever. Towards the beginning of the summer (more specifically on June 2), I looked at COVID-19 statistics of various countries, and now that summer’s almost over, I thought it’d be interesting to gather the same statistics and compare them! I’m curious to see how the distribution of COVID-19 cases has changed through time. The statistics I used were COVID-19 confirmed cases, and to focus on the older population, I compared the proportion of COVID-19 cases in the 60+ age group with the proportion of people 60+ within the whole population. Basically, I did (# of COVID-19 cases in ages 60+ / total # of COVID-19 cases) - (# of people 60+ / total population). I subtracted the proportions in order to compare the statistics more easily between countries, and I will call the difference in percentages the “delta”. I actually did this for different age groups (60-69, 70-79, and 80+), but for this post, I decided to just focus on the comparisons between countries. The countries I used are Japan, Sweden, New Zealand, Australia, Spain, and California (which I know is a state, but I wanted to compare to somewhere in the US, and the US groups the cases from age 65, not 60). Here’s the data from the beginning of June (6/2): The more positive the delta, the more “exposed” the elderly are to COVID-19 because this means that the proportion of elderly with COVID-19 is greater than their share of the total population. In comparison to the other countries, it seems like the elderly in Spain and Sweden were most exposed because they have the most positive deltas. California and Australia were a little better, and Japan and New Zealand had deltas closest to zero, meaning the proportion of cases is around the same as the proportion of the total population (and Japan actually had a negative delta!). Here is the data from yesterday (7/25): It’s interesting to see that for every place, except Spain, the delta decreased, and pretty significantly. This means that the proportion of elderly cases of COVID-19 became less compared to other age groups. I think Spain is an exception because during this time frame, the peak of the pandemic was already over in Spain, so there wasn’t much change in the distribution of COVID-19 cases. However, if Spain’s delta stayed relatively the same, then shouldn’t Japan’s, too, because Japan was one of the first countries where COVID-19 spread to (as measured by the date of the first confirmed case)? Since the beginning of July, Japan has been seeing a spike in cases, and many of the cases are within younger age groups. Australia has also had a rise in cases in around the same time frame. With less restrictions, younger people could be moving more freely, perhaps because they believe the risk is low or because of necessity, like for work. On the other hand, older people may be continuing to stay home and be cautious because they recognize that the risk is still high for them. Spain is actually now beginning to see a spike in cases, so it’d be interesting to see if its delta changes. In both California and Sweden, there was never really an end to the first wave of the pandemic, but their deltas have still decreased. I think a similar theory could be applied to these places, too: as the pandemic continues and worsens, people realize the risks of the elderly obtaining COVID-19, and elderly people could become more cautious in order to lessen exposure to COVID-19. If this is the case, then it makes sense that the delta decreases because not as many elderly people are becoming infected, at least compared to other age groups in the country. For New Zealand, there have been single-digit new cases per day throughout the whole summer, and its delta has changed the least. It’s actually quite interesting to see how well New Zealand has handled the pandemic, and I’m curious to know what factors contribute to their success. This brings me to my conclusion: there are definitely many more factors that contribute to people’s behaviors in different places and consequently, the trajectory of the COVID-19 pandemic. Nevertheless, it’s interesting to find commonalities between places and explore potential theories for them. The sources for the COVID-19 data are the government websites for each country (and California's state website). I obtained population estimates from https://population.un.org/wpp/ and https://statisticalatlas.com/state/California/Age-and-Sex for California. Please contact me if you have any questions about the statistics! Hello everyone! I've been doing some research about COVID-19 and the elderly population, and I would like to share my thoughts on a couple topics. The first one I'll be covering today is transportation. I found surveys from Japan and NSW that ask about the transportation methods the elderly use most often, and the results are summarized below: It is first interesting to look at the variance of transportation methods between age groups within the countries and also between the two countries. However, I should note that since the data come from different surveys, comparisons should be taken with caution. Here are some points that I found most interesting:
Now I will be looking at the data within the context of COVID-19. Both Japan and NSW imposed restrictions on going out and nonessential travel but are now reopening. The transportation method of focus is any type of public transportation (including point-to-point transport in NSW) because it poses the most risk for infection, as people are in close proximity to each other, and it’s a shared space. Although public transportation was not completely restricted in either place, the suggestions or orders to stay at home affect the usage of public transportation. It is reasonable to assume that overall public transportation usage decreased during this time, and this is evident through mobility trends data, like from Facebook, Google, and Apple. From the variety of transportation methods the elderly use in both countries, it’s likely that most individuals are able to adapt and use another transport method, like using a private car, biking, or walking, that pose less of a risk than public transportation. The population group that I’ve noticed that may have difficulty adjusting is the 80+ group in Australia. This is because while the percentage that uses public transportation is similar to the other age groups, another popular form of transportation is the point-to-point and community transport, which may pose a greater risk of infection. It could be that it's more difficult to find an alternative method of transport for the 80+ age group. Another consideration is the 80+ age group in Japan. Although the percentage of drivers decreases significantly, those who are driven by others, both by family and in taxi, increases significantly from the other age groups. The increase in taxi usage could increase risk of infection, but being driven by family could mean that more of those who are 80+ are cared for by their family. This could then make it easier to adjust to COVID-19, as they already have family in their support system. Although being driven is also popular amongst those in the 70-79 and 80+ age group in Australia, the description does not specify if the driver is a family member or someone else. I must say, transportation is far from the only variable that matters with regards to how exposed one is to COVID-19, but it was so interesting to think about how transportation may play a role. Many other variables can also affect how transportation methods change due to COVID-19. For example, it could be that the elderly are not going out at all and others run errands for them, like buying groceries and necessities. If this is the case, then we’d have to look at what transportation method the caregiver uses. But how many people do ask for help from others and how many continue to do things independently? I think independence also plays a role in this because people who value independence may not be inclined to asking for help. Also, if the elderly live far from other family members, or if other family members aren’t able to help, then would they ask for help from formal services or neighbors? It’s interesting to see how intertwined everyone’s lives are. This just demonstrates how everyone is responsible to be responsible during this time because even if we aren’t directly involved with those vulnerable to COVID-19, our actions can still affect them. Sources: https://www.facs.nsw.gov.au/download?file=631888 https://www.facs.nsw.gov.au/download?file=631889 https://www8.cao.go.jp/kourei/ishiki/h30/gaiyo/ https://www.nsw.gov.au/covid-19/find-facts-about-covid-19 https://toyokeizai.net/sp/visual/tko/covid19/en.html You may be wondering, why am I talking about Australia specifically? Honestly, I chose it because Australia is one of my favorite places I’ve been to, which makes me curious on how the aging care system works there. Who knows, maybe I’ll retire in Australia!
Australia’s aging population: As is the trend in many countries, birth rates in Australia are declining as life expectancy increases. In 2017, 15% of Australians were 65 years old and older. Twenty years later, in 2037, the proportion is estimated to increase to 20%, and in another twenty years, to 22%. With the growing amount of older people, care services for the elderly are becoming important topics of discussion. How does the aged care system work? Here, I will be focusing on the government-funded programs. The main types of care available are residential aged care, home care, and home support. Residential care includes long and short term stays in residential care facilities. The home care program is called Home Care Packages Program (HCP) and provides different levels of care for people in their homes. The home support program is called the Commonwealth Home Support Programme (CHSP) and provides basic care for those who don’t need the full support of home care. In order to qualify for aged care, the individual must be 65+ (50+ for Aboriginal or Torres Strait Islander people) and complete an assessment. Home care: Services provided to help people remain at home include personal care, therapy, food services, home maintenance and modifications, transportation, and more. The CHSP provides services to help people remain independent and safe. HCP is for more intensive care and has different levels, depending on the amount of support needed. Short term care: There are three types of short term care available: restorative, transition, and respite care. Restorative care is for those who are just starting to need help with daily activities. Transition care is for those who are recovering from being in the hospital and integrate back into everyday life. Respite care enables caregivers to take a little break, whether it be a couple hours or a couple days. Long term care: Individuals who can no longer live independently can move into an aged care home, which is basically a nursing home. I like how Australia has two types of care programs for those who want to continue living at home because I think that having a place to call your own home is important in everyone’s lives, but especially for the elderly. This is because in today’s society, aging is often associated with disability. However, even if someone needs help with certain tasks, this doesn’t mean that they are completely incapable or should lose their independence and home completely. In fact, most older Australians do live in their own homes: 73.4% of those 65+ were homeowners in 2011, and only 6.6% lived in residential aged care. It’s important to note that residential care isn’t something totally terrible to avoid, only that it just may not be right for some, like those who enjoy the freedom of living independently. For these people, moving into a facility can be a shock because they’re stripped of their own home, daily routines, and safe place. Along with searching about official aging care services, I also looked at a couple other programs that aim to improve the elderly’s lives. Intergenerational playgroups: This is an interesting model that I came across. In Australia, there are thousands of intergenerational playgroups around the country, with the goal of strengthening ties between generations. These playgroups work by getting 3+ generations together. In long term care facilities, it’s popular for adults to bring their young children to meet with the residents. They all then spend time together, doing activities like singing, painting, and telling stories. I think these playgroups are such a great idea because they benefit everyone involved. For the residents, they are able to socialize and play with the younger generation, which likely helps to brighten their moods and their overall wellbeing. And for the children, they are able to improve social interactions and awareness about the older generation. Be Connected Initiative: This is yet another program helping to connect generations. The goal is to help older adults strengthen their digital skills and online safety. All of its resources are free, including in-person help through the Be Connected Network, which consists of community organizations! In this digital age, it’s important for everyone to be able to access and understand technology. However, the older population is often left behind while the younger generation becomes more fluent and dependent on technology. Another stigma of aging: incompetence with technology. Yes, it may be hard for older people to adapt to technology, as they didn’t have the exposure to such advances growing up, but this doesn’t mean that they can’t learn. I think the Be Connected Initiative can be so helpful for the elderly because through it, they can not only connect to technology, but also with those in their communities through the Be Connected Network. The overall purpose of these two programs that I noticed is connection. As people get older, it does seem like they become disconnected from society, as firstly, they retire and therefore may lose a sense of productivity and purpose, and secondly, society in general is more attracted towards youth. I really think it’s important to address this negative stigma around aging because it’s inevitably going to occur to all of us. By connecting generations through playgroups and technology, everyone involved is able to improve each other’s lives. Sources: https://www.gen-agedcaredata.gov.au/ https://melbourneinstitute.unimelb.edu.au/__data/assets/pdf_file/0010/3398464/HILDA-Statistical-Report2019.pdf https://arc2018.aarpinternational.org/countries/australia https://beconnected.esafety.gov.au/ It’s so crazy to think about how much our world has changed this year. COVID-19 has completely changed the way we interact with each other. Although restrictions are loosening and places are opening up, it’s still necessary to take precautions, especially with the elderly. Today, I want to focus on how COVID-19 affects those with dementia.
There’s no doubt that COVID-19 is especially dangerous for the elderly, but there’s an even higher risk for people with dementia. This is because those with dementia are likely to also have other health problems, like cardiovascular disease and pneumonia, and behaviors related to dementia can increase the risk of them contracting COVID-19. For example, since a characteristic of dementia is memory loss, they may have difficulties remembering safety measures to take, like washing hands or covering coughs. Individuals with more advanced stages of dementia may not fully understand the current situation and risks due to overall cognitive impairment. Those living in long term care facilities are also cut off from their family and friends, which can worsen confusion and stress. Social distancing in general interferes with the social activities, exercise groups, and other types of meaningful activities that are important parts of daily life. Therefore, it’s necessary to provide not only protection against the virus, but also care for mental and physical well being. Both caregivers and patients have roles to play in staying healthy and connected. Here are some examples:
What is music therapy?
Music therapy can involve a variety of different activities, like listening to music, creating music, and reflecting on music. This can help in physical rehabilitation, increasing motivation for treatment, providing emotional support, and expressing oneself. A certified music therapist assesses an individual’s needs and decides what type of music and activity is most beneficial. Who can benefit from music therapy? Music therapy can be used to help people suffering from anxiety, depression, schizophrenia, insomnia, and trauma. It can also help people with Alzheimer’s, dementia, and brain damage. Music is particularly effective in helping people because of its ability to activate the whole brain, as mentioned in this blog post, affecting a person’s cognitive, emotional, and physical functions and abilities. If you’re familiar with my blog, then you know that I am a supporter of music as a way to help people with Alzheimer’s and other types of dementia. Music therapy can help both caregivers and patients by connecting them back to shared experiences, providing meaningful time spent together, being a relaxing experience, and uniting through nonverbal communication. I’d like to share a couple inspiring quotes I found on the American Music Therapy Association’s website, about how music therapy has impacted people’s lives: “The wife of a man with severe dementia said, ‘When I was encouraged by a music therapist to sing to my husband who had been lost in the fog of Alzheimer’s disease for so many years, he looked at me and seemed to recognize me. On the last day of his life, he opened his eyes and looked into mine when I sang his favorite hymn. I’ll always treasure that last moment we shared together. Music therapy gave me that memory, the gift I will never forget.’” “A gentleman in the early stages of progressive dementia improvised on a xylophone during a music therapy session to express his feelings, and then stated: ‘I don’t know how anyone can live without music.’” “When a couple danced together for the first time after five years of the husband’s deterioration from probable Alzheimer’s disease, the wife said: ‘Thank you for helping us dance. It’s the first time in three years that my husband held me in his arms.’ Tearfully, she said that she had missed him just holding her and that music therapy had made that possible.” From just a few sentences, it’s evident that music therapy has profound effects on both patients and loved ones. Once again, I am amazed at how much is able to help so many people and impact them in ways that traditional methods of care may not. Especially for those with Alzheimer’s, I think music is a path worth going down to evoke memories and emotions. Wow, it's been such a busy time! The reason I didn't post last week was because I'm in the middle of taking AP tests, which is quite an experience right now. I've already taken four (my hardest ones), and I have three more to go. I'm just glad I'm not encountering problems submitting because I've heard so many horror stories about it! For this post, I decided to write about how music affects different regions of the brain. I'm not going to lie, part of the reason I decided to write about this now is because it helped me review a little for my AP Psychology test coming up. Nonetheless, I do believe it's so interesting that music can reach so many parts of the brain!
Different regions of brain impacted by music:
https://www.ashford.edu/online-degrees/student-lifestyle/how-does-music-affect-your-brain Hi everyone! I came across this inspiring documentary, Alive Inside, towards the beginning of my journey researching music and memory. I think this documentary is a great introduction to music's impact on seniors, and anyone interested in this topic should watch it!
What is this documentary about? Alive Inside follows Dan Cohen, the founder of Music & Memory. Music & Memory is a nonprofit organization that focuses on music therapy as a way to unlock memories and comforting emotions in seniors with dementia. The documentary captures a few different seniors and their reactions to listening to beloved music from their childhood. It’s so inspiring to see these seniors literally wake up when they listen to the music. The documentary is also very informational on some shortcomings of the current healthcare system, demonstrating how some seniors react negatively to traditional care methods, like taking medicine. The documentary even includes interview clips with neurologist Oliver Sacks! Here is a touching clip from the documentary of a senior who was usually unresponsive, but when listening to music, became animated and alive again. https://www.youtube.com/watch?v=8HLEr-zP3fc I’ve also included a couple more documentaries about seniors with dementia that are on my list to watch soon. I love watching documentaries as a way to learn more about Alzheimer’s disease and caring for seniors because they enable the viewer to visually see the impact of memory loss and how effective different methods of treatment are. Memory for Max, Claire, Ida and Company
I Remember Better When I Paint
Alzheimer’s: Every Minute Counts
The Alzheimer's Project
Do You Know What My Name Is?
It's almost been a month since I've been mostly staying at home, and it's become the new normal. I decided to take a break from posting about current events, and instead, I'm going to write about something I've always been interested in: the different types of memories we have.
Memory is so valuable to us because it gives us our identity. Our past forms us: even the worst parts that we would rather forget have contributed to who we are today. For this post’s topic, I decided to focus on the types of memories, which, at least to me, has surprisingly many different layers. Memory: “the faculty by which the mind stores and remembers information”. The first thing that comes to my mind is a little area in the brain where all memories are stored, kind of like a storage closet. To some extent, this isn’t terribly off target, but there are actually a few different types of memories, and they involve different parts of the brain. Sensory memory: This is basically what our senses take in from the outside world. It occurs for a very brief period and allows us to retain what we heard, saw, etc, after the stimuli has disappeared. Short term memory: As the name basically describes, short term memory deals with information stored for a short amount of time, around 30 seconds, before we forget it. We can usually hold 7 pieces of information in our short term memory. Working memory: This is a newer, modified concept regarding short term memory. It’s more complex, but here is a brief summary: working memory involves processing short term memories by relating them to previous memories, like a continuous loop. Most of this action occurs in the prefrontal cortex. Long term memory: In long term memory, memories can be stored from a few hours to lifetime. Memories from short term memory become long term through encoding and consolidation. To convert memories to long term, we can rehearse the information (ex by repeating a phone number over and over), or in general, memories with significant meaning (ex emotionally) are more memorable. Every type of memory mentioned below is a type of long term memory. Explicit memory: This includes facts, concepts, events, and anything we have to actively think about to remember. The hippocampus, neo-cortex, and amygdala are involved in explicit memory. Semantic memory: This is a type of explicit memory solely involving general facts and information. Episodic memory: This is a type of explicit memory involving experiences in life. This includes the sensations and emotions involved with the event, and the basic who, what, when, where. Autobiographical memory: Again, as the name says, this type of memory refers to personal experiences and knowledge of an individual’s life. It can be viewed as a subset of episodic memory. Flashbulb memory: This is a specific type of autobiographical memory and is a highly vivid snapshot of a significantly emotional moment. This can be a happy moment, like a wedding, or a traumatic one, like during the 9/11 attacks. Implicit memory: This memory uses past experiences to remember without consciously thinking about them. The basal ganglia and cerebellum are involved in implicit memory. Procedural memory: This is a type of implicit memory, and it involves performing certain procedures. An example is riding a bike: after learning how to ride a bike, we always remember how to ride one later, without having to think about the specific mechanics of it, like balancing and controlling the bike. Priming: This is another type of implicit memory, so it also occurs unconsciously. Priming occurs when the exposure to one stimulus influences the response to another stimulus. For example, if you see food, you are likely completely S _ _ P as SOUP. In the world, priming can influence behavior and perception, both positively and negatively. Wow, that’s a lot of memory types! I also found a picture that shows some of the brain areas that are related to the different memories. Memory is definitely more of a continuous process than a simple storage area. I think what amazes me the most is how much information we are able to store in our brains; there are no limits! |
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